Clinical/methodological problem: The identification of clinically significant prostate carcinomas while avoiding overdiagnosis of low-malignant tumors is a challenge in routine clinical practice. Standard radiologic procedures: Multiparametric magnetic resonance imaging (MRI) of the prostate acquired and interpreted according to PI-RADS (Prostate Imaging Reporting and Data System Guidelines) is accepted as a clinical standard among urologists and radiologists. Methodological innovations: The PI-RADS guidelines have been newly updated to version 2.1 and, in addition to more precise technical requirements, include individual changes in lesion assessment. Performance: The PI-RADS guidelines have become crucial in the standardization of multiparametric MRI of the prostate and provide templates for structured reporting, facilitating communication with the referring physician. Evaluation: The guidelines, now updated to version 2.1, represent a refinement of the widely used version 2.0. Many aspects of reporting have been clarified, but some previously known limitations remain and require further improvement of the guidelines in future versions.

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