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2023 Lowell Milken – PCF Young Investigator Award

MMUVE Prostate Cancer: Multi-Omic Evaluation of Micro-Ultrasound VisiblE Prostate Cancer

Wayne Brisbane, MD
University of California, Los Angeles

Mentors: Leonard Marks MD, Robert Reiter MD, Paul Boutros PhD

Description:

  • Diagnosis of prostate cancer begins with PSA screening, often followed by multiparametric MRI imaging or a biomarker test to confirm suspicion (and location, if MRI) of cancer, before biopsy. However, these procedures are not optimal, as MRI is costly and not widely available, while biomarker tests cannot provide information such as cancer location and disease staging.
  • Micro-Ultrasound is a high-resolution transrectal ultrasound method that may offer a promising alternative prostate cancer diagnostic, as it retains similar cancer visualization sensitivity as MRI, at 6% of the cost. However, dense benign tissue appears cancerous on Micro-Ultrasound, resulting in low cancer specificity. Further refinement of this method is required for widespread clinical adoption.
  • Wayne Brisbane is investigating methods to improve Micro-Ultrasound specificity and evaluate Micro-Ultrasound versus MRI for prostate cancer visualization.
  • In this project, Dr. Brisbane and team will create a machine learning-based image analysis algorithm to improve cancer specificity following PSA screening. This model will use data including age, PSA, DRE findings, prostate volume, and whole gland Micro-Ultrasound images to risk stratify patients following PSA screening.
  • The team will also compare the specificity and sensitivity of Micro-Ultrasound versus MRI and evaluate if a urine-based biomarker test can further improve specificity for cancer diagnosis.
  • MRI and Micro-Ultrasound employ different physical mechanisms for visualizing tissue. The team will compare the biological differences in what these imaging methods detect, the molecular characteristics of tumors visible on MRI and Micro-Ultrasound vs. tumors visible by only one modality.
  • If successful, this project will improve understanding of tumor visibility by Micro-Ultrasound, and result in a 3-minute prostate scan and urine sample test that identifies patients at risk for prostate cancer and improves decisions on whether patients should undergo prostate biopsy or not.

What this means to patients: Current prostate cancer screening methods either lack specificity (PSA tests) or are costly and not widely available (MRI), thus many more patients undergo invasive prostate biopsies than are necessary. Dr. Brisbane and team are investigating methods to improve the use of a rapid and cheap alternative, Micro-Ultrasound, possibly with a urine biomarker test, to accurately determine a patient’s risk for prostate cancer and aid in decisions about whether to undergo prostate biopsy.