Dr. P. here focusing on the transitional zone or transition zone, T2 scores of two. What is a T2 score of two and what has changed? Well, just to refresh you, a T2 score of two means you have a transitional zone nodule. So let's make our nodule. And that nodule can be very homogeneous with no capsule, as long as it's got a pretty sharp zone of transition against the background, or it can be partially encapsulated. That would be a T2 score of two, not a PI-RADS score. It's a score within a score. Now what if that capsule went all the way around? Then it would be a T2 score of one and wouldn't apply to this discussion. So once we have a T2 score of two, now we layer upon that, the diffusion weighted imaging score.
So let's see what happens when we enhance our diagnostic acumen by adding diffusion restriction capability. And PI-RADS 2.0, a T2 score of two in the transitional zone remained a PI-RADS two regardless of any diffusion related score. So we had profound diffusion restriction and a T2 score of two, it was still a PI-RADS two. But now in PI-RADS 2.1, If we have a T2 score in the transitional zone of two, which we just defined for you, and the diffusion restriction is pronounced, in other words, we give it a diffusion score of four or greater, now the PI-RADS designation, which was a two, becomes a three. And that is a change and should be clear. Dr. P. out.
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Content reviewed: December 29, 2021