Video Archives

Current and Emerging Role of Radiogenomics in Risk Assessment

Posted by John Feller, MD | 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.

Blue Light vs. White Light Cystoscopy for NMIBC

Posted by Sanjay G. Patel, MD | Jul 2021

Sanjay G. Patel, MD, Assistant Professor of Urology at the University of Oklahoma in Oklahoma City, considers the benefits of blue light versus white light cystoscopy for non-muscle-invasive bladder cancer (NMIBC) imaging. He goes over the importance of good imaging in minimizing progression and recurrence, then looks at the evidence behind blue light cystoscopy, highlighting the improved rates of detection of Ta, T1, and CIS tumors compared to white light cystoscopy. Dr. Patel also notes that these improved rates of detection appear to translate to reduced rates of recurrence and progression as well as increased time to recurrence and progression. He concludes by looking at guideline recommendations on when to use blue light cystoscopy.

Pay for Performance Model to Improve Quality of Active Surveillance in Low-Risk Prostate Cancer

Posted by Franklin Gaylis, MD, FACS | Jun 2021

In the final installment of a 3-part series, Franklin Gaylis, MD, FACS, Chief Scientific Officer of Genesis Healthcare Partners and Voluntary Professor of Urology at the University of California, San Diego, reviews measures derived from a project looking at the value of a pay for performance model in improving the quality of active surveillance in low-risk prostate cancer. He also considers the utility, simplicity, and economy of using an electronic medical record-embedded template. Dr. Gaylis concludes by suggesting that government entities and physicians should collaborate to create the best medical standards and practices possible as the US healthcare system makes the transition from volume to value.

A Review of AUA / SUO / ASTRO Guidelines for MIBC

Posted by Michael S. Cookson, MD, MMHC | Jun 2021

Michael S. Cookson, MD, MMHC, Professor and Chairman of the Department of Urology at the University of Oklahoma Health Sciences Center, summarizes the updated AUA/SUO/ASTRO guideline for the treatment of muscle-invasive bladder cancer (MIBC), a particularly deadly and difficult-to-treat disease. He explains the purpose and methodology of the guideline, summarizes its contents, and makes a note of recent and ongoing research in the areas of chemotherapy, extended pelvic lymphadenectomy, and bladder preservation that may change the guidelines in the future.

Leveraging the EMR to Improve Quality in Clinical Practice

Posted by Franklin Gaylis, MD, FACS | Jun 2021

In part 2 of a 3-part series, Franklin Gaylis, MD, FACS, Chief Scientific Officer of Genesis Healthcare Partners and Voluntary Professor of Urology at the University of California, San Diego, shows how quality reporting improves adherence to best practices in use of active surveillance for low-risk prostate cancer. He reviews the results of a study he and his team began conducting in 2011 which showed that adoption of active surveillance for low-risk prostate cancer increased from 32% to 58% over the course of 3 years as a result of the adoption of reporting standards and reporting transparency whereby doctors could see others’ data. Since widespread adoption of active surveillance is considered a best practice, these data demonstrate how quality reporting can improve care.