Gerald L. Andriole, Jr., MD, presented “Prostate Micro-ultrasound” during the 42nd Annual Ralph E. Hopkins Urology Seminar on February 1, 2023, in Jackson Hole, Wyoming.
How to cite: Andriole, Jr., Gerald L. “Prostate Micro-ultrasound.” February 1, 2023. Accessed Jul 2024. https://grandroundsinurology.com/Prostate-Micro-ultrasound/
Prostate Micro-ultrasound – Summary
Gerald L. Andriole, Jr., MD, Director of Urology in the National Capital Region at the Brady Urologic Institute at Johns Hopkins University, discusses micro-ultrasound. He explains that novel micro-ultrasound operates at 29 MHz (much higher than conventional 6-9 MHz systems) and that it allows most prostate ducts to be visualized and tissue patterns appreciated. He explains the prostate risk identification using micro-ultrasound (PRI-MUS) risk identification protocol for systematically characterizing tissue, illustrating examples of various PRI-MUS levels. Dr. Andriole cites research that concludes practitioners become adept at interpreting micro-ultrasound lesions after about 30-40 scans. He presents a comparison of images from conventional ultrasound, micro-ultrasound, and multiparametric magnetic resonance imaging (mpMRI) that illustrates the superior imaging produced by micro-ultrasound. Dr. Andriole addresses transrectal and transperineal approaches, as well as MRI fusion biopsy using cognitive-assist fusion. He shows data validating PRI-MUS classification and research that concludes micro-ultrasound finds more cancer than conventional transrectal ultrasound (TRUS) systematic biopsy. Dr. Andriole also shares data that show that using systematic biopsy, micro-ultrasound targeted biopsy, and MRI together identifies the greatest proportion of clinically significant prostate cancer. He cites additional comparative studies of imaging types, and a recent study that examined micro-ultrasound results in men with negative MRI and found, of 125 patients with a negative MRI, 47 had cancer (and 33 of 34 who had clinically-significant disease were identified with micro-ultrasound). Dr. Andriole then reviews National Comprehensive Cancer Network (NCCN) guidelines that state “it is recommended that MRI should precede biopsy and image-guided biopsy techniques be employed routinely,” before describing the OPTIMUM trial. Dr. Andriole concludes that micro-ultrasound provides a fast, flexible, and accurate MRI-fusion experience with real-time visualization.
About The 42nd Annual Ralph E. Hopkins Urology Seminar:
The Ralph E. Hopkins Urology Seminar is a multi-day meeting focused on training urologists in the latest in assessing, diagnosing, and treating urologic conditions in the clinical setting. Updates are provided on urologic cancers, stone disease, urologic reconstruction, female urology, infertility, sexual function, emerging surgical techniques, and general urology. The 42nd iteration of the meeting took place from February 1st to 4th, 2023, in Jackson Hole, Wyoming.
For further educational activities from this conference, visit our collection page.
ABOUT THE AUTHOR
Gerald L. Andriole, Jr., MD, is the global Chief Medical Officer at Prostatype Genomics. He previously was Professor and Director of Urology in the National Capital Region at the Brady Urologic Institute at Johns Hopkins University. He also formerly served as the Robert K. Royce Distinguished Professor and Chief of Urologic Surgery at Barnes-Jewish Hospital, the Siteman Cancer Center, and Washington University School of Medicine in St. Louis, Missouri. Dr. Andriole received his medical degree from Jefferson Medical College in Philadelphia, Pennsylvania. He trained in surgery at Strong Memorial Hospital and the University of Rochester and completed his Urology Residency at Brigham and Women’s Hospital and Harvard Medical School. Subsequently, he was a Fellow in Urologic Oncology at the National Cancer Institute in Bethesda, Maryland. Dr. Andriole has over 40 years of consistent contributions in the areas of prostate cancer screening and prevention research as well as BPH. He has contributed over 450 peer-reviewed publications. He chaired the Prostate Committee of NCI’s PLCO Cancer Screening Trial, the Steering Committee of the international REDUCE Chemoprevention Trial and the Prostate Committee of the SUO Clinical Trials Consortium. He is a member of the American Urological Association, the Academy of Master Surgical Educators of the American College of Surgeons, the American Surgical Association, the American Association of Genitourinary Surgeons, and the Clinical Society of Genitourinary Surgeons, among other societies.
He has received the Outstanding Achievement Award from the Urologic Oncology Branch of NCI, the Distinguished Clinician Award from Washington University, the Alumni Award from Jefferson Medical College and the Williams Award for Prostate Cancer Research Excellence from the AUA Urology Care Foundation, among others.
