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Table 1.

Histopathological characteristics of the dominant intraprostatic lesion and maximum standard uptake values from [11C]Acetate.

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Table 2.

Sensitivities, specificities, diagnostic accuracy, area under the curve, significance, and 95% confidence intervals for the assessment of each single parameter, and MP [11C]Acetate PET-MRI with one to five parameters.

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Fig 1.

MP [11C]Acetate PET-MRI performed in a 68-year-old patient with an elevated prostate-specific antigen (PSA) level (5.3ng/ml) at the time of imaging.

(a) Axial 3-mm thick T2-w image (TR/TE/TI 4000/101/230ms) of the middle third of the prostate. The observers described a focal hypointense lesion in the left peripheral zone (T2w-positive). (b) On the ADC map, the lesion presents as a focal area with low signal intensity, with corresponding high signal intensity on b800s/mm2 images (DWI-positive). (c-d) 1H-MRSI shows an elevated choline/citrate ratio in the suspicious region (1H-MRSI-positive). (e-f) The DCE-MRI shows a focal contrast enhancement for the suspicious area (e –T1w image 80s post contrast, f—Ktrans map overlaid on T2w image) (DCE-positive). (g) [11C]Acetate PET-MRI shows a focal tracer hotspot in this area with a maximal SUV 6.5 (PET-positive). Multiparametric [11C]Acetate PET-MRI was rated true-positive in this patient. (h) Histopathological work-up after RPE confirmed a high-grade PCa Gleason 9 (5+4) tumor.

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Fig 2.

ROC curves for all lesions of the prostate independent of the Gleason score depict the diagnostic accuracy of all investigated MP reading approaches.

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