Fig. 5. 3D single–time point localized MRSI data.

Images were obtained from patient A in Table 2, who had a serum PSA of 4.5 ng/ml, was originally diagnosed with bilateral biopsy-proven Gleason grade 3 + 3 prostate cancer, and received the highest dose of hyperpolarized [1-¹³C]pyruvate (0.43 ml/kg). The upper panel shows an axial T₂-weighted images and corresponding spectral array with the area of putative tumor highlighted by pink shading. A region of tumor was observed on the T₂-weighted images (red arrows), as well as on ADC images and ¹H MRSI data (fig. S1). A region of relatively high hyperpolarized [1-¹³C]lactate was observed in the same location as the abnormalities that had been observed on the multiparametric ¹H staging exam. The lower panels show axial T₂ images with and without metabolite overlays for different axial slices from the same patient. The colored regions in these overlays have a ratio of [1-¹³C]lactate/[1-¹³C]pyruvate ≥0.2. These demonstrated a large volume of bilateral cancer.