Magnetic Resonance Imaging to Evaluate Prostate Cancer

Progress in effective local therapy of prostate cancer has been stymied by the lack of an imaging technique capable of reliably identifying the location of cancer within the prostate. Magnetic Resonance Imaging is a promising candidate for imaging the prostate because of its high soft tissue contrast, multiplanar capabilities, and the potential for providing unique biologic information not available with other modalities. In addition to conventional T2-weighted imaging MRI techniques that provide unique biologic information include MR spectroscopy, diffusion weighted MRI, dynamic enhanced MRI and hypoxia imaging. All have shown promise in imaging tumors at a magnetic field strength of 1.5 Tesla but all have been limited by sensitivity. Since MR signal is proportional to magnetic field strength, 3.0 Tesla clinical systems potentially could improve overall diagnostic accuracy. A comprehensive imaging package which incorporates all these techniques to study prostate cancer on a state-of-the-art 3.0 Tesla magnet has not yet been developed. In this pilot study we seek to develop and evaluate a comprehensive prostate MR exam at 3.0 Tesla. Patients with biopsy proven prostate cancer will undergo an MRI with endorectal and surface phased array coils which will include conventional sequences, MR spectroscopy, Diffusion weighted MRI, Dynamic enhanced MR and Hypoxia imaging. In the development phase of this trial (30 patients), the robustness of the techniques and test-retest reproducibility will be evaluated. In the second phase, the comprehensive prostate MRI exam will be validated against the results of prostate biopsy (50 patients). The expected accrual period is two years. We hope that this method will offer prostate cancer patients a more accurate method of localizing their prostate cancer than is now possible which should improve outcomes and minimize complications of treatment.