Early stage prostate cancer is very common. However, current methods for diagnosis and treatment miss significant cancers in some men, and over-treat others with therapies that are expensive, lengthy, and have significant risks and morbidity. MRI is emerging as a promising method for revealing clinically significant prostate cancer, raising the provocative possibility of minimally invasive, focal, MR-guided therapy that would be more selective, safer, and quicker than current whole-gland radiotherapy and surgical procedures.
The aims of this project are to develop minimally invasive biopsy and treatment methods for prostate cancer: 1. Design, testing and final fabrication of a new system for real-time, interactive, trans-perineal minimally invasive access to the prostate while the patient is in a 3T MRI scanner, using MRI-compatible robotic technology for passive remote needle manipulation, embedded miniature fiber optics and MR-tracking to sense needle shape and tip position, and integration with real-time MR scanning for automated visualization. 2. Clinical Trial of MRI-guided Trans-perineal biopsy of prostate targets, compared with subsequent TRUS-guided standard systematic 12-core biopsies (the gold standard) in 12 men with abnormal PSA levels. 3. Development and in vivo testing of MRI-compatible needle tip micro-robotics to dramatically increase physician control, including needle tip force sensing and rendering, and photonic needle tip steering. 4. Investigation of 3T methods for guiding and monitoring cryosurgery, including ultra-short TE 3D MR thermal mapping in frozen tissue, and advanced diffusion and MT-weighted images of acute cryo-injury. When complete, these technologies will be poised for future clinical trials assessing the utility of minimally invasive MRI-guided focal cryosurgery for treating early stage prostate cancer
Achieving the aims of this project will provide a simple, powerful, intuitive, elegant method for biopsy and cryoablation of focal prostate targets, using MRI guidance, that is ready for clinical trials. Essential biopsy system components will have been tested in humans. Second generation robotic sensing and control mechanisms, and MRI imaging of tissue freezing effects will have been validated at 3T and tested in vivo.
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