Video Archives

Genetic Testing in Prostate Cancer Management

Posted by Abhinav Sidana, MD, MPH | Dec 2024

Abhinav Sidana, MD, MPH, highlights the critical role of genetic testing in prostate cancer management, aiming to familiarize urologists with its fundamentals and practical application. In this 17-minute presentation, Dr. Saadana shares a detailed case study of a healthy 63-year-old male with prostate cancer, underscoring the importance of DNA damage repair pathway genes.

Dr. Sidana categorizes genetic mutations into germline mutations and somatic mutations. Both are essential in identifying actionable genetic alterations that guide early diagnosis, prognosis, and treatment. He emphasizes the prognostic implications of genetic testing in driving treatment strategies. Dr. Sidana highlights the utility of multi-gene panels that assess a broad range of cancers and the importance of genetic counseling in addressing the clinical and psychosocial aspects of testing. Current guidelines recommend testing for high-risk, metastatic, or familial prostate cancer cases.

Course Introduction: Description of Terminology and Review of Guidelines

Posted by Natalie Reizine, MD | Dec 2024

Natalie Reizine, MD, delves into the current understanding, treatment options, and future directions for managing prostate cancer. In this 23-minute presentation, Dr. Reizine discusses disease progression, from localized stages to advanced and metastatic forms, emphasizing the evolving role of imaging technologies like PSMA PET scans in early detection and monitoring.

Dr. Reizine reviews the biology of prostate cancer, particularly its reliance on androgen receptor signaling, which forms the foundation for many therapeutic strategies. She highlights the importance of understanding disease-specific nuances, such as low versus high-volume metastases, to tailor treatment strategies.

Bone health in prostate cancer is emphasized, particularly for patients on long-term ADT. Similarly, dental care and endocrinology referrals are underscored as part of comprehensive management.

Dr. Reizine focuses on emerging therapies and personalized medicine approaches, with attention given to biomarkers like DNA damage repair mutations and new treatment modalities, including PARP inhibitors, radioligand therapies, and T-cell activating constructs. She underscores the need for improved predictive and prognostic biomarkers to effectively refine therapy selection and sequence treatments.

Optimizing Flow: Practical AI Applications in Urology

Posted by Arun Rai, MD, MBA, MS | Dec 2024

Arun Rai, MD, MBA, MS, explores how artificial intelligence can address inefficiencies in healthcare administration and improve patient workflows, particularly in urology. In this 15-minute presentation, Dr. Rai emphasizes that while clinical AI applications are advancing, many opportunities lie in streamlining administrative processes. AI offers solutions to automate repetitive tasks like billing, scheduling, and operational workflows, reducing costs and freeing up staff for more critical work.

The presentation highlights a real-world example from Northwell Health: AI-based scheduling models significantly reduced wait times for patients with prostate cancer and kidney masses. By leveraging data from billing, diagnosis, and operational systems, the models improved access to specialized care, ensuring timely treatment.

The talk also outlines a practical roadmap for developing AI solutions, emphasizing the need to define clear problems, ensure high-quality data, validate models in real-world settings, and implement scalable, user-focused systems.

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.

Robotic Pyeloplasty in 2024: Technical Considerations and Approaches

Posted by David M. Strauss, MD | Dec 2024

David M. Strauss, MD, focuses on robotic pyeloplasty and highlights its role in managing ureteropelvic junction (UPJ) obstruction through various surgical techniques and approaches.

In this 9-minute presentation, Dr. Strauss shows videos of both transecting and non-transecting approaches. He details positioning and access for robotic surgery, emphasizing replicating setups similar to nephrectomy and using a combination of robotic arms. He notes the flexibility of surgical platforms, including transperitoneal and retroperitoneal approaches.

Strauss underlines the durability of pyeloplasty, the importance of individualized patient care, and the value of mastering multiple surgical approaches to optimize outcomes.