Biopsy Tracking and MRI Fusion to Enhance Imaging of Cancer Within the Prostate

活检追踪和 MRI 融合可增强前列腺内癌症的成像

• 批准号: 8477016
• 负责人: Leonard Stephen Marks
• 金额: $ 42.53万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-07-05 至 2014-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8477016
• 关键词: Accounting; Autopsy; Biopsy; California; Cessation of life; Clinical; Development; Devices; Diagnosis; Diffusion; Diffusion weighted imaging; Disease; Early Diagnosis; FDA approved; Feasibility Studies; Future; Gleason Grade for Prostate Cancer; Goals; Growth; Guidelines; Histologic; Human; Image; Imaging Device; Indolent; Institutes; Lesion; Life; Location; Longevity; Magnetic Resonance; Magnetic Resonance Imaging; Malignant Neoplasms; Malignant neoplasm of prostate; Measures; Methods; Modality; Newly Diagnosed; Organ; Outcome; Pathology; Patients; Pilot Projects; Process; Prostate; Prostatectomy; Prostatic; Publishing; Qualifying; Quality of life; Radiation; Radical Prostatectomy; Research; Risk; Sampling; Sampling Studies; Savings; Site; Staging; Structure; Surveillance Program; System; Testing; Time; Translations; Transrectal Ultrasound; Tumor Volume; Ultrasonography; United States National Institutes of Health; Urology; Visual; Weight; active method; arm; artemis; base; blind; cancer diagnosis; cancer imaging; cancer risk; digital; follow-up; imaging modality; improved; in vivo; male; men; new technology; novel; operation; programs; prospective; reconstruction; rectal; research clinical testing; success; tool; tumor; tumor progression

DESCRIPTION (provided by applicant): Prostate cancer (CaP) is the commonest internal malignancy in U.S. males, accounting for 192,000 new cases and 27,300 deaths annually. However, CaP also exists in a common, non-fatal, insignificant form which does not cause disease. Up to half of newly diagnosed CaP cases qualify histologically as insignificant, but 90% of men with CaP, serious and not, choose immediate curative therapy. Ability to image cancer within the prostate would help define the important cancers, but presently that ability is lacking. We propose to evaluate an advanced imaging system, the Artemis device, in men undergoing prostate biopsy to exclude malignancy. The device employs digital video processing of conventional ultrasound images to (1) create a contemporaneous 3D reconstruction of the prostate, (2) plan biopsy sites systematically, (3) digitally record the biopsy sites for future re-call, and (4) fuse or superimpose previously-obtained magnetic-resonance imaging (MRI) of the prostate with concurrent ultrasound images in a real-time manner. Potential advantages of this new technology include improved ability to sample the entire prostate thoroughly, to precisely record sampling sites for future re-biopsy, and to directly use images from MRI as well as ultrasound for biopsy targeting. MRI of the prostate, when performed in a multi-modal fashion---3Tesla coil combined with dynamic contrast enhancement and diffusion-weighted imaging---appears to be approaching clinical utility in visualizing cancer within the prostate. In the present study, results obtained with the new imaging system would be compared with (1) findings on whole-mount prostate pathology, for men undergoing prostatectomy (N=350/yr at UCLA), and (2) biopsy findings at diagnosis and subsequently, for men undergoing active surveillance (vast unmet need in Southern California). Accuracy of ultrasound/MRI fusion would be tested by comparing location of fiducial markers in the prostate seen on each of the two modalities. Value of MRI as a biopsy guide would be tested by comparing results of biopsies targeted at suspicious lesions seen on MRI vs 12-core systematic biopsies. The surveillance arm will provide opportunity for longitudinal testing of the imaging device in men with low- risk CaP in a structured, prospective program. Improved imaging and precise biopsy of the prostate, as provided by multi-modal MRI and the Artemis device, may help re-define significant and insignificant cancer.

描述（由申请人提供）：前列腺癌（CaP）是美国男性最常见的内部恶性肿瘤，每年有192,000例新病例和27,300例死亡。然而，CaP也以一种常见的、非致命的、无足轻重的、不会引起疾病的形式存在。多达一半的新诊断的CaP病例在组织学上不明显，但90%的CaP患者，无论严重与否，都选择立即治疗。在前列腺内成像癌症的能力将有助于确定重要的癌症，但目前缺乏这种能力。我们建议评估一种先进的成像系统，Artemis装置，在男性接受前列腺活检，以排除恶性肿瘤。该设备采用传统超声图像的数字视频处理(1)创建前列腺的同期三维重建，(2)系统地规划活检部位，(3)以数字方式记录活检部位以备将来调用，以及(4)将先前获得的前列腺磁共振成像（MRI）与并发超声图像实时融合或叠加。这项新技术的潜在优势包括提高了对整个前列腺进行彻底采样的能力，精确记录采样位置以备将来重新活检，并直接使用MRI和超声图像进行活检靶向。前列腺MRI，当以多模式方式进行时——3Tesla线圈结合动态对比增强和扩散加权成像——似乎正在接近前列腺癌可视化的临床应用。在本研究中，使用新成像系统获得的结果将与(1)接受前列腺切除术的男性的全前列腺病理结果（UCLA的N=350/年）和(2)诊断时和随后接受主动监测的男性的活检结果（南加州大量未满足的需求）进行比较。超声/MRI融合的准确性将通过比较两种方式在前列腺中所见的基准标记物的位置来测试。MRI作为活检指南的价值将通过比较MRI上针对可疑病变的活检结果与12核系统活检结果来检验。监测臂将提供机会，纵向测试成像设备的男性低风险的CaP在一个结构化的，前瞻性的程序。多模态MRI和Artemis装置所提供的前列腺成像和精确活检的改进，可能有助于重新定义重要和不重要的癌症。

项目成果

p53 Mutation Directs AURKA Overexpression via miR-25 and FBXW7 in Prostatic Small Cell Neuroendocrine Carcinoma.

• DOI: 10.1158/1541-7786.mcr-14-0277-t
• 发表时间: 2015-03
• 期刊: Molecular cancer research : MCR
• 作者: Li Z;Sun Y;Chen X;Squires J;Nowroozizadeh B;Liang C;Huang J
• 通讯作者: Huang J

Risk Stratification Among Men With Prostate Imaging Reporting and Data System Version 2 Category 3 Transition Zone Lesions: Is Biopsy Always Necessary?

• DOI: 10.2214/ajr.17.18008
• 发表时间: 2017-12-01
• 期刊: AMERICAN JOURNAL OF ROENTGENOLOGY
• 影响因子: 5
• 作者: Felker, Ely R.;Raman, Steven S.;Marks, Leonard S.
• 通讯作者: Marks, Leonard S.

Molecular pathology of prostate cancer revealed by next-generation sequencing: opportunities for genome-based personalized therapy.

下一代测序揭示的前列腺癌的分子病理学：基于基因组的个性化治疗的机会。

• DOI: 10.1097/mou.0b013e32835e9ef4
• 发表时间: 2013-05
• 期刊: Current opinion in urology
• 影响因子: 2.5
• 作者: Huang J;Wang JK;Sun Y
• 通讯作者: Sun Y

The Relationship between Intolerance of Uncertainty and Anxiety in Men on Active Surveillance for Prostate Cancer.

• DOI: 10.1016/j.juro.2016.01.108
• 发表时间: 2016-06
• 期刊: The Journal of urology
• 作者: Tan HJ;Marks LS;Hoyt MA;Kwan L;Filson CP;Macairan M;Lieu P;Litwin MS;Stanton AL
• 通讯作者: Stanton AL

Screening and detection advances in magnetic resonance image-guided prostate biopsy.

磁共振图像引导前列腺活检的筛查和检测进展。

• DOI: 10.1016/j.ucl.2014.01.007
• 发表时间: 2014
• 期刊: The Urologic clinics of North America
• 作者: Stephenson,SamuelK;Chang,EdwardK;Marks,LeonardS
• 通讯作者: Marks,LeonardS