Video

AI and Prostate Imaging and Biopsy

Baris Turkbey, MD, discusses the transformative potential and challenges of artificial intelligence (AI) in prostate imaging and biopsies. He begins this 19-minute presentation detailing the benefits of MRI-guided prostate biopsies for localized cancer diagnosis. However, he highlights significant limitations, including low interobserver agreement among radiologists, undermining MRI’s reliability in broader clinical applications.

Turkbey explains how AI can address challenges by standardizing imaging quality and assisting in lesion detection. He references a large-scale European study (PI-CAI) demonstrating AI’s ability to detect clinically significant cancers. Importantly, he illustrates the critical yet underexplored interaction between AI and radiologists, showing that while AI often detects lesions missed by radiologists, its findings are sometimes disregarded, resulting in missed cancers.

Dr. Turkbey introduces an AI model developed at NCI that demonstrates high performance in lesion detection with low false positives. This model, employed for prospective biopsies, radiation oncology planning, and focal therapy, automates prostate segmentation and lesion identification processes, delivering results within minutes. However, his research reveals that human radiologists outperform AI in estimating tumor burden, particularly for PIRADS 4 lesions.

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Introduction to AI in Healthcare

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.

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Rectal Spacer

Abhinav Sidana, MD, MPH, addresses the role of rectal spacers in reducing gastrointestinal toxicity during prostate radiation therapy. The 11-minute presentation discusses three types of FDA-approved rectal spacers: Polyethylene Glycol-Based Spacers (SpaceOAR), Hyaluronic Acid-Based Spacers, and Balloon Spacers (BioProtect).

Dr. Sidana shares images to illustrate the procedural steps for patient preparation, numbing, hydro-dissection, and accurate spacer placement, guided by imaging. Post-procedure imaging, such as MRI or CT scans, can be used to confirm correct placement.

Dr. Sidana also discusses potential complications, including minor pain and rectal fullness and rare instances of severe outcomes like rectourethral fistulas or sepsis. He notes, however, that these devices generally have a favorable safety profile.

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“Just Drink a Glass of Wine” and Other Things Doctors Get Wrong About Sex Med

Kelly J. Casperson, MD, discusses the complexities surrounding female sexual health, addressing both societal misconceptions and medical gaps. In this 21-minute talk, she emphasizes that sex education, even for medical professionals, has been inadequate, with little attention paid to female anatomy.

Casperson highlights the medical community’s oversimplification of female sexual dysfunction, dividing it into issues of desire, arousal, orgasm, and pain. She critiques the cultural tendency to prescribe medications for low sexual desire without first addressing lifestyle, relational dynamics, and patient understanding of their own sexual health.

In her discussion on treatments, Casperson points out the challenges women face in getting access to effective therapies for sexual dysfunction. Additionally, Casperson addresses misconceptions about menopause and the effects of declining hormones on sexual and urinary health.

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