New Applications and Clinical Possibilities in Prostate Cancer with Micro-Ultrasound

Posted by E. David Crawford, MD | Mar 2019

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 Apr 2024. 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.

Abstract:

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.

About The Author

E. David Crawford, MD

Researcher-physician E. David Crawford, MD, has devoted his career in medicine to educating the public about men's health issues and finding effective techniques and procedures to address prostate cancer, the most common malignancy affecting men in the United States. He is currently a Professor of Urology and Jack A. Vickers Director of Prostate Research at the University of California, San Diego. Dr. Crawford received his medical degree from the University of Cincinnati and his postgraduate training included an internship and residency in urology at the Good Samaritan Hospital in Cincinnati. He subsequently completed a genitourinary cancer fellowship at the University of California Medical Center in Los Angeles. Dr. Crawford is an internationally recognized expert in benign prostate hypertrophy, urologic cancers, and in particular, prostate cancer. He has conducted research in the treatment of advanced bladder cancer, metastatic adenocarcinoma of the prostate, hormone-refractory prostate cancer, and other areas of urological infections and malignancies. He has authored or coauthored over 810 scientific articles, has published seven textbooks, authored over 60 book chapters, and provided more than 2,200 educational talks for patients and physicians. In an effort to raise public awareness about prostate health, Crawford in 1989 founded the Prostate Conditions Education Council (PCEC). The non-profit organization is comprised of a consortium of leading physicians, health educators, scientists, and men's health advocates. PCEC's advocacy for free or low-cost prostate screening has affected the lives of millions of American men. He currently chairs the PCEC. Crawford is an active member of many national and international organizations, including the American Society of Clinical Oncology, the American Urological Association (AUA), and the American Association for the Advancement of Science. Within the AUA, he has been a member of the Committee to Study Urologic Research Funding and the prostate cancer clinical trials subcommittee. Crawford served on the board of governors, the scientific advisory board of the Southwest Oncology Group, and was chairman of the Genitourinary Cancer Committee for 27 years. This group is the largest clinical trials group in the world. Crawford's involvement in the national prostate cancer arena has been widely recognized. He has received many honors and awards, including the CAP Cure Annual Award for Scientific Presentation in 1999 In 1997, he was presented with a 'Freddie Award" at the AMA International Health and Medical Film Competition for the program, ITV: The Cutting Edge Medical Report (Prostate Cancer: Understanding, Diagnosing, and Defeating), which Crawford hosted with special guest, retired General Norman Schwarzkopf. Crawford again won a prestigious 'Freddie Award" 5 years ago... He is a member of Best Doctors of America and was named Healthcare Provider of the Year in the Denver Metro area by the Denver Business Journal. He has been recognized as one of the Best Doctors of America for the past two decades and is recognized as one of the top 20 urologists in the country, for men, by Men’s Health Magazine. In 2018 he received the honor of being named the Distinguished Alumnus of the Year from the University of Cincinnati School of Medicine. In May of 2019, he received the Presidential citation from the American Urological Association recognizing for his “tireless role in genitourinary cancer research that has benefited countless urologic cancer patients.” He accepted the position of Editor in Chief of Grand Rounds in Urology in June of 2019. In 2021, he was the recipient of the Merle Stringer, M.D. annual award for excellence in medicine by the Florida State Medical Association.

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