PI-QUAL Assistant

A quick prostate MRI quality-assessment workspace using PI-QUAL v2-style sequence scoring for T2-WI, DWI, and DCE.

Sequence quality inputs

Start with sequence-level quality scores, then use the checklist below to document the limiting factor.

Protocol type

T2-WI quality

Select the description below that best matches the T2-WI quality. Consider anatomic sharpness, motion/blur, coverage, slice/resolution, and ability to delineate capsule, SVs, neurovascular bundles, ejaculatory ducts, and sphincter.

Practical T2-WI scoring guide (simplified):

1/4Nondiagnostic. Severe motion, blur, poor coverage, or very low spatial resolution. You cannot confidently assess zonal anatomy or key structures such as capsule, seminal vesicles, or sphincter.

2/4Markedly limited. Some anatomy is visible, but artifact or technical limitation substantially reduces confidence for lesion localization or staging.

3/4Adequate / diagnostic. Minor to moderate limitations are present, but the gland and surrounding structures are still interpretable for routine clinical use.

4/4Optimal. Sharp anatomy, complete coverage, appropriate planes, and minimal artifact. Capsule, seminal vesicles, and EPE-relevant structures are well seen.

DWI/ADC quality

Select the description below that best matches the DWI/ADC quality. Look for adequate ADC/high-b-value images, SNR, lesion conspicuity, PZ/TZ discrimination, and absence of severe susceptibility distortion.

Practical DWI/ADC scoring guide (simplified):

1/4Nondiagnostic. Severe distortion, very poor SNR, or unusable ADC / high-b-value images. Lesion detection is not reliable.

2/4Markedly limited. Important quality issues are present, such as susceptibility artifact or weak lesion conspicuity, and diagnostic confidence is reduced.

3/4Adequate / diagnostic. Mild to moderate distortion or noise may be present, but ADC and high-b-value images are still interpretable with acceptable lesion conspicuity.

4/4Optimal. High-quality ADC and high-b-value images with good SNR, minimal distortion, and confident PZ/TZ assessment.

Limiting factors / quality notes

Motion / blurring Rectal gas / susceptibility Metal-related distortion Low SNR Coverage / plane mismatch Wrap / chemical shift Suboptimal DCE Patient-related limitation

How to use the scoring on this page

Step 1: Score each sequence

1/4 = essentially nondiagnostic.
2/4 = technically limited, with major loss of confidence.
3/4 = diagnostically acceptable.
4/4 = optimal / near ideal quality.

Step 2: Convert to overall PI-QUAL

Inadequate image quality (PI-QUAL 1): At least one dominant sequence is not diagnostically acceptable.
Acceptable image quality (PI-QUAL 2): The exam is usable, but not optimal.
Optimal image quality (PI-QUAL 3): Dominant sequences are excellent, and DCE is adequate when used.

Practical reporting point

Use the final score to communicate whether the exam was inadequate, acceptable, or optimal, and document the specific technical limitation. If image quality is poor enough to compromise diagnosis, note the reason and consider repeat imaging when clinically appropriate.

Educational note: This page is a practical, simplified workflow support tool based on PI-QUAL v2 concepts. It is not a replacement for the full PI-QUAL v2 score sheet, official PI-RADS technical specifications, or local prostate MRI QA protocols.