Grant: Collaborative Health Research Projects

Prostate cancer remains the most common cancer diagnosed in men in Canada, with about 25,000 new cases per year. Given the vagaries of early detection of prostate cancer (PCa) with the use of prostate specific antigen, there is an acute need to enhance detection and grading of this malignancy in order to improve its clinical management. High grade PCa must be diagnosed early and accurately to appropriately treat patients at higher risk of morbidity and mortality. Meanwhile, this has to be balanced against over-treatment of low grade PCa which can be minimized via active surveillance. The gold standard for PCa diagnosis and grading is Transrectal ultrasound (TRUS)-guided biopsy followed by pathology. TRUSguided biopsy is performed by taking eight to 12 tissue samples from the prostate using a standard protocol that is blind to individual patient anatomy or pathology and has a high rate of false negatives. Recent advancements in magnetic resonance imaging (MRI) have helped improve high grade PCa detection rate. Unfortunately, MRI alone is not able to accurately diagnose PCa. In addition, cancer foci identified in MR have to be accurately located during TRUS-guided biopsy. Currently, this requires either sophisticated mechanical platforms to guide the biopsy needles or, if performed by software, does not fully account for patient motion or organ deformation occurring during biopsy. We propose a turnkey technology we name RF Flashlight, where information from a time series of ultrasound RF signals is used along with MR information in order to improve the detection of high grade cancer for clinical intervention. We also design advanced ultrasound imaging methods to enable localization of cancer foci identified by MRI in freehand biopsy; our method compensates for patient or clinician motion. This technology has the potential to positively and rapidly impact the lives of all patients.