Intraoperative Imaging of Cavernous Nerves in Radical Prostatectomy for Prostate Cancer
Abstract
Prostate cancer is the second leading cause of death for men in the United States. Radical prostatectomy is the most effective treatment method in clinic compared to radiotherapy or watchful waiting. While it significantly reduces prostate cancer mortality, radical prostatectomy can result in postoperative sexual dysfunction in a significant proportion of patients (up to 60% 1-year post-surgery) due to the damage of cavernous nerves, which highly affects the quality of people’s lives after surgery. Modern radical prostatectomy techniques, including nerve-sparing radical prostatectomy and robotic-assisted radical prostatectomy, have improved the preservation rate of nerves to a certain extent. However, the preservation of cavernous nerves remains challenging during radical prostatectomy due to limited understanding of the location and course of cavernous nerves and lack of effective tools to pinpoint nerves from surrounding tissues. Therefore, it is urgent and highly desirable to develop an advanced technique for effectively identifying the cavernous nerves during surgery, which would improve postoperative sexual function, thus directly benefit patients’ quality of life. Among recent advances in biomedical imaging, optical coherence tomography is a widespread imaging technique that measures back-scattered or back-reflected light generated from a light source delivered to the examined tissue, which is able to provide optical scattering property of tissue in high resolution. Photoacoustic microscopy is another emerging non-invasive three-dimensional technique capable of imaging tissue absorption in high resolution. In photoacoustic microscopy, an image is formed through the detection of laser-induced ultrasound waves with an (un)focused ultrasound transducer. Photoacoustic microscopy is ideal for mapping strong light absorbers in biological tissue at a microscopic level. Compared to pure optical-based imaging, photoacoustic microscopy is able to obtain images with relatively deep penetration depth, while photoacoustic microscopy has superior optical contrast that is much higher than the contrast of pure ultrasound imaging. Since ultrasound can penetrate into deep tissue, a common ultrasound transducer can be used for both ultrasound imaging and photoacoustic microscopy. Thus, we propose to develop multimodal endoscopy integrating optical coherence tomography, photoacoustic microscopy, and ultrasound imaging for intraoperative mapping of prostate cavernous nerves and their surrounding tissues in high resolution during radical prostatectomy. We expected that, with improved visualization of prostate cavernous nerves via the proposed multimodal endoscopy, it will improve the rates of nerve preservation and postoperative potency after radical prostatectomy, enhancing people’s well-being who are experiencing the impact of prostate cancer. I am dedicated to developing novel biomedical imaging techniques for improving diagnosis, management, and treatment of human diseases and for enhancing people’s well-being who are experiencing the impact of diseases. This award will offer me a requisite training to become an efficient researcher in the field of prostate cancer. The proposed training plan includes a set of career development activities and workshops (e.g., grant writing, public speaking, laboratory management) that will enhance my ability to be an independent investigator. The actively built strong mentoring team of experts will help further my career as independent researcher in the field of prostate cancer and augment my knowledge in prostate cancer, cancer biology, medical imaging, radiation oncology, medical devices, and clinical science. After completion of this award, I will gain experience in preclinical research using animal models of prostate cancer and clinically used techniques and procedures for prostate cancer and finally prepare myself as an independent investigator in prostate cancer research. Th
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Nov 19, 2019
- Source ID
- W81XWH1910567
Entities
People
- Xianjin Dai
Organizations
- Emory University
- United States Army