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 Indian J Med Microbiol  
 

Figure 3 (A-C): A 69-year-old man presented with serum PSA 21.4 ng/ml. Overlay of MR spectroscopic matrix and multi-voxel spectra on the T2W image of mid-prostate (A). The voxel on the left (yellow) shows markedly reduced citrate (Ci) signal and increased chol-creatine (Cho + Cr)-to-citrate ratio consistent with cancer (C). On TRUS-guided biopsy, this was later confirmed to be a high-grade cancer, Gleason score 9 (5 + 4). The voxel on the right (red) represents a normal spectrum (B). The addition of spectroscopy to MRI improves the ability to localize the cancer more precisely reducing the inter-observer variability. Higher the metabolite ratio, higher are the chances of finding a high-grade cancer

Figure 3 (A-C): A 69-year-old man presented with serum PSA 21.4 ng/ml. Overlay of MR spectroscopic matrix and multi-voxel spectra on the T2W image of mid-prostate (A). The voxel on the left (yellow) shows markedly reduced citrate (Ci) signal and increased chol-creatine (Cho + Cr)-to-citrate ratio consistent with cancer (C). On TRUS-guided biopsy, this was later confirmed to be a high-grade cancer, Gleason score 9 (5 + 4). The voxel on the right (red) represents a normal spectrum (B). The addition of spectroscopy to MRI improves the ability to localize the cancer more precisely reducing the inter-observer variability. Higher the metabolite ratio, higher are the chances of finding a high-grade cancer