Prostatic Neoplasms Clinical Trial
Official title:
Targeted Fusion Biopsy of the Prostate
The purpose of this study is to see if using Positron Emission Tomography (PET) scan and transrectal ultrasound (TRUS) guided biopsy together (creating a 3-dimensional ultrasound) will detect prostate cancer more accurately than the standard 2-dimensional approach which uses only the TRUS to guide the biopsy.
The objective of the proposed study is to evaluate a molecular image directed,
three-dimensional (3D) ultrasound guided biopsy system in human patients. Prior studies have
shown that Positron Emission Tomography (PET)/Computed Tomography (CT) imaging with the PET
molecular imaging agent, a synthetic amino acid, anti-1-amino-3-[18F]fluorocyclobutane-1-
carboxylic acid (FACBC), is more sensitive than the FDA-approved prostate specific membrane
antigen single-photon emission computed tomography (SPECT) radiotracer in prostate cancer
detection. FACBC images showed higher focal uptake in tumor foci than in normal prostate and
thus could be ideal information to direct targeted biopsy of the prostate. This targeted
biopsy system has a unique feature that PET/CT images can be registered with 3D ultrasound
images, as a result, a suspicious PET lesion is superimposed over the real-time ultrasound
data; and the fused image is then used to direct biopsy needles to tumor targets.
The hypothesis of the study is that PET/ultrasound fusion targeted biopsy can detect more
cancer per core than the standard 12-core TRUS guided biopsy.
The specific aims include:
1. To perform PET/CT directed, 3D ultrasound-guided biopsy and determine if fusion targeted
biopsy can detect more cancers than 2D transrectal ultrasound (TRUS)-guided biopsy
2. To develop the workflow for performing deformable registration and fusion of PET/CT and
3D ultrasound images of human patients
Thirty six patients, who have suspicion of recurrent prostate cancer after definitive therapy
such as radiotherapy, will be recruited into this study. At least half of the patients will
have positive imaging findings and will undergo 2D TRUS-guided biopsy as well as
PET/ultrasound fusion biopsy. The proposed study will be the first-in-human trial that uses
PET/CT imaging to direct 3D ultrasound-guided biopsy of the prostate. The multimodality
imaging approach will combine the high sensitivity from PET and real-time information from
ultrasound for improved cancer detection.
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