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Fig. 3 —Axial T2-weighted MR image through midgland of prostate in 50-year-old man with prostate-specific antigen value of 6.9 ng/mL and no prior biopsy. Indistinct focus of reduced T2 signal intensity is seen in left midgland, and four corresponding MR spectroscopic imaging (MRSI) voxels all show marked choline elevation (spectral peaks labeled 1 for choline, 2 for creatine, and 3 for citrate). MRI and MRSI findings were considered likely due to malignancy, but all biopsy cores in left hemigland showed only prostatitis. Inflammation may be confounding variable in interpreting MRI and MRSI in patients with prostate cancer, although number of patients with inflammation in our study was insufficient to allow meaningful analysis of this variable.