Prostate Cancer Assessment Via Integrated 3D ARFI Elasticity Imaging and Multi-Parametric MRI

 描述（由申请人提供）：前列腺癌（PCA）是美国男性中最常见的非皮肤癌，也是癌症死亡的第二大原因，在美国每年有超过186，000例新诊断病例和超过28，000例PCA死亡。超声引导活检是确诊癌症的标准治疗方法，通常在PSA水平升高后进行;然而，据估计，高达20%的男性需要三次或三次以上的活检来诊断，活检有很高的出血和感染风险。此外，活组织检查不足以进行肿瘤描绘或表征，因为它们稀疏地对整个器官进行采样。遗憾的是，活检的缺陷导致了对无痛性疾病的过度治疗，即根治性前列腺切除术，这是一种具有感染、出血、尿失禁和阳痿的显著风险的激烈治疗。 我们是声辐射力脉冲（ARFI）成像和剪切波弹性成像（SWEI）方法的发明者。我们现在已经将这些方法结合到ARFI-SWEI成像序列中，定义了一个新的和新颖的多参数超声弹性成像系统。这种多参数弹性成像方法使用超声在3D中以高分辨率提供组织硬度的绝对定量测量。 我们假设协同诊断 来自B模式、ARFI-SWEI和多参数MRI（mpMRI，例如，扩散加权成像和MR波谱成像）使得（a）PCA的敏感和特异性诊断和（B）PCA边缘的精确描绘成为可能。我们建议对现有的3D B模式，ARFI-SWEI和mpMRI成像数据集进行回顾性研究，以验证这一假设。1

 DESCRIPTION (provided by applicant): Prostate cancer (PCA) is the most common non-skin cancer and the second leading cause of cancer death in American men, with over 186,000 new cases diagnosed and over 28,000 PCA deaths annually in the United States. Ultrasound-guided biopsy is the standard of care for confirming cancer, typically following elevated PSA levels; however, it has been estimated that up to 20% of men require three or more biopsy sessions for diagnosis, and biopsies have a high risk of hemorrhage and infection. Furthermore, biopsies are not sufficient for tumor delineation or characterization because they sparsely sample the entire organ. Regretfully, the deficiencies of biopsy have lead to over-treatment of indolent disease with radical prostatectomies, a drastic treatment that has significant risks of infection, hemorrhage, urinary incontinence, and impotence. We are the inventors of Acoustic Radiation Force Impulse (ARFI) imaging and the inventors of Shear Wave Elasticity Imaging (SWEI) methods. We have now combined those methods into ARFI-SWEI imaging sequences that define a new and novel multi-parametric ultrasonic elasticity imaging system. This multi-parametric elasticity imaging approach provides an absolute, quantitative measure of tissue stiffness, at high resolution, in 3D, using ultrasound. We hypothesize that synergistic diagnostic information from B-mode, ARFI-SWEI and multi-parametric MRI (mpMRI, e.g., diffusion weighted imaging and MR spectroscopy imaging) enable (a) the sensitive and specific diagnosis of PCA and (b) the accurate delineation of PCA margins. We propose retrospective studies on existing 3D B-mode, ARFI-SWEI and mpMRI imaging datasets to test this hypothesis. 1