MRI and Biomarkers in Prostate Cancer
MRI and Biomarkers in Prostate Cancer
Prostate cancer has been the most common neoplastic disease in men in Finland over the last
 ten years. Prostate-specific antigen (PSA) plays an important role in screening of prostate
 cancer. However, PSA has a limited sensitivity and specificity for prostate cancer detection.
 Commonly, the diagnosis of prostate cancer is done by transrectal ultrasonography (TRUS)
 guided biopsy. Because of the low accuracy of TRUS a systematic biopsy is usually performed
 instead of targeted TRUS biopsy. As biopsy carries a significant risk of complications, there
 is an increasing interest in developing more accurate non-invasive imaging modalities.

 This prospective multi-institutional study will enroll 400 men with clinical suspicion of
 prostate cancer due to higher serum level of PSA than 2.5 ng/ml and/or abnormal digital
 rectal examination. Anatomical magnetic resonance imaging (MRI) and diffusion weighted
 imaging (DWI) at 1.5/3 Tesla (T) magnetic field using surface coils will be used to
 non-invasively predict the presence or absence of prostate cancer. Targeted TRUS guided
 biopsy based on MRI findings will be performed in addition to routine twelve core TRUS
 biopsy. Moreover, selected serum and urine biomarkers as well as biomarkers extracted from
 fresh biopsy sample will be collected and correlated with the presence or absence of prostate
 cancer.
Inclusion Criteria:

 -  Age: 18 to 85 years

 -  Clinical suspicion of prostate cancer, based on: serum level of PSA from 2,5 ng/ml to
 20 ng/ml in two following measurements and/or abnormal digital rectal examination

 -  Mental status: Patients must be able to understand the meaning of the study

 -  Informed consent: The patient must sign the appropriate Ethics Committee (EC) approved
 informed consent documents in the presence of the designated staff

 Exclusion Criteria:

 -  previous prostate biopsies within 6 months

 -  previous diagnosis of prostate carcinoma

 -  previous prostate surgeries, e.g. TURP (transurethral prostatic resection)

 -  symptomatic of acute prostatitis

 -  contraindications for MRI (cardiac pacemaker, intracranial clips etc)

 -  uncontrolled serious infection

 -  claustrophobia

 -  hip replacement surgery or other metal implants in the pelvic area