Belqees Yawar, Khurram Khaliq Bhinder, Salma Gul, Hira Rana, Mariam Shah, Ahmed Moqeet, Zenab Farooq, Humaira Bashir, Sabiyal Sagheer.
Assessment of prostate lesion using PI-RADS 2.1 in correlation with biospy findings; our expereince at Shifa international hospital.
Pak J Radiol Dec ;33(2):76-80.

Aims/Objective: The objective of this article is to correlate and evaluate the diagnostic performance and reliability of MRI based prostate imaging reporting and data system (PI-RADS) grading with the biopsy findings. Materials and Methods: Total of 72 patients were selected from the radiology database retrospectively from 2020 to 2021. MRI scans were performed on Siemens 3 tesla and reviewed by consultants after which their PIRADS was calculated. Result: These patients had mean age of 64, mean prostatic volume of 54.5cm3 and mean PSA density of 0.70229. Biopsy was not performed in score 1 and 2 having 2 and 9 patients respectively. Biopsy result of 1 patient out of 3 was positive for adenocarcinoma in PIRADS 3. 10 patients` opted for biopsy in PIRADS 4 and results of 3 patients turned out to be adenocarcinoma. 9 out of 14 patients biopsies were positive for adenocarcinoma in PIRADS-5. Bone metastasis was frequent and was seen in 21 % of patients followed by neurovascular bundle involvement which was seen in 18.1% of the patients. 16.7 % of patients had seminal vesicles involvement and extra-cellular spread. Internal iliac and external iliac lymph nodes were more frequently involved i.e seen in 22.2% and 20.8% patients respectively. However, para-aortic and obturator lymph nodes are very involved in very few numbers of patients. Conclusion: This PIRADS scoring system in MRI showed a statistically proven significant correlation with adverse histopathological findings. A Higher PIRADS score may help to project poor prognostic consequences like results more in favor of neoplasm, extracellular spread, bone metastasis, neurovascular bundle involvement, seminal vesicle involvement, and lymph node involvement. Thus, PIRADS scoring provides a potent substructure for evaluating the livelihood of prostate cancers on MRI.

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