Identification of treatment field of focal therapy for prostate cancer using MRI and biopsy

2018 Fiscal Year Final Research Report

• Project/Area Number: 15K10578
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Urology
• Research Institution: Tokyo Medical and Dental University
• Principal Investigator: MATSUOKA YOH 東京医科歯科大学, 医学部附属病院, 講師 (90401380)
• Co-Investigator(Kenkyū-buntansha): 藤井 靖久 東京医科歯科大学, 大学院医歯学総合研究科, 教授 (70282754)
• Project Period (FY): 2015-04-01 – 2019-03-31
• Keywords: 前立腺癌 / MRI / 生検 / focal therapy

Outline of Final Research Achievements

The aim of our study is to identify appropriate candidates of focal therapy for prostate cancer and to establish how to design treatment field using multiparametric MRI and targeted/systematic biopsy. Firstly, we investigated the diagnostic performance of MRI and biopsy for clinically significant cancer and extraprostatic extension. The current MRI reporting and data system seemed to be useful to assess the eligibility for focal therapy because of its higher sensitivity for extraprostatic extension than previous system. Secondly, in a simulation study using prostatic phantoms, MRI/ultrasound image-fusion guidance enabled more accurate targeted sampling than transrectal ultrasound guidance. Clinical analysis demonstrated that treatment margin is needed in the treatment field planning of legion-targeted focal therapy.

Free Research Field

前立腺癌

Academic Significance and Societal Importance of the Research Achievements

高齢社会において前立腺癌の過剰治療削減は課題の一つである。近年の診断技術の進歩により、前立腺癌の低侵襲治療の開発が期待されている。病巣を選択的に治療するfocal therapyでは制癌効果と臓器/機能温存の両立を図るが、治療域縮小に伴う過少治療リスクに対して正確な病巣局在評価と治療域設定が必要である。本研究では、MRIおよび融合画像ガイド下生検の診断精度を明らかとし、その診断能に基づくfocal therapy治療域設定について解析を行った。focal therapyの治療計画基準を定めることで本治療の普及に貢献することが期待される。