Image guided targeted biopsy of clinically significant prostate cancer with acoustic radiation force

利用声辐射力对具有临床意义的前列腺癌进行图像引导靶向活检

• 批准号: 9386411
• 负责人: Kathryn Radabaugh Nightingale
• 金额: $ 54.62万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-01-18 至 2022-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9386411
• 关键词: Acoustics; Address; Affect; Amination; Amines; Appearance; Benign; Biopsy; Calibration; Cancer Detection; Characteristics; Clinic; Clinical; Clinical Management; Collaborations; Computer software; Core Biopsy; Custom; Detection; Development; Diagnosis; Diagnostic; Disease; Elasticity; Feedback; Funding; Gland; Gleason Grade for Prostate Cancer; Goals; Healthcare; Healthcare Systems; Human; Image; Industrialization; Internships; Lead; Malignant Neoplasms; Malignant neoplasm of prostate; Nature; Needle biopsy procedure; Needles; Normal tissue morphology; Pathologic; Pathology; Patient-Focused Outcomes; Patients; Peat; Performance; Positioning Attribute; Predictive Value; Procedures; Prostate; Prostate-Specific Antigen; Prostatic Diseases; Radiation; Radical Prostatectomy; Resources; Rotation; Sampling; Screening for Prostate Cancer; Side; Staging; Structure; Structure of base of prostate; System; Technology; Time; Tissues; Transducers; Translating; Transrectal Ultrasound; Treatment Cost; Tumor Tissue; Ultrasonics; Ultrasonography; United States; Visualization software; Work; anxiety treatment; base; cancer diagnosis; clinical decision-making; clinical translation; clinically significant; computerized data processing; cost; data visualization; density; design; digital; experience; graduate student; image guided; imaging platform; imaging system; improved; in vivo; indexing; industry partner; innovation; men; novel; prostate biopsy; prototype; rectal; screening; standard of care

Abstract: Over 1,000,000 biopsies are performed annually in the United States to diagnose prostate cancer (PCa)[1]. Prostate biopsies are performed using transrectal ultrasound (TRUS) guidance to diagnose PCa when suspicion is raised through screening mechanisms. However, ultrasonic prostate imaging does not facilitate tar- geting biopsies to suspicious regions because PCa does not have unique B-mode image characteristics that can delineate diseased tissues from normal structures and benign pathologies. Therefore, the current standard of care has poor sensitivity mainly because the sampling grid, which samples <5% of the prostate, only randomly intersects pathologic tissues. As a result, PCa detection rates are only 18-36% for both first and second-time repeat biopsies[1–5]. In addition, many of the cancers that are detected with the systematic sampling approach are clinically insignificant [2, 6], leading to overly aggressive treatment that adversely affects patients and places an unnecessary burden on our healthcare system. During the previous funding cycle we developed a novel 3D Acoustic Radiation Force Impulse (ARFI) prostate ultrasound elasticity imaging system. Our experience with 3D ARFI prostate imaging in over 100 patients demonstrated the exciting result that 3D ARFI imaging is specific for clinically significant disease (CSD)[7], which means it can be used to screen the entire prostate gland and target biopsies toward regions suspicious for CSD. We have identified the key tech- nical challenges that must be addressed to bring a low-cost, 3D-ARFI prostate cancer screening and targeted biopsy guidance system into the current clinical work-flow. In this competing renewal, submitted under PAR- 15-075 for academic-industrial collaborations, we propose to partner with Siemens ultrasound to resolve these challenges and build a clinic-ready system and assess its performance in the clinic as compared to systematic TRUS biopsy. The proposed system will remove the random nature of systematic sampling, facilitat- ing initial diagnosis based upon the most aggressive disease present in the gland. We hypothesize that this system will reduce the required number of biopsy cores, the number of repeat biopsy procedures, and the number of unnecessary radical prostatectomies associated with PCa. There are 3 specific aims: 1) To translate our prototype system into a clinic-ready system through: development and integration of a custom designed, side-fire transrectal transducer and biopsy needle guides, implementation of our data processing and 3D data visualization tools on-board a state-of-the-art prototype ultrasound scanner, and integration of positioning feed- back in the motorized rotation system. 2) To assess the performance of the 3D TRUS ARFI targeted biopsy guidance system in tissue mimicking phantoms. 3) To assess the performance of 3D ARFI in vivo in humans in targeting clinically significant prostate disease.

摘要：在美国，每年有超过1,000,000例活检用于诊断前列腺癌