Nelson N. Stone, MD

Nelson N. Stone, MD

Icahn School of Medicine at Mount Sinai

New York, New York

Nelson N. Stone, MD, is Professor of Urology, Radiation Oncology, and Oncological Sciences at the Icahn School of Medicine at Mount Sinai and chief medical officer at Viomerse, Inc. Dr. Stone earned his medical degree from the University of Maryland in 1979. He completed a Residency in General Surgery in 1981 at the University of Maryland, followed by a Residency in Urology at the University of Maryland. He then completed a Fellowship in Urologic Oncology at Memorial Sloan-Kettering Cancer Center and a Research Fellowship in Biochemical Endocrinology at Rockefeller University in 1986. He was Chief of Urology at Elmhurst Hospital Queens from 1986-1996. Dr. Stone has founded several medical companies and serves on the editorial board of many scientific journals. He is a member of many professional societies, including the Prostate Conditions Education Council, the Society for Minimally Invasive Therapy, the New York State Urological Society, the American Association of Clinical Urologists, and the American Urologic Association. Dr. Stone has participated in approximately 25 research studies on prostate cancer and has authored more than 500 articles, abstracts, and book chapters, primarily on prostate cancer. He invented the real-time technique for prostate brachytherapy in 1990 and has trained more than 5,000 physicians worldwide through his company ProSeed. His most recent company, Viomerse, creates synthetic body parts (phantoms) for surgical training and has recently released an extended reality remote training platform.

Disclosures:

Talks by Nelson N. Stone, MD

Integration of Augmented Reality (AR) and Extended Reality (XR) into Urology Training and Practice

Nelson N. Stone, MD, examines the immense transformative potential of augmented reality in the realm of surgical education and training. With a comprehensive approach, he dives deep into the concepts of augmented reality, virtual reality, and extended reality, shedding light on their applications within the field of Urology.

Throughout his presentation, Dr. Stone places a strong emphasis on the pressing need for advanced training methods in response to the rapid evolution of technology and the increasing prominence of minimally invasive surgical techniques. He delves into the utilization of simulation models as a crucial tool for training, while also addressing the unique challenges posed by the COVID-19 pandemic and its impact on traditional training approaches.

Venturing further into the realm of augmented reality, Dr. Stone explores the development of wearable headsets that harness the power of augmented reality, along with web-based platforms that facilitate remote training opportunities. He illustrates how augmented reality enables remote training, empowering instructors to provide guidance and facilitating hands-on practice for trainees, regardless of their physical location.

Dr. Stone showcases real-life scenarios, including transperineal biopsy and renal puncture procedures. These examples highlight the tangible benefits of augmented reality in enhancing hand-eye coordination and improving overall training efficacy.
Concluding his presentation, Dr. Stone presents a survey received from practitioners who have experienced augmented reality training. The survey findings underscore the potential benefits of augmented reality in revolutionizing surgical education by fostering enhanced skill development and promoting a more immersive learning experience.

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Transperineal Mapping Biopsy: Does Technique Matter?

Nelson N. Stone, MD, Professor of Urology, Radiation Oncology, and Oncological Sciences at the Icahn School of Medicine at Mount Sinai and at the Derald H. Ruttenberg Cancer Center at Mount Sinai School of Medicine in New York, discusses transperineal mapping biopsy (TPMB). He explains that treating a single quadrant as identified by MRI may leave unidentified clinically-significant prostate cancer behind. For focal therapy, Dr. Stone advocates for what he calls a unified approach using TPMB, which can be done under local anesthesia.

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Does the Radiation Dose Required to Eradicate Local Disease Differ by Gleason Grade Group?

Nelson N. Stone, MD, Professor of Urology, Radiation Oncology, and Oncological Sciences at the Icahn School of Medicine at Mount Sinai and at the Derald H. Ruttenberg Cancer Center at Mount Sinai, discusses the radiation dose requirements for local disease eradication and the implications for focal therapy. He presents studies of external vema radiation and brachytherapy, which both showed that as the radiation dose increased the likelihood of a positive biopsy decreased two years post treatment. Dr. Stone concludes that it does not matter what type of disease the patient has, it matters how much radiation is used to get rid of the disease. Longer term follow up is needed to see the impact of radiation doses. Post-irradiation biopsies imply that a BED of over 240 Gy can eradicate all prostate cancer. If a tumor is small then there is a potential for a high dose of radiation just to the affected regions. Larger tumors or cases with extensive multifocality will require a full dose treatment with a full or partial implant.

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Can One Biopsy Event Determine Type and Amount of Focal Therapy Treatment?

Nelson N. Stone, MD, Professor of Urology, Radiation Oncology, and Oncological Sciences at the Icahn School of Medicine at Mount Sinai and at the Derald H. Ruttenberg Cancer Center at Mount Sinai argues for the use of Transperineal Mapping Biopsy (TPMB), and against the use of strict criteria and cursory cancer identification methods for finding Focal Therapy eligible patients. He expresses a clinical need for a process that identifies Focal Therapy candidates and lists which portions of the prostate require treatment. He suggests that TPMB can fulfill these goals. Dr. Stone summarizes a review of the evidence for using focal therapy for the treatment of prostate cancer and found that despite at least 50% of patients being Focal Therapy eligible only a minority of patients actually receive the therapy. He critiques a study on Focal Therapy eligibility determined by MRI/US fusion biopsy on the basis of using too strict of criteria for selecting patients and in consideration of the possibility of missing many patients due to not using a biopsy. Dr. Stone discusses several other studies that depict MRI as unreliable in accurately identifying Focal Therapy patients compared to TPMP due to the lower accuracy of MRI across the prostate.

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