Dr P, back with an overview of PI-RADS 2.1 revisions. We're focused on three areas of revision; revision and criteria for T2 weighted imaging, scores of one and two in the transitional zone, clarify in a second; revision and determination of overall assessment category in the transitional zone, clarify in a second; and revision and criteria for diffusion weighted imaging, scores of two and three in both the peripheral zone and transitional zone.
In addition, we'll clarify the distinction between what we consider a positive and a negative enhancement on dynamic contrast enhanced MRI, clarification of the measurement of the prostate volume, which I'm not going to show you here, I'm going to show you in an actual case, and then a slight revision to the overall sector map. We're also going to address by parametric MRI in which we look at simply T2 imaging and diffusion weighted imaging and discuss the role of dynamic contrast enhanced MRI and the implications for using by parametric MRI for PI-RADS designation and especially for screening since you don't have to inject the patient.
Let's focus on these three revisions and clarify. Here's a chart or a table showing you that within each of these categories, T2 diffusion weighted imaging, dynamic contrast enhanced MRI, and there could be others as well, we have sub-levels or assignments or grades; within T2, one, two, three, four; within diffusion weighted imaging, one, two, three, four; and it's these sub categories that have been revised or classified.
For instance, there's been a revision in criteria for what we're going to call a T2 one and a T2 two. These are going to contribute to what the overall PI-RADS score is going to be. Another example, there's been a revision in the determination of the overall assessment in the transitional zone. In other words, when you add some of these sub-categories together the overall PI-RADS designation for TZ lesions has altered slightly. In other words, the synthesis of this information has changed slightly.
For diffusion weighted imaging for scores of two and three. In other words what we're going to give a two score or a three score, no matter whether it's in the peripheral zone or transitional zone, is going to change from what it was before and become a bit more clear. Let's move on.
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Content reviewed: December 29, 2021