Image-Guided Molecular Optical Spectroscopy for Tumor-Targeted Prostate Cancer Interventions

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Confirming the location, extent, and grade of prostate cancer for diagnostic and therapeuticpurposes remains challenging due to the architectural and phenotypic heterogeneity. In thecase of blind systematic ultrasound-guided biopsies, this leads to more than 30% of falsenegative rates, while for tumor-targeted (focal) therapies such as brachytherapy, theirsuccess hinge on precise mapping of MRI cancer targets to provide the gross tumor location,but lack molecular information at the treatment location, without accurate grading of the tumorand can lead to a poor balance of toxicities. Therefore, there is no existing medicaltechnologies addressing the timely confirmation of tumor location/grade during therapy. Ourobjective is to develop an image-guidance system integrating real-time molecular tissuecharacterization with an optical Raman spectroscopy (RS) instrument for tumor-targetedprostate cancer interventions, improving tumor localization and characterization. Specifically,we will develop and conduct first in-human studies using a real-time navigation platformtechnology allowing for high-precision and tumor-specific harvesting of samples during biopsyprocedures. Four research aims will be completed to insure in-human translation of thetechnology into to our partners Elekta and Philips Canada within 3 years: (1) Develop a fiberoptics RS needle device for tissue characterization to guide prostate interventions; (2) Trainsupervised machine-learning algorithms from spectral RS signatures to infer biologicalproperties; (3) Implement an integrated image-guidance platform with real-time RS tissueclassification and needle tracking to identified MRI targets with prostate motion compensation;(4) Conduct a pilot clinical study patients with localized PCa visible on MRI and who willundergo HDR brachytherapy. Ultimately, we will have a high-end technique clinically tested inprostate interventions for practical molecular identification and cancer detection.