3D SONOELASTOGRAPHY IMAGING FOR PROSTATE CANCER

描述（申请人提供）：前列腺癌是男性最常见的癌症，也是男性癌症死亡的第二大原因，目前通过筛查PSA和体检发现，并通过trus引导的前列腺活检确诊。目前的诊断灵敏度受到肿瘤可视化不良和采样不足的限制。我们的基本假设是超声弹性成像可以检测前列腺癌，否则在常规体内超声成像中表现正常。这一假设的一个推论是，三维超声弹性成像可以划定并帮助计算可疑肿瘤区域的体积。超声弹性成像由于更好的活检指导和更少的假阴性活检，可以早期诊断前列腺癌。三维肿瘤体积分析将为定制治疗提供量化和定位，包括近距离治疗中的肿瘤增强剂量。迄今为止，我们的进展导致了关于声弹性成像基本要素的新信息，包括混叠和模态模式，组织频率依赖性和可变光束模式；三维图像病理融合技术。我们在体内的工作也同样确定了需要控制的增益、频率、源波束模式和衰减的变量。我们下一阶段的研究将集中在以下三个目标上：

DESCRIPTION (provided by applicant): Prostate Cancer, the most prevalent male cancer and second leading cause of male cancer death, is currently detected by screening PSA and physical examination and confirmed with TRUS-guided prostate biopsy. Current diagnostic sensitivity is limited by poor visualization of tumor and inadequate sampling. Our fundamental hypothesis is that sonoelastography imaging can enable the detection of prostate cancer that otherwise appears normal in conventional in-vivo US imaging. A corollary of this hypothesis is that 3D sonoelastography can demarcate and help to calculate the volume of a suspected tumor region. Sonoelastic ultrasound imaging will enable earlier prostate cancer diagnosis due to better biopsy guidance and fewer false negative biopsies. Three-dimensional tumor volume analysis will provide quantification and localization for customized treatment, including tumor boost dose in brachytherapy. Our progress to date has led to new information regarding basic elements of sonoelastography including aliasing and modal patterns, tissue frequency dependence and variable beam patterns; and the techniques of 3D image pathology fusion. Our in-vivo work has similarly identified variables of gain, frequency, source beam patterns, and attenuation, which need to be controlled. Our next phase of research will focus on the following three aims: Aim 1: Develop the (currently unknown) theoretical and experimental characterization of the frequency dependent elastic properties of the normal prostate and of the prostate with benign and malignant conditions of high prevalence. (Year 1, with later extensions) Aim 2: Refine and advance our 3D Sonoelastography systems to increase the sensitivity, linearity, spatial resolution, and vibration frequency range so as to increase the detectability of cancer. (Year 1: 25 patients) Aim 3: Apply the results of aims 1 and 2 to evaluate the clinical utility of in-vivo prostate cancer detection by sonoelastography. (Years 2-4: 90 patients)