Prostate mpMRI and MRI-Targeted Biopsy: State-of-the-art Protocol + PI-RADS v2.1

the current state-of-the-art imaging modality in the assessment of patients with suspected or confirmed prostate cancer (PC). In mpMRI morphological T2-weighted images (T2-WI) are supplemented with diffusion-weighted imaging (DWI) and dynamic contrast-enhanced imaging (DCE). High-grade PC can be detected on mpMRI with high accuracy as it typically appears as a low signal intensity lesion on T2-WI (Figure 1), with restricted diffusion (Figure 2) and strong contrast enhancement. With the technical improvement of the available DWI sequences in recent years, the added value of performing DCE in all patients is currently being questioned. To standardize the scanning protocol and the interpretation of mpMRI, the European Society of Urogenital Radiology (ESUR) introduced the Prostate Imaging and Reporting and Database System (PI-RADS) in 2011, which was adopted by the American College of Radiology (ACR) in 2015 (PI-RADS version 2). The PI-RADS scoring system