Unmet NeedGlobally, prostate cancer is the second leading cause of cancer and the sixth leading cause of cancer-related death in men. In the U.S., prostate cancer is the most common and diagnosed cancer in males. It is estimated there are 2.5 million men living with prostate cancer in the US, and the number is on the rise. The survival of prostate cancer depends on its stage in diagnosis and treatment options. One common treatment of prostate cancer is the removal of the prostate through minimally invasive surgery using surgical robots to better aid in recovery and reduce surgical side effects such as the occurrence of impotence (erectile dysfunction) and incontinence among patients following surgery. The preservation of the cavernous nerves during prostate cancer surgery is essential in maintaining a man’s sexual potency. Because of the proximity of the cavernous nerves to the prostate, these microscopic nerves are at high risk of damage during surgical procedures. Improvements in identifying the cavernous nerves and distinguishing prostate nerves from normal or cancerous prostate tissue during surgery would aid in preservation, resulting in improved sexual function postoperatively.
Technology OverviewJHU researchers developed a novel imaging guidance approach to precisely visualize and preserve the cavernous nerve map in real time during robot-assisted radical prostatectomy (RaRP). JHU researchers utilized several current imaging modalities to develop an innovative approach to overcome the limitations of RaRP. This approach uses a novel voltage-sensitive dye (VSD) to visualize the nerves, ultrasound neuromodulation (UNM) to stimulate nerves, and Fluorescence imaging technologies to identify and image the cavernous nerves during RaRP.
Stage of DevelopmentThe inventors have carried out preliminary studies addressing the multiple aspects of technologies that will be used with the RaRP protocol. The inventors have tested and characterized the fluorescence behaviors (absorption/emission spectrum) of several novel dyes (VSDs). In addition,
in vitro studies using VSDs and cellular stimulation with ultrasound targeting neurons cultured with kidney cells provides a proof-of-principle that neurons could be distinguishable from surrounded tissues/cells. To support
in vitro studies,
in vivo proof-of-concept using a rodent (rat) prostate model with the combination of optic imaging and electrical stimulation allowed for the localization of the cavernous nerve map and the prostate. More studies are needed in large animal models followed by clinical trials to evaluate the effectiveness of identifying and sparing nerves during RaRP.
PublicationsH. K. Zhang, et al. J. of Biomedical Optics. 2017
