Understanding PI-QUAL for prostate MRI quality: a practical primer for radiologists

Insights into Imaging

Table 2 Assessment of the diagnostic quality of multiparametric MRI scans using the PI-QUAL score

PI-QUAL score	Criteria	Clinical implications
1	All mpMRI sequences are below the minimum standard for diagnostic quality	It is NOT possible to rule in all significant lesions^a
2	Only one mpMRI sequence is of acceptable diagnostic quality	It is NOT possible to rule out all significant lesions^a
3	At least two mpMRI sequences taken together are of diagnostic quality	It is possible to rule in all significant lesions
		It is NOT possible to rule out all significant lesions
4	Two or more mpMRI sequences are independently of diagnostic quality	It is possible to rule in all significant lesions
5	All mpMRI sequences are of optimal diagnostic quality	It is possible to rule out all significant lesions

PI-QUAL Prostate Imaging Quality, mpMRI multiparametric magnetic resonance imaging, PI-RADS Prostate Imaging Reporting and Data System
Reprinted with permission from Giganti et al. [23]
^aTherefore, reports should not include PI-RADS or Likert scores