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SEER Inquiry System - Report
Produced: 08/02/2025 1:12 PM
Question 20170023
Inquiry Details
References:
2016 SEER Manual, 11-12
Question:
Reportability/Date of Diagnosis--Prostate: Is PI-RADS 5 diagnostic of prostate cancer, and if so, can we use the date of the impression on the scan that states PI-RADS category 5 as the diagnosis date? See Discussion.
Discussion:
We are seeing more use of PI-RAD categories on scans. The final impression on the scan will be PI-RADS Category 5, with no specific statement of malignancy. The scans include a blanket statement with the definitions of the PI-RADS categories as below.
PI-RADS (v2) categories:
PI-RADS 1 - Very low (clinically significant cancer is highly unlikely to be present)
PI-RADS 2 - Low (clinically significant cancer is unlikely to be present)
PI-RADS 3 - Intermediate (the presence of clinically significant cancer is equivocal)
PI-RADS 4 - High (clinically significant cancer is likely to be present)
PI-RADS 5 - Very high (clinically significant cancer is highly likely to be present)
A previous SINQ 20010094 indicates that we cannot use BI-RADS categories for breast cancer diagnosis, and SINQ 20160008 indicates we can use LI-RADS for HCC diagnosis, but those definitions are slightly different. Most often there will be a subsequent biopsy diagnosis of carcinoma, so the question is also in reference to Diagnosis Date. Can we use the date of the scans impression, which states PI-RADS category 5, as the Diagnosis Date?
Answer:
Updated answer
PI-RADS categories 4 and 5 are reportable, unless there is other information to the contrary.
PI-RADS 4: high (clinically significant cancer is likely to be present)
PI-RADS 5: very high (clinically significant cancer is highly likely to be present)
Use the date of the scan as the date of diagnosis.
