Behfar Ehdaie, MD, MPH

Memorial Sloan Kettering Cancer Center

New York, New York

Behfar Ehdaie, MD, MPH, is a urologic surgeon at Memorial Sloan Kettering Cancer Center in New York City. He earned his medical degree at Georgetown University School of Medicine and then went on to a urology residency at the University of Virginia School of Medicine and a fellowship at Memorial Sloan Kettering Cancer Center. Dr. Ehdaie is an expert in minimally invasive surgical techniques for the treatment of urologic cancers, and has a particular interest in novel management of prostate cancer, kidney tumors, and bladder cancer. He has performed more than 500 MRI-guided prostate biopsies and is experienced in doing extensive lymph node removals at the time of prostate surgery. His research is focused on achieving prostate cancer cures while also preserving quality of life, and he is currently the principal investigator on a clinical trial of partial gland ablation that theoretically could allow patients with prostate cancer to receive effective treatment minus side effects like incontinence and erectile dysfunction. Dr. Ehdaie also aims to improve active surveillance by developing a large surveillance clinic that will use advanced imaging and biomarkers to detect cancer progression. Dr. Ehdaie has given presentations on prostate cancer throughout the United States and around the world, and has also published numerous articles and studies in peer-reviewed journals.

Disclosures:

Talks by Behfar Ehdaie, MD, MPH

Transperineal Biopsy & Classification of Risk Using Novel Gleason Pattern Quantification

Posted by Behfar Ehdaie, MD, MPH | Jan 2022

Behfar Ehdaie, MD, MPH, a urologic surgeon at Memorial Sloan Kettering Cancer Center in New York City, outlines the role of Gleason pattern quantification on prostate cancer outcomes. He explains data indicating biopsy pathology primary Gleason grade (GG) is prognostic of disease recurrence after treatment. Research showed an association between the total length of Gleason pattern 4 across all biopsy scores and worse pathologic outcomes among men with GG2 prostate cancer. Dr. Ehdaie explains the total length of Gleason pattern 4 across all biopsy cores best predicts risk of adverse pathology post radical prostatectomy (RP) compared to overall percentage or maximum percentage pattern 4 in a single core. Dr. Ehdaie then asserts that multi-parametric magnetic resonance imaging (mpMRI) and image-based tracking software has improved detection of higher grade prostate cancer. He displays data that show MR-targeted prostate biopsy improves detection of higher grade disease for men on active surveillance. Dr. Ehdaie explains 22 percent of patients on active surveillance experienced an increase in Prostate Imaging Reporting and Data System (PI-RADS) score on surveillance MRI, emphasizing that patients do experience changes in imaging that can be correlated with outcomes. He then explains the shift to transperineal biopsy and points out it enables systematic cores to be taken in a gridlike fashion that offers opportunity for standardization. He displays data comparing transperineal and transrectal biopsy that indicate transperineal prostate biopsy improves detection of higher-grade prostate cancer for men under active surveillance. Dr. Ehdaie concludes that transperineal biopsy may provide a standardized technique for better sampling and, consequently, better classification of risk, emphasizing that technology capable of transitioning from transrectal to transperineal prostate biopsy is key. Dr. Ehdaie concludes his talk by emphasizing that the incorporation of total biopsy length Gleason pattern 4 improves risk classification for men with GG2 and GG3 prostate cancer. This can help select patients for active surveillance and can develop triggers to recommend subsequent treatment. Additionally, Dr. Ehdaie reiterates that adding systematic biopsy cores to MR-targeted biopsy improves overall detection of higher-grade cancer, and seamless transition from transrectal to transperineal biopsy enables a template-based biopsy technique to standardize sampling for risk stratification.

Role of MR-Targeted Prostate Biopsy in Active Surveillance

Posted by Behfar Ehdaie, MD, MPH | Dec 2020

Behfar Ehdaie, MD, MPH, a urologic surgeon at Memorial Sloan Kettering Cancer Center, discusses how MR-targeted prostate biopsy in active surveillance improves detection of higher grade prostate cancer and reduces misclassification of patients with low-risk disease. He summarizes the findings of studies that demonstrate MR-targeted biopsy’s superiority over systematic biopsy in detecting cancer, the particular benefits of MR-ultrasound software fusion prostate biopsy as compared to visually targeted biopsy, and the importance of combining MR-targeted biopsy with systematic biopsy since some tumors are not visible on MRI. Dr. Ehdaie also notes that patients on active surveillance particularly benefit from scheduled MR-targeted biopsies since only using changes in surveillance MRI and clinical stage to trigger biopsy can cause many higher grade cancers to be missed. Dr. Ehdaie concludes by emphasizing the importance of using a transperineal biopsy technique as opposed to a transrectal one in order to reduce complications and improve cancer detection.