MR Cancer group

PET and MR imaging in personalised prostate cancer management

In prostate cancer, diagnostic and therapeutic alternatives are limited and the ability to predict outcome of the disease is largely the same as in the 1970s. Clinical decision-making is based on morphological evaluation of a more or less randomly collected biopsy. In contrast to other cancers, medical imaging only plays a minor role in the diagnostic work-up of prostate cancer.

The objective of the MR Cancer Group is to introduce advanced medical methods into clinical practice, thereby improving diagnostic accuracy.

In 2013, the MR Cancer Group was awarded a total of NOK 15.1 mill from the Norwegian Cancer Society and the Movember Foundation, thereby funding a project addressing unmet clinical needs in prostate cancer.

Background

Prostate cancer (PCa) is the most common cancer among men in Europe and constitutes a substantial health care problem. In 2010, 4210 new cases were diagnosed in Norway and PCa was the second most common cause of death from cancer in men (Cancer Registry of Norway 2012). A major challenge is that current diagnostic tools cannot distinguish high-risk PCa from low-risk PCa, where the latter is unlikely to progress into life-threatening disease.

Assessing the extent of disease is the principal step in diagnosis of all cancers, and is therefore a cornerstone in the personalisation of treatment. In contrast to other cancers, this is still not straightforward in prostate cancer. This project is designed to address this problem through the development, implementation and evaluation of novel medical imaging techniques. In addition, we will search for, and validate, biomarkers associated with aggressiveness both in biopsies collected in subsets of patients recruited to this project, and in biopsies available in the comprehensive/extensive biobanks already established and maintained by the research group.

Objectives

Unmet clinical needs

 

Main objectives

Diagnosis: More accurate biopsy procedures

Implement and evaluate MR-guided biopsy in primary diagnosis of prostate cancer

Staging/grading: Low-risk or high-risk disease?

Identify biomarkers that distinguish high-risk form low-risk prostate cancer

Active surveillance: When to start active treatment?

Establish an image-based active surveillance programme for low-risk prostate cancer patients

Rising post-treatment PSA: Can we image relapse?

Establish the role of the 18FACBC PET-MRI in diagnosis of prostate cancer