Fig. 2.

Visual comparison of nondiagnostic versus optimal quality according to the PI-QUAL scoring system. (A–E) PI-QUAL 5. (A) T2WI sequence, axial plane of adequate quality showing an 18-mm nodule of low signal intensity located in the left lateral middle part of the prostate. (B) DWI sequence of adequate quality with a high b value (1500 s/mm²) exhibiting restriction of the diffusion as shown by high signal intensity. (C) ADC sequence with the same slice thickness as for the T2 axial view and FOV, showing intense restriction of the diffusion. (D) DCE sequence of adequate quality with adequate fat suppression and acquisition for 4 min showing a high signal intensity during the early phase of the acquisition. (E) Axial cuts of a radical prostatectomy specimen from the apex to the base (top to bottom); two distinct foci were identified, with tumor shown in red and green. All sequences are concordant for a Prostate Imaging-Recording and Data System score of 5, with a high suspicious of malignancy. All sequences are adequate and have optimal diagnostic quality; the final PI-QUAL score is 5. (F–J) PI-QUAL 2. (F) ADC interpretation is limited because of kinetic artifacts and air in the rectum. (G) DCE sequence of inadequate quality because the definition of the prostatic capsule is unclear and the temporal resolution was too long (13 s). (H) DWI of inadequate quality because the FOV is too large (34 cm × 26 cm) and the high b value is too low (800 s/mm²). (I) T2WI axial view of adequate quality with adequate FOV, in-plane resolution, slice thickness, and correct z-axis position. (J) Axial cuts of a prostatectomy specimen from the apex to the base (top to bottom); six distinct foci were identified, with tumor shown in blue. As only the T2WI sequence has acceptable diagnostic quality, the final PI-QUAL score is 2. ADC = apparent diffusion coefficient; DCE = dynamic contrast-enhanced; FOV = field of view; PI-QUAL = Prostate Imaging Quality; T2WI = T2-weighted imaging.