Assigning a PI-RADS v2 score to a lesion in the transition zone. Multiparameteric prosatate MRI images from an 80 year old man with elevated PSA (a–d) (a) Axial T2W. (b) Axial b-value 1400 DWI, (c) ADC map. (d) Axial DCE image. Step 1 (localization – zone and sector): The mass is located in the transition zone at the base and midgland in the AFS, TZa, and TZp sectors (arrows) (a-d). Step 2 (measurement): The lesion measures 2.0 cm in maximum diameter (a). Step 3 (Provide an overall score): T2W score=5 (Lenticular, homogeneous, moderately hypointense mass >1.5 cm). DWI score=5 (Focal markedly hypointense on ADC and markedly hyperintense on high b-value DWI >1.5 cm). DCE =positive (focal early enhancement). Overall PI-RADS score=5