Research: 2017 – Kingston-Quinte

Project Title:
Real time MRI fused to cone beam CT guided biopsies of the prostate: The safety and feasibility of a novel method of prostate biopsy.
Investigators:

Dr. Jason Izard, Department of Urology, Kingston General Hospital
Dr. Alexandre Menard, Department of Diagnostic Imaging, Kingston General Hospital

Lead Investigator Bio:

Dr Jason Izard completed his surgical residency in Urology at Queen’s University in 2011. He then completed a 2-year clinical and research fellowship in Urologic Oncology at the University of Washington in Seattle while concurrently completing a Master’s of Public Health with a specialization in Health Services. In 2013, he was hired back at Queen’s University with appointments to both the Departments of Urology and Oncology and an adjunct research appointment to the Division of Cancer Care and Epidemiology at the Queen’s Cancer Research Institute. His research interests are in Epidemiology, Health Services and Patient Centered Outcomes Research. As well, he is an active participant in the clinical trials housed through the Centre for Applied Urologic Research at Queen’s.

 

Dr. Alexandre Menard has been practicing vascular and interventional radiology at Kingston General Hospital for 9 years. He has completed a vascular and interventional radiology fellowship from St Michael’s Hospital at the University of Toronto. He is the undergraduate lead for diagnostic imaging at Queen’s University and co-chairs the national undergraduate diagnostic imaging education committee. He trains physicians nationally in the use of Philips XperGuide cone-beam CT guided procedures. His research interest are centered on cone-beam CT guided procedures and creation of image based anatomic flow models using 3d printing methods.

Project Abstract:
Prostate cancer is the most common cancer diagnosed in Canadian men. The standard method used to detect prostate cancer involves an ultrasound probe being inserted into the rectum and needle biopsies piercing the rectal wall to take tissue samples from the prostate. This procedure is uncomfortable, has significant risks of infection and occasionally does not accurately detect prostate cancer. The purpose of this study is to investigate a novel method of prostate biopsy using a state of the art computerized guidance system. Cancer within the prostate is not accurately detected by CT. Prostate cancer can be accurately detected by MRI. However, the metal components used to perform biopsies cannot be placed in an MRI machine. Our novel method of prostate biopsy involves using a new computerized technology that permits a lesion detected on MRI to be projected by a computer into 3 dimensions on a patient’s CT scan. A CT guided biopsy can then be performed where a needle is advanced into the patient, where the computer has projected the image of the tumor that cannot normally be seen on CT. We plan to compare this new method of prostate biopsy to the currently employed standard prostate biopsy technique.
Scientific Abstract:
Prostate cancer is the most common cancer diagnosed in Canadian men. The standard method used to detect prostate cancer involves an ultrasound probe being inserted into the rectum and needle biopsies piercing the rectal wall to take tissue samples from the prostate. This procedure is uncomfortable, has significant risks of infection and occasionally does not accurately detect prostate cancer. The purpose of this study is to investigate a novel method of prostate biopsy using a state of the art computerized guidance system. Cancer within the prostate is not accurately detected by CT. Prostate cancer can be accurately detected by MRI. However, the metal components used to perform biopsies cannot be placed in an MRI machine. Our novel method of prostate biopsy involves using a new computerized technology that permits a lesion detected on MRI to be projected by a computer into 3 dimensions on a patient’s CT scan. A CT guided biopsy can then be performed where a needle is advanced into the patient, where the computer has projected the image of the tumor that cannot normally be seen on CT. We plan to use a randomized, cross over designed trial to compare this new method of prostate biopsy to the currently employed standard prostate biopsy technique.
Impact on prostate cancer patients:
Currently men are subjected to an invasive and uncomfortable procedure (TRUSP biopsy) with a substantial infection risk in order to determine if there is cancer present within the prostate. Our novel method of prostate biopsy avoids this discomfort by eliminating the need to place equipment in the rectum while performing a prostate biopsy. We anticipate that it will be a more comfortable and safer procedure for prostate cancer patients to undergo. One of the measured outcomes of this study is patient preference for the novel method of prostate biopsy versus the conventional TRUSP biopsy, making this study truly patient-centered. We also believe that this novel method of prostate biopsy will be able to detect prostate tumors that traditional biopsy techniques may miss. We, therefore, believe that this study may help to improve the diagnostic accuracy of prostate biopsies.