PI‑RADS v2.1 for prostate MRI: current applications, ongoing debates, and synergies with advanced technologies—a narrative review

Prostate Imaging Reporting and Data System (PI-RADS) version 2.1 is the current standard for prostate multiparametric magnetic resonance imaging (mpMRI) reporting, aimed at improving diagnostic consistency for clinically significant prostate cancer (csPCa). This review aims to summarize the current applications of PI-RADS v2.1, analyze its diagnostic performance and limitations, and explore emerging synergies with biomarkers, biparametric MRI (bpMRI), artificial intelligence (AI), and advanced quantitative MRI techniques.