{"id":4493,"date":"2021-12-17T09:37:17","date_gmt":"2021-12-17T02:37:17","guid":{"rendered":"https:\/\/drsoaraweeurology.com\/?p=4493"},"modified":"2026-08-25T23:04:20","modified_gmt":"2026-08-25T16:04:20","slug":"%d0%b8%d0%bd%d1%82%d0%b5%d1%80%d0%bf%d1%80%d0%b5%d1%82%d0%b0%d1%86%d0%b8%d1%8f-%d0%bc%d1%80%d1%82-%d0%bf%d1%80%d0%be%d1%81%d1%82%d0%b0%d1%82%d1%8b","status":"publish","type":"post","link":"https:\/\/drsoaraweeurology.com\/ru\/2021\/12\/17\/mri-prostate-interpretation\/","title":{"rendered":"\u041a\u0430\u043a \u043f\u043e\u043d\u044f\u0442\u044c \u0440\u0435\u0437\u0443\u043b\u044c\u0442\u0430\u0442\u044b \u041c\u0420\u0422 \u043f\u0440\u0435\u0434\u0441\u0442\u0430\u0442\u0435\u043b\u044c\u043d\u043e\u0439 \u0436\u0435\u043b\u0435\u0437\u044b: \u0447\u0442\u043e \u043e\u0437\u043d\u0430\u0447\u0430\u044e\u0442 \u0431\u0430\u043b\u043b\u044b PI-RADS"},"content":{"rendered":"\n<div class=\"wp-block-columns coblocks-author-columns has-background is-layout-flex wp-container-core-columns-is-layout-52275889 wp-block-columns-is-layout-flex\" style=\"background-color:#8C8C971A;padding-top:2.5rem;padding-right:2.5rem;padding-bottom:2.5rem;padding-left:2.5rem\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:25%\">\n<figure class=\"wp-block-image size-full is-style-rounded\"><img data-recalc-dims=\"1\" fetchpriority=\"high\" decoding=\"async\" width=\"800\" height=\"800\" data-attachment-id=\"7037\" data-permalink=\"https:\/\/drsoaraweeurology.com\/ru\/new-photo-2024\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?fit=800%2C800&amp;ssl=1\" data-orig-size=\"800,800\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"Dr. Soarawee Weerasopone \u2014 Board-Certified Urologist in Bangkok, Thailand\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Dr. Soarawee Weerasopone \u2014 Board-Certified Urologist in Bangkok, Thailand&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?fit=800%2C800&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=800%2C800&#038;ssl=1\" alt=\"Best Urologist working in Chonburi and Cambodia\" 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https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=200%2C200&amp;ssl=1 200w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><\/figure>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:75%\">\n<p class=\"wp-block-paragraph\"><strong><a href=\"https:\/\/drsoaraweeurology.com\/\" target=\"_blank\" rel=\"noreferrer noopener\">Soarawee Weerasopone, Urologist<\/a><\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/www.bangkokhospital.com\/en\/bangkok\/doctor\/dr-soarawee-weerasopone-2\" target=\"_blank\" rel=\"noreferrer noopener\">Bangkok hospital Headquarter, Bangkok<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"tel:+66880221445\" target=\"_blank\" rel=\"noreferrer noopener\">Samitivej Sriracha Hospital \u2014 Urology department: <strong>088-022-1445<\/strong><\/a><\/p>\n\n\n\n<div class=\"wp-block-buttons is-layout-flex 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1.246.262.353.175.622.443.806.804.044.083.083.157.117.222.034.066.069.144.105.235.022.054.011.099-.034.135l-.66.292c-.045.027-.082.013-.112-.045a4.043 4.043 0 0 0-.155-.27 1.247 1.247 0 0 0-.49-.495c-.225-.131-.522-.196-.892-.196-.402 0-.726.064-.972.193-.247.13-.422.302-.527.518-.027.045-.054.099-.082.16a1.39 1.39 0 0 0-.067.197 2.46 2.46 0 0 0-.05.282 5.51 5.51 0 0 0-.033.43c-.008.17-.013.376-.013.617 0 .242.005.448.013.618.008.17.02.314.034.43.013.117.03.21.05.282.02.072.042.137.066.197.105.216.28.39.527.518.246.13.57.193.972.193.4 0 .714-.07.94-.21.227-.14.394-.346.503-.617a2.43 2.43 0 0 0 .104-.395c.018-.123.027-.282.027-.477V13.2H2.34c-.04 0-.06-.02-.06-.062v-.5c0-.04.02-.062.06-.062h1.812c.04 0 .062.02.062.06v.5c0 .156-.005.296-.014.422a4.71 4.71 0 0 1-.04.342 1.732 1.732 0 0 1-.064.262c-.13.523-.402.913-.815 1.17-.413.255-.95.382-1.61.382z\"\/>\n    <\/svg>\n  <\/a>\n  \n  <a href=\"https:\/\/orcid.org\/0009-0004-8387-3559\" \n     target=\"_blank\" \n     rel=\"noopener\"\n     title=\"ORCID iD\"\n     aria-label=\"View ORCID Profile\"\n     style=\"text-decoration: none; color: #A6CE39; transition: transform 0.2s; display: inline-block;\"\n     onmouseover=\"this.style.transform='scale(1.15)'\"\n     onmouseout=\"this.style.transform='scale(1)'\">\n    <svg width=\"28\" height=\"28\" viewBox=\"0 0 24 24\" fill=\"currentColor\">\n      <path d=\"M12 0C5.372 0 0 5.372 0 12s5.372 12 12 12 12-5.372 12-12S18.628 0 12 0zM7.369 4.378c.525 0 .947.431.947.947 0 .525-.422.947-.947.947-.525 0-.946-.422-.946-.947 0-.525.421-.947.946-.947zm-.722 3.038h1.444v10.041H6.647V7.416zm3.562 0h3.9c3.712 0 5.344 2.653 5.344 5.025 0 2.578-2.016 5.025-5.325 5.025h-3.919V7.416zm1.444 1.303v7.444h2.297c3.272 0 4.022-2.484 4.022-3.722 0-2.016-1.284-3.722-4.097-3.722h-2.222z\"\/>\n    <\/svg>\n  <\/a>\n  \n  <a href=\"https:\/\/scholar.google.com\/citations?user=lTgsRMUAAAAJ&#038;hl=en\" \n     target=\"_blank\" \n     rel=\"noopener\"\n     title=\"Google Scholar\"\n     aria-label=\"View Google Scholar Profile\"\n     style=\"text-decoration: none; color: #4285F4; transition: transform 0.2s; display: inline-block;\"\n     onmouseover=\"this.style.transform='scale(1.15)'\"\n     onmouseout=\"this.style.transform='scale(1)'\">\n    <svg width=\"28\" height=\"28\" viewBox=\"0 0 24 24\" fill=\"currentColor\">\n      <path d=\"M5.242 13.769L0.5 9.5 12 1l11.5 8.5-4.742 4.269C17.548 11.249 14.978 9.5 12 9.5c-2.977 0-5.548 1.748-6.758 4.269zM12 10a7 7 0 1 0 0 14 7 7 0 0 0 0-14z\"\/>\n    <\/svg>\n  <\/a>\n  \n<\/div>\n\n\n\n<p class=\"wp-block-paragraph\">Not long ago, a man with a raised PSA had one route available: a biopsy. Most of those biopsies came back clear \u2014 which meant a great many men went through an uncomfortable procedure, and occasionally a complication from it, to be told nothing was wrong.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">MRI of the prostate, performed <em>before<\/em> any biopsy, is what changed that. It does not replace the biopsy; it decides who needs one. And it comes back with a score most men have never heard of.<\/p>\n\n\n<script type=\"application\/ld+json\">\r\n{\r\n  \"@context\": \"https:\/\/schema.org\",\r\n  \"@type\": \"FAQPage\",\r\n  \"mainEntity\": [\r\n    {\r\n      \"@type\": \"Question\",\r\n      \"name\": \"What is PI-RADS in an MRI prostate report?\",\r\n      \"acceptedAnswer\": {\r\n        \"@type\": \"Answer\",\r\n        \"text\": \"PI-RADS stands for Prostate Imaging \u2013 Reporting and Data System. It is a standardized scoring system used by radiologists to report MRI prostate results. The score ranges from 1 to 5 and indicates the likelihood of clinically significant prostate cancer, helping urologists and patients make informed decisions about whether a biopsy is needed.\"\r\n      }\r\n    },\r\n    {\r\n      \"@type\": \"Question\",\r\n      \"name\": \"What does PI-RADS 1 and PI-RADS 2 mean?\",\r\n      \"acceptedAnswer\": {\r\n        \"@type\": \"Answer\",\r\n        \"text\": \"PI-RADS 1 means the finding is most probably not cancer, and PI-RADS 2 means probably not cancer. Both scores carry a 0% chance of aggressive prostate cancer based on published US data from 2018. Biopsy is generally not recommended at these levels.\"\r\n      }\r\n    },\r\n    {\r\n      \"@type\": \"Question\",\r\n      \"name\": \"What does PI-RADS 3 mean on a prostate MRI?\",\r\n      \"acceptedAnswer\": {\r\n        \"@type\": \"Answer\",\r\n        \"text\": \"PI-RADS 3 is an indeterminate finding, meaning the result is uncertain. It carries an 8.9% chance of aggressive prostate cancer. A biopsy may be recommended at this level and requires careful discussion between the urologist and patient.\"\r\n      }\r\n    },\r\n    {\r\n      \"@type\": \"Question\",\r\n      \"name\": \"What does PI-RADS 4 or PI-RADS 5 mean?\",\r\n      \"acceptedAnswer\": {\r\n        \"@type\": \"Answer\",\r\n        \"text\": \"PI-RADS 4 means the finding is probably cancer, with a 21.4% chance of aggressive prostate cancer. PI-RADS 5 means the finding is most probably cancer, with a 62.7% chance of aggressive prostate cancer. Biopsy is strongly recommended for both scores.\"\r\n      }\r\n    },\r\n    {\r\n      \"@type\": \"Question\",\r\n      \"name\": \"Why is MRI prostate done before a biopsy?\",\r\n      \"acceptedAnswer\": {\r\n        \"@type\": \"Answer\",\r\n        \"text\": \"MRI prostate helps identify which patients truly need a biopsy, avoiding unnecessary procedures in men who do not have cancer. Prostate biopsy carries risks including rectal pain, rectal bleeding, bloody urination, and rarely, serious bloodstream infection. MRI helps prevent these unnecessary complications.\"\r\n      }\r\n    },\r\n    {\r\n      \"@type\": \"Question\",\r\n      \"name\": \"At what PI-RADS score should I get a prostate biopsy?\",\r\n      \"acceptedAnswer\": {\r\n        \"@type\": \"Answer\",\r\n        \"text\": \"Based on current evidence, a prostate biopsy is generally recommended for patients with a PI-RADS score of 3 or higher. However, the final decision should always be made jointly between the patient and their urologist, taking into account other clinical factors such as PSA level and age.\"\r\n      }\r\n    }\r\n  ]\r\n}\r\n<\/script>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" decoding=\"async\" width=\"800\" height=\"495\" data-attachment-id=\"4502\" data-permalink=\"https:\/\/drsoaraweeurology.com\/ru\/2021\/12\/17\/mri-prostate-interpretation\/blood-on-white-background-2\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/12\/Complication.jpg?fit=1200%2C742&amp;ssl=1\" data-orig-size=\"1200,742\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;10&quot;,&quot;credit&quot;:&quot;Yeko Photo Studio&quot;,&quot;camera&quot;:&quot;Canon EOS 6D&quot;,&quot;caption&quot;:&quot;Murder. Red blood on white background&quot;,&quot;created_timestamp&quot;:&quot;1393437655&quot;,&quot;copyright&quot;:&quot;Yeko Photo Studio&quot;,&quot;focal_length&quot;:&quot;100&quot;,&quot;iso&quot;:&quot;250&quot;,&quot;shutter_speed&quot;:&quot;0.008&quot;,&quot;title&quot;:&quot;Blood on white background&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"Unnecessary complication can be happened with unnecessary prostate cancer biopsy.\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Unnecessary complication can be happened with unnecessary prostate cancer biopsy.  &lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/12\/Complication.jpg?fit=800%2C495&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/12\/Complication.jpg?resize=800%2C495&#038;ssl=1\" alt=\"Patient experiencing discomfort after a prostate biopsy, illustrating the burden of unnecessary biopsies\" class=\"wp-image-4502\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/12\/Complication.jpg?resize=1024%2C633&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/12\/Complication.jpg?resize=300%2C186&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/12\/Complication.jpg?resize=768%2C475&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/12\/Complication.jpg?resize=18%2C12&amp;ssl=1 18w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/12\/Complication.jpg?w=1200&amp;ssl=1 1200w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">Every avoidable biopsy is soreness, bleeding and a small infection risk a man did not need to face.<\/figcaption><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">What PI-RADS is<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">PI-RADS stands for Prostate Imaging Reporting and Data System. It is a standardised way for a radiologist to record <strong>how suspicious an area on the scan looks<\/strong>, on a scale of 1 to 5. It is not a measure of how much cancer is present, and it is not a diagnosis \u2014 only tissue gives a diagnosis.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Two things about the score are worth knowing before reading your report.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>It scores a lesion, not a man.<\/strong> A report may describe more than one area with different scores; the highest one generally drives the decision.<\/li>\n\n\n\n<li><strong>It depends heavily on who is reading and what scanner was used.<\/strong> The same prostate can be scored differently in different hands, which is why an unexpected result is sometimes worth a second opinion rather than immediate action.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">What each score means<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Approximate likelihoods of finding <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/30038389\/\">clinically significant cancer<\/a>. The figures vary between studies and centres, so read them as orders of magnitude rather than precise probabilities.<\/p>\n\n\n\n<figure class=\"wp-block-table is-style-stripes\"><table><tbody><tr><td><strong>Score<\/strong><\/td><td><strong>Wording in the report<\/strong><\/td><td><strong>Roughly how often significant cancer is found<\/strong><\/td><\/tr><tr><td>1<\/td><td>Very unlikely to be cancer<\/td><td>Low \u2014 but not zero<\/td><\/tr><tr><td>2<\/td><td>Unlikely to be cancer<\/td><td>Low \u2014 but not zero<\/td><\/tr><tr><td>3<\/td><td>Genuinely uncertain<\/td><td>Around one in ten<\/td><\/tr><tr><td>4<\/td><td>Likely to be cancer<\/td><td>Roughly one in five<\/td><\/tr><tr><td>5<\/td><td>Very likely to be cancer<\/td><td>The majority<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<h3 class=\"wp-block-heading\">A correction: a low score is not a zero<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">An earlier version of this article gave <strong>PI-RADS 1 and 2 as a 0% chance of aggressive prostate cancer.<\/strong> That was wrong, and it is the most important correction on this page.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A reassuring MRI is genuinely reassuring \u2014 significant cancer is unlikely, and that is exactly why a low score can justify following the PSA instead of proceeding to biopsy. But <strong>MRI misses some cancers<\/strong>, particularly certain patterns that do not show up well, and a small proportion of men with a normal-looking scan do have significant disease.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The practical consequence is what matters: <strong>a low PI-RADS score means you are followed, not discharged.<\/strong> If the PSA keeps climbing, or the examination is abnormal, or there is a strong family history, the question stays open regardless of what the scan said. A man told he has a 0% risk has been given a reason to ignore a rising PSA, and that is the harm the old wording could do.<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" decoding=\"async\" width=\"800\" height=\"437\" data-attachment-id=\"4505\" data-permalink=\"https:\/\/drsoaraweeurology.com\/ru\/2021\/12\/17\/mri-prostate-interpretation\/diagram-of-prostate-cancer-3\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/12\/Prostate-cancer.jpg?fit=1200%2C655&amp;ssl=1\" data-orig-size=\"1200,655\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;Diagram of prostate cancer illustration&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;Diagram of prostate cancer&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"Prostate cancer can be accurately detected by MRI Prostate modality.\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Prostate cancer can be accurately detected by MRI Prostate modality.&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/12\/Prostate-cancer.jpg?fit=800%2C437&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/12\/Prostate-cancer.jpg?resize=800%2C437&#038;ssl=1\" alt=\"Prostate MRI images showing a suspicious area assessed under the PI-RADS system\" class=\"wp-image-4505\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/12\/Prostate-cancer.jpg?resize=1024%2C559&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/12\/Prostate-cancer.jpg?resize=300%2C164&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/12\/Prostate-cancer.jpg?resize=768%2C419&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/12\/Prostate-cancer.jpg?resize=18%2C10&amp;ssl=1 18w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/12\/Prostate-cancer.jpg?w=1200&amp;ssl=1 1200w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">MRI shows suspicious areas well \u2014 but it is an image, not a diagnosis.<\/figcaption><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">PI-RADS 3 is a conversation, not an instruction<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The earlier version of this article stated that <em>biopsy must be recommended for anyone scoring at least 3<\/em>, and then said in the following sentence that the score is only additional information requiring careful counselling. Those two statements contradicted each other, and <strong>the first has been corrected.<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">PI-RADS 3 means the radiologist genuinely cannot tell. It is the largest source of uncertainty in the whole system, and treating it as an automatic biopsy sends a great many men to a procedure most of them do not need. What resolves it is the surrounding information:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>PSA density<\/strong> \u2014 the PSA in relation to the size of the prostate. A moderately raised PSA in a large gland means something quite different from the same PSA in a small one, and this is the single most useful figure for deciding what to do with a PI-RADS 3.<\/li>\n\n\n\n<li><strong>Whether you have had a biopsy before<\/strong>, and what it showed.<\/li>\n\n\n\n<li><strong>The examination, family history, age and general health<\/strong> \u2014 including what you would want done if a low-grade cancer were found.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">For scores of 4 and 5 the discussion is much shorter: those areas are sampled.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">If a biopsy follows<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The MRI images are fused with live ultrasound so the suspicious area is sampled directly, and some additional systematic samples are usually taken as well \u2014 because MRI does not see everything, which is the same reason a low score is not a discharge. The needle is passed through the skin of the perineum rather than through the rectal wall, which is what keeps serious infection uncommon.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">See <a href=\"https:\/\/drsoaraweeurology.com\/2024\/01\/13\/mri-transperineal-prostate-biopsy\/\">MRI-fusion transperineal prostate biopsy<\/a> and <a href=\"https:\/\/drsoaraweeurology.com\/2021\/04\/30\/prostate-biopsy-instruction\/\">what to expect afterwards<\/a>. If the biopsy confirms cancer, note that finding it does not automatically mean operating \u2014 some prostate cancers are correctly managed by monitoring, and the grade determines what follows. The treatment options are set out under <a href=\"https:\/\/drsoaraweeurology.com\/services\/robotic-prostatectomy\/\">robotic radical prostatectomy<\/a>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">If you arrived here holding a raised PSA rather than a scan report, start with <a href=\"https:\/\/drsoaraweeurology.com\/2021\/05\/07\/what-should-you-do-if-high-psa\/\">what a high PSA actually means<\/a>.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Symptoms that need attention rather than a scan report<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">In an emergency in Thailand, call <strong>1669<\/strong>.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Inability to pass urine with a painful full bladder.<\/li>\n\n\n\n<li>Visible blood in the urine or semen.<\/li>\n\n\n\n<li>New bone pain in the back, hips or ribs, or unexplained weight loss.<\/li>\n\n\n\n<li>New leg weakness or numbness, or loss of bladder or bowel control, in a man known to have prostate cancer \u2014 emergency assessment.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Frequently Asked Questions About PI-RADS<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\">My MRI is PI-RADS 2. Does that mean I definitely do not have cancer?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">No. It means significant cancer is unlikely, which is genuine reassurance and often a good reason not to biopsy \u2014 but not a zero. MRI misses some cancers. An earlier version of this article stated a 0% risk for PI-RADS 1 and 2, which was wrong. A low score means you are followed rather than discharged, and a PSA that keeps rising still needs acting on.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">I scored PI-RADS 3. Do I have to have a biopsy?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Not automatically. PI-RADS 3 means the radiologist genuinely cannot tell, and most men in this group do not have significant cancer. The decision rests on PSA density, any previous biopsy, examination findings, family history, age and your own view \u2014 an earlier version of this article said biopsy must be recommended at 3 or above, which overstated it.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Can PI-RADS tell how aggressive a cancer is?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Not directly. A higher score raises the likelihood that significant cancer will be found, but grade comes from the pathologist examining tissue. PI-RADS estimates suspicion; it does not diagnose or grade.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">My report lists two different scores. Which one counts?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">PI-RADS scores individual areas rather than the whole man, so a report may contain several. The highest score generally drives the decision, and the location of each area matters for planning where to sample.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Would a different radiologist give the same score?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Not necessarily. Scoring depends on the quality of the scan and on the experience of the person reading it, and agreement between readers is imperfect \u2014 particularly around PI-RADS 3. Where a result is unexpected or does not fit the clinical picture, review of the images is reasonable before acting on the number.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Arranging a consultation<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Dr. Soarawee Weerasopone sees patients at <a href=\"https:\/\/www.bangkokhospital.com\/en\/bangkok\/doctor\/dr-soarawee-weerasopone-2\">Bangkok Hospital Headquarters<\/a> and at Samitivej Sriracha Hospital in Chonburi on <a href=\"tel:0880221445\">088-022-1445<\/a>. Bring the MRI images themselves rather than only the report, and every previous PSA result with its date.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Bangkok Hospital Telemedicine is available for patients who cannot attend in person, including international patients \u2014 arrange it in advance by email to the Urology department at <a href=\"mailto:bhquro@bdms.co.th\">bhquro@bdms.co.th<\/a>. Samitivej Sriracha is in-person only. Enquiries about cost are answered by the hospital, not by this website.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Disclaimer:<\/strong> This content is written and reviewed by Dr. Soarawee Weerasopone, a board-certified urologist at Bangkok Hospital Headquarters, and is intended for education only. It is not medical advice, diagnosis or a prescription for any individual, and no advice, diagnosis or prescription is given through personal messaging channels or social media. Dr. Soarawee operates no public social media account; any account offering private consultation in his name is fraudulent. In an emergency in Thailand, call <strong>1669<\/strong>.<\/p>\n\n\n\n<script type=\"application\/ld+json\">\n{\n  \"@context\": \"https:\/\/schema.org\",\n  \"@graph\": [\n    {\n      \"@type\": \"MedicalWebPage\",\n      \"@id\": \"https:\/\/drsoaraweeurology.com\/2021\/12\/17\/mri-prostate-interpretation\/#webpage\",\n      \"url\": \"https:\/\/drsoaraweeurology.com\/2021\/12\/17\/mri-prostate-interpretation\/\",\n      \"name\": \"Understanding Your Prostate MRI Report: What PI-RADS Scores Mean\",\n      \"description\": \"PI-RADS grades how suspicious an area on prostate MRI appears, from 1 to 5. A low score is reassurance rather than a guarantee, and PI-RADS 3 is an indeterminate result requiring discussion rather than automatic biopsy.\",\n      \"inLanguage\": \"en\",\n      \"datePublished\": \"2021-12-17\",\n      \"dateModified\": \"2026-08-25\",\n      \"isPartOf\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#website\" },\n      \"author\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#physician\" },\n      \"reviewedBy\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#physician\" },\n      \"publisher\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#physician\" },\n      \"about\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/2021\/12\/17\/mri-prostate-interpretation\/#pirads\" },\n      \"audience\": { \"@type\": \"MedicalAudience\", \"audienceType\": \"Patient\" },\n      \"disambiguatingDescription\": \"Two errors in the earlier version have been corrected. PI-RADS 1 and 2 were given as carrying a 0% chance of aggressive prostate cancer; multiparametric MRI has a high but imperfect negative predictive value and significant cancer is occasionally present despite a reassuring scan, so a low score means continued follow-up rather than discharge. The article also stated that biopsy must be recommended for any score of 3 or above, while asserting in the following sentence that the score is only additional information; PI-RADS 3 is indeterminate and the decision rests on PSA density, prior biopsy history, examination, family history and patient preference. The score applies to individual lesions rather than to the patient, and inter-reader agreement is imperfect; both points have been added.\"\n    },\n    {\n      \"@type\": \"MedicalTest\",\n      \"@id\": \"https:\/\/drsoaraweeurology.com\/2021\/12\/17\/mri-prostate-interpretation\/#pirads\",\n      \"name\": \"Multiparametric prostate MRI with PI-RADS assessment\",\n      \"description\": \"Multiparametric magnetic resonance imaging of the prostate reported using the Prostate Imaging Reporting and Data System, which grades the likelihood that a given lesion represents clinically significant cancer on a scale of 1 to 5.\",\n      \"normalRange\": \"PI-RADS 1 and 2 indicate that clinically significant cancer is unlikely but not excluded. PI-RADS 3 is indeterminate. PI-RADS 4 and 5 indicate progressively higher likelihood. 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Does that mean I definitely do not have cancer?\",\n          \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"No. It means significant cancer is unlikely, which is genuine reassurance and often a good reason not to biopsy, but not a zero. MRI misses some cancers. A low score means continued follow-up rather than discharge, and a rising PSA still needs acting on.\" }\n        },\n        {\n          \"@type\": \"Question\",\n          \"name\": \"I scored PI-RADS 3. Do I have to have a biopsy?\",\n          \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"Not automatically. PI-RADS 3 means the radiologist genuinely cannot tell, and most men in this group do not have significant cancer. The decision rests on PSA density, any previous biopsy, examination, family history, age and patient preference.\" }\n        },\n        {\n          \"@type\": \"Question\",\n          \"name\": \"Can PI-RADS tell how aggressive a prostate cancer is?\",\n          \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"Not directly. A higher score raises the likelihood that significant cancer will be found, but grade comes from pathological examination of tissue. PI-RADS estimates suspicion rather than diagnosing or grading.\" }\n        },\n        {\n          \"@type\": \"Question\",\n          \"name\": \"Would a different radiologist give the same PI-RADS score?\",\n          \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"Not necessarily. Scoring depends on scan quality and reader experience, and agreement between readers is imperfect, particularly around PI-RADS 3. Review of the images is reasonable where a result does not fit the clinical picture.\" }\n        }\n      ]\n    }\n  ]\n}\n<\/script>\n","protected":false},"excerpt":{"rendered":"<p>PI-RADS grades how suspicious an area on the scan looks, from 1 to 5. A low score is reassuring but is not a zero, a score of 3 is genuinely undecided rather than an automatic biopsy, and the number is one input among several.<\/p>","protected":false},"author":185281453,"featured_media":10070,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"advanced_seo_description":"What PI-RADS 1 to 5 mean for cancer risk, why a low score is reassurance rather than a guarantee, and why PI-RADS 3 is a discussion rather than an automatic biopsy.","jetpack_seo_html_title":"Prostate MRI: What PI-RADS Scores Mean | Dr. Soarawee Bangkok","jetpack_seo_noindex":false,"jetpack_seo_schema_type":"","_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_wpcom_ai_launchpad_first_post":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"{title}\n\n{excerpt}\n\n{url}","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2},"_wpas_customize_per_network":false,"jetpack_post_was_ever_published":false},"categories":[1364],"tags":[1418,1571,1419],"class_list":["post-4493","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-oncology","tag-mri-prostate","tag-mri-prostate-interpretation","tag-prostate-cancer"],"jetpack_publicize_connections":[],"jetpack_likes_enabled":false,"jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/pgZdrK-1at","jetpack_featured_media_url":"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/04\/MRI-Prostate-Reading.webp?fit=1200%2C630&ssl=1","_links":{"self":[{"href":"https:\/\/drsoaraweeurology.com\/ru\/wp-json\/wp\/v2\/posts\/4493","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/drsoaraweeurology.com\/ru\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/drsoaraweeurology.com\/ru\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/ru\/wp-json\/wp\/v2\/users\/185281453"}],"replies":[{"embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/ru\/wp-json\/wp\/v2\/comments?post=4493"}],"version-history":[{"count":19,"href":"https:\/\/drsoaraweeurology.com\/ru\/wp-json\/wp\/v2\/posts\/4493\/revisions"}],"predecessor-version":[{"id":11716,"href":"https:\/\/drsoaraweeurology.com\/ru\/wp-json\/wp\/v2\/posts\/4493\/revisions\/11716"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/ru\/wp-json\/wp\/v2\/media\/10070"}],"wp:attachment":[{"href":"https:\/\/drsoaraweeurology.com\/ru\/wp-json\/wp\/v2\/media?parent=4493"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/ru\/wp-json\/wp\/v2\/categories?post=4493"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/ru\/wp-json\/wp\/v2\/tags?post=4493"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}