|Clare M. Tempany, MD|
|Kemal Tuncali, MD|
|Fiona Fennessy, MD, PhD|
|Junichi Tokuda, PhD|
|Andriy Fedorov, PhD|
There are two complex issues that drive the clinical need to change current paradigms for prostate cancer (PCa): The inability to predict aggressiveness of a given cancer, which in turn leads to over treatment, and the increasing evidence that disease progression in men with seemingly low-risk PCa is due to inadequate biopsy sampling. Recent trends indicate that the treatment of patients with localized PCa is shifting more and more towards either active surveillance or focal therapy. Technical solutions to address these challenges, and their validation in clinic, are lacking. We are working to address these challenges by integrating innovative MR image acquisition and analysis with the MR targeted biopsy platform we developed in the previous cycle. We are developing a diagnostic biomedical imaging platform to detect, characterize and diagnose prostate cancer and will provide new opportunities to understand the aggressiveness and heterogeneity of prostate cancer and ultimately allow for development and testing of new predictive markers in focal therapy. Our projects are:
Platform for validating novel imaging biomarkers with molecular and routine pathology. We are developing methods of assessment of tumor heterogeneity by supplementing mpMRI with new hypoxia and multi b value MR imaging and add molecular profiling to the pathology options for core biopsy tissue, thus provide a unique platform for imaging, biopsy and both routine and molecular pathology. We will correlate genomic diversity with MR imaging parameters. We will propose novel motion compensation techniques combined with hypoxia imaging that will be applied jointly with the multi-b-value diffusion weighted imaging (DWI) for improved characterization of PCa. These novel-imaging approaches will be validated in biopsy and cryotherapy patient cohorts. (Contact: Clare M. Tempany, Fiona Fennessy)
Platform for focal cryoablation of PCa with accurate temperature mapping and motion compensation. Our goal is to develop and evaluate thermometry methods to monitor MR-guided focal cryoablation for localized prostate cancer, by internal ice ball thermometry using a “voxelwise thermal history” method. We will develop and test a new method for tracking the prostate gland motion, using active MR tracking coils embedded in a urethral warming catheter, investigate Ultrashort TE (UTE) MRI to monitor the internal thermal dosimetry within the ice-ball, and develop and evaluate software for voxel-wise thermal history tracking during all stages of the procedure. (Contact: Junichi Tokuda)
Informatics solution in support of targeted prostate biopsy and focal therapy for localized prostate cancer. This aim will have three tasks: 1) develop software tools to support structured PCa reporting and image registration for biopsy and focal therapy applications; 2) investigate and implement improved practices for structured data collection and provenance, prepare and disseminate curated validation datasets to facilitate validation of the role of mpMRI in cancer characterization and the evaluation of image registration accuracy/reliability; 3) investigate methods for non-rigid registration to enable recovery of prostate gland deformation for treatment response assessment and propose and apply methodologies for statistical assessment of the reliability of the registration tools. All three aims are interconnected, and leverage unique resources provided by the Center to enable development and validation of novel solutions, which will enable subsequent dissemination and application in other institutions, academic and community hospital settings. In addition to developing novel technologies, we will create platform for collecting validation imaging datasets annotated with the analysis results, molecular and pathology markers, which will be one of a kind resource for investigating the role of imaging and development of novel image analysis tools for PCa. In summary we will design, develop and test a comprehensive platform to provide a MR imaging biomarker for prostate cancer detection, characterization and provide techniques to supplement routine diagnostics with molecular profiling and generalizable image processing tools.(Contact: Andriy Fedorov)
Software and Documentation
3D Slicer, a comprehensive open source platform for medical image analysis, contains several modules that have been contributed by us for Image-Guided Prostate Interventions. These include:
These presentations have been selected as tutorials for readers interested in learning about the clinical science and technology of the Prostate Core.
Full Publication List
Peer-reviewed publications on our research in Image-Guided Prostate Interventions can be found in the NIH/NLM database of biomedical literature by clicking here.
In addition, abstracts presented at national and international meetings are available online here.