Prostate cancer detection and disease progression monitoring relies on systematic multi-core
biopsies. Minimal invasive imaging capacities for lesion targeting and monitoring are badly
needed. The purpose of this study is to determine if a new MRI technique can identify and
monitor prostate disease progression. If so biopsy core number can be reduced to as small as
one, and frequency for biopsy repeat can be reduced. The new technique is about a new way of
analyzing the pictures taken as part of prostate MRI exam. This part is called dynamic
contrast-enhanced MRI. It involves an injection of contrast reagent (or dye) through the arm
vein during a time period when prostate MRI pictures are continuously taken.
The aim of the study is to perform contrast-enhanced (CE) magnetic resonance imaging (MRI)
at OHSU on subjects with diagnosed prostate cancer. This pilot project will study 20
subjects prior to their next scheduled clinical procedures (biopsy or radical
prostatectomy). Data from this project will be used to explore new capabilities of the
software platform developed under current SBIR funding. CE-MRI will involve the use of an
extracellular (Gadolinium based, Gd) contrast agent. When Gd is used,
(dynamic-contrast-enhanced) DCE-MRI signal intensity time-course data will be analyzed
analytically using the so called "shutter-speed" paradigm which takes into account of the
effects of finite water exchange kinetics. Region of interest (ROI) and high resolution
(~millimeter) parametric maps of pathophysiologic quantities, such as tumor vessel
permeability, tumor perfusion, extracellular extravascular volume fraction, will be
generated from the DCE-MRI data. All parameters will be compared to literature results for
software validation and correlated with pathology for clinical potential.
- Men, age >18 years.
- Any patient scheduled for prostate biopsy repeat or radical prostatectomy.
- Ability to understand and the willingness to sign a written informed consent
- Patients who would be normally excluded from undergoing an MRI examination - patients
with a pacemaker, aneurysm clip or any other condition that would warrant avoidance
of a strong magnetic field.
- Patients who are unable to cooperate for an MRI exam.
- Major surgery within a month of enrollment.
- Prostate biopsy six weeks prior to enrollment.
- Subject-reported reaction to gadolinium contrast reagent.