High resolution volumetric MRI for prostate cancer active surveillance

高分辨率体积 MRI 用于前列腺癌主动监测

• 批准号: 9919515
• 负责人: HYUNG L KIM
• 金额: $ 38.02万
• 依托单位: CEDARS-SINAI MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-05-01 至 2022-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9919515
• 关键词: 3-Dimensional; Area; Biopsy; Cancer Etiology; Cessation of life; Characteristics; Clinical; Clinical Trials; Computer software; Data; Data Set; Detection; Diagnosis; Diffusion; Diffusion Magnetic Resonance Imaging; Disease; Disease Progression; Echo-Planar Imaging; Enrollment; Erectile dysfunction; Feedback; Hemorrhage; Histologic; Hospitalization; Image; Lead; Lesion; Life; Local Therapy; Magnetic Resonance Imaging; Magnetism; Malignant neoplasm of prostate; Modality; Modernization; Molecular; Monitor; Morphologic artifacts; Motion; Newly Diagnosed; Noise; Operative Surgical Procedures; Organ; Pain; Pathology; Patients; Predisposition; Prostate Cancer therapy; Prostatic Neoplasms; Protocols documentation; Public Health; Quality of life; Radiation; Radiation therapy; Radical Prostatectomy; Reproducibility; Resolution; Risk; Sampling; Sampling Errors; Scanning; Scheme; Sepsis; Signal Transduction; System; Techniques; Testing; Three-Dimensional Imaging; Time; Tumor stage; Ultrasonography; Update; Urinary Incontinence; anatomic imaging; cancer imaging; cost; curative treatments; data acquisition; disorder risk; follow-up; healthy volunteer; imaging modality; improved; men; novel; prospective; prostate biopsy; prostate cancer progression; side effect; surveillance strategy; tumor; tumor ablation; tumor growth

PROJECT SUMMARY The vast majority of men diagnosed with prostate cancer do not die of their disease and can choose to delay or avoid surgical or radiation treatment by undergoing active surveillance. Unfortunately, men on active surveillance remain at risk for progression of prostate cancer and even death from prostate cancer. Therefore, men are carefully followed with transrectal prostate biopsies every 1-2 years. Unlike with tumors in other organs, there is no imaging modality that can be used to accurately detect and monitor prostate tumors. Furthermore, prostate biopsies are painful and associated with a significant risk of sepsis and hospitalization. Therefore, the personal and public health burden of life-long active surveillance is significant. We introduce a novel MRI sequence that improves image quality and resolution. Our preliminary data shows that in men on active surveillance, standard MRI detects only 61% of biopsy-proven prostate tumors. However, our novel HR- MRI detects nearly all (96%) biopsy-proven prostate tumors, which is iimpressive since men on active surveillance tend to have small, low grade tumors. Our HR-MRI used to generate our preliminary data had a 5-fold improvement in resolution; however, the resolution can be improved up to 25-fold at a cost of increased scan time. The first aim will be to further optimize our HR-MRI to improve resolution and image quality while minimizing the scan time. The optimized HR-MRI will be used to detect changes in tumor size or grade in men on active surveillance and consider the possibiity that tumor growth rate or other imaging characteristics predict the risk of disease progression. A more accurate MRI modality for localizing and monitoring prostate tumors will allow men on active surveillance to reduce the number of followup biopsies, identify tumors for biopsies that can be used for molecular characterization, and localize tumors for focal ablative therapies. The HR-MRI can be deployed on existing 1.5T and 3T MRI systems with a simple software installation and does not require new hardware.

项目摘要 绝大多数被诊断患有前列腺癌的男性不会死于他们的疾病，可以选择延迟或 通过积极监测避免手术或放射治疗。不幸的是，男性在积极 监测仍然存在前列腺癌进展甚至前列腺癌死亡风险。因此，我们认为， 每1-2年对男性进行经直肠前列腺活组织检查。与其他肿瘤不同， 由于前列腺肿瘤是器官的一部分，因此没有可以用于准确检测和监测前列腺肿瘤的成像模式。 此外，前列腺活检是痛苦的，并与败血症和住院的重大风险相关。 因此，终身主动监测的个人和公共卫生负担是巨大的。我们引入一个 新的MRI序列，提高了图像质量和分辨率。我们的初步数据显示， 在主动监测下，标准MRI只能检测到61%的活检证实的前列腺肿瘤。然而，我们的新HR- MRI检测几乎所有（96%）活检证实的前列腺肿瘤，这是令人印象深刻的，因为男性在活跃的 监测往往有小，低级别的肿瘤。用于生成初步数据的HR-MRI具有 5-分辨率可提高25倍;然而，分辨率最高可提高25倍， 扫描时间第一个目标是进一步优化我们的HR-MRI，以提高分辨率和图像质量， 最小化扫描时间。优化的HR-MRI将用于检测男性肿瘤大小或级别的变化 并考虑肿瘤生长速度或其他影像学特征 预测疾病进展的风险。一种更准确的MRI模式，用于定位和监测前列腺 肿瘤将允许男性进行积极的监测，以减少后续活检的数量， 活组织检查可用于分子表征，并定位肿瘤以进行局部消融治疗。的 HR-MRI可以部署在现有的1.5T和3 T MRI系统上，只需简单的软件安装， 不需要新的硬件。