Evaluation of prostate cancer on MRI with PI-RADS 2.1: A serial case

Background: Cancer that affects men's prostate glands is called prostate cancer. Magnetic resonance imaging (MRI) is a much more recommended method of examination because it evaluates the prostate in detail. MRI with Prostate Imaging–Reporting and Data System (PI-RADS) 2.1 can be used as a reporting system for prostate expertise and looking at the character of a lesion. This case series aims to present the prostate cancer cases on MRI with PI-RADS 2.1. Case report: First case, a 61-year-old male patient came with complaints of bloody urine and difficulty urinating. MRI results showed a well-defined lesion at the apex to mid of the peripheral zone in the right and left posteromedial sector, without extraprostatic extension, according to PI-RADS 4, and a lesion with indistinct boundaries at the apex, mid to base of the transition zone, with extraprostatic extension to the bladder, according to PI-RADS 5. The second case, a man aged 63 years with complaints of difficulty urinating and feeling incomplete for 1 month. The MRI results suggested prostatic hypertrophy with intravesical protrusion of +/- 1.2 cm with an ill-defined lesion in the mid portion of the right and left posterolateral peripheral zone, suggesting PI-RADS 4 and an ill-defined lesion at the left anterior transitional zone apex, suggesting PI-RADS 3. In the third case, a 79-year-old man came with complaints of discomfort when urinating. The MRI showed lesions with ill-defined borders on the posterior aspect of the mid-inferior portion of the right peripheral zone according to PI-RADS 5, and multiple lesions with ill-defined borders on the anteroposterior segment of the apex-inferior portion transitional zone correspond to PI-RADS 5. Conclusion: MRI with PI-RADS 2.1 can evaluate suspected malignancy in the prostate, so it can be considered as the modality of choice in evaluating malignancy in the prostate.