Radiologic-pathologic correlation of Prostate Imaging Reporting & Data System (PI-RADS) scores ensures local quality and offers opportunities to improve future iterations of the reporting system. Tracking positive predictive values of lesion-targeted biopsies helps provide generalizable population-level risks associated with each PI-RADS category and can highlight the sources of variation. While this process of formalized pathologic correlation is somewhat new to abdominal radiology, we are fortunate to have a model to follow which was developed by our colleagues in breast imaging. If the success and multi-national adoption of BI-RADS is an indicator, building a scoring system anchored on a histologic reference is an important step to ensuring diagnostic quality and reliability.
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