Smart Multi-grid Template for Focal Therapy of Prostate Cancer

项目总结/摘要 物理科学公司(PSI)，与布里格姆和妇女的放射科合作， 医院（BWH），建议开发一种自动化的智能多网格引导模板（SMT）技术 这将使磁共振成像（MRI）引导的经会阴局部治疗改善前列腺 癌（PCa）。靶向局部PCa病变的局灶性治疗是PCa患者日益增长的治疗选择 患单灶性中低危癌症的患者各种能量治疗方式，如冷冻消融， 激光消融术、射频消融术、高强度聚焦超声，已被临床研究 关于改善治疗后性功能和泌尿功能的保护， PCa。尽管这些PCa局灶性治疗方式已被广泛用于与成像结合， 用于PCa病变精确定位的引导方法， PCa病变仍然是提高PCa治疗成功率的主要挑战性问题。因此，我们认为， 临床上需要一种技术 在局部治疗过程中，将针头固定在靶向PCa病变上。在第一阶段，PSI/BWH团队将专注于 确认SMT系统对局部冷冻消融治疗的潜在影响。临床前原型， SMT系统将在前列腺体模上进行开发和优化， 将在离体动物前列腺上测试放置。此外，它提供真实的- 时间针监测和多个治疗针的准确放置将在体内进行评估， 在MRI引导的局灶性冷冻消融术期间的大型动物模型。根据第一阶段的结果， 结论，一个强大的SMT系统，具有改善的性能，用于临床使用的各种焦点治疗 将提出在第二阶段中在人类患者上开发和验证模式。

Project Summary/Abstract Physical Sciences Inc. (PSI), in collaboration with the Department of Radiology at Brigham and Women's Hospital (BWH), proposes to develop an automated Smart Multi-grid-guidance Template (SMT) technology that will enable magnetic resonance imaging (MRI)-guided transperineal focal therapy improvement of prostate cancer (PCa). Focal therapy that targets localized PCa lesions is a growing therapeutic option for PCa patients with unifocal, low- and intermediate-risk cancer. Various energy therapy modalities, such as cryoablation, laser ablation, radiofrequency ablation, high-intensity focused ultrasound, have been clinically investigated with regards to improving post-treatment preservation of sexual and urinary function while focally treating PCa. Although these PCa focal therapy modalities have widely been utilized in conjunction with the imaging- guided approaches for precise localization of PCa lesions, accurate placement of the therapy needles within the PCa lesions remains a major challenging problem in improving the PCa therapy success rate. Therefore, there is a clinical need for a technology that can provide highly accurate placement of multiple therapy needles onto the targeted PCa lesions during focal therapy. During Phase I, PSI/BWH team will focus on the validation of the potential impact of the SMT system on focal cryoablation therapy. A preclinical prototype of the SMT system will be developed, optimized on a prostate phantom, and then its accuracy for needle placement will be tested ex vivo on excised animal prostate glands. Additionally, its capability to provide real- time needle monitoring and accurate placement of multiple therapy needles will be evaluated in vivo on a large animal model during MRI-guided focal cryoablation procedures. Based on the Phase I results and conclusions, a robust SMT system with improved performance for clinical use in various focal therapy modalities will be proposed to be developed and validated on human patients in Phase II.