Magnetic Resonance Imaging with Hyperpolarized 13C Bicarbonate for the Measurement of Tissue pH in Localized Prostate Cancer

Inclusion Criteria

• Patients age >= 18 years
• Patients must have biopsy-proven adenocarcinoma of the prostate; biopsy may be performed outside of University of California San Francisco (UCSF), if detailed results of sextant biopsy are available
• Tumor size of at least 1.0 cm in long axis on MRI or ultrasound; if no prior imaging is available, at least 3 cores positive on biopsy
• Patients must have planned radical prostatectomy at UCSF within 12 weeks following protocol MRI/MRSI (magnetic resonance imaging/magnetic resonance spectroscopy imaging)
• Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
• Absolute neutrophil count >= 1,500 cells/uL
• Platelets >= 75,000 cells/uL
• Hemoglobin >= 9.0 gm/dL
• Total bilirubin < 1.5x upper limit of normal (ULN) (within normal institutional limits, unless elevated due to Gilbert’s syndrome and direct bilirubin is within normal limits)
• Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase [SGOT]) =< 1.5 x institutional upper limit of normal
• Alanine aminotransferase (ALT) (serum glutamic pyruvic transaminase [SGPT]) =< 1.5 x institutional upper limit of normal
• Creatinine clearance >= 50 calculated using the Cockcroft-Gault equation, unless data exists supporting safe use at lower kidney function values, no lower than 30 mL/min/1.73 m^2
• Ability to understand and the willingness to sign a written informed consent document

Exclusion Criteria

• Patients who because of general medical or psychiatric condition, or physiologic status, cannot give valid informed consent
• Patients unwilling or unable to undergo MR imaging, including patients with contra-indications to MRI as per UCSF radiology departmental guidelines
• Patients who cannot tolerate or have contra-indications to endorectal coil insertion, for example, patients with a prior abdominoperineal resection of the rectum or latex allergy
• Patients with contra-indications to injection of gadolinium contrast as per UCSF radiology departmental guidelines
• Patients who take carbonic anhydrase inhibitors (e.g. acetazolamide, dichlorphenamide, methazolamide)
• Metallic hip implant or any other metallic implant or device that distorts local magnetic field and compromises the quality of MR imaging
• Cryosurgery, surgery for prostate cancer, prostatic or pelvic radiotherapy prior to study enrollment. No limit on number of prior prostate biopsies. Prior transurethral resection of the prostate (TURP) is not allowed
• Poorly controlled hypertension, with blood pressure at study entry > 160/100. The addition of anti-hypertensives to control blood pressure is allowed for eligibility determination
• Congestive heart failure or New York Heart Association (NYHA) status >= 2. A history of clinically significant electrocardiography (EKG) abnormalities, including QT prolongation, a family history of prolonged QT interval syndrome, or myocardial infarction (MI) within 6 months of study entry. Patients with rate-controlled atrial fibrillation/flutter will be allowed on study