Improved Prostate Cancer Detection Using Combined Ultrasound and Photoacoustic Im

描述（由申请人提供）：前列腺癌是唯一通过非病变定向系统活检诊断的恶性肿瘤。今年，美国将进行近80万例经直肠超声引导（TRUS）活检手术，诊断出20多万例前列腺癌。尽管进行了大量的活组织检查，但目前的前列腺活组织检查方案遗漏了大约15-25%的癌症。准确的前列腺成像具有可靠的成像特征，可显著减少不必要的活检，提高诊断准确性，并可用于监测主动监测患者的肿瘤大小或特征。光声成像（PAI）是一种新兴的光学（非电离）成像技术，它可以提供具有高超声空间和时间分辨率的高光学对比度图像。与利用光声效应（光转化为超声波）的现有光学成像方式相比，PAI能够产生具有更高空间分辨率的体内三维图像（在组织穿透深度约5厘米时高达500米）。内源性光声信号主要由血红蛋白产生，这使得该技术非常适合成像血管化组织，如肿瘤。为了提供临床级设备，我们结合了我们最近改进的光声检测技术，利用电容式微机械超声换能器（CMUT）阵列进行高灵敏度的深部组织成像，并结合了TRUS平台。本提案的目的是测试经直肠超声和光声联合成像（TRUSPA）引导前列腺活检。为了实现这一目标，TRUSPA设备将首先使用前列腺模拟幻影进行测试和优化，并通过手术切除已知前列腺肿瘤的整个前列腺。在设备验证之后，我们将在接受前列腺癌活检的患者中进行TRUSPA仪器的试点测试，这些患者有或没有FDA批准的注射造影剂吲哚菁绿（ICG）。我们假设，与传统的超声引导活检相比，TRUSPA成像设备具有从初始测试中获得的明确的图像指标，可以准确地识别潜在的活检病变，并且ICG染料的使用将进一步增强这种效果。

DESCRIPTION (provided by applicant): Prostate cancer is the only malignancy diagnosed by non-lesion directed systematic biopsy. Nearly 800,000 transrectal ultrasound guided (TRUS) biopsy procedures will be performed in the United States this year resulting in the diagnosis of over 200,000 cases of prostate cancer. Despite the large number of biopsies performed, current prostate biopsy schemes miss approximately 15-25% of incident cancers. Accurate prostate imaging with reliable imaging characteristics could significantly reduce unnecessary biopsies, improve diagnostic accuracy and be used to monitor tumor size or characteristics for patients on active surveillance. Photoacoustic imaging (PAI) is an emerging optical (non-ionizing) imaging technique that can provide high optical contrast images with the high spatial and temporal resolution of ultrasound. PAI is capable of producing an in-vivo three-dimensional image with higher spatial resolution (up to 500 ¿m at tissue penetration depth of about 5 cm) than existing optical imaging modalities using photoacoustic effect (transformation of light to ultrasound). Endogenous photoacoustic signal is primarily produced from hemoglobin, making the technique well suited for imaging vascularized tissue, such as tumors. In order to provide a clinical grade device we have combined our recently improved photoacoustic detection technology, utilizing capacitive micromachined ultrasound transducer (CMUT) arrays for highly sensitive deep tissue imaging, with a TRUS platform. The goal of this proposal is to test combined transrectal ultrasound and photoacoustic (TRUSPA) imaging for guided prostate biopsy. To achieve this, the TRUSPA device will first be tested and optimized using prostate mimicking phantoms and surgically removed whole prostates with known prostate tumors. Following device validation, we will conduct a pilot test of the TRUSPA instrument in patients undergoing prostate cancer biopsy with and without the FDA approved injectable contrast agent indocyanine green (ICG). We hypothesize that the TRUSPA imaging device, with well-defined image metrics derived from initial testing, will accurately identify potential lesions for biopsy compared to traditional ultrasound guided biopsy and that the use of ICG dye will further enhance this effect.