Samir S. Taneja, MD, presented “How to Utilize MRI for Focal Therapy Planning” during the 25th Annual Southwest Prostate Cancer Symposium conference on December 11, 2021, in Scottsdale, Arizona.
How to cite: Taneja, Samir S. “How to Utilize MRI for Focal Therapy Planning.” December 11, 2021. Accessed Nov 2024. https://grandroundsinurology.com/how-to-utilize-mri-for-focal-therapy-planning/
How to Utilize MRI for Focal Therapy Planning
Samir S. Taneja, MD, the James M. Neissa and Janet Riha Neissa Professor of Urologic Oncology, Co-Director of the Smilow Comprehensive Prostate Cancer Center, and Vice Chair of the Department of Urology at NYU Grossman School of Medicine, discusses how to use MRI in planning and doing follow-up on focal therapy for prostate cancer. He begins by introducing the critical decisions in focal therapy implementation, including candidate selection, method of disease mapping/identification, choice of energy, and manner of follow-up/verification of efficacy. Dr. Taneja then lists imaging-related factors influencing oncologic efficacy including tumor size/extent, tumor location, focality, energy source, and gland size. He considers biopsy vs. MRI in treatment planning, explaining that systematic biopsy is inadequate for mapping disease, transperineal template biopsy is the gold standard, and MRI/MRI-targeted biopsy is not perfect, but very good. Dr. Taneja notes that MRI misses some clinically significant cancer, but observes that a 9 to 10 millimeter MRI/MRI-targeted biopsy guided focal ablation seems to identify all the index tumors. He also goes over imaging factors such as disease location and volume affect the choice of energy selection for focal therapy. Dr. Taneja then considers the benefits of imaging post partial gland ablation, explaining that very early imaging evaluates the anatomy of ablation but not its efficacy, intermediate interval imaging guides biopsy and identifies need for retreatment, delayed imaging identifies recurrence. He also briefly discusses the use of PET in cases where MRI does not detect recurrence. Dr. Taneja concludes that MRI has the ability to localize the index tumor, that margin considerations should take into account the known limitations of MRI in disease mapping, and that MRI remains the essential mainstay for monitoring following focal ablation.
About the 25th Annual Southwest Prostate Cancer Symposium:
Presented by Program Chairs Nelson N. Stone, MD, and Richard G. Stock, MD, this conference educated attendees about advances in the management of localized and advanced prostate cancer, with a focus on imaging, technology, and training in the related devices. It included a scientific session, as well as live demonstrations of surgical techniques. You can learn more about the conference here.
ABOUT THE AUTHOR
Dr. Samir S. Taneja is the James M. Neissa and Janet Riha Neissa Professor of Urologic Oncology in the Department of Urology at NYU Grossman School of Medicine, as well as the Vice Chair of Urology and Director of Urologic Oncology at NYU Langone Health. When Dr. Taneja first joined NYU Langone he focused broadly on urologic oncology, treating people with cancers of the prostate, kidney, bladder, and testis. Now, about 70 percent of his practice focuses on prostate cancer or the suspicion of prostate cancer.
The work Dr. Taneja has been able to conduct at NYU Langone and its Perlmutter Cancer Center and Smilow Comprehensive Prostate Cancer Center has transformed the field of prostate cancer diagnosis and treatment by improving methods of prostate imaging, cancer detection, and disease localization. Dr. Taneja strives to integrate new technologies into his practice to evolve the practice of oncology. This has allowed him to care for prostate cancer patients individually by avoiding surgery or radiation when not needed, and using new targeted approaches to treat the disease when possible.
Dr. Taneja's clinical research focuses on the use of imaging to detect and treat prostate cancer. He pioneered the use of MRI to diagnose and pinpoint prostate cancer, and in MRI-guided focal ablative therapies that aim to destroy only the cancerous portion of the prostate.
He has authored more than 200 articles, 30 book chapters, and 6 textbooks and monographs on urologic cancer and surgery. In addition, he is the editor of Taneja’s Complications of Urologic Surgery: Prevention and Diagnosis, one of the most widely read textbooks in American urology.
