Over the last three decades the number of men diagnosed with prostate cancer has increased 85% as a result of new screening and diagnostic tools. However, a significant number of these newly diagnosed men are harboring clinically insignificant disease, which means that they are not likely to die from prostate cancer. A difficul decision facing urologists daily is determining whether a man with some degree of prostate cancer needs to be treated or not. Currently, men who have elevated PSA levels or abnormal digital rectal examinations are biopsied to confirm presence of prostate cancer. Unfortunately, typical biopsy protocols sample less than 1% of the entire prostate. As a result, regions of cancer are often entirely missed by biopsy and the small volumes of cancer sampled in other cases do not always provide an accurate assessment of the extent and aggressiveness of the disease. We propose to develop a commercial prototype of a sensor-equipped biopsy needle capable of sensing a larger volume of the prostate while still retaining the ability to distinguish between cancer and normal prostate to improve patient care. Specifically, we have developed a research-based biopsy needle that incorporates a sensor capable of measuring the electrical properties of prostate into a standard clinical biopsy needle. We have previously shown that the electrical properties of tissue are sensitive to a tissue's cellular arrangement and can be used to distinguish between cancer and benign prostate. Based on these findings and the development of a research-based prototype, we aim to design, construct and evaluate a commercially viable prototype of this device. We will evaluate the probe in terms of the tissue volume it senses and conduct a small pre-clinical trial to evaluate the probes utility. The pre- clinical phase of this investigation will consist of obtaining fresh prostates from 15 men following radical prostatectomy. We will use the designed probe to collect tissue samples and record electrical properties from each excised prostate following biopsy protocols typically used in the clinic. The potential clinical applications of this novel probe include use in an everyday clinical setting to provide urologists additional information they can use for treatment planning. Also, because these electrical properties can be displayed to the urologist in real-time it will be possible for them to obtain multiple biopsies from areas suspicious of cancer based on the electrical property signatures recorded. The sensing mechanism used in this novel probe is based on injecting small electrical currents that are imperceptible and well-below FDA-approved current levels. Further, the device does not change appreciably the construction and implementation of a standard biopsy device. As a result, no foreseeable additional risks associated with clinical use of this device are expected. Finally, since we are augmenting a clinical standard tool (a biopsy needle) we expect that by the end of this Phase I program we will be in a position to use this new device in an in vivo clinical trial and we realistically envision seeing this product in clinicians hands and benefiting patients in as little as 5 years.
Current clinical practices using transrectal ultrasound (TRUS) imaging to guide prostate biopsy unfortunately miss up to a third of all cancers and do not accurately identify the clinical significance of the disease. The tissue-structure dependent electrical properties of prostate are significantly different in cancer and normal tissue and provide levels of contrast that far exceed those of TRUS. We have developed a research-based prototype of an electrical property sensing biopsy needle that is able to provide in real-time a measure of the pathological state of tissue during a biopsy procedure;we aim to take the significant step of translating it to the clinic by developing a more accurate commercial prototype of this device.