Periodic Reporting for period 1 - IMPROVE (IMaging PROstate cancer using ViscoElastic biomarkers and a novel transurethral viscoelastic elastography procedure)
Période du rapport: 2023-09-01 au 2025-08-31
Prostate cancer is one of the most prevalent malignancies among men and a major public health challenge in Europe. Minimally invasive treatments such as High Intensity Focused Ultrasound (HIFU) have emerged as effective alternatives to radical surgery, selectively ablating cancerous tissue while preserving healthy structures and reducing side effects. However, during the intervention, clinicians currently have no reliable means to determine whether the ablation fully covers the tumour or has achieved the required thermal dose. This lack of immediate feedback often leads to under- or overtreatment, compromising therapeutic success and patient safety.
The IMPROVE project aims to address this unmet clinical need by developing Transurethral Shear Wave Elastography (TUSWE), a novel ultrasound-based imaging concept that can monitor the effectiveness of HIFU focal therapy from within the urethra, in real time. By mapping thermal-induced changes in tissue stiffness, TUSWE seeks to provide clinicians with direct, quantitative feedback on treatment outcome while the patient remains anaesthetised.
By establishing the scientific and technological foundations of this approach, IMPROVE contributes to Europe’s strategic priorities in personalised, image-guided and minimally invasive healthcare. The project’s long-term goal is to enable safer, more effective focal therapies for prostate cancer, reducing retreatment rates, shortening recovery times, and ultimately improving patients’ quality of life. Its potential impact extends beyond urology, paving the way for a new generation of real-time biomechanical imaging tools applicable to other organs and therapeutic contexts within the European digital health landscape.
The IMPROVE project aims to address this unmet clinical need by developing Transurethral Shear Wave Elastography (TUSWE), a novel ultrasound-based imaging concept that can monitor the effectiveness of HIFU focal therapy from within the urethra, in real time. By mapping thermal-induced changes in tissue stiffness, TUSWE seeks to provide clinicians with direct, quantitative feedback on treatment outcome while the patient remains anaesthetised.
By establishing the scientific and technological foundations of this approach, IMPROVE contributes to Europe’s strategic priorities in personalised, image-guided and minimally invasive healthcare. The project’s long-term goal is to enable safer, more effective focal therapies for prostate cancer, reducing retreatment rates, shortening recovery times, and ultimately improving patients’ quality of life. Its potential impact extends beyond urology, paving the way for a new generation of real-time biomechanical imaging tools applicable to other organs and therapeutic contexts within the European digital health landscape.
The IMPROVE project has taken decisive steps towards turning Transurethral Shear Wave Elastography (TUSWE) into a viable technique for monitoring prostate cancer treatments in real time. Over two years, the project has generated new experimental tools, models, and results that together form the scientific groundwork for future clinical translation.
The work began by creating the experimental platform required to study how shear waves travel through soft tissues. A high-precision computer-controlled system was built to position tissue samples and perform controlled scans across three spatial dimensions, including rotational motion for full 3D characterisation. This setup allowed highly accurate reproduction and measurement of complex vibration patterns under laboratory conditions and became central to all experimental investigations carried out within the project.
With this setup, IMPROVE achieved one of its most significant milestones: demonstrating how heat modifies the mechanical properties of prostate tissue. Experiments on biological samples showed that as tissue is exposed to increasing thermal doses, it becomes much stiffer—by up to five times—an effect directly linked to the degree of ablation produced during therapy. This discovery provided the first clear evidence that changes in stiffness can serve as a quantitative marker of thermal treatment, a fundamental step toward real-time therapy monitoring.
Alongside these experiments, the project advanced the theoretical and computational understanding of the problem. New numerical models were developed to simulate how elastic waves propagate within prostate-like geometries, helping to predict how signals collected by transurethral probes relate to the underlying tissue structure. These models now guide the optimisation of future probe designs and data-processing algorithms.
To move from theory to imaging, IMPROVE explored innovative methods for reconstructing stiffness maps from simulated measurements. The approach successfully retrieved the location and size of regions altered by heat, showing that the principle of TUSWE can indeed resolve the effects of thermal therapy. Although further optimisation is required to reach real-time performance, this represents an important proof of concept for future developments.
Finally, the project also contributed to the creation of a new generation of miniature capacitive sensors capable of detecting the minute vibrations caused by shear waves. Laboratory testing confirmed their excellent sensitivity and reliability, paving the way for their integration into a future TUSWE probe.
Together, these achievements demonstrate consistent progress across experimental, modelling, and sensing fronts. IMPROVE has laid the essential scientific foundation for transforming TUSWE from a promising idea into a technology with the potential to make prostate cancer treatments safer, more precise, and more effective.
The work began by creating the experimental platform required to study how shear waves travel through soft tissues. A high-precision computer-controlled system was built to position tissue samples and perform controlled scans across three spatial dimensions, including rotational motion for full 3D characterisation. This setup allowed highly accurate reproduction and measurement of complex vibration patterns under laboratory conditions and became central to all experimental investigations carried out within the project.
With this setup, IMPROVE achieved one of its most significant milestones: demonstrating how heat modifies the mechanical properties of prostate tissue. Experiments on biological samples showed that as tissue is exposed to increasing thermal doses, it becomes much stiffer—by up to five times—an effect directly linked to the degree of ablation produced during therapy. This discovery provided the first clear evidence that changes in stiffness can serve as a quantitative marker of thermal treatment, a fundamental step toward real-time therapy monitoring.
Alongside these experiments, the project advanced the theoretical and computational understanding of the problem. New numerical models were developed to simulate how elastic waves propagate within prostate-like geometries, helping to predict how signals collected by transurethral probes relate to the underlying tissue structure. These models now guide the optimisation of future probe designs and data-processing algorithms.
To move from theory to imaging, IMPROVE explored innovative methods for reconstructing stiffness maps from simulated measurements. The approach successfully retrieved the location and size of regions altered by heat, showing that the principle of TUSWE can indeed resolve the effects of thermal therapy. Although further optimisation is required to reach real-time performance, this represents an important proof of concept for future developments.
Finally, the project also contributed to the creation of a new generation of miniature capacitive sensors capable of detecting the minute vibrations caused by shear waves. Laboratory testing confirmed their excellent sensitivity and reliability, paving the way for their integration into a future TUSWE probe.
Together, these achievements demonstrate consistent progress across experimental, modelling, and sensing fronts. IMPROVE has laid the essential scientific foundation for transforming TUSWE from a promising idea into a technology with the potential to make prostate cancer treatments safer, more precise, and more effective.
The clinical management of prostate cancer is progressively moving towards minimally invasive therapies such as High Intensity Focused Ultrasound (HIFU). These treatments can selectively destroy cancerous tissue while sparing healthy structures, but a major limitation remains unresolved: during the procedure, clinicians cannot determine in real time whether the targeted region has been completely and effectively ablated. In current practice, treatment outcomes are assessed using magnetic resonance imaging (MRI) several months after the intervention, once the tissue has healed. At that point, if residual tumour is detected, repeating the HIFU procedure is often no longer possible, and patients may require more invasive or ionising alternatives.
IMPROVE has laid the scientific groundwork to address this unmet need by exploring the feasibility of Transurethral Shear Wave Elastography (TUSWE) — a new imaging concept designed to monitor, in the future, the mechanical effects of focal therapy from within the urethra. The project has demonstrated under controlled laboratory conditions that heat induces measurable and reproducible changes in prostate tissue stiffness, establishing a physical link between thermal dose and mechanical response. These findings define a key principle upon which future real-time monitoring could be built.
In parallel, IMPROVE has produced the computational and experimental tools needed to study how shear waves propagate through prostate tissue and how these signals could be interpreted to generate stiffness maps. This dual experimental–theoretical framework represents a step beyond the current state of the art in ultrasound elastography, extending its application from diagnosis to the monitoring of therapy.
A further advance was achieved through the design of highly sensitive capacitive sensors capable of detecting very small vibrations with exceptional precision. Their successful characterisation provides a foundation for developing transurethral probes specifically adapted to the TUSWE concept.
While TUSWE is still at an early research stage, the progress achieved within IMPROVE significantly expands current knowledge of tissue biomechanics and acoustic wave propagation in the prostate. The next steps will involve integrating the developed components into a preclinical prototype, validating the approach in controlled experimental settings, and optimising image reconstruction for near-real-time operation. These efforts will be crucial to transform the current proof of feasibility into a practical medical technology able to support safer and more effective prostate cancer treatments.
IMPROVE has laid the scientific groundwork to address this unmet need by exploring the feasibility of Transurethral Shear Wave Elastography (TUSWE) — a new imaging concept designed to monitor, in the future, the mechanical effects of focal therapy from within the urethra. The project has demonstrated under controlled laboratory conditions that heat induces measurable and reproducible changes in prostate tissue stiffness, establishing a physical link between thermal dose and mechanical response. These findings define a key principle upon which future real-time monitoring could be built.
In parallel, IMPROVE has produced the computational and experimental tools needed to study how shear waves propagate through prostate tissue and how these signals could be interpreted to generate stiffness maps. This dual experimental–theoretical framework represents a step beyond the current state of the art in ultrasound elastography, extending its application from diagnosis to the monitoring of therapy.
A further advance was achieved through the design of highly sensitive capacitive sensors capable of detecting very small vibrations with exceptional precision. Their successful characterisation provides a foundation for developing transurethral probes specifically adapted to the TUSWE concept.
While TUSWE is still at an early research stage, the progress achieved within IMPROVE significantly expands current knowledge of tissue biomechanics and acoustic wave propagation in the prostate. The next steps will involve integrating the developed components into a preclinical prototype, validating the approach in controlled experimental settings, and optimising image reconstruction for near-real-time operation. These efforts will be crucial to transform the current proof of feasibility into a practical medical technology able to support safer and more effective prostate cancer treatments.