{
  "resourceType": "CodeSystem",
  "id": "npcr-pirads-category",
  "url": "https://npcr.se/fhir/CodeSystem/npcr-pirads-category",
  "name": "NPCRPIRADSCategory",
  "title": "NPCR PI-RADS Assessment Category Code System",
  "status": "draft",
  "experimental": false,
  "description": "NPCR-internal code system for the highest PI-RADS (Prostate Imaging Reporting and Data System) assessment category reported in MRI examinations, based on NPCR Variabelbeskrivning variable D_Pirads.\n\nPI-RADS v2.1 is a 5-point scale developed by the American College of Radiology (ACR) to assess the likelihood of clinically significant prostate cancer from multiparametric MRI. NPCR extends the standard 5-point scale with one additional combined option (code 6 = PI-RADS 1-2 combined) and one missing-data marker (98 = Uppgift saknas).\n\nCodes 1 through 5 directly correspond to PI-RADS v2.1 categories as defined by ACR. Code 6 is an NPCR-specific data-entry convenience representing a combined 'PI-RADS 1 or 2' option (low likelihood, not distinguishable in the source report); code 98 indicates missing data in the MRI report.\n\nTerminology binding rationale: NPCR documentation does not specify an international code system binding for PI-RADS values. PI-RADS is an ACR reporting system rather than a standard terminology like SNOMED CT or LOINC; while LOINC does contain codes for PI-RADS-related observations, NPCR Info Spec does not reference them. This CodeSystem mirrors NPCR's internal coded values to preserve documentation fidelity. Future mapping to LOINC/SNOMED CT for PI-RADS is noted as future work.",
  "content": "complete",
  "caseSensitive": true,
  "count": 7,
  "concept": [
    {
      "code": "1",
      "display": "PI-RADS 1 - Very low likelihood",
      "definition": "Very low likelihood of clinically significant prostate cancer (Mycket låg sannolikhet att kliniskt signifikant tumör föreligger)."
    },
    {
      "code": "2",
      "display": "PI-RADS 2 - Low likelihood",
      "definition": "Low likelihood of clinically significant prostate cancer (Låg sannolikhet att kliniskt signifikant tumör föreligger)."
    },
    {
      "code": "3",
      "display": "PI-RADS 3 - Equivocal",
      "definition": "Equivocal: unclear whether clinically significant prostate cancer is present (Oklart om kliniskt signifikant tumör föreligger). Per NPCR Manual: when EPI or SVI is assessed at PI-RADS 3, these should not be reported."
    },
    {
      "code": "4",
      "display": "PI-RADS 4 - High likelihood",
      "definition": "High likelihood of clinically significant prostate cancer (Hög sannolikhet att kliniskt signifikant tumör föreligger)."
    },
    {
      "code": "5",
      "display": "PI-RADS 5 - Very high likelihood",
      "definition": "Very high likelihood of clinically significant prostate cancer (Mycket hög sannolikhet att kliniskt signifikant tumör föreligger)."
    },
    {
      "code": "6",
      "display": "PI-RADS 1-2 combined - Low likelihood",
      "definition": "NPCR-specific combined category for PI-RADS 1 or 2 when the source report does not distinguish between them (Låg sannolikhet att klinisk signifikant tumör föreligger)."
    },
    {
      "code": "98",
      "display": "Uppgift saknas",
      "definition": "Information missing / not available."
    }
  ]
}