Radiotherapy to the Prostate and Dominant Intra-Prostatic Lesion (DIL)

Exclusion Criteria

• •Prior androgen deprivation therapy for prostate cancer
• •Evidence of metastatic disease on bone scan or MRI/CT
• •MRI ineligibility due to the presence of a cardiac pacemaker, defibrillator or other implanted metallic or electronic device which is considered MR unsafe, severe claustrophobia or inability to lie flat for the duration of the study, etc.
• •Metallic hip implant, metallic implant or device in the pelvis that might distort the local magnetic field and compromise quality of MP-MRI.
• •Lateral pelvic separation greater than 50 cm and/or anterior-posterior separation greater than 35 cm which are incompatible with MRCAT reconstruction
• •Contra-indications to receiving gadolinium contrast
• •KPS \< 80
• •Pelvic MRI or CT (MRI preferred) evidence of radiographic T3, T4 or N1 disease.
• •Prior history of transurethral resection of the prostate
• •Prior history of chronic prostatitis
• •Prior history of urethral stricture
• •Prior history of pelvic irradiation
• •History of inflammatory bowel disease
• •Unable to give informed consent
• •Unable to complete quality of life questionnaires
• •Abnormal complete blood count. Any of the following
• •* Platelet count less than 75,000/ml
• •* Hb level less than 10 gm/dl
• •* WBC less than 3.5/ml
• •Abnormal renal function tests (creatinine \> 1.5)