Prostate cancer is the most frequent newly diagnosed cancer of males in Germany and takes third rank among deaths caused by cancers. One of the reasons is that in about 30 percent of cases the preoperative assessment of the tumor growth is inaccurate. Thus the most promising way to remove the tumor is endoscopic radical prostatectomy, i.e. complete removal of the prostate. At the same time, the surgeon has to avoid any damage to the tissue surrounding the prostate in order to safeguard the patient's virility and continence. On the other hand, even a small amount of cancerous tissue left at the surgical margins significantly reduces the patient's chance of full recovery. Today this risk can be minimized only by taking, during the surgery, tissue samples that are then examined under the microscope. This time-consuming procedure prolongs the operation and does not allow to take more than a few samples, as in the critical areas (nerve tissue and urethral sphincter) even very small biopsies may cause serious damage.
In the MoBiGuide project Fraunhofer FIT and our spin-off LOCALITE GmbH develop an improved diagnostic procedure to determine more precisely the growth of the tumor (staging). In the pre-operative phase, it combines powerful imaging and prostate biopsy navigated in parallel in a magnetic resonance tomograph to identify the cancerous tissue in the prostate boundaries. Based on this information, patient and urologist can make better planning decisions regarding the operation.
For the intra-operative phase, MoBiGuide aims for a system that lets the surgeon determine if the cancerous tissue is completely removed, based on the pre-operative data and on biomolecular tests performed almost in real-time. For patient and urologist alike this would significantly improve the quality of prostate cancer treatment. Our work focuses on an endoscopic ablator that uses water to let the urologist take minimal samples of tissue from a suspect region. The ablator is attached to a system built around a microfluidic chip in whose miniature pipes cells from the sample circulate. The chip will contain a number of biomarkers (antibodies) still under development, which will identify healthy and cancerous cells. Thus, the system will tell the urologist almost in real-time if all cancerous tissue has been removed in a precisely localized spot. KARL STORZ GmbH, Tuttlingen, one of the leading suppliers of endoscopic equipment worldwide, develops the MoBiGuide ablator in cooperation with Fraunhofer FIT.