Latest Videos Archives

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.

AI and Prostate Imaging and Biopsy

Posted by Baris Turkbey, MD | Dec 2024

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.

Introduction to AI in Healthcare

Posted by Giovanni Cacciamani, MD, MSc, FEBU | Dec 2024

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.

Rectal Spacer

Posted by Abhinav Sidana, MD, MPH | Dec 2024

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.