[3] Following this initiative the ACR, ESUR, and the AdMeTech Foundation formed a Joint Steering Committee, and by 2016 published a second version of PI-RADS (v.2) in European Urology.
Various studies have compared the predictive performance of PI-RADS v1 for detecting significant prostate cancer against either image-guided biopsy results (definitive pathology) and/or prostatectomy specimens (histopathology).
In a 2015 articles in the Journal of Urology, Thompson reported multi-parametric MRI detection of significant prostate cancer had sensitivity of 96%, specificity of 36%, negative predictive value and positive predictive values of 92% and 52%; when PI-RADS was incorporated into a multivariate analysis (PSA, digital rectal exam, prostate volume, patient age) the area under the curve (AUC) improved from 0.776 to 0.879, p<0.001.
[7] Other applications for which PI-RADS may be useful include prediction of termination of Active Surveillance due to tumor progression/aggressiveness,[8] detection of extraprostatic extension of prostate cancer,[9] and supplemental information when considering whether to re-biopsy patients with a history of previous negative biopsy.
These tools, while not officially endorsed by the ACR, are becoming more popular among radiologists for their ability to reduce variability and improve diagnostic efficiency.