Advanced Imaging for Prostate Cancer

Age: 18+

Sex: Male

Trial Phase: Academic

Sponsor: University Health Network, Toronto

Must not be taking: Anticoagulants

Disqualifiers: Hip replacement, Bowel disease, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if advanced imaging techniques can make radiation treatment for prostate cancer more precise and effective. By combining MRI with daily CT scans, the researchers plan to better target the cancer while protecting nearby healthy tissue, such as the bladder and rectum. This approach might improve patient outcomes by reducing side effects. Men with low or intermediate-risk prostate cancer (Gleason score 7 or less, PSA under 20, and certain cancer stages) may be suitable candidates for this study. As an unphased trial, it offers patients the opportunity to contribute to innovative research that could enhance future treatment precision and safety.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications, but if you are on anticoagulant therapy (blood thinners), you may need to stop them temporarily for safety reasons.

What prior data suggests that this imaging technique is safe for prostate cancer treatment planning?

Research has shown that using MRI and CBCT together for planning prostate cancer treatment is safe. Studies have found that MRI can detect prostate cancer more accurately with a low risk of complications. For instance, one study found that MRI-targeted biopsies successfully identified cancers with few side effects.

Using CBCT in treatment planning also helps deliver radiation more precisely, reducing the chance of affecting healthy tissues like the rectum or bladder. Evidence suggests this method keeps side effects low while improving treatment accuracy.

Overall, using MRI and CBCT in prostate cancer treatment has demonstrated good results with minimal side effects for patients, supporting a favorable safety profile for these advanced imaging techniques. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores the use of advanced imaging, specifically MRI combined with CBCT (Cone Beam Computed Tomography), for planning and guiding radiotherapy in prostate cancer treatment. Unlike traditional imaging methods that might not provide as detailed a view, this combination offers a more precise visualization of the prostate and surrounding tissues. This level of detail could lead to more targeted and effective radiotherapy, minimizing damage to healthy tissue and potentially improving patient outcomes. By refining how radiotherapy is administered, this approach could represent a significant step forward in prostate cancer care.

What evidence suggests that advanced imaging is effective for prostate cancer?

Research has shown that using MRI and CBCT in prostate cancer treatment can improve targeting accuracy while protecting nearby healthy tissues. Studies have found that MRI provides clearer images of prostate cancer, enhancing treatment planning. Additionally, using MRI during radiotherapy may improve outcomes for localized prostate cancer. These advanced imaging techniques, such as MRI and CBCT, help reduce side effects by shielding healthy organs like the rectum and bladder from unnecessary radiation. Overall, these imaging methods hold promise for enhancing the effectiveness of prostate cancer treatments. ^{1 6 7 8 9}

Who Is on the Research Team?

Peter Chung, MD

Principal Investigator

University Health Network, Toronto

Are You a Good Fit for This Trial?

This trial is for men with low or intermediate risk localized prostate cancer, specifically those with a Gleason score of 7 or less, PSA under 20, and no more than half of biopsy cores involved with tumor. It's not for men who've had hip replacements, inflammatory bowel diseases, severe reactions to prostate biopsies, or are on certain anticoagulant therapies.

Inclusion Criteria

My prostate cancer is at an early stage, with a low Gleason score, PSA under 20, and limited tumor involvement.

Exclusion Criteria

I had a severe reaction to a previous prostate biopsy.

I refuse to have fiducial marker placement.

I am not receiving a specific prostate cancer radiation treatment of 78Gy in 39 doses.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment - Stage 1

Advanced imaging integrated without altering dose planning techniques

Approximately 1 year

Daily visits for radiotherapy sessions

Treatment - Stage 2

Dose reduction to normal tissues with collection of toxicity outcome measures

Approximately 1 year

Daily visits for radiotherapy sessions

Follow-up

Participants are monitored for safety and effectiveness after treatment

1 year

What Are the Treatments Tested in This Trial?

Interventions

• Advanced imaging for radiotherapy planning and guidance

Trial Overview The study tests if using advanced MRI in planning and daily CBCT imaging during treatment can improve outcomes by reducing radiation doses to non-cancerous parts like the rectum and bladder. The trial has two stages: first integrating advanced imaging without changing dose plans; secondly reducing doses to healthy tissues.

How Is the Trial Designed?

Group I: MRI + CBCT in prostate cancer Experimental Treatment 1 Intervention

Who Is Running the Clinical Trial?

University Health Network, Toronto

Lead Sponsor

Trials

1,555

Recruited

526,000+

Princess Margaret Hospital, Canada

Collaborator

Trials

121

Recruited

40,000+

Published Research Related to This Trial

Magnetic resonance imaging (MRI) significantly improves the staging and characterization of prostate cancer compared to traditional methods like clinical evaluation and CT scans, allowing for better assessment of tumor location and extent.

The combination of MRI with dynamic contrast-enhanced MRI (DCE-MRI) and MR spectroscopic imaging (MRSI) provides critical prognostic information that can guide personalized and minimally invasive treatment strategies for patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Prostate cancer imaging. Fuchsjäger, M., Shukla-Dave, A., Akin, O., et al.[2022]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12191943/

From CBCT to MR-Linac in Image-Guided Prostate Cancer ... This study provides an overview of factors, clinical and physical alike, that increase treatment accuracy in prostate cancer radiotherapy in the context of ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11970571/

Correlation of T2-Weighted Magnetic Resonance Imaging ... The purpose of this study was to analyze correlations between prostate radiomic features (RFs) derived from T2-weighted (T2w) MRI, CT, and first fraction CBCT ...

3. nature.com nature.com/articles/s41391-025-01014-2

Clinical impact of MRI-based risk calculators for prostate ... The meta-analysis demonstrated that MRI-based RCs had significantly improved discriminative ability compared to clinical RCs, with the largest ...

4. sciencedirect.com sciencedirect.com/science/article/pii/S2405630824000193

MRI-guided radiotherapy in twenty fractions for localised ... This study examines the potential clinical benefits of MRIgRT for men with localised prostate cancer, in the setting of moderately hypofractionated radiotherapy ...

5. nejm.org nejm.org/doi/full/10.1056/NEJMoa1910038

MRI-Targeted, Systematic, and Combined Biopsy for ... Combined biopsy led to cancer diagnoses in 208 more men (9.9%) than with either method alone and to upgrading to a higher grade group in 458 men ...

6. sciencedirect.com sciencedirect.com/science/article/abs/pii/S1120179724001637

Evaluation of safety margins for cone beam CT-based ... The aim of this work is to propose a methodology to compute the systematic and random contributions of the delineation uncertainty in CBCT-based online adaptive ...

7. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12106061/

Prostate cancer detection and complications of MRI-targeted ... For this analysis, if a patient underwent MRI-TB plus SB the outcome was the detection of csPCa at combined biopsies, whereas if the patient ...

8. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11363040/

Clinical Outcomes of Prostate SBRT Using Non-adaptive ... Our experience with non-adaptive MRgSBRT of the prostate highlights its short treatment times as well as efficacy with good PSA control and low toxicity ...

9. clinicaltrials.gov clinicaltrials.gov/study/NCT04180592

Real Time MRI Fused to Cone Beam CT Guided Biopsies ... The purpose of this study is to investigate a novel method of prostate biopsy using a computerized guidance system to accurately target lesions within the ...