Andre Abreu, MD

Andre Abreu, MD

Keck Hospital of University of Southern California

Los Angeles, California

Andre Luis de Castro Abreu, MD, is an assistant professor of Clinical Urology at Keck School of Medicine at the University of Southern California in Los Angeles, California. Dr. Abreu has expertise in MRI/TRUS fusion prostate biopsy and focal therapy, including high intensity focused ultrasound (HIFU) and cryoablation for prostate cancer. 

He earned his medical degree in general surgery and urology in Brazil. He then completed his clinical fellowship at Keck School of Medicine at USC, after being a research scholar at the USC Institute of Urology in Los Angeles California. He has been developing new techniques and applying new technologies to minimally invasive urological surgery, including robotics, focal therapy (cryosurgery and HIFU), endourology, and active surveillance.

Dr. Abreu performs robotic surgery for prostate, kidney and bladder cancers, as well as practicing general urology. During his clinical fellowship at USC, he was involved in more than 400 complex robotic urologic surgeries, treating cancers and benign diseases, and performed more than 1,500 3D prostate biopsies. Dr. Abreu has authored many book chapters and more than 85 peer-reviewed publications in various prestigious medical journals. In addition, Dr. Abreu has presented many abstracts on such topics as robotic and laparoscopic urologic surgery, as well as focal therapy, active surveillance, and image-guided biopsies.

Talks by Andre Abreu, MD

Energy Selection Ablative Technologies for Focal Therapy

Energy Selection Ablative Technologies for Focal Therapy

| Jan 2025

Andre Abreu, MD, delves into energy modalities for focal therapy in prostate cancer, presented with a comprehensive and practical approach. This 16-minute presentation explores multiple energy options, including cryoablation, high-intensity focused ultrasound (HIFU), irreversible electroporation (IRE), laser ablation, and microwave ablation. Dr. Abreu emphasizes the importance of aligning energy selection with institutional expertise and patient-specific factors.

Patient-specific considerations guide technology selection, including rectal wall thickness and proximity to critical structures. Transition zone lesions benefit from tools like aqua ablation, while anterior lesions present challenges for certain devices. The speaker emphasizes the need for personalized management, integrating oncologic characteristics with procedural capabilities.

Dr. Abreu optimistically frames the future of focal therapy, with ongoing trials like vapor ablation and the potential for low-dose radiation therapy combined with IRE promising advancements. He calls for practical recommendations and an invitation for ongoing exploration in the evolving field of prostate cancer management.

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AI and Treatment Planning for Prostate Cancer

AI and Treatment Planning for Prostate Cancer

| Dec 2024

Andre Abreu, MD, explores the role of artificial intelligence in treatment planning for prostate cancer, with a particular emphasis on focal therapy. This presentation, lasting approximately 15 minutes, begins by acknowledging the complexity of selecting candidates for focal therapy, which involves synthesizing clinical data, imaging, and biopsies. The potential for AI to streamline this intricate process is highlighted, particularly in improving MRI quality and prostate cancer detection.

Key insights include evidence that AI performs on par with non-expert radiologists in MRI interpretation and can enhance imaging outcomes, directly impacting prostate cancer detection rates. AI-driven segmentation is emphasized, showing its value in planning biopsies, surgeries, and focal therapies. Using a database of 750 patients at USC, Dr. Abreu provides an AI model with a reported accuracy compatible with leading deep learning systems.

The application of AI extends to histology, where it quantifies cancer presence with greater precision than traditional pathology methods. Combining clinical, imaging, and histological data demonstrates the potential for multimodal risk stratification, improving the selection process for intermediate-risk patients.

AI limitations are also addressed, including small sample sizes, lack of diversity in studies, and the “black box” nature of AI models, which raises concerns about transparency and explainability in healthcare. Dr. Abreu underscores the need for rigor in AI research to ensure its reliable integration into clinical practice.

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

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

| 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.

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