Contrast Enhanced Transrectal Ultrasonography (TRUS) to Assess Prostatic Vascularity After Radiotherapy (XRT)

Not Applicable

Terminated

Brief Summary: Solid tumors, including prostate cancer, commonly exhibit tumor-associated neovascularity (growth of new blood vessels to feed the tumor) with increased microvessel density. Systemic, hormonal, and radiotherapy treatments typically decrease or suppress tumor - associated vascularity through several mechanisms, including apoptosis (process of cell death) and anti-angiogenic pathways (ways to destroy new blood vessel growth). Previously at the investigators' center, they have demonstrated that increased prostatic vascularity (blood vessels defined to prostate) detected ultrasonographically correlated with disease free survival after radical prostatectomy (surgical removal of entire prostate), and may be indicative of higher grade, higher stage disease. The significance of prostate neovascularity in response to treatment with external beam radiotherapy (EBRT) (standard of care) has not been well studied. The investigators hypothesize that prostate cancer that recurs after radiotherapy may exhibit measurable patterns of tumor-associated vascularity, which may represent a minimally invasive marker of cancer stage, grade and response to treatment. The investigators propose a pilot study to assess the feasibility of serial enhanced transrectal ultrasonography (TRUS) examinations during and after radiotherapy for prostate cancer.

Recruitment & Eligibility

Inclusion Criteria

Men aged 40 - 80 years old
Biopsy proven intermediate/high risk clinically localized prostate cancer, as determined by a Gleason score of 7 or higher, clinical stage T2b or higher, or PSA > 10. Pathology will be confirmed by at least two reviews
Patients opting for EBRT (external beam radiation therapy, standard of care) without hormonal ablation
Ability to undergo serial TRUS procedures
Ability to give informed consent

Exclusion Criteria

Subject has known hypersensitivity to octafluoropropane.
Evidence of distant metastatic disease on staging evaluation
Previous treatment for prostate cancer, including any form of androgen ablation
Previous procedures involving the anus or rectum, making serial TRUS difficult or dangerous
Expected life expectancy less than 10 years
Baseline testosterone < 200 ng/dL
Subject with cardiac shunts and elevated pulmonary hypertension
Subject has worsening or clinically unstable congestive heart failure.
Subject has acute myocardial infarction or acute coronary syndrome.
Subject has ventricular arrhythmias or is high risk for arrhythmias.
Subject has respiratory failure, severe emphysema or pulmonary emboli.
Subject has a history of cardiac shunt or pulmonary hypertension.

Arm && Interventions

Group	Intervention	Description
Contrast Enhanced Transrectal Ultrasound (TRUS)	Contrast Enhanced-Transrectal Ultrasound	-

Primary Outcome Measures

Name	Time	Method
Measurable Decrease in Prostate Vascularity During and/or After Radiation Treatment	1 year

Secondary Outcome Measures

Name	Time	Method
Sonographic Appearance of Prostate and Prostate Vascularity Before, During and After External Beam Radiotherapy (Standard of Care) for Prostate Cancer	1 year
Patient Tolerance of TRUS Evaluation During/After Radiation Treatment	1 year