Latest Videos Archives

Genomics and Natural History of MRI Invisible vs Visible Cancers – Implications for Clinical Practice

Posted by Laurence Klotz, MD, FRCSC | Nov 2024

Laurence Klotz, MD, FRCSC, explores the genomics and natural history of MRI-visible versus invisible prostate cancers and their clinical implications.

In this 12-minute presentation, he highlights that while MRI is transformative in identifying significant prostate cancer, it misses about 15% of “invisible cancers.” Recent research reveals that the invisibility of these tumors correlates with favorable genomic profiles, including fewer genetic aberrations and reduced aggressivity.

Dr. Klotz presents compelling evidence linking visible tumors to adverse molecular features and worse clinical outcomes, whereas invisible cancers are largely indolent. He underscores the potential of radiogenomics in guiding treatment decisions, advocating for management strategies based on imaging rather than solely histology.

Dr. Klotz considers avoiding unnecessary systematic biopsies in favor of targeted MRI approaches can minimize patient anxiety and reduce overdiagnosis of insignificant cancers. However, challenges remain in addressing gray areas, such as PI-RADS 3 lesions and visible but low-grade cancers, which may require more nuanced management.

PCa Commentary | Volume 195 – November 2024

Posted by Edward Weber, MD | Nov 2024

PCa Commentary | Volume 195 – November 2024 Posted by Edward Weber | November 2024 NEW...

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.