Abstract
Prostate cancer surgery risks erectile problems and incontinence for the patient. An instrument for guiding surgeons to avoid nerve bundle damage and ensure complete cancer removal is desirable. We present a tactile resonance sensor made of PZT ceramics, mounted in a 3D motorized translation stage for scanning and measuring tissue stiffness for detecting cancer in human prostate. The sensor may be used during surgery for guidance, scanning the prostate surface for the presence of cancer, indicating migration of cancer cells into surrounding tissue. Ten fresh prostates, obtained from patients undergoing prostate cancer surgery, were cut into 0.5 cm thick slices. Each slice was measured for tissue stiffness at about 25 different sites and compared to histology for validation cancer prediction by stiffness. The statistical analysis was based on a total of 148 sites with non-cancer and 40 sites with cancer. Using a generalized linear mixed model (GLMM), the stiffness data predicted cancer with an area under the curve of 0.74, after correcting for overfitting using bootstrap validation. Mean prostate stiffness on the logarithmic scale (p = 0.015) and standardized Z-scores (p = 0.025) were both significant predictors of cancer. This study concludes that stiffness measured by the tactile resonance sensor is a significant predictor of prostate cancer with potential for future development towards a clinical instrument for surgical guidance.
Highlights
Prostate cancer (PCa) is the second most common form of cancer for men worldwide (Bray et al 2018) with 10 580 estimated cases in 2018 in Sweden alone (Ferlay et al 2018)
We have further investigated the ability of a tactile resonance sensor to detect prostate cancer ex vivo
Several earlier studies have given promising results (Nyberg et al 2015, Astrand et al 2017, Lindahl et al 2017), based on the stiffness parameter produced by a resonance sensor on different biological tissues
Summary
Prostate cancer (PCa) is the second most common form of cancer for men worldwide (Bray et al 2018) with 10 580 estimated cases in 2018 in Sweden alone (Ferlay et al 2018). The first clinical investigation upon suspected PCa is palpation of the prostate gland through the rectum. Transrectal ultrasound is often used to visualize the prostate during biopsy procedures, but it cannot detect tumors in the prostate, only informing about the location of the prostate gland, and usually in 2D only. Another widely used technology is MRI (Magnetic Resonance Imaging), which can visualize anatomical features in 3D. An MRI equipment is a multimillion investment, and each investigation is rather expensive
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