AMS Professorship award for Professor Zion Tse, Queen Mary University of London

(1) Project: AI-guided Prostate Biopsy 1.1.Goal: We will develop a next-generation image-guided biopsy system for suspected prostate cancer based on novel artificial intelligence (AI) navigation and image fusion, and we will validate the technology in patients through partnerships with Addenbrooke's Hospital. 1.2.Background: Transperineal prostate biopsy has become a popular alternative to transrectal biopsy to lower the risks of infection, sepsis, and death.

This technique also allows patients to undergo local anaesthesia, which increases patient care throughput and lowers costs.

Additionally, transperineal ultrasound (TPUS) imaging reduces patient discomfort compared to transrectal ultrasound (TRUS). Hence, transperineal prostate biopsy guided by TPUS is seen as the future of prostate biopsy.

However, the image quality and prostate cancer sensitivity of TPUS are unsatisfactory, so it is desirable to fuse TPUS with MRI. 1.3.Clinical Pain Point: Image fusion between MRI and ultrasound improves biopsy yield, but image-fusion devices are cost-prohibitive, typically costing £80,000-120,000/unit.

Currently, less than 10% of urology practices in the UK have image-fusion systems for guiding prostate biopsies, and there are no image-fusion systems for guiding transperineal biopsies specifically. 1.4.Our Solution: In response to these problems, we will develop and clinically translate AI navigation technology to guide freehand transperineal prostate biopsy.

The proposed technology is an auxiliary AI software add-on that does not require existing US hardware to be altered. 1.5.Impact: This project will pioneer AI image-guided biopsy, enabling high-precision image-fusion guided biopsy to be performed cost effectively.

This project is exciting because better prostate biopsy technology could drive breakthroughs in early diagnosis and treatment of prostate cancer. 1.6.Work Packages (WP): The project will include: (WP1) Developing a 3D MRI-US image-fusion system to guide freehand needle manipulation to targeted areas with submillimetre precision for prostate biopsy and needle-based interventions. (WP2) Co-developing, testing and clinically translating the technology in partnership with Addenbrooke's Hospital (see letter). (2) Synergy with my Research Plan A driving inspiration of my research plan is to utilise AI to improve image-guided cancer diagnosis.

The proposed technology will enable accurate and effective prostate biopsies suitable for out-patient procedures through novel AI.

The system will be compatible with all US scanners, and the procedures will remain freehand (but AI-guided), so current practitioners will require minimal training. (3) Added Value to my Research Career 3.1.Translational research agenda This Professorship will allow me to establish research collaborations with Prof.

Tristan Barrett’s and Prof. Vincent Gnanapragasam’s teams in the Radiology and Urology Departments of Addenbrooke's Hospital. Their groups have pioneered many prostate studies and health economic assessments.

This collaboration will be crucial for me to develop my clinical translation research agenda. 3.2.Taking my research to the next level With data generated from this project, I will apply for longer term research support, such as through the Royal Academy of Chair in Emerging Technologies scheme, which could provide around 10-years of funding.

I will also submit an MRC Developmental Pathway Funding application to secure support for patient studies of the proposed technology at scale and its commercialisation.