Priya N. Werahera, PhD, presented “ExactVu™ Micro-Ultrasound for Diagnosis of Prostate Cancer” during the 29th Annual Perspectives in Urology: Point-Counterpoint, on November 19, 2021, in Coronado Island, San Diego, California.
How to cite: Werahera, Priya N. “ExactVu™ Micro-Ultrasound for Diagnosis of Prostate Cancer.” November 19th, 2021. Accessed Jul 2024. https://grandroundsinurology.com/exactvu-micro-ultrasound-for-diagnosis-of-prostate-cancer/
ExactVu™ Micro-Ultrasound for Diagnosis of Prostate Cancer – Summary:
Priya N. Werahera, PhD, Research Associate Professor in the Departments of Pathology and Bioengineering at the University of Colorado Anschutz Medical Campus, discusses the advantages of using the ExactVu micro-ultrasound platform to diagnose prostate cancer. First, he considers whether MRI imaging can be considered standard of care, arguing that it cannot be seen as such since many cancers are MRI-invisible, it is not cost effective, the technology remains in evolution, and there is high interobserver variability among radiologists. Dr. Werahera then turns to micro-ultrasound, explaining that the new ExactVu system is a 29 MHz machine which provides real-time imaging of prostate cancer lesions, has a high resolution of 70 microns, and can provide both lateral and axial resolution. He cites a meta-analysis which shows that micro-ultrasound is a relatively convenient and cost-effective method of real-time imaging which is highly sensitive in detecting clinically significant prostate cancer. Dr. Werahera then discusses a study at the University of Colorado comparing micro-ultrasound lesions vs. histopathology data of mapping biopsy which found that PRIMUS scores 4-5 have 100% sensitivity at the patient-level and 80% sensitivity at lesion-level for diagnosis of ≥ Gleason Grade 2 prostate cancer lesions. There were 2 undiagnosed Gleason Grade 2 lesions, both of which were small and located anteriorly. Dr. Werahera concludes that ExactVu micro-ultrasound has the potential to improve current imaging standards since it has comparable screening performance to MRI and comparable biopsy performance to MRI fusion, while also allowing for easier, more effective micro-ultrasound/MRI fusion. He also notes that ExactVu micro-ultrasound may enable widespread focal therapy due to its high accuracy in finding satellite lesions and lesion boundaries.
About the 29th Annual Perspectives in Urology: Point Counterpoint conference:
Presented by Program Chair and Grand Rounds in Urology Editor-in-Chief E. David Crawford, MD, this conference brought together leading experts in urology, medical oncology, and radiation oncology to discuss and debate the latest topics in genitourinary cancers, primarily prostate cancer and bladder cancer. This interactive conference offered topical lectures, pro/con debates, interesting-case presentations, interactive panel discussions, and interactive audience and faculty networking.
ABOUT THE AUTHOR
Priya N. Werahera, PhD, is a Research Associate Professor (Retired) in the Departments of Pathology and Bioengineering at the University of Colorado Anschutz Medical Campus. He received his PhD in Electrical and Computer Engineering in 1994. His main research interests are biomedical imaging, optical spectroscopy, bioinstrumentation, computer modeling, and nanotechnologies for cancer diagnostics and therapeutics.
Dr. Werahera is a renowned leader in clinical translational research in prostate cancer diagnosis and therapy with over 30 years of experience. He developed a novel computer algorithm and methodology to create equivalent 3D computer models of human prostate specimens. One of his major accomplishments is the proof-of-concept work on template-guided transperineal mapping biopsy protocol to identify low-risk prostate cancer patients. Additionally, Dr. Werahera led a team of investigators that measured prostate tumor growth rates in humans to find out whether there is a difference in growth rates of latent versus aggressive prostate cancer, proving that maximum tumor doubling times of latent and prostate tumors are not significantly different, as was previously thought.
Dr. Werahera has prototyped a minimally invasive 16g optical biopsy needle capable of diagnosing prostate cancer with very high sensitivity and specificity by inserting an optical sensor at the tip of a biopsy needle (US patent). Additionally, he is the Chief Science Officer (CSO) and Consultant of PreView Medical Inc., a startup company which has licensed this technology and is working on development of ClariCore Optical Biopsy System™ for real-time diagnosis of prostate cancer. Dr. Werahera has written over 60 peer-reviewed journal and conference publications. He is a Senior Life Member of the Institution of Electrical and Electronics Engineers (IEEE).
