Video Archives

Rise of the Machines: AI in Prostate MRI

Posted by Baris Turkbey, MD | Jun 2024

Baris Turkbey, MD, explores the capabilities and training gaps of Artificial Intelligence in MRI prostate cancer detection. He begins by establishing the ubiquity of MRI technology in prostate cancer treatment across the globe and highlighting the shortcomings of previous and current guidelines on the use of MRI for disease detection.

Dr. Turkbey highlights the shortcomings of previous and current guidelines on the use of MRI for disease detection, noting that current data is too dependent on the experience of the practitioner. He then introduces the idea of using Artificial Intelligence (AI) to standardize prostate cancer detection.

Dr. Turkbey then presents examples of AI successfully detecting prostate cancer lesions on MRI imaging. However, he cautions that more rigorous training and supervision is still needed for AI imaging, as AI has a high false-positive rate.

Dr. Turkbey concludes by examining the impact of image quality on AI performance, indicating that more training is required before these models can be deployed as a diagnostic aid. He presents data that demonstrates that low-quality images significantly impact the cancer detection rate of AI models.

Focal Therapy for Prostate Cancer: Role of Brachytherapy

Posted by Daniel Y. Song, MD | Jun 2024

Dr. Daniel Y. Song examines the critical role of brachytherapy as a focal therapy in the management of prostate cancer, emphasizing its significance within the broader context of precision oncology. Dr. Song discusses the technical aspects and advancements in brachytherapy, including the use of image-guided techniques. He underscores the importance of meticulous planning and execution in achieving optimal therapeutic outcomes.
Dr. Song also addresses the evolving role of brachytherapy in the era of multimodal treatment approaches. He explores its integration with other therapeutic modalities, such as external beam radiation therapy and hormonal therapy, to enhance treatment efficacy and tailor interventions to individual patient profiles. This approach aligns with the principles of personalized medicine, aiming to optimize therapeutic benefits while minimizing treatment-related morbidity.

Prostate Cancer Screening Update

Posted by Gerald L. Andriole, Jr., MD | Jun 2024

Gerald L. Andriole, Jr., MD, provides guidance on how urologists can effectively streamline their processes for prostate cancer screening. In his presentation, he discusses five supplemental areas where urologists can improve prostate cancer screening:

Identification of Above Average Risk Patients
Simplification of PSA Guidance for Patients and PCPs
Early Identification of Clinically Significant Prostate Cancer
Reduction of Unnecessary Initial and Repeated Biopsies
Enhanced Risk Stratification

For each area, Dr. Andriole outlines the current standard practice and suggests methods for improvement. To support the suggested methods, he presents data illustrating the method’s outcome for patients and practitioners.

Testosterone Treatment and Prostate Cancer Risk

Posted by Thomas J. Walsh, MD, MBA, MS | Jun 2024

Thomas J. Walsh, MD, MBA, MS, explores the relationship between testosterone treatment and risk for developing prostate cancer. Dr. Walsh begins by stating that he does not believe that testosterone treatment should be considered a risk factor for prostate cancer. He explains that according to the American Urological Association (AUA), testosterone therapy is appropriate treatment for patients with clinically significant testosterone deficiency after full discussion of potential adverse effects.

Dr. Walsh then outlines the positive and negative effects of testosterone therapy and shares data from a meta-analysis of the effect of testosterone replacement therapy on prostate cancer. He notes the issue of screening bias and compares the longitudinal comorbidities that showed virtually no difference in risk regardless of testosterone treatment.

Dr. Walsh concludes by sharing longitudinal data on cumulative testosterone treatment results that showed no increased risk of prostate cancer. Similarly, data did not show a statistical difference in prostate cancer risk according to the type of testosterone therapy a man received.

Understanding Metastatic Castration-Resistant Prostate Cancer

Posted by Shell Liang, PhD | Jun 2024

Shell Liang, PhD, discusses metastatic castration-resistant prostate cancer (mCRPC), a form of prostate cancer that progresses despite androgen deprivation therapy (ADT). Dr. Liang emphasizes the critical need for advanced therapeutic strategies to manage this aggressive cancer subtype effectively.
The presentation reviews the current therapeutic landscape for mCRPC, focusing on second-generation AR pathway inhibitors such as abiraterone and enzalutamide. Additionally, the discussion includes the role of chemotherapeutic agents like docetaxel and cabazitaxel. Dr. Liang also explores emerging treatment modalities, including PARP inhibitors and immunotherapies.
Dr. Liang advocates using genomic profiling to identify actionable mutations and tailor treatments to individual patient profiles. This approach aims to optimize therapeutic efficacy and minimize adverse effects, aligning with the principles of precision medicine.