PI-QUAL Calculator v2 – Prostate MRI Image Quality

Created by Nelly Tan, MD · Abdominal radiologist · Prostate imaging · Phoenix, Arizona

PIQUAL · PI-QUAL 2.0

One-page prostate MRI quality form · uncheck exceptions only

mpMRI + contrast No contrast

3

OptimalT2 4/4 · DWI 4/4 · DCE +

Fast use: leave everything checked if it passes. Uncheck only failed criteria or technical prerequisites.

T2-WI 4/4

All met

1Adequate SNR throughout axial T2-WI 2Relevant prostatic structures clearly delineatedCapsule, ejaculatory ducts, NVBs, external urethral sphincter 3No significant artifact in the prostatic regionMotion, blurring, signal loss, ringing, wrap-around 4Sagittal/coronal T2 has adequate SNR, resolution, and no significant artifact

Technical prerequisite

3 mm slices

DWI 4/4

All met

1Adequate contrast and SNR on high b-value images 2Peripheral and transition zones clearly differentiated on ADC 3No significant artifact on high b-value images or ADCDistortion / susceptibility artifact 4No significant geometric mismatch with axial T2-WI

Technical prerequisites

≤4 mm High b ≥1400 ADC b-values ≤1000

DCE +

All met

1No significant artifact; adequate contrast arrival / enhancement 2Relevant prostatic structures clearly delineated on DCE

Technical prerequisites

3 mm ≤15 s temporal Fat suppression / post-processing

PI-QUAL 3

Optimal image quality

Essential technical prerequisites per sequence

T2-WI

• 3 mm slice thickness

DWI

• Slice thickness ≤4 mm
• High b-value sequence ≥1400 s/mm², calculated or acquired
• ADC map using at least two b-values up to 1000 s/mm²

DCE

• 3 mm slice thickness
• Temporal resolution ≤15 seconds
• Fat suppression or post-processing, e.g. subtraction/heat maps
• 3D sequences preferred

T2-WI: T2-weighted imaging · DWI: diffusion-weighted imaging · DCE: dynamic contrast enhancement · ADC: apparent diffusion coefficient

Quick reference adapted from Table 2, de Rooij et al., PI-QUAL version 2 (2024). 3D DCE is a preference and is not an additional scored checkbox.

Reference: de Rooij M, et al. PI-QUAL version 2. European Radiology (2024). Read the source article.