This year prostate cancer will afflict 189,000 new patients in the United States[l]. In many, the significant burden of tumor will be localized within a portion of the gland. New MRI techniques, including MR Spectroscopy and dynamic MRI, are becoming increasingly able to define the extent of disease in these patients. However, current therapies for prostate cancer are either systemic, or treat the entire gland. We believe advances in MRI guidance will enable minimally invasive, super-selective, targeted cryosurgery as an outpatient treatment for localized disease with minimal risk and morbidity. Potential advantages of MRI guidance over sonography are: Monitoring the entire 3D iceball boundary. Mapping tissue temperature inside the iceball non-invasively. The key to successful cryosurgery is achieving a sufficiently low freezing temperature. Determining the extent and lethality of the cryo-lesion. This would enable re-freezing of any under-treated areas during the same procedure. We will pursue two specific aims to develop MRI guidance technology for prostate cryosurgery: 1 . Calibrate MRI-Thermometry during cryosurgery of prostate cancer: Refine MRI thermometry for human use. ? Calibrate MRI-thermometry in 25 prostate cancer patients. We will also assess the efficacy, and morbidity of MRI-guided cryoablation 2. Develop advanced MRI to assess acute and chronic cryo-induced injury: Refine perfusion- and diffusion-weighted MRI for imaging immediately after cryosurgery Evaluate post-cryo perfusion- and diffusion-MRI for depicting acute ischemia and cellular injury in animals and tumor necrosis in humans. Evaluate post-cryo perfusion- and diffusion-weighted MRI for predicting ultimate volume of lethal cryoablation in an animal survival model. Completing these aims will pave the way for future clinical trials that definitively measure the efficacy of MRI-guided selective cryoablation compared to other treatments for localized prostate cancer.
| Ghanouni, Pejman; Gill, Harcharan; Kaye, Elena et al. (2011) MR imaging-guided cryoablation for the treatment of benign prostatic hyperplasia. J Vasc Interv Radiol 22:1427-30 |
| Lu, Aiming; Daniel, Bruce L; Kaye, Elena et al. (2011) MRI of frozen tissue demonstrates a phase shift. Magn Reson Med 66:1582-9 |
| Kaye, Elena A; Josan, Sonal; Lu, Aiming et al. (2010) Consistency of signal intensity and T2* in frozen ex vivo heart muscle, kidney, and liver tissue. J Magn Reson Imaging 31:719-24 |
| Park, Yong-Lae; Elayaperumal, Santhi; Daniel, Bruce et al. (2010) Real-Time Estimation of 3-D Needle Shape and Deflection for MRI-Guided Interventions. IEEE ASME Trans Mechatron 15:906-915 |
| Josan, Sonal; Bouley, Donna M; van den Bosch, Maurice et al. (2009) MRI-guided cryoablation: In vivo assessment of focal canine prostate cryolesions. J Magn Reson Imaging 30:169-76 |
| Josan, Sonal; Kaye, Elena; Pauly, John M et al. (2009) Improved half RF slice selectivity in the presence of eddy currents with out-of-slice saturation. Magn Reson Med 61:1090-5 |
| Josan, Sonal; Pauly, John M; Daniel, Bruce L et al. (2009) Double half RF pulses for reduced sensitivity to eddy currents in UTE imaging. Magn Reson Med 61:1083-9 |
| Lu, Aiming; Daniel, Bruce L; Pauly, John M et al. (2008) Improved slice selection for R2* mapping during cryoablation with eddy current compensation. J Magn Reson Imaging 28:190-8 |
| Chen, Jing; Daniel, Bruce L; Diederich, Chris J et al. (2008) Monitoring prostate thermal therapy with diffusion-weighted MRI. Magn Reson Med 59:1365-72 |
| Wansapura, Janaka P; Daniel, Bruce L; Vigen, Karl K et al. (2005) In vivo MR thermometry of frozen tissue using R2* and signal intensity. Acad Radiol 12:1080-4 |
