E. David Crawford, MD, presented “Urologic Debate Part 2: MRI vs. Molecular Markers: Which One Should I Use? Markers Perspective” virtually during the Innovations in Urologic Practice 2020 virtual conference in September 2020.

How to cite: Crawford, E. David. “Urologic Debate Part 2: MRI vs. Molecular Markers: Which One Should I Use? Markers Perspective” September 26th, 2020. Accessed Aug 2021. https://grandroundsinurology.com/urologic-debate-part-2-mri-vs-molecular-markers-which-one-should-i-use-molecular-markers/

Urologic Debate Part 2: MRI vs. Molecular Markers: Which One Should I Use? Markers Perspective – Summary:

In the second part of this urologic debate (Part 1 is here), E. David Crawford, MD, Editor-in-Chief of Grand Rounds in Urology and Professor of Urology at the University of California, San Diego, argues that while MRI has a role in prostate cancer detection, PSA and other molecular marker tests should be used earlier in sequence. He notes that while many healthcare providers are unhappy with the current state of early detection for prostate cancer, this has less to do with PSA’s merits as a test for determining the relative risk of prostate cancer, and more with a lack of good guidance on how to interpret it. Dr. Crawford argues that all men with a PSA greater than 1.5 should receive further evaluation, first for evidence of benign prostatic hyperplasia, and then for prostate cancer. Other molecular markers can help determine increased risk and help doctors decide whether or not to biopsy, and marker tests like ConfirmMDx can also help if a biopsy is inconclusive. Dr. Crawford concludes by noting that MRI is best used after patients have been biopsied.

After watching this video and part 1 of this debate (linked above), I agree with:

About the Innovations in Urologic Practice 2020 virtual conference:
Presented by co-chairs Mohit Khera, MD, MBA, MPH, and Michael Coburn, MD, FACS, the Innovations in Urologic Practice conference provides a detailed review and commentary on multiple genitourinary and urologic diseases. Among the featured oncological topics are bladder cancer and immunotherapies, as well as upper tract cancer management, prostate cancer, including state-of-the-art imaging, focal therapy, and MRI. Experts also discuss new tools and techniques for nephrectomy and treating advanced renal cell carcinoma. In terms of general urological approaches, conference also include pelvic reconstruction and trauma, men’s health topics like male infertility and sexual dysfunction, and ways to diagnose and treat infections in the urology patient. Dr. Crawford presented this talk virtually at this year’s conference.