Molecular Phenotyping and Image-Guided Surgical Treatment of Prostate Cancer Using Ultrasmall Silica Nanoparticles

Inclusion Criteria: Primary RP + PLND * Age ≥18 years * Patients meeting one of the following criteria: * Tumor clinical stage T3a or higher * Gleason score 8-10, or * PSA level \> 20 ng/mL * Patients deemed fit for surgery on the basis of preoperative evaluation at the physician's discretion * Patient is scheduled for standard of care laparoscopic radical prostatectomy (with or without robotic assistance) Salvage PLND * Age ≥18 years * Patients with presence of suspicious lymph node on CT or MRI (of a pelvic node =\> 10mm in short axis or a node with abnormal morphology such as roundness irregularity or loss of fatty hilum, or PSMA-avid on PSMA PET imaging * Patients deemed fit for surgery on the basis of preoperative evaluation at the physician's discretion * Patient is scheduled for standard of care salvage pelvic lymph node dissection (with or without robotic assistance) Exclusion Criteria: * Contraindications to standard-of-care MR imaging (e.g., metal implants, claustrophobia) * Prior androgen-deprivation therapy for prostate cancer (N/A for Salvage PLND) * Prior pelvic radiotherapy (N/A for Salvage PLND ) * Medical illness unrelated to the tumor that, in the opinion of the attending physician and principal investigator, will preclude administration of the tracer °This includes patients with uncontrolled infection, chronic renal insufficiency (EGFR \< 60 mL/min/1.73m2), myocardial infarction within the past 6 months, unstable angina, cardiac arrhythmias other than chronic atrial fibrillation and chronic active or persistent hepatitis, or New York Heart Association Classification III or IV heart disease * Weight greater than the 400-lb weight limit of the PET scanner * Unmanageable claustrophobia * Inability to lie in the scanner for 30 min