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Intra-operative MRI-guided Robotic System for Photothermal Therapy of Bladder Cancer

Funder: University Grants Committee

Funding period
HKD 632 K
USD 81 K
Funding amount
Title: Intra-operative MRI-guided Robotic System for Photothermal Therapy of Bladder Cancer
Abstract Non-muscle-invasive bladder cancer (NMIBC) accounts for 80% of all diagnosed cases of bladder cancer, and has a recurrence rate of up to 61% at one year, and 78% at five years, despite bladder cancer ranked 8th by the mortality rate worldwide. The standard treatment path for NMIBC is transurethral resection (TUR), often in combination with intravesical chemotherapy. Rigorous surgical monitoring is performed via cystoscopy for cases with high risk of recurrence. A frequency as high as once every 3 months for 2 years, then every 6 months for 3 years, followed by annual lifelong procedures can be expected. In cases where the cancer progresses to muscle-invasive bladder cancer, complete removal of the bladder, called radical cystectomy, is usually performed. Afterwards, the patient’s urine must be diverted to an external urostomy bag via a conduit. Although a new way of collecting urine inside the body with a neobladder is possible, it requires reconstruction from 50-60cm of the patient’s small intestine. Both kinds of diversion are associated with the worst health-related quality of life for patients. This fact creates great demand for a more complete and reliable first-line treatment to NMIBC. In recent years, gold nanoparticle (GNP) technology has gained prevalence due to their potential for diagnosis and treatment of cancer. The enlarged vasculature exhibited by tumors provides an entry point for drug-coated GNPs, and enables permeation and accumulation within the tumors. Particularly, GNPs show promise in their ability to perform ablation of tumors cells in a process called photothermal therapy (PTT). Gold nanoparticles have a high absorbance of light in the near-infrared (NIR) light spectrum, therefore, when a NIR laser is shone onto GNPs accumulated inside a tumor, the GNPs generate heat that can destroy the cancer cells. Unfortunately, the delivery of the NIR laser to regions deeper within the body, such as the bladder, is problematic due to the low penetration depth of NIR lasers, and the control of heat diffusion to nearby healthy tissue due to PTT is not well investigated. To this end, we propose to employ robot-assisted endoscopic techniques and ablation control methods so that the ablative capabilities of GNPs can take effect on target regions of the bladder with the aid of intra-operative (intra-op) MRI. The overall goal of this project is to develop and validate an MR-conditional cystoscopic robot system that can deliver NIR laser energy to targeted cancer in the bladder. The proposed robotic system will be driven by fluid and tendons, and will be guided by an MRI-based surgical roadmap. The system will be the first to synergistically incorporate miniaturized RF-coil tracking and optical fiber Bragg grating (FBG) shape sensing to enhance 3-D positional tracking of a cystoscope under intra-op MRI. MRI contrasting agents applied to the GNPs will also enable effective localization of the ablation targets intra-operatively. Novel soft linear actuation at the cystoscope tip will provide adjustable laser projection. In combination with the high-fidelity cystoscope, learning-based feedback control, and tissue heat diffusion model under MR thermometry, precise and complete tumor ablation can be achieved while minimizing damage to nearby healthy tissue due to its excessive heat conduction. Validation of the system will be performed in lab-based and MRI-based test, using phantom bladders, ex-vivo porcine bladders, and then live pig specimens. This study may serve as the first step towards MR-guided robot-assisted PTT, and could potentially be the stepping stone for its adoption to cancer treatment in other regions of the body, not limited to the bladder. The successful introduction of PTT as standard care may result in the reduced dependence on chemotherapeutic agents, reducing treatment duration and improving patient quality-of-life.
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    0903 Biomedical Engineering


    1112 Oncology and Carcinogenesis

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    Diagnostic Radiology

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    Urologic Diseases



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  • Broad Research Areas

    Clinical Medicine and Science