Focused Diffusion Weighted Imaging in Prostate Cancer

• Research type

  Research Study

• Full title

  Focused Diffusion Weighted Imaging in Prostate Cancer

• IRAS ID

  182283

• Contact name

  Paul Malcolm

• Contact email

  paul.malcolm@nnuh.nhs.uk

• Sponsor organisation

  Norfolk and Norwich University Hospital

• Duration of Study in the UK

  2 years, 0 months, 1 days

• Research summary

  Most low-grade prostate cancers have an indolent course and never result in patient mortality, but some are highly malignant requiring aggressive treatment.
  A significant proportion of patients are affected by over-diagnosis and over-treatment due to difficulties in determining the most suitable patients to investigate and treat aggressively. It is estimated 37 men will undergo prostatectomy to prevent 1 cancer-related death

  MRI is established in the investigation of prostate cancer, but is limited at identifying smaller, less aggressive tumours. Functional MRI sequences such as diffusion-weighted imaging (DWI) have complemented standard sequences and improved accuracy.

  DWI is based on the principle that different tissues have differences in water molecule diffusion. Those with higher cell density such as tumours are more likely to prevent water diffusion. The b-value is the strength of the gradient applied to the tissues during the acquisition. The sequence also creates an ADC map which provides a quantifiable measure of diffusion. The ADC value of prostate cancer is lower than normal tissue and is inversely proportional to tumour grade.

  Higher b-values and more recently field-of-view (FOV) reduction of DWI sequences have been tested to improve tumour conspicuity and the spatial and contrast resolution. The FOCUS sequence combines both high b-value and small FOV techniques to provide both functional and anatomical delineation of tumours.

  Patients who meet eligibility requirements, have had their scan on the 3T GE scanner, and have proceeded to radical prostatectomy will have their FOCUS and conventional DWI sequences analysed by two radiologists blinded to the results. Each sequence will be compared to the whole-mount radical prostatectomy specimen, which will be analysed by two histopathologists.

  We hypothesize that FOCUS will provide better spatial and contrast resolution, more accurate correlation with tumour aggressiveness, and better correlation with histopathological analysis of prostatectomy specimens.

• REC name

  London - Surrey Borders Research Ethics Committee

• REC reference

  16/LO/0115

• Date of REC Opinion

  18 Jan 2016

• REC opinion

  Favourable Opinion