Quantitiative MRI of prostate cancer as a biomarker and guide for treatment

描述（由申请人提供）：前列腺癌是美国男性最常见的恶性肿瘤，也是癌症相关死亡的第三大原因。由于“婴儿潮一代”的老龄化，患有局限性前列腺癌的男性数量将会增加，对精确的非侵入性成像工具的需求也会增加。磁共振（MR）成像能够提供精确的肿瘤解剖图谱。较新的MR技术允许对前列腺组织进行药代动力学（PK）评估。磁共振成像的这种功能方面可以极大地有助于肿瘤检测和定位的准确性，并可能作为局灶性消融治疗的指导，或在新辅助治疗中对前列腺组织微循环的功能方面进行无创评估。因此，本研究的目的是确定优化的MR分析工具和算法是否可以用作靶向治疗的生物标志物指南，并作为前列腺癌疾病复发的替代品。我们计划通过四个具体目标来实现我们的目标：

DESCRIPTION (provided by applicant): Prostate cancer is the most common malignancy and third leading cause of cancer-related mortality in American men. Due to the ageing "baby boomers", the number of men with localized prostate cancer will increase, as will the need for an accurate non-invasive imaging tool. Magnetic Resonance (MR) imaging has the ability to deliver precise anatomical mapping of tumor. Newer MR techniques allow for pharmacokinetic (PK) evaluation of prostate tissue. This functional aspect of MR imaging could contribute greatly to the accuracy of tumor detection and localization, and potentially serve as a guide for focal ablative therapy, or non-invasively assess functional aspects of prostate tissue microcirculation in response to neoadjuvant treatment. The objective of this study is therefore to determine if optimized MR analysis tools and algorithms can be used as a biomarker guide for targeted therapy and as a surrogate for disease recurrence in prostate cancer. We plan to achieve our objective through 4 specific aims: 1. To develop and implement imaging methodology and analysis tools for automated, robust quantitative assessment of prostate tumor volumetry and assessment of the functional properties (vascularity and permeability) using quantitative multi-parametric MR imaging (mpMRI). 2. To clinically validate the prostate mpMRI quantitative analysis tools described in Aim 1. We will perform a multivariate analysis of the results of the analyses tools, and patient-specific parameter maps for tumor localization (a summary statistic display) will be obtained and correlated with pathology at prostatectomy. 3. To determine the clinical use of the analysis tools as a biomarker guide for targeted therapy and as a surrogate for disease recurrence in low-risk prostate cancer patients. We will obtain mpMRI maps, detailing the index lesion and its margins, and register them with focal ablative therapy treatment planning images. Follow up mpMRI maps will be registered the pre-treatment maps to detect changes, and will be correlated with PSA to determine the "expected" treatment margin and untreated prostate mpMRI characteristics. 4. To determine the clinical use of the analysis tools in evaluating tumor response to treatment with neoadjuvant androgen deprivation therapy (ADT) in patients with high-risk prostate cancer. We will assess the changes in mpMRI maps after 12 weeks of ADT to determine if prostate tumor vascular permeability changes may be a suitable predictor of pathological response, by correlation with prostatectomy specimens.