3D SONOELASTOGRAPHY IMAGING FOR PROSTATE CANCER

前列腺癌是最常见的男性癌症，也是男性癌症死亡的第二大原因。目前，前列腺癌是通过筛查PSA和体检发现的，并通过TRUS引导的前列腺活检确诊。目前的诊断灵敏度受到肿瘤可视化差和采样不足的限制。我们的基本假设是，超声弹性成像可以检测到前列腺癌，否则在传统的活体US成像中看起来是正常的。这一假设的一个推论是，3D超声弹性成像可以划定并帮助计算可疑肿瘤区域的体积。由于更好的活检指导和较少的假阴性活检，超声超声成像将使前列腺癌早期诊断成为可能。三维肿瘤体积分析将为个性化治疗提供量化和定位，包括近距离放射治疗中的肿瘤增强剂量。我们提出了一个三阶段的研究计划来开发超声弹性成像技术来验证这一假设：第一阶段。将使用GE Logiq 700MR和专门配置的软件在幻影和体外组织模型中测试振源、频率、信号处理、3D渲染和分析的设备优化。第二阶段：优化的参数将应用于前列腺癌患者新鲜的、完整的前列腺切除标本，并与阶梯切片病理相关联。还将评估声弹图像的体积和形态参数以及渲染体积与样本尺寸的关系。根据这些结果，将对硬件和软件进行进一步调整。第三阶段：体内扫描将对同意接受前列腺癌筛查的患者进行，随后转诊为根治性前列腺癌切除术，并选择接受膀胱前列腺切除术的未患前列腺癌的对照患者。将与第二阶段的标本扫描和病理结果进行比较。这些假设的成功验证将允许前列腺癌检测和治疗的显著改进。

Prostate Cancer, the most prevalent male cancer and second leading cause of male cancer death, is currently detected by screening PSA and physical examination and confirmed with TRUS-guided prostate biopsy. Current diagnostic sensitivity is limited by poor visualization of tumor and inadequate sampling. Our fundamental hypothesis is that sonoelastography imaging can enable the detection of prostate cancer that otherwise appears normal in conventional in-vivo US imaging. A corollary of this hypothesis is that 3D sonoelastography can demarcate and help to calculate the volume of a suspected tumor region. Sonoelastic ultrasound imaging will enable earlier prostate cancer diagnosis due to better biopsy guidance and fewer false negative biopsies. Three-dimensional tumor volume analysis will provide quantification and localization for customized treatment, including tumor boost dose in brachytherapy. We propose a three-stage research plan to develop the technology of sonoelastography to test this hypothesis: Stage 1. Equipment optimization of vibration source, frequency, signal processing, 3D rendering and analysis will be tested in Phantom and ex-vivo tissue models using a GE Logiq 700MR with specially configured software. Stage 2. Optimized parameters will be applied to fresh, whole prostatectomy specimens from patients with prostate cancer, and correlated with step-section pathology. Volumetric and morphologic parameters of sonoelastic images and rendered volumes versus specimen dimensions will also be assessed. Further adjustments will be made to hardware and software as suggested by these results. Stage 3. In-vivo scans will be performed on consenting patients screened for prostate cancer subsequently referred for radical prostatectomy and in selected control patients without prostate cancer undergoing cystoprostatectomy. Comparisons will be made with specimen scans and pathology results as in Stage II. Successful verification of these postulates will permit significant improvement in prostate cancer detection and treatment.