Advancement of Imaging Technologies for Improved, Early Diagnosis and Treatment of Prostate Cancer

Challenge
Prostate cancer has reached epidemic proportions, becoming the most common major cancer in the United States and the second most lethal cancer in men. Management of this disease must overcome numerous obstacles:

• Diagnostic technologies are not reliable in providing such critical information for successful treatment as the presence, location, extent and aggressiveness of prostate cancer. This leads to treatment failures in as many as 1 in 2 men, leading to recurrence and/or progression of prostate cancer.
• Methods to distinguish virulent prostate cancer that needs to be treated from non-aggressive cancer which requires only active monitoring are not available, leading to unnecessary treatment in up to 44 percent of men.
• Conventional treatment (i.e., radical surgery or radiation) frequently fails or is administered unnecessarily. This results in high costs and many complications, leaving about 50% of patients incontinent and/or impotent.

The answer for safe and cost-effective patient care: Advanced imagining technologies
The advancement of imaging instrumentation will enable:

• Early detection and noninvasive differentiation of benign from malignant disease;
• Assessment of size and spread of tumor, probability of progression, and response to treatment;
• More precise guidance of treatment to target and eradicate tumors while sparing normal tissues to reduce complications;
• More reliable approach for active monitoring of men who have non-aggressive prostate cancer and chose “watchful waiting”, and for patients who underwent treatment and
• More effective and less invasive cancer care at lower cost than current treatment.

Approach
AdMeTech designs, funds, and manages multidisciplinary research projects to advance image-guided, minimally invasive, precisely targeted diagnosis and treatment of prostate cancer. AdMeTech integrates the efforts of leading academic and industrial institutions into a comprehensive program to:

• Expedite development and testing of imaging instrumentation;
• Facilitate advancement of treatment tools and their integration with imaging instrumentation for online monitoring of clinical procedures;
• Expedite early evaluation of promising technologies to enable rapid transition to routine clinical use.

Selection of projects is based on scientific merit and potential to advance AdMeTech's overall objectives.

Impact
AdMeTech's priority program will advance image-guided diagnosis and treatment of prostate cancer to enable minimally invasive, cost-effective alternatives to current patient care (Figure 1). Advanced, integrated diagnostic and treatment tools will make it possible for many major medical and surgical procedures now conducted in hospitals and operating theaters to be replaced by interventions performed in outpatient clinics, with reducing discomfort, complications, and cost. Ultimately, these technologies will eliminate prostate cancer as a major socio-economic problem.

Figure 1: Three-Dimensional Display of Magnetic Resonance Imaging (MRI) detects early, small prostate cancer (red) before it has spread to surrounding organs. In addition to prostate cancer, the MRI clearly shows normal surrounding tissues:

• Normal Prostate Tissue (Green)
• Rectum (Magenta)
• Urinary Bladder and Tract (Yellow)
• Seminal Duct and Testicles (Blue)

This advanced MRI now makes it possible to provide precisely targeted guidance for treatment and removal of cancer while sparing normal tissues to reduce complications.

Photo Courtesy of Dr. Ron Kikinis, Harvard Medical School