Los Angeles Archives

Complications of Focal Therapy – Risk Factors, Timepoints, Management

Posted by Amir Lebastchi, MD | Dec 2024

Amir Lebastchi, MD, explores complications associated with focal therapy for prostate cancer, emphasizing the variability influenced by patient characteristics, disease features, treatment factors, and operator experience.

In this 14-minute keynote presentation, Dr. Lebastchi highlights studies reporting a 13-32% overall complication rate. Bleeding complications, sensory changes like penile numbness, and functional impacts such as erectile dysfunction and transient urinary incontinence are discussed.

To minimize risks, operator expertise and careful patient selection are emphasized. Strategies for prevention and management include tailored ablation templates, urethra-sparing techniques, and post-procedure interventions like alpha-blockers and antibiotics. Advanced techniques such as hydro-dissection and real-time monitoring with temperature probes further mitigate risks.

Dr. Lebastchi stresses the safety profile of focal therapy, noting its significantly lower morbidity compared to radical treatments like prostatectomy or radiation. Close postoperative monitoring is recommended to ensure patient recovery and address complications promptly.

Oral Abstracts – Best Clinical Practices for Transperineal Postate Biopsy

Posted by Lorenzo Ramacciotti, MD | Dec 2024

Lorenzo Ramacciotti, MD, a research fellow at USC Urology, explores a consensus-driven approach to addressing unanswered questions about transperineal prostate biopsy. In this 3-minute presentation, Dr. Ramacciotti shares the results of a consensus panel of urologists and interventional radiologists.

Overall, the study underscores the growing preference for transperineal biopsy. These findings enhance patient safety, diagnostic accuracy, and procedural efficacy in prostate cancer management.

AI and Treatment Planning for Prostate Cancer

Posted by Andre Abreu, MD | 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.

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.

Artificial Intelligence for Improving Prostate Cancer Management

Posted by Wayne G. Brisbane, MD | Dec 2024

Wayne Brisbane, MD, explores the integration of AI in focal therapy for prostate cancer management at UCLA.