Prostate Diffusion Imaging with Distortion Correction
Research type
Research Study
Full title
Prostate Diffusion Imaging with Distortion Correction
IRAS ID
250301
Contact name
Paul Malcolm
Contact email
Sponsor organisation
Norfolk and Norwich University Hospitals NHS Foundation Trust
Clinicaltrials.gov Identifier
N/A, N/A
Duration of Study in the UK
1 years, 7 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 sequence creates an apparent diffusion co-efficient (ADC) map, quantifying the diffusion from a number of “b-values”, the duration of a gradient to the magentic field is applied while the water diffuses.
As aspect of DWI is that it can be prone to image distortion due to the presence of gas in the adjacent rectum. The distortion, in addition to creating a warped image, causes the signal to be concentrated into an unrepresentative small region. Therefore any tumour in this area, which would otherwise show as a lower ADC value, can easily be missed.
We propose that introducing this distortion correction would greatly improve the DWI images used for tumour detection. For this study we propose testing this hypothesis as a primary objective, and as a secondary objective including additional b-values to further refine the ADC value. The study involves adding one additional distortion correcting scan to the standard clinical study, adding approximately 2 minutes to the study.
REC name
London - Stanmore Research Ethics Committee
REC reference
19/LO/0960
Date of REC Opinion
13 Nov 2019
REC opinion
Further Information Favourable Opinion