PI-QUAL version 2: an update of a standardised scoring system for the assessment of image quality of prostate MRI.

Multiparametric MRI is the optimal primary investigation when prostate cancer is suspected, and its ability to rule in and rule out clinically significant disease relies on high-quality anatomical and functional images. Avenues for achieving consistent high-quality acquisitions include meticulous patient preparation, scanner setup, optimised pulse sequences, personnel training, and artificial intelligence systems. The impact of these interventions on the final images needs to be quantified. The prostate imaging quality (PI-QUAL) scoring system was the first standardised quantification method that demonstrated the potential for clinical benefit by relating image quality to cancer detection ability by MRI. We present the updated version of PI-QUAL (PI-QUAL v2) which applies to prostate MRI performed with or without intravenous contrast medium using a simplified 3-point scale focused on critical technical and qualitative image parameters. CLINICAL RELEVANCE STATEMENT: High image quality is crucial for prostate MRI, and the updated version of the PI-QUAL score (PI-QUAL v2) aims to address the limitations of version 1. It is now applicable to both multiparametric MRI and MRI without intravenous contrast medium. KEY POINTS: High-quality images are essential for prostate cancer diagnosis and management using MRI. PI-QUAL v2 simplifies image assessment and expands its applicability to prostate MRI without contrast medium. PI-QUAL v2 focuses on critical technical and qualitative image parameters and emphasises T2-WI and DWI.

European radiology. 2024 May 24 [Epub ahead of print]

Maarten de Rooij, Clare Allen, Jasper J Twilt, Linda C P Thijssen, Patrick Asbach, Tristan Barrett, Giorgio Brembilla, Mark Emberton, Rajan T Gupta, Masoom A Haider, Veeru Kasivisvanathan, Vibeke Løgager, Caroline M Moore, Anwar R Padhani, Valeria Panebianco, Philippe Puech, Andrei S Purysko, Raphaële Renard-Penna, Jonathan Richenberg, Georg Salomon, Francesco Sanguedolce, Ivo G Schoots, Harriet C Thöny, Baris Turkbey, Geert Villeirs, Jochen Walz, Jelle Barentsz, Francesco Giganti

Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands., Department of Radiology, University College London Hospital NHS Foundation Trust, London, UK., Department of Radiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany., Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK., Department of Radiology, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy., Division of Surgery and Interventional Science, University College London, London, UK., Department of Radiology, Duke University Medical Center, Durham, NC, USA., Joint Department of Medical Imaging, Sinai Health System, Lunenfeld Tanenbaum Research Institute, University of Toronto, Toronto, Canada., Department of Radiology, Herlev Gentofte University Hospital, Herlev, Denmark., Paul Strickland Scanner Centre, Mount Vernon Hospital, Northwood, Middlesex, UK., Department of Radiological Sciences, Oncology and Pathology, Sapienza University/Policlinico Umberto I, Rome, Italy., Department of Radiology, CHU Lille, University Lille, Lille, France., Abdominal Imaging Section and Nuclear Radiology Department, Diagnostic Institute, and Glickman Urological and Kidney Institute Cleveland Clinic, Cleveland, OH, USA., AP-HP, Radiology, Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France., Department of Imaging, Sussex universities Hospitals NHS Foundation Trust, Brighton, UK., Martini Clinic (Prostate Cancer Centre), University of Hamburg, Hamburg, Germany., Department of Medicine, Surgery and Pharmacy, Università degli Studi di Sassari, Sassari, Italy., Department of Radiology & Nuclear Medicine, Erasmus University Medical Centre, Rotterdam, The Netherlands., Department of Diagnostic and Interventional Radiology, Fribourg Cantonal Hospital, Fribourg, Switzerland., Molecular Imaging Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA., Department of Medical Imaging, Ghent University Hospital, Ghent, Belgium., Department of Urology, Institut Paoli-Calmettes Cancer Centre, Marseille, France., Andros Clinics, Arnhem, The Netherlands., Department of Radiology, University College London Hospital NHS Foundation Trust, London, UK. .