Standardized Radiolabeling and PET/MRI Imaging Protocol

A standard ⁶⁸Ge/⁶⁸Ga generator (Eckert and Ziegler) was used for elution of ⁶⁸Ga prior to labelling with PSMA-HBED-CC (ABX GmbH, Radeberg, Germany)^{22 (link),23 (link),34 (link)}. After injection of 129.0 ± 26.2MBq of ⁶⁸Ga-PSMA-HBED-CC, a low dose CT for attenuation correction (120 kVp, 30 mAs) and anatomical mapping was acquired within 89.0 ± 42.5 min immediately before the PET scan, using a Gemini TF 16 Astonish PET-CT scanner (Philips medical systems)^{35 (link)}. All 130 patients underwent a non-contrast-enhanced prostate multiparametric MRI at our institution at 3T (Magentom Skyra, Siemens Healthcare, Erlangen, Germany). Standard prostate MRI acquisition protocol included high resolution T2 weighted high resolution turbo spin echo sequences (T2 HR TSE, 25 slices, thickness 3 mm, gap 3 mm, TR 4040 ms, TE 116 ms, resolution: 0.47 × 0.47 mm), including DWI sequences (DWI, 25 slices, thickness 3 mm, gap 3 mm, TR 4800 ms, TE 58 ms, resolution 1.4 × 1.4 mm and b-factors 0/160/1200 s/mm²) with generation of an ADC map from b 0, b 160 and b 1200 images of the DWI. Native T1 high resolution isotropic volume sequences (T1 TSC, 49 slices thickness 5 mm, gap 6 mm, TE 11 ms, TR 800 ms, resolution 0.63 × 0.63 mm). No endorectal coils were used throughout all exams.