New Image-Based Techniques for Prostate Biopsy and Treatment

The PI strives to become a successful researcher and trainer who can advance the field of image-based medical interventions for treatment and diagnosis of prostate cancer. To achieve this goal, the PI needs a supportive environment where he can focus on research goals. The environment of research excellence in the University of British Columbia, BC Cancer Agency, and Vancouver General Hospital, if complemented by the financial support provided through the Prostate Cancer Training Award, will provide the PI with the opportunity to implement the research ideas put forward in this proposal and develop new image-based techniques for prostate cancer care. The mentorship of Professor Tim Salcudean, Canada Research Chair, and the collaboration of the visionary Dr. Larry Goldenberg will be the key elements of the training plan.

Proposed Research: Prostate cancer is the most prevalent type of cancer among men and affected 186,320 American men in 2008 with a death toll of 28,660. The diagnosis and treatment of prostate cancer are both challenging problems. For diagnosis, the accepted method is biopsy under the guidance of transrectal ultrasound. However, as a result of the multi-focal nature of the disease and the variability of the appearance of prostate tumors on ultrasound B-mode images, the sensitivity of the biopsy procedure is as low as 50%. Common treatment options include low-dose brachytherapy (implanting the prostate with small radioactive seeds) and radical prostatectomy (the surgical removal of the prostate). While current treatment options are quite successful at controlling the disease, they often lead to complications, including incontinence and impotence. Treatment options that will reduce the rate of complications are currently being sought by many groups worldwide and include localized radiation treatment and high-intensity focused ultrasound. In virtually all diagnosis and treatment interventions related to the prostate, new imaging tools that can combine accurate visualization of the prostate region and the cancerous tumors could have an enormous impact.

The primary objectives of this research are: (1) To enhance the sensitivity of the TRUS-based biopsy procedure and reduce the complications of the prostatectomy surgery. (2) Ultimately, to provide a real-time in-field determination of prostate tumor location, extension, and proximity to critical structures such as nerves, bladder, or rectum for the surgeon. Novel techniques recently proposed by the PI and his academic mentor will be utilized for this purpose. For validation purposes, clinical data collection will be performed. The accuracy of cancer detection and boundary visualization in prostate based on these novel approaches will be compared with current clinical gold standards.

Patient Outcomes: Different groups of patients will benefit from the outcome: The improvement to biopsy process will benefit the general public by enhancing the accuracy of screening for prostate cancer. Patients who undergo prostatectomy will benefit from optimized plans that ensure that sensitive organs are spared during the removal of the prostate. Patients who undergo brachytherapy (treatment by implanting radioactive seeds) will also benefit from more accurate visualization of the prostate boundaries, and determination of cancerous areas, during the operation.

The clinical approvals and data collection protocols are prepared for this study. It is expected that patient-related outcomes will become available in two years.