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，目前通过筛查PSA和体格检查发现，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不良和采样不足的限制。我们的基本假设是超声弹性成像可以检测前列腺癌，否则在常规体内超声成像中表现正常。这一假设的一个推论是，三维超声弹性成像可以划定并帮助计算可疑肿瘤区域的体积。超声弹性成像由于更好的活检指导和更少的假阴性活检，可以早期诊断前列腺癌。三维肿瘤体积分析将为定制治疗提供量化和定位，包括近距离治疗中的肿瘤增强剂量。我们提出了一个分三个阶段的研究计划，以发展超声弹性成像技术来检验这一假设：振动源、频率、信号处理、3D渲染和分析的设备优化将在Phantom和离体组织模型中使用GE Logiq 700MR进行测试，并配备专门配置的软件。阶段2。优化后的参数将应用于前列腺癌患者新鲜的全前列腺切除术标本，并与阶梯切片病理相关联。还将评估声弹性图像的体积和形态参数以及渲染体积与标本尺寸的关系。将根据这些结果对硬件和软件进行进一步调整。阶段3。体内扫描将在同意接受前列腺癌筛查的患者中进行，随后转诊进行根治性前列腺切除术，并在选择的对照组患者中进行膀胱前列腺切除术。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使前列腺癌的检测和治疗得到显著改善。

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.