Project 462176

Prostate cancer (PCa) remains the most commonly diagnosed solid organ malignancy in men. However, unlike other more aggressive cancers, prostate cancers exhibit a broad range of biology ranging from indolent to highly aggressive. The term "clinically significant" prostate cancer has recently been introduced to distinguish those tumors likely to lead to death from those likely to be indolent and have no impact on survival. As a result of this categorization of prostate cancer, management can range from active surveillance to aggressive multimodal radical surgical and radiative therapies. The goal of the proposed research is to improve PCa diagnosis to accurately establish where in the broad spectrum of this disease a particular tumor lies and to identify its true aggressiveness. The goals will be achieved by the development of a next-generation prostate imaging system based on a combination of prostate-targeted Positron Emission Tomography (PET) and transrectal ultrasound (TRUS) imaging. The PET component of this system is significantly more sensitive than existing analogs. Increased sensitivity means that the amount of radiation needed for imaging can be greatly reduced while still reducing false negative findings and decreasing exam times. The PET component will be integrated with a TRUS biopsy device, which will jointly provide an accurate, precise and efficient method for spatial sampling of prostate tumors under PET/TRUS fused image guidance. The project also addresses the importance of having a method for assessing the effectiveness of the therapy and side effects, detection of early biochemical recurrence (BCR), and monitoring men on active surveillance. Our research will advance the field of prostate cancer detection beyond the current standard of care and will result in an improvement of prostate cancer survival yielding significant clinical (and economic) benefits.