Imaging for Significant Prostate Cancer Risk Evaluation
Imaging for Significant Prostate Cancer Risk Evaluation
The incidence of prostate cancer is rising however the number of deaths from prostate cancer
 is stable. Meaning the investigators are diagnosing many men with prostate cancer that will
 not impact on their life. The rise in incidence is mainly due to increased use of the blood
 test Prostate Specific Antigen (PSA), as a screening test.

 Currently men suspected of having prostate cancer, identified by a raised PSA undergo
 trans-rectal ultrasound guided prostate biopsy (TRUS biopsy). Many men have this test
 unnecessarily, only 1/3 being diagnosed with prostate cancer. TRUS biopsy is problematic as
 it is random and performed blind-the operator does not know where the cancer is. Thus many
 low-risk cancers that do not need treating are diagnosed and many high risk cancers are
 missed or incorrectly classified. So, men with a negative biopsy or those with low risk
 disease are usually advised to undergo another TRUS biopsy.

 An imaging test is needed that could help men and their doctors decide whether the biopsy is
 a true reflection of what is inside his prostate.

 The investigators will test the role of two imaging tests. The first, multi-parametric
 magnetic resonance imaging (mp-MRI) uses magnetic signals from the body to form images. The
 second, Prostate HistoScanning™ (PHS) uses sound-waves. The investigators will compare the
 results of these tests with a detailed biopsy map-transperineal template prostate mapping
 biopsy (which is currently the best way to find out what is in the prostate but requires
 multiple biopsies to be taken under general anaesthetic. Eligible men will have undergone one
 or more TRUS biopsies and who have been advised to have further tests on as part of standard
 of care. They will be recruited from UCLH referral letters and clinics.

 The investigators aim is to see if either of these tests can confidently rule out the
 presence of clinically important disease.
Inclusion Criteria:

 -  Men who have undergone prior trans-rectal biopsies.

 -  Men undergoing further evaluation of their prostate and who are seeking
 characterisation using Transperineal Template Prostate Mapping Biopsy.

 Exclusion Criteria:

 -  Previous history of prostate cancer treatment

 -  Men unable to have MRI scan, or in whom artefact would reduce quality of MRI.

 -  Men unable to have general or regional anaesthesia

 -  Men unable to give informed consent