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What is a PI-RADS?

PI-RADS is an acronym for Prostate Imaging Reporting and Data System from images obtained following an imaging test such as multiparametric magnetic resonance imaging (mpMRI). It is a scale for rating the likelihood that clinically significant prostate cancer is present. It’s a 5-digit system, from least likely to most likely. In other words, when a mpMRI is performed, the results are interpreted in PI-RADS.

Medically reviewed by the Surgeon-Urologist Dr. Thierry Lebeau on 03/23/2022

The PI-RADS system was developed by a panel of prostate imaging specialists. Its goal was simple: to improve agreement among radiologists interpreting prostate MRI results by providing detailed, standardized descriptions of which imaging sequences to use and how prostate cancer appears in each sequence.


MRI has become increasingly useful for identifying abnormal areas in prostates that are suspected of being cancerous. Although not a substitute for a prostate biopsy, doctors are increasingly using imaging technology to aid in the diagnosis and treatment of prostate cancer. mpMRI is one such technology.

While standard MRI can detect a tumor in the prostate, mpMRI provides more detail about its exact location, how aggressive it is, and whether it has spread outside the prostate. This may help your doctor decide if you need a biopsy.

MRI is a test that involves creating detailed three-dimensional images of your prostate and surrounding tissues using waves and a magnetic field. The images are reconstructed by a computer and interpreted by a radiologist.

PI-RADS scores from 1 to 5

The radiologist will assign the images obtained from your prostate a Pi-RADS score from 1 to 5. The higher the number, the more likely you are to have prostate cancer and need a biopsy.

If your PI-RADS score is 1 or 2, it means you are unlikely to have prostate cancer that needs to be treated. Your doctor may then decide that you do not need to have a biopsy. Instead, he may suggest measuring your PSA level regularly so that he can intervene if the results indicate an abnormal increase in your PSA level. 

If your PI-RADS score is 3, your doctor will review your other test results to decide if you should have a prostate biopsy.

If your PI-RADS score is 4 or 5, you will usually be offered a prostate biopsy to find out if you have cancer.

As not everything is black and white, your results of an imaging test like mpMRI or those of a biopsy, if you undergo one, should always be supervised and explained by your specialist and not Google. 

Take the time to visit each of our pages on this website, as well as our YouTube channel, in order to get familiar with the disease, our expert lectures and webinars, our section on available resources, the support that is offered to you, our events and ways to get involved in advancing the cause.

You have questions or concerns? Don’t hesitate. You can chat with us or contact us at 1-855-899-2873 to discuss with one of our nurses specialized in uro-oncology. They are there to listen, support and answer your questions, as well as those of your family or loved ones. It’s simple and free, like all of our other services.

Webinar to review
Prostate Cancer: Your test preparation, procedures and results

Pages on our site that might interest
Want to know more? Just click on one of the links below
All about biopsy and diagnosis
Choosing your treatment

PROCURE blog articles that might enlighten you
Every week, we publish a blog article. Here are a few for you.
Prostate cancer: Did you say zero symptoms?
Scared to death of having a biopsy?
Can an MRI of my prostate replace a biopsy?

Written by PROCURE. © All rights reserved – 2022

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