Background:Prostate cancer is among the most common malignancies in men worldwide. Accurate imaging plays a vital role in its early detection, localization, and staging. Multiparametric magnetic resonance imaging (mpMRI), evaluated through the Prostate Imaging Reporting and Data System (PI-RADS) version 2.1, has emerged as a key diagnostic tool to improve detection accuracy and guide clinical management.

Objective:To evaluate the diagnostic role of MRI in identifying prostate cancer and to assess its accuracy using PI-RADS version 2.1 in correlation with clinical significance.

Materials and Methods:This prospective study included 34 male patients aged 45–87 years with elevated serum PSA levels and clinical suspicion of prostate cancer. Each patient underwent mpMRI of the prostate using a 3-Tesla scanner with T1-, T2-, diffusion-weighted (DWI), and dynamic contrast-enhanced (DCE) sequences. Lesions were categorized using PI-RADS v2.1, and the likelihood of clinically significant cancer was recorded. Data were analysed for age distribution, affected prostatic zones, and PI-RADS classification.

Results:The mean age of patients was 66.41 ± 10.32 years, and the median PSA value was 22.87 ng/ml. The transitional zone was most frequently affected (44.12%), followed by multizonal (29.41%) and peripheral zone (20.59%) involvement. According to PI-RADS assessment, 12 patients (35.29%) were scored as PI-RADS 2, 13 (38.23%) as PI-RADS 3, 2 (5.89%) as PI-RADS 4, and 7 (20.59%) as PI-RADS 5. All highly clinically significant cancers corresponded to PI-RADS 4 and 5 lesions, confirming a strong correlation between PI-RADS scoring and clinical aggressiveness.