Prostate Screening Study Using MRI in BRCA Carriers
Men with a BRCA1 or BRCA2 mutation are at increased risk for early onset, aggressive prostate cancer compared to men in the general population.
Stand of care screening for men with a BRCA mutation includes PSA testing and digital rectal examination (DRE), the same as with men in the general population.
This study is being done to assess whether there is value in using MRI as a screening tool to detect prostate cancer at an earlier stage than may otherwise be detected using standard of care screening (PSA, DRE). It is unclear whether MRI has utility as a screening tool in this specific population at high risk for aggressive disease.
Procedure: MS3TMRI / TRUS Guided Biopsy
Device: MS3TMRI / TRUS Guided Biopsy
|Study Design:||Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
|Official Title:||Screening Male BRCA Mutation Carriers: Effectiveness of Multispectral 3T Magnetic Resonance Imaging|
- Prostate MRI in BRCA carriers [ Time Frame: 2 years (January 2016) ] [ Designated as safety issue: Yes ]Measure of prostate MRI to determine the PPV of MRI for detection of actionable prostate cancer
- Prostate cancer in BRCA carriers [ Time Frame: 2 years January 2016 ] [ Designated as safety issue: Yes ]Prevalence of any prostate cancer compared to actionable cancer in men with a BRCA1 or BRCA2 mutation independent of serum PSA value.
|Study Start Date:||January 2014|
|Estimated Study Completion Date:||January 2017|
|Estimated Primary Completion Date:||January 2016 (Final data collection date for primary outcome measure)|
|Experimental: MS3TMRI / TRUS Guided Biopsy||
Procedure: MS3TMRI / TRUS Guided Biopsy
Patients would undergo MS3TMRI and then have a transrectal ultrasound (TRUS) biopsy performed within one month after the MRI. The initial cores would be obtained using TRUS without MRI information (TRUSBx). During the same biopsy session, the MS3TMRI information would be given to the physician performing the biopsy and additional cores specifically targeted to suspicious areas would be performed (MS3TMRI-TRUSBx).Device: MS3TMRI / TRUS Guided Biopsy
Multispectral 3T MRI (MS3TMRI) is a device that uses a 3T MRI system without an endorectal receiver coil and with a surface phased array coil. 3T MRI in addition to established computer aided diagnosis (CAD) has been used to perform guided biopsies in an active surveillance population and demonstrated a positive predictive value and negative predictive value of 83% and 81%.
A recently completed a study looking at repeat prostate biopsies in men followed on an active surveillance population at Sunnybrook has shown that the PPV of MS3TMRI guided biopsy to be 85%, while the negative predictive value was 100% (Haider, Vesprini and Milot, unpublished).
To determine the value of using Multispectral 3T MRI (MS3TMRI) for prostate cancer screening in men with a high risk of developing early onset aggressive prostate cancer given known BRCA1 or BRCA2 mutation carrier status, with no prior prostate cancer diagnosis, independent of baseline PSA levels.
- Determine the prevalence of prostate cancer in BRCA1 and BRCA2 mutation carriers independent of baseline PSA levels.
- To evaluate the accuracy of tumor targeting based on MRI and ultrasound (US) tumor co-localization. To evaluate the sensitivity, specificity, PPV, NPV, and accuracy of an automated computer aided diagnosis method (CAD) applied to MS3TMRI in the prediction of zonal biopsy results for the presence or absence of a significant cancer.
|Contact: Danny J Vesprini, MD MSc FRCPCfirstname.lastname@example.org|
|Contact: Justin A Lorentz, MSc||416-480-500 ext email@example.com|
|Sunnybrook Odette Cancer Centre||Not yet recruiting|
|Toronto, Ontario, Canada, M4N 3M5|
|Contact: Danny J Vesprini, MD, FRCPC 416-480-4806 firstname.lastname@example.org|
|Contact: Justin A Lorentz, MSc 416-480-5000 ext 83683 email@example.com|
|Sub-Investigator: Justin A Lorentz, MSc|
|Principal Investigator: Danny J Vesprini, MD, FRCPC|
|Principal Investigator:||Danny J Vesprini, MD MSc FRCPC||Sunnybrook Health Sciences Centre|