Video Archives

Update on PRAISE-U Project – European Union Initiative in PC Screening

Posted by Monique Roobol, PhD | Nov 2024

Monique Roobol, PhD, focuses on prostate cancer screening practices in Europe, highlighting recent developments, ongoing initiatives, and future prospects. In 2022, the European Union (EU) updated its cancer screening recommendations, formally including prostate cancer alongside breast, lung, colorectal, and gastric cancers, spurring momentum for organized prostate cancer screening initiatives across Europe.

In this 11-minute presentation, Dr. Roobol shares the PRAISE-U initiative, launched following the EU’s recommendations. This initiative seeks to pilot and evaluate risk-based screening strategies across all EU member countries, including Spain, Ireland, Lithuania, and Poland.

Overview of Liquid Biomarkers

Posted by E. David Crawford, MD | Nov 2024

E. David Crawford, MD, professor of Urology at the University of California, San Diego, discusses advancements in risk stratification and biomarkers for prostate cancer detection. In his 10-minute presentation, he highlights the challenges of inconsistent screening guidelines, criticizing the current fragmented approach to PSA screening and underscoring the need for simplified, standardized messaging for primary care providers.

He advocates using a PSA cutoff of 1.5 ng/mL as a threshold for identifying at-risk individuals. Molecular markers, combined with PSA levels, improve precision in detecting clinically significant cancers and reducing overtreatment. Dr. Crawford outlines the complementary roles of PSA testing, molecular diagnostics, and multiparametric MRI in refining prostate cancer risk assessments.

Dr. Crawford introduces novel liquid biomarkers and their evolving role in guiding treatment decisions, cautioning that they serve as data points rather than definitive answers. Drawing analogies, he illustrates the multifactorial approach required for accurate prostate cancer diagnosis, akin to assessing risk in complex scenarios.

Optimization of Prostate Biopsy – Micro-Ultrasound versus MRI (OPTIMUM)

Posted by Laurence Klotz, MD, FRCSC | Nov 2024

Laurence Klotz, MD, FRCSC, introduces the OPTIMUM trial, a landmark international study comparing micro-ultrasound and MRI for prostate cancer detection. In this 9-minute presentation, Dr. Klotz explains that micro-ultrasound, operating at 29 MHz, offers three times greater resolution than conventional ultrasound. Using a PRIMUS scoring system analogous to PI-RADS, micro-ultrasound demonstrates its utility in identifying highly sensitive lesions.

Dr. Klotz details the trial’s three-arm design, which involves MRI with conventional ultrasound, MRI with micro-ultrasound, and micro-ultrasound alone to assess non-inferiority and complementary detection capabilities.

Dr. Klotz emphasizes the trial’s importance for minimizing bias and improving diagnostic practices, particularly given its potential to replace or complement MRI. He highlights the study’s robust design, comprehensive objectives, and international collaboration, anticipating its transformative impact on prostate cancer diagnosis and management.

MRI PI-RADS Standardization and Clinical Evaluation

Posted by Clare Tempany, MB, BCh, BAO | Nov 2024

Clare Tempany, MB, BCh, BAO, Harvard Medical School, addresses the standardization and clinical evaluation of PI-RADS, a key tool in prostate cancer imaging. In her 13-minute presentation, Dr. Tempany begins by tracing the history of the RADS program, emphasizing its role in reducing variability and improving communication in radiological reporting. She highlights the utility of prostate MRI, focusing on its capacity to aid in detection, characterization, and targeted biopsies for clinically significant cancers.

Dr. Tempany reviews the PI-RADS v2.1 updates, which refine imaging protocols and stress the inclusion of previously overlooked areas like the anterior fibromuscular stroma. She provides examples to illustrate how these improvements enhance lesion detection and biopsy targeting. While discussing the growing interest in bi-parametric MRI, Dr. Tempany remains cautious, advocating for multiparametric MRI in most cases due to its added value for less experienced readers or in challenging cases.

She highlights the global shift toward recommending MRI before biopsy, citing changes in major guidelines and increased adoption rates. Dr. Tempany underscores the ongoing efforts to enhance MRI quality and interpretation, focusing on integrating AI for future improvements.

Optimizing MRI Techniques for Prostate Cancer Diagnosis

Posted by Fergus Coakley, MD | Nov 2024

Fergus Coakley, MD, Portland Health and Science University, Portland, Oregon, delivers a 10-minute presentation on optimizing MRI for prostate cancer diagnosis, addressing key shifts in diagnostic paradigms. He explains the transition from systematic biopsies following PSA screening to a targeted approach using multiparametric MRI (mpMRI) and in-bore biopsies. He highlights the superior signal-to-noise ratio of endorectal coils, emphasizing their role in enhancing tumor detection and staging. Through case studies, Dr. Coakley demonstrates the efficacy of high-quality MRI in identifying clinically significant cancers that were missed by traditional methods. Data supporting targeted-only biopsies for positive MRI findings are presented, with discussions on the low yield and increased complications of systematic sampling. Dr. Coakley challenges conventional views on multifocality and secondary foci, showing minimal impact on prognosis. He urges the adoption of advanced MRI-guided techniques while acknowledging the need for further research. This insightful presentation invites viewers to explore evolving strategies in prostate cancer diagnostics and their implications for patient outcomes.