MR Image Guided Therapy in Prostate Cancer

INCLUSION CRITERIA:
Men greater than 18 years of age
Organ confined clinical T1C or clinical T2a prostate cancer that is visualized on magnetic resonance (MR) imaging

Prostate cancer is diagnosed by transrectal ultrasound guided standard 12 core biopsy or MR image guided biopsies

Gleason Score less than or equal to 7 (3+4), less than or equal to 3 cores positive in a standard 12 core biopsy or less than or equal to 4 cores positive on MR image guided biopsy where in 2 cores are taken from each of the two magnetic resonance imaging (MRI) target lesions
If the standard biopsy cores are positive, they must be from the same location in the prostate as MR Lesion was biopsied and proven to be cancer. (Left / Right, Base, Mid Gland, Apex).
MRI obtained within 6 months of ablation
Metastatic Disease work up as per National Comprehensive Cancer Network (NCCN) guidelines (www.nccn.org). Bone scan indicated to r/o metastatic disease if [clinical T1 and prostate-specific antigen (PSA) > 20 or T2 and PSA > 10]
PSA less than or equal to 15 ng/ml or PSA density less than or equal to 0.15 ng/ml(2) in patients with a PSA > 15 ng/ml
The patient has given written informed consent after the nature of the study and alternative treatment options have been explained.
Patients who present with local recurrence or residual tumor after prostate cancer treatment which is visible on MRI.

EXCLUSION CRITERIA:

The presence of 3 or more MR Visible lesions positive on biopsy
The presence of extra capsular, seminal vesical invasion or metastatic disease.
Patient is unable to tolerate MRI (foreign body, i.e. pacemaker or other implanted device; claustrophobia; inability to tolerate rectal coil; etc.)
Patient with inability to follow up
Acute urinary tract infection
Lower urinary tract symptoms defined by a International Prostate symptom score (IPSS) >20
Patients with renal insufficiency with an estimated glomerular filtration (EGF) <= 30 are excluded, due to they will not be able to undergo gadolinium enhance MRI.
Patients with Uncontrolled Coagulopathies who are at increased risk of bleeding.
Altered mental status preventing consent or answering questions during conduct of the trial will be excluded for safety purposes.
Other serious illnesses according to the Principal Investigator (PI): involving the cardiac, respiratory, central nervous system (CNS), renal or hepatic organ systems, which would preclude study completion or impede the determination of causality of any complications experienced during the conduct of this study.
A Standard 12 core biopsy positive for cancer with no corresponding MR targeted lesion positive for cancer in the same general region of the prostate (Right Apex, Right Mid Gland, Right Base, Left Base, Left Mid Gland, Left Apex)