Validation of the Diagnostic Accuracy of Multi-parametric MRI with PI-RADS V2.1 for Detecting Clinically Significant Prostate Cancer

229 PZ and 270 TZ lesions were included in this study. The proportion of overall PCa and clinically important PCa detection (Gleason score≥3+4) for each PI-RADS version 2.1 category was determined. The performance of PI-RADS version 2.1 in cancer detection was evaluated. The diagnostic accuracy of the overall(82.6%) and csPCa TZ lesions(83.0%) is higher than the accuracy of PZ lesions(80.4%, 77.7%). For the csPCa diagnosis, the AUCs of PI-RADS version 2.1 in TZ(0.84) was higher than in PZ(0.77) without significance(P=0.06). Higher PI-RADS version 2.1 scores were associated with increasing likelihood of the presence of clinically important PCa (P<0.01).