Patients with prostate cancer do not die from the primary tumor, but from (extended) metastatic disease. One of the first steps towards extended metastatic disease is the presence of lymph node metastases, which is an important factor determining the patients' prognosis. With continuously improving opportunities to very selectively treat small numbers of metastatic sites it is of utmost importance to accurately diagnose the first signs of oligometastatic disease and to define its extent and aggression.
Within our department nano-MRI as well as 68Ga/18F-PSMA PET-CT are two unique complementary techniques for diagnosis of nodal disease, even in very small lymph nodes. However, the biggest challenge we currently face is the surgical removal of these nodes, to histopathologically validate our imaging findings, and to provide guidance to treat oligometastatic disease with curative intent.
The main focus of this PhD project will be to combine pre- and intra-operative imaging for the detection of lymph node metastases to improve the gold standard for pre-operative imaging techniques and to improve the surgical outcome in prostate cancer patients who are at risk of having lymph node metastases. For this, a prospective clinical study will be started in patients with prostate cancer who are eligible for surgical lymph node dissection. Pre-operative 68Ga/18F-PSMA PET-CT and nano-MRI will be acquired, and during surgery a gamma probe will be used for exact localization and identification of suspicious lymph nodes.
Tumorous and non-tumorous lymph nodes as determined on 7T MRI images and by histopathology (gold standard) will be retrospectively assessed on the pre-operatively acquired images.
The PhD candidate will have a pivotal role in the project and collaborate with researchers and clinicians from the Prostate MR Expertise Center (PMRC), the radiology and nuclear medicine research groups and the urology department.
Tasks and responsibilities - Design and perform the prospective clinical studies as described above;
- Analyze scientific data;
- Write scientific publications and present findings at scientific meetings;
- Work in a team with other scientists and clinicians to plan, discuss, and perform research in a stimulating environment.