Synopsis

The PI-RADS scoring system consists in a visual assessment to detect the presence of suspicious foci within the prostate. It has also been developped to describe signs of tumor extraprostatic extension. Diffusion Weighted Imaging (DWI) plays an unvaluable role to achieve this goal. Very high computed b-values allow to visually increase the conspicuity of tumor foci within the peripheral zone (PZ). DWI has also an important role to increase the sensitivity of T2W-MRI to localise tumor foci originating in the transition zone (TZ), without affecting the specificity. Dynamic Contrast Enhanced MRI plays a role to confirm the presence of a tumor in specific areas, like the Anterior FibroMuscular Stroma or to detect signs of seminal vesicle invasion, which may remain undetected by DWI alone.