Image-guided Focal Brachytherapy Utilizing Combined 18F-DCFPyl PET/CT and Dynamic Dosimetry With Registered Ultrasound and Fluoroscopy for Localized Prostate Cancer
The Principal Investigator's (PI) working hypothesis is that the PI can utilize the high predictive value of 18F-DCFPyl PSMA to identify clinically significant tumors in patients who will undergo brachytherapy, as well as areas which are uninvolved or contain only clinically insignificant disease. In the PI's clinical trial, the uninvolved regions (as defined by combined PET-MR-biopsy data) will not be targeted and receive only fall-off dose, which we have shown to be associated with reductions in toxicity.
• Adenocarcinoma of the prostate
• Performance Status \< 2
• Clinical stages (not radiographic stage) T1c - T2a, Nx or N0, Mx or M0
• Gleason 6-7 cancer
• Prostate volume \< 60 cc (if MRI and TRUS have conflicting values, then MRI value will be utilized)
• International Prostate symptom score (IPSS) 20 or less
• Ability to undergo DCF-Pyl PSMA PET as part of pretreatment staging
• Signed study-specific consent form prior to registration