Evaluation of MRI-controlled transurethral ultrasound therapy for the treatment o

描述(申请人提供)：与前几十年相比，现代前列腺癌筛查方法导致发现低风险到中等风险疾病的男性比例增加，平均发现年龄下降。不幸的是，目前的检测方法主要基于活检，采样不到前列腺体积的1%，提供的关于腺体内癌症的确切位置和大小的信息很少。因此，局限性前列腺癌的治疗针对整个前列腺癌，这在消除疾病方面是有效的，但会给许多男性留下性、尿路和肠道功能的长期并发症。近年来，MRI的诊断成像已经发展到可以看到前列腺内肿瘤的位置和大小的地步。此外，在影像引导下治疗前列腺癌的新方法的开发为更精确的治疗提供了希望，并有可能减少并发症。在这项提案中，将评估MRI控制的经尿道超声治疗局限性前列腺癌的能力。这项技术涉及(通过高温)使用从插入尿路的装置发出的高强度超声波能量来治疗前列腺癌中的特定区域。这种治疗的独特之处在于，它完全是在磁共振成像仪中进行的，它可以提供加热过程中前列腺内部温度的非侵入性图像。这种加热和温度监测的集成使得能够非常精确地治疗腺体内的组织。这项研究的总体目标是将局限性前列腺癌的治疗转变为一种微创的门诊手术，与目前的治疗方法一样有效，但相关并发症要低得多。这项建议的目的将是评估MRI控制的经尿道超声治疗对诊断MRI发现的局限性前列腺癌的有效治疗能力。这项研究将在计划进行手术的男性身上进行，因此可以在切除后对他们的前列腺体进行研究，以评估治疗的效果。这项研究设计是必要的，以确保对这项新技术的安全评估，这项技术最近由我们的团队首次在人类身上进行了测试。如果成功，这项拟议的研究将证明这项技术能够有效地治疗前列腺癌，为未来将这项技术与现有的局部前列腺癌治疗方法进行比较铺平道路。

DESCRIPTION (provided by applicant): Contemporary screening methods for prostate cancer have resulted in an increase in the proportion of men detected with low- to intermediate-risk disease, and a decrease in the average age of detection, compared to previous decades. Unfortunately, current detection methods largely based on biopsy, sample less than 1% of the volume of the prostate and provide little information about the exact location and size of the cancer within the gland. As a result, treatments for localized prostate cancer target the entire prostate gland, which is effective at eliminating disease, but leaves many men with long-term complications to sexual, urinary, and bowel function. Diagnostic imaging with MRI has advanced in recent years to the point where it is possible to see the location and size of tumours within the prostate gland. In addition, the development of new ways to treat prostate cancer under image-guidance offer the promise of more precise treatments with the potential for reduced complications. In this proposal, the ability of MRI-controlled transurethral ultrasound therapy to treat localized prostate cancer will be evaluated. This technology involves treatment (through high temperatures) of specified regions in the prostate gland using high-intensity ultrasound energy delivered from a device inserted into the urethra. The unique feature of this treatment is that it is performed entirely within a magnetic resonance imager, which provides non-invasive images of the temperature within the prostate during heating. This integration of heating and temperature monitoring enables very precise treatment of tissue within the gland. The overall goal of this research is to transform the treatment of localized prostate cancer into a minimally- invasive, outpatient procedure that is as effective as current treatments, but has much lower complications associated with it. The goal of this proposal will be to evaluate the ability of MRI-controlled transurethral ultrasound therapy to effectively treat localized prostate cancer detected with diagnostic MRI. This study will be performed in men scheduled for surgery, so their prostate glands can be studied after removal to evaluate the effectiveness of the treatment. This study design is necessary to ensure a safe evaluation of this novel technology which was tested recently for the first time in humans by our group. If successful, the proposed study will demonstrate the ability of this technology to be used to treat prostate cancer effectively, paving the way for future studies comparing this technology with existing treatments for localized prostate cancer.