Metabolite levels in non-recurrent and recurrent prostate cancers at the 5-year mark. (A) Average HR-MAS MRS spectra from tumours from non-recurrent (black) and recurrent (red) prostate cancer groups in the NTNU1 cohort. Magnifications of the polyamine (containing spermine and putrescine) and citrate regions are shown. (B) Quantified peak integrals of spermine, citrate, choline and creatine (nmol mg−1), and tChoCre/Spm and tChoCre/Cit ratios in the groups from all samples in all included cases from the three cohorts are shown as beeswarm plots (n=158). The thin horizontal lines make out the 25% and 75% quartiles, and the median value is shown as thick black horizontal lines. Statistical significance was calculated by LMM to account for multiple samples per patient (*P<0.05, **Q<0.05). Ala, alanine; Cho, choline; Cit, citrate; Cre, creatine; Gln, glutamine; Glu, glutamate; Gly, glycine; Lac, lactate; Myo-ino, myo-inositol; NS, nonsignificant; PA, polyamines; PCho/GPC, phosphocholine and glycerophosphocholine peaks; Sc-ino, scyllo-inositol; Spm, spermine; Succ, succinate; Tau, taurine; tCho, total choline.