Preston C. Sprenkle, MD

Our laboratory has a long-standing track record in advanced prostate imaging and image-guided intervention, with a central focus on improving cancer control while preserving quality of life. We were among the early adopters and pioneers in leveraging multiparametric prostate MRI to refine prostate cancer detection and risk stratification, helping move the field beyond systematic sampling toward more accurate, lesion-directed evaluation. Building on this foundation, our work has expanded from improving diagnosis to enabling and optimizing targeted therapies, using imaging not only to find clinically significant disease but also to guide treatment delivery and assess post-treatment response.

A major thrust of our research has been the clinical translation of PSMA PET/CT. Our group contributed to the initial trials establishing PSMA PET/CT for prostate cancer staging, and we are now actively evaluating its emerging roles earlier and later in the disease course—particularly its performance in primary diagnosis and in surveillance after focal, tissue-sparing ablation therapies. By studying how PSMA PET/CT complements MRI (and where each modality may fall short), we aim to develop evidence-based imaging pathways that improve decision-making, reduce unnecessary procedures, and better identify patients who are most likely to benefit from focal versus whole-gland approaches.

In parallel, we have extensive experience integrating tumor genomic characteristics into prognostication and outcomes research. We study how molecular features of prostate cancer interact with imaging phenotypes and clinical variables to influence disease behavior and treatment response. A key goal is to determine whether genomic information can be used to select personalized treatment strategies—matching the right intensity and modality of therapy to an individual patient’s risk profile, rather than relying on population averages. This work supports a broader vision of precision oncology in which imaging and genomics jointly inform diagnosis, treatment planning, and follow-up.

Our lab maintains multiple prospectively collected clinical databases that enable rigorous outcomes analyses across the prostate cancer care continuum. These include large cohorts of patients undergoing MRI–ultrasound fusion biopsy, allowing us to investigate how imaging findings, biopsy targeting parameters, and clinical characteristics affect diagnostic yield and downstream management. We also curate detailed datasets on focal ablation therapies, including cryoablation, Irreversible Electroporation (IRE), and Transurethral Ultrasound Ablation (TULSA). Using these resources, we examine oncologic outcomes (local control, recurrence patterns, need for salvage therapy) alongside functional outcomes and complications, with the aim of identifying predictors of success and refining patient selection criteria for each approach.

Methodologically, we are committed to continuous improvement of imaging performance and interpretability. In collaboration with Dr. Gigi Galiana at Yale and colleagues at the J. Craig Venter Institute (JCVI), we are advancing MRI acquisition and analysis techniques to enhance cancer conspicuity, improve lesion characterization, and strengthen the link between imaging features and underlying biology. These collaborations support translational work at the intersection of physics, engineering, computational analysis, and clinical implementation—accelerating the development of imaging biomarkers that can be deployed in real-world workflows.

While cancer control remains a core priority, our research program is equally grounded in the understanding that prostate cancer care affects far more than oncologic endpoints. A patient’s quality of life, functional outcomes, and lived experience navigating evaluation and treatment are essential components of “success.” Accordingly, we incorporate patient-reported outcome measures into our studies and are developing more robust ways to quantify patient experience—capturing domains such as decisional burden, uncertainty, treatment-related identity changes, and the longitudinal impact of surveillance and therapy. By integrating these patient-centered measures with imaging, genomics, and clinical outcomes, our lab aims to define—and ultimately deliver—prostate cancer care that is both biologically precise and personally respectful.