超声/光声分子影像融合引导前列腺癌早期精准介入诊疗的基础研究

Prostate cancer (PCa), which is difficult in early diagnosis and therapy, is one of the most threatening diseases for male. To achieve the aim of “early detection”, “accurate position” and “precise operation” during PCa managements is of urgent expected. In this project, molecular photoacoustic imaging-transrectal ultrasound (PAI/TRUS) image fusion will be used to realize the early accurate diagnosis and precise interventional therapy of PCa from phantom to animal model on the basic of the 3D visualization and real-time image aided navigation technologies. Firstly, we will synthesis novel organic dye encapsulating nanoparticles, which are further decorated by anti-prostate stem cell antigen (PSCA) monoclonal antibody, as a PAI probe with high sensitivity and targeting ability. With the aid of accurate detection of the early lesion by PAI/TRUS image fusion application, prostatic biopsy will be carried out to confirm PCa diagnosis. Secondly, preoperative planning of puncture path and platform of thermal ablation will be realized using 3D visualization technology. Then the real-time image aided navigation will be employed intraoperatively to ensure the veracity of the procedures of puncture and ablation. Finally, therapeutic effects will also be evaluated using 3D image fusion technology immediately after the thermal ablation. The novel PAI/TRUS image fusion technology exhibits a great potential to promote the precise diagnosis and therapy in PCa.

前列腺癌是男性最常见的恶性肿瘤之一，其早期诊断及治疗均困难。本项目围绕如何满足对前列腺癌 “看得早、定得准、治得准”的临床迫切需求，采用高敏感及特异性的光声分子成像前沿技术与实时、便利的经直肠超声（TRUS）融合，结合三维可视化及实时导航技术，从仿体模型到动物模型多层次、多方面研究前列腺癌早期精准介入诊疗。首先制备以新型有机材料为核心的前列腺癌靶向分子探针，通过光声分子成像与TRUS融合成像早期发现并精准定位早期癌病灶，引导靶向穿刺活检，明确诊断；然后在光声分子成像导航基础上，采用三维可视化技术规划穿刺路径及布针计划，磁定位实时导航引导准确实施消融计划，精准靶向毁损癌病灶，减少对周围组织的损伤；术中采用三维融合成像即时精准评估疗效，指导及时再治疗，确保完全消融病灶。实现早期精准诊断与治疗一体化，达到高敏感性、高效性、高精准及超微创目的。为解决前列腺癌早期诊断及治疗难题提供新方法、新思路。

本项目就前列腺癌临床诊断与治疗均存在困难，提出超声/光声分子影像及融合引导技术，研究如何满足前列腺癌“看得早、定得准、治得准”的临床需求。项目研发了系列多模态分子探针，对肿瘤进行分子影像成像诊断和精确定位；研发了系列光声/超声双模态成像系统，并通过创新的经尿道导入激光的设计解决光声在前列腺中成像深度不足的难题；通过多模态的三维图像可视化技术实现肿瘤的精确分割和术前消融计划；以图像融合技术实现术中穿刺引导和精准术后疗效评估。通过上述研究取得的系列论文和专利成果，本项目为前列腺癌早期精确诊断、术前精确定位和术中精准治疗提供了新方法和思路；同时成为超声/光声分子影像及图像融合精准引导肿瘤介入治疗向临床转化的重要依据。