Electrical Property Based Image-guided Prostate Biopsy

基于电特性的图像引导前列腺活检

• 批准号: 7829268
• 负责人: Ryan Joseph Halter
• 金额: $ 48.81万
• 依托单位: DARTMOUTH COLLEGE
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-30 至 2011-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7829268
• 关键词: Address; Algorithms; Area; Benign; Biopsy; Cancer Detection; Clinic; Clinical; Clinical Management; Clinical Trials; Clinical assessments; Couples; Coupling; Data; Detection; Development; Devices; Diagnosis; Diagnostic; Digital Rectal Examination; Disease; Electrodes; Elements; Enhancement Technology; Evaluation; Funding; Gland; Gleason Grade for Prostate Cancer; Goals; Image; Imaging Device; Imaging technology; Institution; Investigation; Lesion; Malignant - descriptor; Malignant Neoplasms; Malignant neoplasm of prostate; Measurement; Measures; Modality; Needles; Normal tissue morphology; Outcome; Pathology; Patients; Population; Positioning Attribute; Preparation; Procedures; Process; Production; Property; Prostate; Prostatic; Publications; Radial; Radical Prostatectomy; Research; Sensitivity and Specificity; Series; Specimen; Spectrum Analysis; Speed; Staging; Structure; Surface; System; Technology; Testing; Therapeutic; Thick; Time; Tissue Sample; Tissues; Translating; Transrectal Ultrasound; Ultrasonography; United States National Institutes of Health; Urologist; base; clinical practice; clinically significant; cohort; data acquisition; design; disease characteristic; disease diagnosis; electric impedance; electrical property; experience; flexibility; image reconstruction; improved; instrument; meetings; men; minimally invasive; pre-clinical; preclinical study; programs; public health relevance; rectal; sensor; tool; tumor

DESCRIPTION (provided by applicant): This application addresses broad Challenge Area (06): Enabling Technologies and specific Challenge Topic, 06-EB-101: Development of minimally invasive image-guided systems. The primary goal of this program is to couple already existing technologies into a multi-modal image-guidance system to improve the accuracy of prostate biopsy and disease staging. Currently employed transrectal ultrasound (TRUS)-guided prostate biopsy procedures miss up to 30% of all cancers and are not able to accurately gauge the extent and aggressiveness of the disease. Recent studies by our group have shown that significant electrical property differences existing between malignant and benign prostate tissues provide levels of contrast exceeding those of routinely employed sensing and imaging technologies including TRUS. We propose to integrate electrical property imaging and sensing devices we have developed into a standard clinically accepted TRUS-guided biopsy procedure to improve prostate cancer detection and staging. In two separately funded projects, we have developed 1) an electrical impedance imaging (EII) device that couples a flexible array of electrodes directly to a clinical TRUS probe to provide co-registered ultrasound (US) and electrical property images and 2) an electrical impedance spectroscopy (EIS) sensor integrated into a standard 18-gauge prostate biopsy (Bx) needle to permit sensing of internal prostatic electrical properties in tandem with tissue core extraction. We hypothesize that by coupling these modalities for use during image-guided prostate biopsy procedures a clinician will have enhanced focal lesion detection and identification and improved assessment of disease extent and aggressiveness within the prostate. During this program, EII-TRUS and EIS-Bx data acquisition will be synchronized, and the intra-prostatic electrical properties gauged with EIS-Bx will be incorporated into the algorithm used to reconstruct electrical property images from EII. This algorithm will be implemented on high speed graphical processing units to provide near real-time imaging for clinical deployment. In an effort to rapidly translate this technology to the clinic, the multi-modal image-guidance system will be used during a series of routine biopsy procedures at our institution in order to assess the clinical potential imaging the electrical properties of prostate provides. Because these devices were designed to minimally augment already existing and clinically accepted instruments, are relatively inexpensive (<$10k for an EII system and <$100 for each EIS-Bx device, production quantities), and are able to identify malignant prostate with a high degree of sensitivity and specificity, this technology has the potential of being easily translated to and accepted by the clinic for the benefit of men suspected of having prostate cancer. We expect that by the end of this two-year program we will be in a position to conduct a much larger clinical trial evaluating the added benefit this system provides to routine prostate biopsy. This project capitalizes on our group's extensive clinical experience in electrical impedance sensing and imaging. PUBLIC HEALTH RELEVANCE: Current clinical practices using trans-rectal ultrasound (TRUS) imaging to guide prostate biopsy unfortunately miss up to a third of all cancers and do not accurately identify the clinical significance of the disease. The tissue-structure dependent electrical properties of prostate are significantly different in cancer and normal tissue and provide levels of contrast that far exceed those of TRUS. We aim to image these properties during biopsy procedures in order to provide more accurate real-time clinical assessment of cancer content within the prostate and evaluate the gains achievable for disease detection and staging when these electrical properties are sensed.

描述（由申请人提供）：本申请涉及广泛的挑战领域（06）：使能技术和特定的挑战主题，06- eb -101：微创图像引导系统的开发。该项目的主要目标是将现有技术结合到多模态图像引导系统中，以提高前列腺活检和疾病分期的准确性。目前使用的经直肠超声（TRUS）引导的前列腺活检程序错过了高达30%的所有癌症，并且不能准确地衡量疾病的范围和侵袭性。我们小组最近的研究表明，恶性和良性前列腺组织之间存在显著的电特性差异，其对比度水平超过常规使用的传感和成像技术，包括TRUS。我们建议将我们开发的电特性成像和传感设备整合为临床接受的标准trus引导活检程序，以提高前列腺癌的检测和分期。在两个单独资助的项目中，我们开发了1)电阻抗成像（EII）设备，该设备将柔性电极阵列直接耦合到临床TRUS探针上，以提供共同注册的超声（US）和电特性图像；2)电阻抗光谱（EIS）传感器集成到标准的18号前列腺活检（Bx）针中，以便在组织核心提取的同时感知前列腺内部的电特性。我们假设，通过在图像引导前列腺活检过程中使用这些模式，临床医生将增强局灶性病变的检测和识别，并改进对前列腺内疾病程度和侵袭性的评估。在这个项目中，EII- trus和EIS-Bx的数据采集将同步进行，用EIS-Bx测量的前列腺内电特性将被纳入用于从EII重建电特性图像的算法中。该算法将在高速图形处理单元上实现，为临床部署提供近实时成像。为了将这项技术快速应用于临床，我们将在我们机构的一系列常规活检过程中使用多模态图像引导系统，以评估前列腺电学特性提供的临床潜在成像。由于这些设备被设计为对现有和临床接受的仪器进行最小程度的增强，相对便宜（EII系统< 1万美元，每个EIS-Bx设备< 100美元，生产数量），并且能够以高度的灵敏度和特异性识别恶性前列腺，因此该技术具有很容易转化为临床接受的潜力，为怀疑患有前列腺癌的男性带来好处。我们期望在这个为期两年的项目结束时，我们将能够进行更大规模的临床试验，评估该系统为常规前列腺活检提供的额外好处。该项目充分利用了我们在电阻抗传感和成像方面的丰富临床经验。