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Purpose:  To investigate the associations of metabolite levels derived from magnetic resonance spectroscopic imaging (MRSI) and  18 F-fluciclovine positron emission tomography (PET) with prostate tissue characteristics.   Methods:  In a cohort of 19 high-risk prostate cancer patients that underwent simultaneous PET/MRI, we evaluated the diagnostic performance of MRSI and PET for discrimination of aggressive cancer lesions from healthy tissue and benign lesions. Data analysis comprised calculations of correlations of mean standardized uptake values (SUV mean ), maximum SUV (SUV max ), and the MRSI-derived ratio of (total choline + spermine + creatine) to citrate (CSC/C). Whole-mount histopathology was used as gold standard.   Results:  The results showed a moderate significant correlation between both SUVmean and SUVmax with CSC/C ratio.   Conclusions:  We demonstrated that the simultaneous acquisition of  18 F-fluciclovine PET and MRSI with an integrated PET/MRI system is feasible and a combination of these imaging modalities has potential to improve the diagnostic sensitivity and specificity of prostate cancer lesions.

Simultaneous 18F-fluciclovine Positron Emission Tomography and Magnetic Resonance Spectroscopic Imaging of Prostate Cancer