Objective       To evaluate the diagnostic value of diffusion tensor imaging (DTI) combined with MR spectroscopy (MRS) for prostate cancer.        Methods        A total of 45 patients with high suspicion of prostate cancer admitted in our depa

rtment from May 2012 to June 2013 were enrolled in this study. They all underwent DTI and MRS. MRI data were correlated with their pathological results. The average values of apparent diffusion coefficients (ADC)

fractional anisotropy (FA) and choline+creatinine/citrate (CC/C) in cancerous and noncancerous regions were measured. Logistic regression was used to construct diagnostic models

the areas under the ROC curve (AUC) were compared between ADC

FA

DTI

MRS

and DTI+MRS. The sensitivity

specificity

positive predictive value and negative predictive value of DTI

MRS

and DTI+MRS

and DTI/MRS were calculated.       Results        There were 38 patients acquired images that could be analyzed. Whether in peripheral zone (PZ) or central zone (CZ)

the ADC value of cancerous regions was significantly lower than that of noncancerous regions (

P

0.01)

while the FA and CC/C value were significantly higher than noncancerous regions (

P

0.01

P

0.05). In the PZ

the AUC for DTI+MRS was significantly higher than that for either DTI or MRS alone (

P

0.01). In the CZ

the AUC for DTI+MRS was significantly higher than that of DTI alone (

P

0.01)

but no difference than MRS (

P

0.05). DTI+MRS had the highest specificity both in PZ and CZ

significantly higher than that for either DTI or MRS (

P

0.05). DTI/ MRS had the highest sensitivity

significantly higher than MRS in the PZ (

P

0.01) and significantly higher than DTI in the CZ (

P

0.01).        Conclusion       The combination of DTI and MRS performs better than either technique alone in the diagnosis of prostate cancer.