The performance of pelvic mpMRI is superior to that of choline-PET in depicting local relapse after RP and RT, whereas choline PET/CT is more accurate than mpMRI in detecting metastatic disease in pelvic lymph nodes. Both modalities are excellent in the assessment of skeletal metastases. The combination of mpMRI and choline-PET/CT provides a comprehensive assessment for the restaging of patients with biochemical recurrence after RP and RT, thus allowing local recurrence to be distinguished from metastatic disease. Bimodal 18F-choline-PET/mpMRI fusion imaging provides simultaneous reading and interpretation of the two different modalities; this enables morphological, functional and metabolic information to be combined, hence overcoming the limitations of each separate imaging modality. In addition, trimodal 18F-choline-PET/mpMRI/TRUS fusion imaging may be useful for planning and guiding biopsy procedures in order to obtain histological confirmation of the local recurrence.