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Univ. Tests Ultrasound to Diagnose Prostate Cancer

Massimo Mischi (Eindhoven University of Technology)

Massimo Mischi (Eindhoven University of Technology)

Researchers at Eindhoven University of Technology (TU/e) in the Netherlands, with Academic Medical Center Amsterdam, have developed and conducted early tests on an imaging technology that can accurately identify prostate cancer tumors. The technology is based on ultrasound, and also has the potential to assess how aggressive tumors are. A number of ultrasound companies are also involved in the research.

More than 217,000 cases of prostate cancer and 32,000 deaths have been reported this year in the U.S. alone. But diagnosis is still rudimentary. After determining the PSA (prostate-specific antigen) level in the blood, biopsies are performed to see if there are tumors in the prostate. However the PSA level is not a very good indicator, in that two-thirds of all biopsies turn out to have been unnecessary.

The researchers, led by TU/e engineering professor Massimo Mischi (pictured right), say biopsies also have disadvantages. For example prostate biopsies are not targeted, but instead tissue is sampled randomly using 6 to 12 needles. The chance is high that the needles will miss a tumor, causing a false negative result. In around one-third of cases with negative biopsies, tumors are later found to be present. Moreover, doctors often operate after a positive biopsy, but find a tumor so small that it would have been better not to operate.

The new technology uses an injection of microbubbles of a contrast agent with no reported side-effects. The imaging response of the tiny bubbles to ultrasound is different from that of human tissue or blood. This makes the bubbles traceable from the outside, right into the smallest blood vessels.

The pattern of blood vessels in tumors is different from that in healthy tissue, and clinicians can recognize this pattern from advanced analysis of the bubble concentrations. And because tumors need blood — and thus new blood vessels — to grow, the researchers expect to be able to see how aggressive the cancer is from the pattern of the blood vessels.

Mischi’s team has tested the technology on four patients from whom the affected prostate was later removed. The location and size of the tumors turned out to match accurately with the images produced using the new technology. Mischi presented these first results at the Advances in Contrast Ultrasound conference in September.

Next year the research team will carry out a pilot with biopsies guided by images made using the new technology, which should help better target the biopsies. In a later phase the ultrasound technology will be used to decide whether biopsies are required, which should reduce the number of biopsies carried out. The researchers believe the technology can lead to better and more appropriate treatment, and to cost savings in health care.

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