TRUS and transperineal biopsies have risks (infection, bleeding, pain) and can miss the cancer. Magnetic resonance imaging (MRI) is a non-invasive technique that images water in living tissue. Currently, MRI has limitations; as it can be difficult to distinguish cancer from prostatitis or benign prostatic hyperplasia, even with the sophisticated and advanced imaging techniques. Additional methods are needed to improve diagnosis.
MRSI (magnetic resonance spectroscopic imaging) is a technique that quantifies the chemical components of the normal and abnormal prostate tissue. MRSI can be performed while the patient is laying inside the whole body magnet for the MRI scan. When added to standard MRI, MRSI has the potential to improve the accuracy of spatial localisation of cancer within the prostate, as well as differentiation from benign and the histological grade (Gleeson score).
The concept described above can also be used to monitor patients who are undergoing radiotherapy. It is expected that the biochemical make up of prostate to return to normal upon radiotherapy treatment, and this can be reflected in MRSI. In this proposal, we aim to use new MRSI techniques to enable the evaluation of the individual molecular signals in voxels - small 3D pixels of prostate tissue. All this is done in vivo without any need for biopsy. Our aim is to further increase the sensitivity and specificity of prostate cancer stratification by looking at the chemical metabolites of the prostate gland using a more robust MRSI.
The study will be done on five healthy subjects and ten patients. The five healthy ones will be used to establish how a healthy prostate looks like after using the MRSI technique.
Dr Saadallah Ramadan, Dr Peter Stanwell