In vivo MR spectroscopic imaging of the prostate, from application to interpretation.

Proton magnetic resonance spectroscopic imaging (H MRSI) enables non-invasive assessment of certain metabolites in the prostate gland. Several studies have demonstrated that this metabolic information, in combination with anatomical information from T2-weighted MR imaging significantly improves prostate cancer detection, localization and disease characterization. The technology of H MRSI is continuously evolving with improvements of hardware and acquisition methods. Recently, P and C MRSI of the prostate have regained new interest after a dormant period of decades. This review focuses on recent technical progress of in vivoH MRSI of the prostate, in particular those that enhance clinical applicability at 3T with respect to commonly used techniques to examine the prostate. These developments consist of higher magnetic field strengths, and better MR coils and acquisition techniques. Besides the improvements for H MRSI, the developments and opportunities for P and C MRSI for the prostate are reviewed. Finally, we briefly review C MRS of the prostate, in particular the new possibilities with hyperpolarized substrates.