Minimally Invasive MRI-Guided Management of Prostate Disease

早期前列腺癌是非常常见的。然而，目前的诊断和治疗方法 一些男性患有严重的癌症，而另一些人则过度使用昂贵，漫长， 重大风险和发病率。磁共振成像是一种新兴的有前途的方法，揭示临床意义 前列腺癌，提高了微创，局部，MR引导治疗的可能性， 比目前的全腺体放疗和外科手术更具选择性、更安全、更快速。 该项目的目的是开发前列腺癌的微创活检和治疗方法： 1.设计、测试和最终制造一个新的系统，用于实时、交互式、经会阴最小化 当患者在3T MRI扫描仪中时，使用MRI兼容机器人 被动远程针操作技术、嵌入式微型光纤和MR跟踪技术， 感测针形状和尖端位置，并与实时MR扫描集成以实现自动可视化。 2. MRI引导下经会阴前列腺靶点穿刺活检术与常规穿刺活检术的比较 TRUS引导的标准系统性12芯活检（金标准）在12名PSA水平异常的男性中进行。 3. MRI兼容针尖微型机器人的开发和体内测试， 医生控制，包括针尖力感测和呈现，以及光子针尖转向。 4.研究用于引导和监测冷冻手术的3T方法，包括超短TE 3D MR 冷冻组织中的热成像，以及急性冷冻损伤的高级扩散和MT加权图像。 完成后，这些技术将准备用于未来的临床试验，评估最低限度的 MRI引导下局部冷冻治疗早期前列腺癌

Early stage prostate cancer is very common. However, current methods for diagnosis and treatment miss significant cancers in some men, and over-treat others with therapies that are expensive, lengthy, and have significant risks and morbidity. MRI is emerging as a promising method for revealing clinically significant prostate cancer, raising the provocative possibility of minimally invasive, focal, MR-guided therapy that would be more selective, safer, and quicker than current whole-gland radiotherapy and surgical procedures. The aims of this project are to develop minimally invasive biopsy and treatment methods for prostate cancer: 1. Design, testing and final fabrication of a new system for real-time, interactive, trans-perineal minimally invasive access to the prostate while the patient is in a 3T MRI scanner, using MRI-compatible robotic technology for passive remote needle manipulation, embedded miniature fiber optics and MR-tracking to sense needle shape and tip position, and integration with real-time MR scanning for automated visualization. 2. Clinical Trial of MRI-guided Trans-perineal biopsy of prostate targets, compared with subsequent TRUS-guided standard systematic 12-core biopsies (the gold standard) in 12 men with abnormal PSA levels. 3. Development and in vivo testing of MRI-compatible needle tip micro-robotics to dramatically increase physician control, including needle tip force sensing and rendering, and photonic needle tip steering. 4. Investigation of 3T methods for guiding and monitoring cryosurgery, including ultra-short TE 3D MR thermal mapping in frozen tissue, and advanced diffusion and MT-weighted images of acute cryo-injury. When complete, these technologies will be poised for future clinical trials assessing the utility of minimally invasive MRI-guided focal cryosurgery for treating early stage prostate cancer