John Feller, MD

John Feller, MD

Desert Medical Imaging

Palm Desert, California

John Feller, MD, is the Founding Partner and Medical Director of Desert Medical Imaging. In addition, He is an Assistant Clinical Professor in the Departments of Radiology at Loma Linda University in Loma Linda, California, and at Riverside School of Medicine in Riverside, California. He also serves as Chief of Radiology and Partner and the American Medical Center in China. John Feller, MD, graduated from the Ohio State University School of Medicine, completed postgraduate training at Stanford University, and is board-certified in diagnostic radiology. He served in the Air Force as Chief of MRI at the David Grant Medical Center. He was previously Assistant Clinical Professor for the Stanford Department of Radiology, where he was awarded Volunteer Clinical Faculty Teacher of the Year. He has given 400+ lectures worldwide, co-authored numerous peer-reviewed articles and book chapters, and is editor of the textbook Shoulder Magnetic Resonance Imaging. Dr. Feller leads an MRI-based prostate cancer detection and treatment program through Desert Medical Imaging, providing care to 3,000+ patients.

Disclosures:

Talks by John Feller, MD

Current and Emerging Role of Radiogenomics in Risk Assessment for Focal Therapy

Posted by | Mar 2022

John F. Feller, MD, Founding Partner of Desert Medical Imaging, Chief Medical Officer for HALO Diagnostics, Assistant Clinical Professor in the Departments of Radiology at Loma Linda University and at Riverside School of Medicine, and Chief of Radiology and Partner of the American Medical Center in China, discusses the emerging role of radiogenomics in prostate cancer in the context of risk stratification for focal therapy. He explains that he and his colleagues at HALO Diagnostics are interested in finding “Whack-a-Mole” patients whose cancer tends to recur in a way that makes them difficult to manage with focal therapy. Dr. Feller asks whether risk stratification for focal therapy can be done using radiogenomics and whether responders to focal therapy for prostate cancer can prospectively be distinguished from non-responders using biomarkers. He defines responders as those with a negative MR guided biopsy of the treatment site(s) 6 months following focal therapy who do not develop in-field or out-of-field clinically significant recurrences over time. Dr. Feller then lists the biomarkers and other criteria used in risk stratification with radiogenomics, including age, initial serum PSA, initial PSA density, mpMRI, index lesion mpMRI volume, index lesion quantitative ADC, systematic biopsy, Gleason score, tissue-based genomics, liquid biopsy, molecular imaging. He goes into depth about results from the tissue-based genomics PTEN and ERG (ProstaVysion), Decipher for biopsy (Decipher Score), and Decipher GRID. He also further explores liquid biopsy options, including urine (ExoDx) and blood (Biocept). Dr. Feller concludes: that mpMRI followed by genomics and other biomarkers show promise for risk stratification for focal therapy of prostate cancer; that a biomarker ensemble approach to prostate cancer helps mitigate the blind spots of individual biomarkers, as well as the heterogeneity of the disease; that research of radiogenomics in the setting of focal therapy for prostate cancer may help develop novel combination therapies such as focal therapy combined with checkpoint inhibitors; and that multiple biomarker complex data sources present an artificial intelligence/machine learning opportunity.

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Current and Emerging Role of Radiogenomics in Risk Assessment

Current and Emerging Role of Radiogenomics in Risk Assessment

Posted by | Jul 2021

John Feller, MD, Founding Partner and Medical Director of Desert Medical Imaging, Assistant Clinical Professor in the Departments of Radiology at Loma Linda University and at Riverside School of Medicine, Chief of Radiology and Partner of the American Medical Center in China reviews data for evaluating radiogenomics in terms of risk stratification for focal therapy and for developing novel combination therapies. Dr. Feller introduces a phase II study on laser focal therapy of prostate cancer that shows the ability of responders to focal therapy to be distinguished from non-responders with support from findings showing lower PSA values and lower PSA density in responders as opposed to nonresponders, and another study on the Decipher Genomics Resource Information Database (GRID), revealing that genes can be used to differentiate responders from non-responders. He then discusses a phase II clinical trial on outpatient trans-rectal MR-guided Laser Focal Therapy that found that short-term and intermediate-term oncologic control achievable in 79% of patients with initial treatment. He concludes that MpMRI followed by genomics shows promise for risk stratification for focal therapy and that multiple complex data sources present an opportunity for artificial intelligence.

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Current and Emerging Role of Radiogenomics

Current and Emerging Role of Radiogenomics

Posted by | Feb 2020

John Feller, MD, Founding Partner and Medical Director at Desert Medical Imaging, gives an overview of radiogenomics’ current and possible future role in prostate cancer care. He notes the recent promising results of multiparametric MRI (mpMRI) from trials, which have shown that using mpMRI before transrectal ultrasound-guided (TRUS) biopsy can decrease the number of unnecessary biopsies, limit detection of insignificant cancer, and improve detection of significant cancer. These have influenced the updated 2019 National Comprehensive Cancer Network (NCCN) Guidelines for prostate cancer. Dr. Feller further discusses other biomarkers for risk stratification and promising research on radiogenomics in the setting of focal therapy.

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