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Image Guided Therapy Prostate Group

Projects

The work in our group is funded by the NIH P41 EB015898 and R01 CA111288 grants, and includes the following projects.

National Center for Image-Guided Therapy

  1. To develop and evaluate image-guided prostate surgery. This involves the development and validation of image-enhanced laparoscopic robotic prostatectomy (LRP) procedures. We will test our hypothesis that MR imaging, followed by segmentation and post-processing using the 3D Slicer, can create patient-specific MR anatomical maps that are valuable to the surgeon performing LRP. We will test our image-processing method to segment the prostate boundary, the dominant MR tumor, the neurovascular bundles (NVB), and the external urethral sphincter at the apex. We will generate 3D models of all these structures that will be provided to the surgeon in the operating room. We will determine the intraoperative value of this patient-specific, anatomical-topographical 3D map in the context of LRP. The ultimate advantage will be gained by integrating the 3D display with registered real-time intraoperative imaging.
  2. To improve and optimize MR-guided radiation therapy. We develop and test methods to improve and optimize radiation treatment of prostate cancer. MR guidance, using 3T MR imaging, tissue characterization, and image registration techniques should improve the planning and monitoring of the radiation dose to sub-zonal gland regions and peri-prostatic tissues. We also develop methods to extract and study the tissue changes seen on MR, induced by radiation, over time. It allows for the characterization of changes to normal and cancerous tissue using quantitative MR parameters obtained before, during, and after therapy. Correlation of these changes with total radiation dose delivered and the resultant clinical outcomes provide insight into the effectiveness of radiation therapy.
  3. To optimize MR image guided prostate biopsy. We develop comprehensive methods to identify focal prostate lesions/targets using advanced 3T MR techniques; we introduce enabling technologies, such as robotic-assisted needle guidance and placement. We perform biopsy sampling with direct real-time MR in the magnet using the enabling technologies provided in part by our DBP project. We expand our approach through the use of MR/US image registration to allow MR-enhanced transrectal ultrasound (TRUS)-guided biopsy procedures. The advanced 3T MR and multi-parametric imaging protocol allow target identification and provide “added value” to improve accuracy in sampling the prostate. In the longer term, our goal is to use this approach to enhance focal therapy to provide an image-based lesion/target validation technique for MR-guided prostate focused ultrasound surgery (MRgFUS).

Enabling Technologies for Prostate Interventions

  1. To develop an MR/US imaging platform. We are using robotic assistance for precise needle placement in two interventions: transperineal biopsy-guided using either a combination of MR or TRUS and MR-guided brachytherapy with an aim to better identify, target, and treat cancer with fewer side effects. Our approach has the capabilities for dynamic, precise, and quantitative evaluation of biopsy needle or needle and source (seed) position and target dosimetry during the course of a brachytherapy procedure. We believe these capabilities can improve overall biopsy yield and/or quality of therapy (improved dosage, reduced morbidity and toxicity). In our process, cancer treatment will benefit from biopsy-confirmed tumor locations that allow for dose escalation and modification of a treatment plan based upon histological mapping of cancer locations.
  2. To develop an MR/US registration algorithms and MR/US tissue classification. We develop an MR/US registration method for alignment of magnetic resonance (MR) and 3D transrectal ultrasound (TRUS) images of the prostate gland. With the help of an accurate MR-US registration method the tumor can also be targeted under transrectal US guidance. We extend our approaches beyond MR to the more ubiquitous modality of US.
  3. To establish a platform for precise needle placement. We develop a device to efficiently guide a needle into image-defined lesions to allow for image-guided molecular diagnostics. Ultimately any imaging study, traditional or molecular (e.g PET with C- 11 tracers), can be registered with the techniques we propose here and sampled using our robotic approach.