Minimally Invasive MRI-Guided Management of Prostate Disease

前列腺疾病的微创 MRI 引导治疗

• 批准号: 8555394
• 负责人: BRUCE L DANIEL
• 金额: $ 28.33万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-22 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8555394
• 关键词: Ablation; Acute; American; Basic Science; Biopsy; Cancer Intervention; Clinical Research; Clinical Trials; Core Biopsy; Cryosurgery; Development; Diagnosis; Diffusion; Early treatment; Engineering; Fiber Optics; Freezing; Future; Generations; Gland; Gold; Human; Image; Image Guided Biopsy; Imagery; Injury; Institutional Review Boards; Investigation; Magnetic Resonance Imaging; Malignant Neoplasms; Malignant neoplasm of prostate; Maps; Measures; Methods; Monitor; Morbidity - disease rate; Needles; Operative Surgical Procedures; PSA level; Patients; Physicians; Positioning Attribute; Procedures; Prostate; Prostatic Diseases; Prostatic Neoplasms; Radiation therapy; Real-Time Systems; Reporting; Risk; Robot; Robotics; Scanning; Shapes; Slave; Staging; Study of magnetics; System; Technology; Testing; Time; Tissues; Translations; Weight; clinically significant; design; improved; in vivo; manufacturing process; men; minimally invasive; optical fiber; photonics; rectal; research clinical testing; sensor; tool; tumor

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

早期前列腺癌是非常常见的。然而，目前的诊断和治疗方法缺乏 一些男性患有严重的癌症，而另一些人则过度使用昂贵、漫长和 重大风险和发病率。核磁共振成像正在成为揭示临床意义的一种很有前途的方法 前列腺癌，增加了微创、局部、磁共振引导的治疗的挑衅性可能性，这将 比目前的全腺体放射治疗和外科手术更有选择性、更安全、更快。 该项目的目标是开发前列腺癌的微创活检和治疗方法： 1.设计、测试和最终制造一种用于实时、交互、最小限度地经会阴的新系统 当患者在3T MRI扫描仪中时，使用与MRI兼容的机器人进行侵入性前列腺探查 被动式远程针灸技术、嵌入式微型光纤和磁共振跟踪技术 感知针头形状和针尖位置，并与实时MR扫描集成，实现自动化可视化。 2.MRI引导下经会阴前列腺靶向活检的临床试验 对12例PSA水平异常的男性进行经超声引导的标准系统性12核活检(金标准)。 3.与MRI兼容的针尖微机器人的开发和体内测试将大幅提高 医生控制，包括针尖作用力传感和渲染，以及光子针尖转向。 4.包括超短TE 3D MR在内的3T冷冻手术指导和监测方法的研究 冰冻组织的热图，以及急性冷冻损伤的高级弥散成像和MT加权图像。 完成后，这些技术将用于未来的临床试验，评估最低限度的 MRI引导下侵入性冷冻治疗早期前列腺癌