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Using micro-ultrasound to deliver targeted radiotherapy to prostate patients

Prostate cancer is the most common cancer affecting Canadian men, and while there have been significant advances in the treatment of this disease, it’s difficult for patients to access the best possible care.

“We’re not offering state-of-the-art care for these patients due to a lack of resources,” says Dr. Lucas Mendez, an assistant professor at Western University and a radiation oncologist at London Health Sciences Centre.

As a 2024 Terry Fox New Investigator awardee, Dr. Mendez receives funding to create an accessible and cost-effective method of delivering high doses of radiation therapy directly to the main cancerous area in the prostate, a site known as the dominant index lesion (DIL).

“We know that dose escalation to the dominant index lesion gives us a better chance of controlling the disease or curing the cancer, but we lack the resources, namely MRI, to indicate to us where the lesion is,” says Dr. Mendez.

Multiparametric Magnetic Resonance Imaging (mpMRI) is an MRI specifically tailored to produce detailed images of the prostate. Currently, mpMRI is one of the most effective methods of locating and taking a biopsy of cancer within the prostate, however, the machines are expensive, cumbersome and notoriously difficult to access. Considering this, mpMRI may not be the best tool for delivering care to the 25,900 Canadian men who were diagnosed with prostate cancer last year alone.

In this project, Dr. Mendez will test the use of micro-ultrasound (microUS) – a tool currently designed to perform targeted biopsies of prostate cancers – for delivering radiation to cancerous lesions in the prostate. Micro-ultrasound is a relatively inexpensive technology that elicits high-resolution images of the prostate in a matter of minutes. It’s also portable, meaning it can be used right in the practitioner’s office and deliver results in real time.

“This funding from The Terry Fox Research Institute will allow us to translate micro-ultrasound technology to the radiation world,” says Dr. Mendez. “Once we succeed adapting the micro-ultrasound technology to the radiotherapy workflow, we will contrast it to other state of the art imaging modalities that have been used clinically. Then, the newly developed workflow will be evaluated clinically in two small clinical trials.”

Dr. Mendez hopes this work can act as a trailblazer, improving the standard of care for patients with prostate cancer and, potentially, expanding to other pelvic tumours in the future.