Prostate Cancer Localization With a Multiparametric Magnetic Resonance (MR) Approach

Radboud University Medical Center148 enrolled

Overview

The primary objective of this prospective multi-centre study is to prove the diagnostic accuracy of in vivo 3T multi-modality Magnetic Resonance Imaging (high resolution T2-weighted MRI, DCE-MRI, MRSI and DWI techniques) in distinguishing carcinoma from other prostate tissue. The gold standard for distinguishing the tissue types is the analysis of whole-mount sections of the resected prostate by a genitourinary histopathologist.

Goal Proving that multi-parametric MR imaging in a multi-centre setting allows for localizing clinically significant (volume \> 0.5cc; Gleason \> 6) prostate carcinoma in the prostate. Objective 1 To determine the diagnostic accuracy (area under the receiver-operating characteristic curve) of 3-Tesla multi-modality non-endorectal coil (ERC) MR imaging in localizing prostate cancer, by correlating: 1. focal areas of low signal intensity on T2-weighted images; 2. the extent and degree of deviating metabolite ratios derived from MRSI. This can be the choline+creatine/citrate ratio or if possible, the choline / citrate ratio; 3. the extent and degree of apparent diffusion coefficient reduction on DWI; 4. the extent and degree of perfusion abnormality on DCE-MRI; with the presence or absence of cancer at (reconstructed) whole mount section histopathology. Objective 2 Proving that multi-modality MR data allows for predicting tumor grade. The parameters from the different MR methods for a tumor focus can be correlated to the local Gleason grade of the corresponding lesion in the histopathological specimens.

Study Type

OBSERVATIONAL

Enrollment

148

Conditions

Prostate Cancer

Interventions

MRI examinationOTHER

45-minute MRI examination of the prostate and surrounding tissues with T2-weighted MRI, diffusion-weighted MRI, Spectroscopic Imaging and dynamic contrast enhanced imaging

Eligibility

Sex: MALE

Medical Language ↔ Plain English

Inclusion Criteria: * Biopsy-proven diagnosis of adenocarcinoma of the prostate * Subject will sign a consent form prior to study entry * Radical prostatectomy and histopathological exam planned * The time interval between last biopsy and the MR exam must be at least 4 weeks * The time interval between MR exam and radical prostatectomy should not exceed 12 weeks Exclusion Criteria: * Subjects who are unable to give valid informed consent * Subjects who are unwilling or unable to undergo an MR exam, including subjects with contra-indications to MR exams * Therapy or surgical procedure applied to the prostate or to other organs in vicinity to the prostate: among the therapies preventing inclusion are any form of radiation therapy, cryo-therapy, thermal-therapy, therapy based on any other medication (including hormonal therapy). * Patients under hormone deprivation therapy.

Locations (9)

David Geffen School of Medicine at UCLA

Los Angeles, California, United States

Johns Hopkins Medical Institutions

Baltimore, Maryland, United States

Medical University Vienna

Vienna, Austria

Ghent University Hospita

Outcomes

Primary Outcomes

Area under the ROC curve to distinguish between cancer and non-cancer tissue in the prostate

Time frame: December 2015

Secondary Outcomes

Area under the ROC curve to separate low aggressive from intermediate and high aggressive prostate cancer

Time frame: december 2015

Data from ClinicalTrials.gov

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