Magnetic resonance-guided adaptive ultrasound therapy for localized prostate cancer
The widespread use of prostate-specific antigen screening and biopsy to detect prostate cancer has resulted in an increasing number of men being diagnosed with low-grade localized prostate cancer. This presents a dilemma for both patients and clinicians owing to the significant complications associated with conventional therapies. A minimally invasive therapy for localized prostate cancer that is capable of treating targeted volumes within the gland could be an important option for this growing population of men.
We are developing magnetic resonance (MR)-guided transurethral ultrasound therapy, in which a rotating applicator delivers high-intensity ultrasound energy to the prostate to generate a targeted region of thermal damage in the gland. Magnetic resonance imaging is used to measure the spatial temperature distribution in the prostate and surrounding tissues noninvasively during treatment. Accurate measurement of the temperature distribution during energy delivery can be used to produce a precisely shaped heating pattern in the prostate gland.
We have built a unique system for MR-guided transurethral prostate thermal therapy that incorporates real-time active temperature feedback to generate precise volumes of tissue coagulation. In addition we have developed MR-compatible transurethral ultrasound heating applicators. The capability to perform targeted heating in the prostate gland has been evaluated numerically using realistic patient geometries, and experimentally in a tissue-mimicking gel material and in a canine model. We are developing a system for clinical evaluation in patients.
Selected Publications:
- Siddiqui K, Chopra R, Vedula S, Sugar L, Haider M, Boyes A, Musquera M, Bronskill M, Klotz L., "MRI-guided Transurethral Ultrasound Therapy of the Prostate Gland Using Real-time Thermal Mapping: Initial Studies," Urology. 2010 Dec;76(6):1506-11. Epub 2010 Aug 14.
