PI-RADS Report Template INDICATION: (including the date and value of serum PSA level and any prior biopsy type- TRUS, FUSION, IN BORE, date and results), prior therapy (Radiation, Hormones) TECHNIQUE: (state it is PI-RADS-compliant; explicit description of field strength, coils used, route and rate of IV contrast administration, and pulse sequence parameters is recommended) COMPARISON: FINDINGS: Size: L x W x H cm or V cubic cm (with inclusion of PSA density) Quality Hemorrhage: Peripheral zone: Transition zone: Lesion (s) in rank order of severity (highest score- to lowest score, then by size) #1: Location: use PI-RADS SECTOR LABEL and IMAGE SERIES/NUMBER Size: T2: DWI: DCE: Prostate margin: (no involvement, indeterminate, or definite extraprostatic extension) Lesion overall PI-RADS category: Extra-prostatic extension: Neurovascular bundles: Distance from index lesion or any PI-RADS 4/5 lesion to NVB’s Seminal vesicles: Lymph nodes Other pelvic organs: IMPRESSION: Overall PI-RADS category (listing of PI-RADS categories) PI-RADS® v2.1 Assessment Categories PI-RADS 1 – Very low (clinically significant cancer is highly unlikely to be present) PI-RADS 2 – Low (clinically significant cancer is unlikely to be present) PI-RADS 3 – Intermediate (the presence of clinically significant cancer is equivocal) PI-RADS 4 – High (clinically significant cancer is likely to be present) PI-RADS 5 – Very high (clinically significant cancer is highly likely to be present)