E. David Crawford, MD, presented “New Applications and Clinical Possibilities in Prostate Cancer with Micro-Ultrasound” during the 29th Annual International Prostate Cancer Update on January 26, 2019 in Beaver Creek, Colorado.
How to cite: Crawford, E. David “New Applications and Clinical Possibilities in Prostate Cancer with Micro-Ultrasound” January 26, 2019. Accessed Sep 2020. https://grandroundsinurology.com/new-applications-and-clinical-possibilities-in-prostate-cancer-with-micro-ultrasound/
New Applications and Clinical Possibilities in Prostate Cancer with Micro-Ultrasound- Summary:
E. David Crawford, MD, discusses the wide range of clinical possibilities related to prostate cancer imaging with a novel 29 MHz micro-ultrasound technology. He specifically deliberates the possibility of micro-ultrasound to improve screening pathways and focal therapy protocols.
There is strong evidence that a novel 29 MHz micro-ultrasound technology could be a promising solution for the challenges that conventional transrectal ultrasound (TRUS) and multiparametric MRI (mpMRI) present in the evaluation of prostate cancer. Whole mount prostatectomy data from Wodlinger et al. attests to the sensitivity of this modality, reporting that micro-ultrasound found high grade cancers prospectively in 24 out of 25 subjects, as well as 85% of all Grade Group 2 lesions.
This technology offers the possibility of improved screening pathways. While The PRECISION trial suggests men with negative MRI can avoid biopsy, recent work suggests micro-ultrasound has comparable sensitivity to MRI. Under this logic, it could be feasible to use micro-ultrasound to avoid biopsy, as well. However, additional data is necessary to confirm this conclusion.
Further clinical possibilities for this modality may allow broad changes throughout the prostate cancer care pathway. Micro-ultrasound may aid in achieving higher patient compliance to active surveillance, as well as improving protocols for focal therapy. Additionally, there are pre-clinical examples of using micro-ultrasound to guide laser ablation and cryotherapy.
Overall, there is cause for rapid adoption of micro-ultrasound as a replacement for mpMRI in a wide range of applications related to prostate cancer imaging.
About the International Prostate Cancer Update
The International Prostate Cancer Update (IPCU) is an annual, multi-day CME conference focused on prostate cancer treatment updates. The conference’s faculty consists of international experts, and the event caters to urologists, medical oncologists, radiation oncologists, and other healthcare professionals. Topics encompass prostate cancer management, from diagnosis to treating advanced and metastatic disease. Dr. Crawford presented this lecture during the 29th IPCU in 2019. Please visit this page in order to learn more about future IPCU meetings.