Real-world Inter-rater Agreement of PI-QUAL Version 2 for Prostate Magnetic Resonance Imaging Quality Assessment and Its Association with Diagnostic Accuracy

We studied how doctors agree when judging the quality of prostate magnetic resonance imaging (MRI) scan using the Prostate Imaging Quality scoring system. When they focused too strictly on technical rules, agreement was poor; when scans were judged visually, agreement improved. Better-quality MRI scans led to fewer unclear ("indeterminate") results, helping doctors make clearer biopsy decisions.