Keck Medicine of USC Archives

Introduction to AI in Healthcare

Posted by Giovanni Cacciamani, MD, MSc, FEBU | Dec 2024

Giovanni Cacciamani, MD, MSc, FEBU, introduces the transformative role of artificial intelligence (AI) in healthcare, particularly in urology.

He begins his comprehensive 22-minute talk by discussing the historical foundations of AI and transitioning to its current integration into medical practice and its practical applications in diagnosing and classifying urological conditions.

Dr. Cacciamani shares examples demonstrating AI’s potential to enhance prostate cancer diagnostics. Integrating AI into multiparametric MRI interpretation reduces unnecessary biopsies and improves diagnostic precision. Current FDA-approved AI tools also underscore the rapid growth of this field, with many different applications focusing on medical image analysis.

Dr. Cacciamani emphasizes that AI is not replacing physicians but augmenting their capabilities by reducing workload, mitigating human error, and improving patient outcomes. Applications beyond diagnostics include surgical guidance, digital pathology, and treatment planning. By blending technology with clinical expertise, AI is poised to revolutionize urological care while preserving the human touch in medicine.

HIFU Focal Therapy: Prostate Cancer – Emerging Data and Clinical Utility vs. Standard Care

Posted by Andre Abreu, MD | Jan 2021

Andre Abreu, MD, Urologist at the Keck Hospital of University of Southern California, describes how high-intensity focused ultrasound (HIFU) works, and the data that earned it FDA-approval for prostatic tissue ablation in November 2015. Following this, Dr. Abreu reviews the three main goals of focal therapy: selectively ablating known disease, preserving functions, and minimizing morbidity, all without compromising life expectancy. He then uses two systematic reviews, one from 2017 and one from 2019, to explain how focal therapy benefits continence and potency rates. Further presented data includes a 2020 review of evidence and reported outcomes from an October 2020 study of hemigland HIFU ablation as primary treatment for localized prostate cancer, both of which exhibit HIFU’s safety, excellent potency, and continence preservation, as well as adequate short-term prostate cancer control. Dr. Abreu also addresses comparisons to radiation and acknowledges that HIFU works well for intermediate-disease but is still controversial for low- or high-risk disease, showing a need for further study.

Updates in Muscle Invasive Bladder Cancer

Posted by Siamak Daneshmand, MD | Sep 2020

Sia Daneshmand, MD, Associate Professor of Urology and Director of Clinical Research at the University of Southern California, describes the current landscape of muscle invasive bladder cancer treatment, highlighting developments in radical cystectomy and chemotherapy. He observes that while radical cystectomy has long been the gold standard, efforts are being made to preserve reproductive organs in female patients who have low-stage disease. Dr. Daneshmand also notes the significant number of neoadjuvant chemotherapy phase II trials currently underway. While studies examining adjuvant chemotherapy have shown promise, the limitations of these trials necessitate further research. Similarly, research comparing super-extended lymph node dissection (LND) with extended LND have yielded insignificant p-values, but absolute numbers demonstrate a positive upward survival trend over 5 years. Dr. Daneshmand concludes that additional clinical trials will reveal the optimal combination and sequencing of treatment options.

2017 AUA Guidelines for the Treatment of Stress Urinary Incontinence

Posted by Larissa V. Rodriguez, MD | Jun 2018

Larissa V. Rodriguez, MD, summarizes the 2017 American Urological Association (AUA) Stress Urinary Incontinence (SUI) guidelines and critiques their limitations. In particular, she criticizes the fact that their index patient does not represent patients urologists usually see, their exclusion of non-FDA approved interventions, and their insufficient emphasis on urodynamics.

Which Sling to Use – What, When, Why and Who?

Posted by Larissa V. Rodriguez, MD | Jun 2018

Larissa V. Rodriguez, MD, discusses considerations for midurethral sling surgery to treat stress urinary incontinence (SUI) that the American Urological Association (AUA) guidelines do not cover, including how to treat non-index patients and choosing optimal slings for individual cases. Specifically, she compares the outcomes of retropubic, transobturator, and autologous fascia pubovaginal slings in various patient demographics. She also summarizes the evolution of sling surgery and how it came into widespread use.