Imperial Prostate 7 - Prostate Assessment Using Comparative Interventions - Fast Mri and Image-fusion for Cancer

NCT ID: NCT05574647

Last Updated: 2025-07-24

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

3600 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-11-02

Study Completion Date

2026-01-31

Brief Summary

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To evaluate the role of biparametric MRI and image-fusion targeted biopsies for the detection of prostate cancer.

To determine whether biparametric MRI (bpMRI) could be recommended as an alternative to multiparametric MRI (mpMRI) for the detection of clinically significant prostate cancers in patients at risk.

To determine whether image-fusion targeted biopsy is better than visual-registration (cognitive) targeted biopsy at detecting clinically significant prostate cancers in patients requiring prostate biopsy due to a suspicious MRI.

Detailed Description

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Background and study aims:

The aim of this study is to improve the way prostate cancer is diagnosed by looking at two different types of MRI scans and two different types of prostate biopsy (tissue samples). A large study such as this is required to help the NHS decide how to diagnose prostate cancer in the future. If a person is suspected of having prostate cancer, then they are referred by their GP. At the hospital clinic, the participant will then have an MRI scan. If this scan shows that cancer might be present, then the doctor will usually suggest that the patient has a biopsy. There are two ways of doing a prostate MRI. One takes 30-40 minutes and requires a contrast injection called gadolinium (like a dye). This is called long MRI and is most commonly used in the NHS. Gadolinium is safe as it rarely causes any bad reaction but using it means that the scan takes more time. Another type of MRI takes 15-20 minutes and does not use gadolinium contrast. This is called a short MRI. Many studies over the last 5 years have shown that the long and short MRIs are similar in their accuracy in diagnosing important prostate cancer. These studies have not been of high quality or large enough to change NHS practice. Patients with suspicious areas on the MRI are usually advised to have a prostate biopsy. This involves taking tissue samples using a needle. The samples are then looked at under the microscope by a pathologist to see if cancer cells are present. There are two ways of doing a prostate biopsy. One is where the person doing the biopsy decides where to put the biopsy needle by looking at the MRI scans that have been already taken on a computer screen. The needle is guided to the prostate using live ultrasound scans that are shown on a different screen near the patient. The biopsy operator makes a judgement about where to place the biopsy needles. This is called visual registration. Tissue samples from other areas of the prostate that look normal on the MRI scans are also taken to ensure cancer is not missed. The other type of biopsy is called image fusion. During image fusion biopsy, the biopsy operator uses the MRI scans that have been taken beforehand but laid on top of the live ultrasound images during the biopsy. This uses software and takes a few minutes longer to perform. Once the MRI images and ultrasound images are 'fused', the actual biopsies are taken as normal. Studies over the last 5 years have shown mixed results. Some have shown that image fusion biopsy is no better than visual registration biopsy, whilst a few have shown it might make a difference in improving cancer detection. As a result, it is not known for certain which way is better. A large study is needed to show whether the investigators need to do image fusion or not, in order for the NHS to decide whether or not to use it in all hospitals doing prostate biopsies.

Conditions

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Prostate Cancer Adenocarcinoma Prostatic Neoplasms Prostatic Diseases Neoplasms

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

two linked RCTs which will test whether bpMRI and image-fusion make a difference if used in clinical practice, across multiple centres, without the incorporation bias inherent in paired-cohort studies
Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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Standard: mpMRI

Participants will undergo mpMRI. Blinding will not be possible. Once the MRI report is issued, the local clinical team will make a decision about advising whether a biopsy is necessary or not.

Group Type NO_INTERVENTION

No interventions assigned to this group

Intervention 1: bpMRI

Participants will undergo bpMRI. Blinding will not be possible. Once the MRI report is issued, the local clinical team will make a decision about advising whether a biopsy is necessary or not.

Group Type ACTIVE_COMPARATOR

bpMRI

Intervention Type DIAGNOSTIC_TEST

biparametric MRI takes 30-40 minutes and requires a contrast injection called gadolinium (like a dye). This is also called long MRI and is most commonly used in the NHS.

Standard: Visual estimation targeted and systematic biopsy

Randomisation 2 will only be relevant if participants are advised by their clinical team to have a biopsy based on their MRI and other clinical factors. Participants advised to have a biopsy will undergo a visual estimation targeted biopsy

Group Type NO_INTERVENTION

No interventions assigned to this group

Intervention 2: Image-fusion targeted and systematic biopsy

Randomisation 2 will only be relevant if participants are advised by their clinical team to have a biopsy based on their MRI and other clinical factors. Participants advised to have a biopsy will undergo an image fusion targeted biopsy.

Group Type ACTIVE_COMPARATOR

Image-Fusion targeted and systematic Biopsy

Intervention Type DIAGNOSTIC_TEST

During image fusion targeted biopsy, the biopsy operator uses the MRI scans that were taken beforehand but laid on top of the live ultrasound images during the biopsy. This uses software and takes a few minutes longer to perform. Once the MRI images and ultrasound images are 'fused', the actual biopsies are taken as normal.

Interventions

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bpMRI

biparametric MRI takes 30-40 minutes and requires a contrast injection called gadolinium (like a dye). This is also called long MRI and is most commonly used in the NHS.

Intervention Type DIAGNOSTIC_TEST

Image-Fusion targeted and systematic Biopsy

During image fusion targeted biopsy, the biopsy operator uses the MRI scans that were taken beforehand but laid on top of the live ultrasound images during the biopsy. This uses software and takes a few minutes longer to perform. Once the MRI images and ultrasound images are 'fused', the actual biopsies are taken as normal.

Intervention Type DIAGNOSTIC_TEST

Other Intervention Names

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biparametric MRI

Eligibility Criteria

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Inclusion Criteria

* Age 18 years or above (no upper limit)
* Patients with a prostate (either cis-male gender or trans-female gender with no prior androgen deprivation hormone use at all).
* Referred to hospital and advised to undergo a prostate MRI because of an abnormal digital rectal examination (regardless of PSA level) and/or an elevated PSA (within 6 months of screening visit) PSA \>/=3.0ng/ml for age 50-69 years PSA \>/=5.0ng/ml for age \>/=70 years If family or ethnic risk for prostate cancer, PSA \>/=2.5ng/ml for age 45-49 years


* Visible suspicious finding on mpMRI or bpMRI from randomisation 1 requiring a targeted biopsy (MRI score 3, 4, 5 on either Likert or PIRADS schema)

Exclusion Criteria

* PSA \>50ng/ml
* Prior prostate MRI or prostate biopsy in the two years prior to screening visit
* Prior diagnosis of prostate cancer
* Contraindication to MRI or gadolinium contrast
* Previous hip replacement to both hips
* Contraindication to performing a biopsy guided by a transrectal ultrasound probe

Randomisation 2


* As above for randomisation 1
* Patient refusal for biopsy
Minimum Eligible Age

18 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

No

Sponsors

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Cancer Research UK

OTHER

Sponsor Role collaborator

National Institute for Health Research, United Kingdom

OTHER_GOV

Sponsor Role collaborator

Imperial College London

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Southend University Hospital

Southend-on-Sea, Essex, United Kingdom

Site Status RECRUITING

University Hospital Southampton

Southampton, Hampshire, United Kingdom

Site Status RECRUITING

Medway Maritime Hospital

Gillingham, Kent, United Kingdom

Site Status NOT_YET_RECRUITING

Basingstoke Hospital

Basingstoke, , United Kingdom

Site Status RECRUITING

Southmead Hospital

Bristol, , United Kingdom

Site Status RECRUITING

Addenbrooke Hospital, Cambridge

Cambridge, , United Kingdom

Site Status RECRUITING

Cumberland Infirmary

Carlisle, , United Kingdom

Site Status RECRUITING

St Peters Hospital

Chertsey, , United Kingdom

Site Status RECRUITING

Darent valley Hospital

Dartford, , United Kingdom

Site Status RECRUITING

Northwick Park Hospital

Harrow, , United Kingdom

Site Status RECRUITING

St James's Hospital, Leeds

Leeds, , United Kingdom

Site Status RECRUITING

Charing Cross Hospial

London, , United Kingdom

Site Status RECRUITING

Manchester Royal Infirmary

Manchester, , United Kingdom

Site Status RECRUITING

Northampton General Hospital

Northampton, , United Kingdom

Site Status RECRUITING

Hillingdon Hospital

Uxbridge, , United Kingdom

Site Status RECRUITING

Countries

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United Kingdom

Central Contacts

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Hashim Ahmed

Role: CONTACT

0203 311 1673

Thiagarajah Sasikaran

Role: CONTACT

0207 594 6017

Facility Contacts

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Lesley Nichols, FRCS

Role: primary

01702 435555 ext. 6411

Aneta Zahorska

Role: primary

023 8120 3560

Nikki Carney

Role: backup

023 8120 3560

Mandeep Badyal

Role: primary

01634 976513 ext. 6513

Judith Radmore

Role: primary

01256 473202 ext. 44115

Rebecca Cousins

Role: primary

0117 4148109

Bev Wilkinson

Role: primary

01228 814397

Rachel Mutch

Role: backup

01946523410

Carmel Stuart

Role: primary

01322 428100 ext. 4323

Francesca Rawlins

Role: primary

Charlene Hyde

Role: primary

Mariam Nasseri

Role: primary

01895 279021

Other Identifiers

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22CX7488

Identifier Type: -

Identifier Source: org_study_id

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