A 70-year-old man with an elevated level of prostate-specific antigen (17.7 ng/mL) and prior negative transrectal biopsy. Top row, left to right: 11C-choline PET at 5 minutes, contrast enhanced CT, and hybrid PET/CT demonstrates slight enhancement of the right prostate apex with increased choline uptake. Middle row, left to right: 11C-choline PET at 30 minutes, T2 weighted MR, and fully integrated hybrid PET/MR (Siemens Biograph mMR; Siemens Medical Solutions, Erlangen, Germany) shows vague T2 increase and continued prominent choline uptake. Lower row, left to right: Apparent diffusion coefficient MR, early perfusion MR, and area under curve within 60 seconds documents restricted diffusion, increased perfusion with early wash-in of contrast agent. Re-biopsy of the ventral periphery of the right apex demonstrated high-grade prostatic intraepithelial neoplasia. Reproduced with permission from Lippincott Williams & Wilkins; Takei T, Souvatzoglou M, Beer AJ, Ambros J, et al. A Case of Multimodality Multiparametric 11C-Choline PET/MR for Biopsy Targeting in Prior Biopsy-Negative Primary Prostate Cancer. Clin Nucl Med 2012; 37:918–919.