Background Evaluation of interobserver agreement of the PI‐RADS v2 lexicon is important to validate the uniformity of this widely used classification. Purpose To determine the interobserver agreement of PI‐RADS v2 lexicon among eight radiologists with varying levels of experience. Study Type Retrospective. Population In all, 160 consecutively imaged men with confirmatory targeted biopsy. Field Strength/Sequence 3T scanner without an endorectal coil. T2‐weighted imaging (T2w), diffusion‐weighted imaging (DWI), apparent diffusion coefficient (ADC) map and dynamic contrast‐enhanced sequence were performed. Assessment Eight radiologists (two highly experienced, two moderately experienced, and four less experienced) independently read 130 lesions in the peripheral zone (PZ) and 30 lesions in the transition zone (TZ), blinded to clinical MRI indication and biopsy results. The features described in PI‐RADS v2 for TZ and PZ lesions were evaluated. Statistical Tests Conger's kappa, percentage of concordance, and first‐order agreement coefficient (AC1) were used to evaluate interobserver agreement. Results From the features evaluated on PZ lesions, definite extraprostatic extension (EPE) / invasive behavior on T2w had good agreement (AC1 = 0.80), and the others had fair agreement (AC1 = 0.32–0.40). From the features evaluated on TZ lesions, two had good agreement: definite EPE/invasive behavior (AC1 = 0.77) and moderate/marked hypointensity (AC1 = 0.67) on T2w. Encapsulation and lenticular shape on T2w, focal (not indistinct) on DWI and ADC map, and marked hypointensity on ADC map (AC1 = 0.45 to 0.60) had moderate agreement, whereas heterogeneous and circumscribed (not obscured margins) on T2w, marked hyperintensity on high‐b‐value DWI, and the presence or not of early enhancement in the lesion/region of the lesion (AC1 = 0.30 to 0.38) had fair agreement. Data Conclusion Interobserver agreement in PI‐RADS v2 lexicon ranges from fair to good among radiologists and improves with increasing experience. Level of Evidence: 2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2020;51:593–602.

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Tuberculous prostatitis is a rare and often overlooked entity that may mimic prostatic adenocarcinoma on imaging exams, especially multiparametric magnetic resonance imaging (MRI) of the prostate. Detection of a prostatic abscess is a clue to the correct diagnosis.

Corkscrew esophagus (also referred as rosary bead esophagus) is a classic finding of diffuse esophageal spasm (DES) in barium studies reflecting abnormal contractions, leading to compartmentalization and curling of the esophagus, ultimately giving an appearance similar to a corkscrew or rosary beads. We review the pathophysiology of this finding, correlating it to corkscrew and rosary images that originated this classic description.