Pesapane F, et al. - A total of 51 patients were enrolled in order to ascertain the prevalence and predictive value of a series of regularly used MRI criteria for posterolateral extraprostatic extension (EPE) of prostate cancer (PCa). Tumor-capsule contact was the most common sign, although with the lowest PPV, however increasing with broader capsular contact. “Early signs” of EPE including bulging, capsular disruption and unsharp prostatic margin explicated a predominance of 11.8%–18.6% on average, with 74.5%–86.3% of the agreement and the average PPV range was 69.0%–75.0%. “Late signs” of EPE such as irregular prostatic contour, periprostatic fat infiltration, rectoprostatic angle obliteration, and periprostatic mass explicated a predominance of 2.9%–8.8% on average, with 86.3%–94.1% of the agreement and the average positive predictive values (PPVs) varied between 85.7% and 100%. In conclusion, “Early” signs of EPE exhibit high predominances however low PPVs, while “late” signs display lower prevalences but higher PPVs. MRI-staging after this chronological concept could standardize morphologic staging and reduce the existing multi-reader variability.