Prostate MRI: Who needs it?
|
|
- Sarah Stone
- 6 years ago
- Views:
Transcription
1 Prostate MRI: Who needs it? Fergus Coakley MD, Professor of Radiology and Urology, Vice Chair for Clinical Services, Chief of Abdominal Imaging, UCSF Abdominal Imaging Magnetic Resonance Science Center Anatomic Pathology Cho Cr Cit Cho Cr Cit Radiation Oncology Normal Cancer Urology
2 Objectives Provide the evidence-basis for MRI of prostate cancer Describe the role of MRI of prostate cancer according to disease risk category
3 Importance of prostate cancer 200 Breast Average years of life lost: (1000s) Prostate Breast = 13.5 Prostate = ACS 2009 estimates 0 Brit J Can 2005; 92: Incidence Mortality
4 Risk stratification Free of PSA recurrence LOW INTER HIGH Several risk stratification schemes described D Amico system common Important predictor of outcome Months from brachytherapy Potters et al. J Urol 2008; 179: S20-4 D Amico et al, J Urol 2000; 164: PSA <10 < >20 < >20 >20 Gleason DRE % +ve biopsy 2-6 & T1-T2A 2-6 & T1-2A 7 or T2B 8-10 or T2C 2-6 & T1-T2A 7 or T2B 7 or T2B 8-10 or T2C 8-10 or T2C < <34 <34 > > >50
5 Prostate MRI - basic SE T1 axial Aortic bifurcation to symphysis pubis TR/TE=700/8; 5/1mm; FOV=24; 256x192; 1 NEX Frequency direction transverse FSE T2 axial Prostate (high resolution) TR/TE =5000/96; 3/0mm; FOV=14; 256x192; 3 NEX Frequency direction anteroposterior FSE T2 coronal Prostate (high resolution) TR/TE =5000/96; 3/0mm; FOV=14; 256x192; 3 NEX
6 Prostate MRI - advanced Spectroscopic imaging: minute sequence High choline and low citrate in cancer Improves detection/characterization Perfusion: Cancer enhances faster and brighter than normal peripheral zone tissue and has greater washout T2 T1 pre T1 post Diffusion: Reduced diffusion in cancer Clinical role under investigation T2 ADC
7 MRI for low risk disease? A healthy 72 year old man is found to have a PSA of 8.4 ng/ml. DRE is unremarkable. Gleason 6 cancer is found in 15% of one sextant biopsy core. Based on existing guidelines, should this patient undergo MRI, or any other imaging?
8 Existing guidelines Source Recommendations ACR Bone scan, CT, MRI if PSA > 10 or Gleason > 6 AUA Bone scan if PSA > 20, poorly differentiated, or T3 CT, MRI if PSA > 25 Utility of endorectal MRI/MRSI not determined AJCC Bone scan, CT, MRI if PSA > 20 or Gleason > 7-8 Radiology 2007; 243: 28-53
9 No imaging for low risk patients? Likelihood of locally advanced or metastatic disease is low Risk group ECE SVI Node positive Lee et al, Int J Radiat Oncol Biol Phys 2007; 68: Pettus et al. J Endourol 2008; 22: Gleave et al, Urology 1996; 47: Rhoden et al, Int Braz J Urol 2003; 29: Hirobe et al, Jpn J Clin Oncol 2007; 37: Positive bone scan Low 9% 1% 1.3% 0% Intermediate 20% 5% 6% % High 47% 30% 20% 21-41%
10 Possible roles in low risk disease Map tumor prior to focal therapy: 100% PPV if MRSI volume > 0.54 cc Select patients for active surveillance: Az of 0.80 with MRI versus 0.73 without Monitor patients on active surveillance: MRI/MRSI progression correlates with PSA velocity Chang et al, ARRS AGM, 2011 Shukla-Dave et al, BJU Int 2007; 99: Coakley et al, BJU Int 2007; 99: 41-5
11 Imaging for higher risk patients? Likelihood of locally advanced or metastatic disease is high Risk group ECE SVI Node positive Lee et al, Int J Radiat Oncol Biol Phys 2007; 68: Pettus et al. J Endourol 2008; 22: Gleave et al, Urology 1996; 47: Rhoden et al, Int Braz J Urol 2003; 29: Hirobe et al, Jpn J Clin Oncol 2007; 37: Positive bone scan Low 9% 1% 1.3% 0% Intermediate 20% 5% 6% % High 47% 30% 20% 21-41%
12 MRI findings in T3 disease Focal irregular bulge NVB asymmetry Obliteration of RP angle Seminal vesicle invasion 24-38% 21-38% 24-50% 43-71% Sens 77-88% 81-95% 81-95% 99% Spec 58-65% 56-70% 57-71% 95-97% Acc Radiology 1997; 202: and 2005; 237:
13 MRI and staging MSKCC study of 344 patients: MRI (+MRSI in 216) prior to radical prostatectomy Likelihood of ECE rated from 1-5 based on reports 83/344 (24.1%) had ECE at pathology Univariate and multivariate ROC analysis : PSA - Highest % of cancer in cores Gleason score - % of cancer-positive cores DRE stage - Presence of PNI Radiology 2004; 232:
14 Results Univariate: MRI had highest A z (0.74) Multivariate: Better staging with MRI (0.84 vs 0.77; p = 0.02)
15 The BIG issue... Gleason 6 left apex PSA 9.2 EIGHT years later PSA 11.9 Gleason 6 right apex PSA 5.8 ONE year later PSA 10.8
16 Prognostic role of MRI NS T2 T3 Significant Pre-RRP MRI (n = 1025) 5 year PSA outcome v. MR stage D Amico et al, J Urol 2000; 164: Significant Low (1-3: 61%) Intermediate (3-6:19%) High (7-9: 20%) PSA <10 < >20 < >20 >20 Gleason DRE % +ve biopsy 2-6 & T1-T2A 2-6 & T1-2A 7 or T2B 8-10 or T2C 2-6 & T1-T2A 7 or T2B 7 or T2B 8-10 or T2C 8-10 or T2C < <34 <34 > > >50
17 Outcome studies Pre-EBRT studies: MRI alone - ECE only independent predictor of metastases MRI and MRSI - MRSI tumor volume predicts of PSA failure; MRI tumor size & SVI predict metastases All-comers study: Gross ECE/SVI worsens prognosis Radiology 2008; 247:141-6 Int J Rad Onc Biol Phys 2009; 73: Muglia et al, RSNA 2009 Risk Gross ECE/SVI Low 1/1085 (0.1%) Inter 25/489 (5.1%) High 40/203 (19.7%)
18 Illustrative case 58-year old, Gleason 6, PSA 6.1 T2b Rising PSA 4 years later (after brachytherapy) AND FINALLY NECT #1
19 Conclusions Difficult organ and disease to image MRI more useful in intermediate and high risk disease: Contributes to staging and prognostication Role in low risk disease evolving: DO NOT image for T3+, N+, M+ disease MAYBE image for selection/monitoring of active surveillance or planning focal therapy
Low risk. Objectives. Case-based question 1. Evidence-based utilization of imaging in prostate cancer
Evidence-based utilization of imaging in prostate cancer Fergus Coakley MD, Professor of Radiology and Urology, Vice Chair for Clinical Services, Chief of Abdominal Imaging, UCSF Objectives State the modalities,
More informationProstate MRI for local staging and surgical planning in prostate cancer
Prostate MRI for local staging and surgical planning in prostate cancer 15th Annual Floyd A. Fried Advances in Urology Symposium June 23, 2017 Ray Tan, MD, MSHPM Assistant Professor Disclosures None Objectives
More informationCase Discussions: Prostate Cancer
Case Discussions: Prostate Cancer Andrew J. Stephenson, MD FRCSC FACS Chief, Urologic Oncology Glickman Urological and Kidney Institute Cleveland Clinic Elevated PSA 1 54 yo, healthy male, family Hx of
More informationProblems: TRUS Bx. Clinical questions in PCa. Objectives. Jelle Barentsz. Prostate MR Center of Excellence.
Multi-parametric MR imaging in Problems: TRUS Bx Low Risk Prostate Cancer Important cancers are missed Jelle Barentsz Clinically insignificant cancers are identified by Prostate MR Center of Excellence
More informationStephen McManus, MD David Levi, MD
Stephen McManus, MD David Levi, MD Prostate MRI Indications INITIAL DETECTION, STAGING, RECURRENT TUMOR LOCALIZATION, RADIATION THERAPY PLANNING INITIAL DETECTION Clinically suspected prostate cancer before
More informationProstate Cancer DFP Case of the Week
Prostate Cancer DFP Case of the Week Antonio C. Westphalen, MD PhD Clinical Prostate MR Imaging Program, Director Associate Professor of Radiology and Urology University of California, San Francisco Case
More informationUtility of Prostate MRI. John R. Leyendecker, MD
Utility of Prostate MRI John R. Leyendecker, MD Professor of Radiology and Urology Executive Vice Chair of Clinical Operations Section Head, Abdominal Imaging Wake Forest University School of Medicine;
More informationClinically Localized Prostate Cancer: AUA/ASTRO/SUO Guideline Very Low-/Low-Risk Disease
Clinically Localized Prostate Cancer: AUA/ASTRO/SUO Guideline Very Low-/Low-Risk Disease Jeffrey A. Cadeddu, MD Professor, Department of Urology UT Southwestern Medical Center Vice-Chair, AUA/ASTRO/SUO
More informationAnatomic Imaging of Prostate Cancer
Masoom Haider, MD, FRCP(C) Professor of Radiology, University of Toronto Clinician Scientist, Ontario Institute of Cancer Research Senior Scientist, Sunnybrook Research Institute Chief, Dept of Medical
More information11/10/2015. Prostate cancer in the U.S. Multi-parametric MRI of Prostate Diagnosis and Treatment Planning. NIH estimates for 2015.
Multi-parametric MRI of Prostate Diagnosis and Treatment Planning Temel Tirkes, M.D. Associate Professor of Radiology Director, Genitourinary Radiology Indiana University School of Medicine Department
More informationBest Papers. F. Fusco
Best Papers UROLOGY F. Fusco Best papers - 2015 RP/RT Oncological outcomes RP/RT IN ct3 Utilization trends RP/RT Complications Evolving role of elnd /Salvage LND This cohort reflects the current clinical
More informationProstate MRI. Overview. Introduction 2/20/2015. Prostate cancer is most frequently diagnosed noncutaneous cancer in males (25%)
Prostate MRI John Bell, MD Introduction Prostate Cancer Screening Staging Anatomy Prostate MRI overview Functional MRI Multiparametric Approach Indications Example Cases Overview Introduction Prostate
More informationMR-US Fusion Guided Biopsy: Is it fulfilling expectations?
MR-US Fusion Guided Biopsy: Is it fulfilling expectations? Kenneth L. Gage MD, PhD Assistant Member Department of Diagnostic Imaging and Interventional Radiology 4 th Annual New Frontiers in Urologic Oncology
More informationPSMA PET in patients with prostate cancer
PSMA PET in patients with prostate cancer Thomas Hope, MD Assistant Professor of Radiology, UCSF Abdominal Imaging and Nuclear Medicine Co-director, PET/MRI Chief of MRI, San Francisco VA Medical Center
More informationUnderstanding the risk of recurrence after primary treatment for prostate cancer. Aditya Bagrodia, MD
Understanding the risk of recurrence after primary treatment for prostate cancer Aditya Bagrodia, MD Aditya.bagrodia@utsouthwestern.edu 423-967-5848 Outline and objectives Prostate cancer demographics
More informationProstate Cancer Local or distant recurrence?
Prostate Cancer Local or distant recurrence? Diagnostic flowchart Vanessa Vilas Boas Urologist VFX Hospital FEBU PSA - only recurrence PSA recurrence: 27-53% of all patients undergoing treatment with curative
More informationPI-RADS classification: prognostic value for prostate cancer grading
PI-RADS classification: prognostic value for prostate cancer grading Poster No.: C-1622 Congress: ECR 2014 Type: Scientific Exhibit Authors: I. Platzek, A. Borkowetz, T. Paulus, T. Brauer, M. Wirth, M.
More informationDetection, Screening and. Jelle Barentsz, Radboudumc, Nijmegen, NL
Detection, Screening and Staging with mpmri Jelle Barentsz, Radboudumc, Nijmegen, NL NO CONFLICT OF INTEREST Paradigm shift Past staging TRUS-GBx ERC, MRSI invasive Current detection agressive PCa mpmri-directed
More informationProstate Cancer: 2010 Guidelines Update
Prostate Cancer: 2010 Guidelines Update James L. Mohler, MD Chair, NCCN Prostate Cancer Panel Associate Director for Translational Research, Professor and Chair, Department of Urology, Roswell Park Cancer
More informationThe Role of Combined MRI & MRSI in Treating Prostate Cancer
The Role of Combined MRI & MRSI in Treating Prostate Cancer By the Prostate Cancer MRI/MRSI Group (Penelope Wood, BS, John Kurhanewicz, Ph.D., Daniel Vigneron, Ph.D., Mark Swanson, Ph.D., and Saying Li,
More informationNavigating the Stream: Prostate Cancer and Early Detection. Ifeanyi Ani, M.D. TPMG Urology Newport News
Navigating the Stream: Prostate Cancer and Early Detection Ifeanyi Ani, M.D. TPMG Urology Newport News Understand epidemiology of prostate cancer Discuss PSA screening and PSA controversy Review tools
More informationProstate Cancer MRI. Accurate Diagnosis and Treatment. PSA to Prostate MRI. for patients and curious doctors
6 Prostate Cancer MRI Accurate Diagnosis and Treatment PSA to Prostate MRI for patients and curious doctors Samuel Aronson, M.D. Vincent Pelsser, M.D. Franck Bladou, M.D. Armen Aprikian, M.D. & Marc Emberton,
More informationMagnetic resonance imaging predictors of extracapsular extension of prostate cancer: Do they accurately reflect pt3 staging?
Magnetic resonance imaging predictors of extracapsular extension of prostate cancer: Do they accurately reflect pt3 staging? Poster No.: C-1399 Congress: ECR 2010 Type: Scientific Exhibit Topic: Genitourinary
More informationProstate MRI Hamidreza Abdi, MD,FEBU Post Doctoral Fellow Vancouver Prostate Centre UBC Department of Urologic Sciences May-20144
Prostate MRI Hamidreza Abdi, MD,FEBU Post Doctoral Fellow Vancouver Prostate Centre UBC Department of Urologic Sciences May-20144 Objectives: Detection of prostate cancer the need for better imaging What
More informationPercentage of Positive Biopsy Cores Predicts Presence of a Dominant Lesion on MRI in Patients with Intermediate Risk Prostate Cancer
Open Access Journal of Radiology and Oncology Research Article ISSN 2573-7724 Percentage of Positive Biopsy Cores Predicts Presence of a Dominant Lesion on MRI in Patients with Intermediate Risk Prostate
More informationS Crouzet, O Rouvière, JY Chapelon, F Mege, X martin, A Gelet
S Crouzet, O Rouvière, JY Chapelon, F Mege, X martin, A Gelet Why HIFU? Efficacy demonstrated Real time control of the target Early control of the necrosis area is possible with MRI or TRUS using contrast
More informationLocalized Prostate Cancer Have we finally got it right? Shingai Mutambirwa Professor & Chair-Division Urology DGMAH & SMU Pretoria SOUTH AFRICA
Localized Prostate Cancer Have we finally got it right? Shingai Mutambirwa Professor & Chair-Division Urology DGMAH & SMU Pretoria SOUTH AFRICA ESMO Cape Town 14 Feb 2018 Disclosures Advisory boards/lecturer/consultant-
More informationDetection & Risk Stratification for Early Stage Prostate Cancer
Detection & Risk Stratification for Early Stage Prostate Cancer Andrew J. Stephenson, MD, FRCSC, FACS Chief, Urologic Oncology Glickman Urological and Kidney Institute Cleveland Clinic Risk Stratification:
More informationProstate Cancer: Role of Pretreatment Multiparametric 3-T MRI in Predicting Biochemical Recurrence After Radical Prostatectomy
Genitourinary Imaging Original Research Park et al. MRI to Predict Biochemical Recurrence After Radical Prostatectomy Genitourinary Imaging Original Research Jung Jae Park 1,2 Chan Kyo Kim 1 Sung Yoon
More informationAdvances in Magnetic Resonance Imaging: How They Are Changing the Management of Prostate Cancer
EUROPEAN UROLOGY 59 (2011) 962 977 available at www.sciencedirect.com journal homepage: www.europeanurology.com Review Prostate Cancer Advances in Magnetic Resonance Imaging: How They Are Changing the
More informationin 32%, T2c in 16% and T3 in 2% of patients.
BJUI Gleason 7 prostate cancer treated with lowdose-rate brachytherapy: lack of impact of primary Gleason pattern on biochemical failure Richard G. Stock, Joshua Berkowitz, Seth R. Blacksburg and Nelson
More informationDate Modified: May 29, Clinical Quality Measures for PQRS
Date Modified: May 29, 2014 Clinical Quality s for PQRS # Domain Type Denominator Numerator Denominator Exclusions/Exceptions Rationale QCDR-1 QCDR-2 Patient Safety 102 Efficiency and Cost Reduction QCDR-3
More informationClinical Case Conference
Clinical Case Conference Intermediate-risk prostate cancer 08/06/2014 Long Pham Clinical Case 64 yo man was found to have elevated PSA of 8.65. TRUS-biopies were negative. Surveillance PSA was 7.2 in 3
More informationPROSTATE MRI. Dr. Margaret Gallegos Radiologist Santa Fe Imaging
PROSTATE MRI Dr. Margaret Gallegos Radiologist Santa Fe Imaging Topics of today s talk How does prostate MRI work? Definition of multiparametric (mp) MRI Anatomy of prostate gland and MRI imaging Role
More informationProstate MRI: Not So Difficult. Neil M. Rofsky, MD, FACR, FSCBTMR, FISMRM Dallas, TX
Prostate MRI: Not So Difficult Neil M. Rofsky, MD, FACR, FSCBTMR, FISMRM Dallas, TX What is the biggest barrier to your practice incorporating prostate MRI? 1) I don t know how to read the cases 2) I don
More informationPathologists Perspective on Focal Therapy: The Role of Mapping Biopsies and Markers
Pathologists Perspective on Focal Therapy: The Role of Mapping Biopsies and Markers M. Scott Lucia, MD Professor and Vice Chair of Anatomic Pathology Chief of Genitourinary and Renal Pathology Dept. of
More information2/14/09. Why Discuss this topic? Managing Local Recurrences after Radiation Failure. PROSTATE CANCER Second Treatment
Why Discuss this topic? Mack Roach III, MD Professor and Chair Radiation Oncology UCSF Managing Local Recurrences after Radiation Failure 1. ~15 to 75% of CaP pts recur after definitive RT. 2. Heterogeneous
More informationProstate Case Scenario 1
Prostate Case Scenario 1 H&P 5/12/16: A 57-year-old Hispanic male presents with frequency of micturition, urinary urgency, and hesitancy associated with a weak stream. Over the past several weeks, he has
More informationProstate cancer staging and datasets: The Nitty-Gritty. What determines our pathological reports? 06/07/2018. Dan Berney Maastricht 2018
Prostate cancer staging and datasets: The Nitty-Gritty What determines our pathological reports? Dan Berney Maastricht 2018 Biopsy reporting. How not to do it. The TNM 8 th edition. Changes good and bad
More informationMy biopsy shows prostate cancer: How bad is it? How to stage prostate cancer
My biopsy shows prostate cancer: How bad is it? How to stage prostate cancer Giuseppe Petralia giuseppe.petralia@ieo.it Division of Radiology, IEO - European Institute of Oncology IRCCS, Milan Department
More informationDiffusion Weighted Imaging in Prostate Cancer
Diffusion Weighted Imaging in Prostate Cancer Disclosure Information Vikas Kundra, M.D, Ph.D. No financial relationships to disclose. Education Goals and Objectives To describe the utility of diffusion-weighted
More informationHow to detect and investigate Prostate Cancer before TRT
How to detect and investigate Prostate Cancer before TRT Frans M.J. Debruyne Professor of Urology Andros Men s Health Institutes, The Netherlands Bruges, 25-26 September 2014 PRISM Recommendations for
More informationFieldStrength. Multi-parametric 3.0T MRI provides excellent prostate imaging
FieldStrength Publication for the Philips MRI Community Issue 35 September / October 2008 Multi-parametric 3.0T MRI provides excellent prostate imaging Three different centers show that advances in imaging
More informationNIH Public Access Author Manuscript Int J Radiat Oncol Biol Phys. Author manuscript; available in PMC 2013 April 1.
NIH Public Access Author Manuscript Published in final edited form as: Int J Radiat Oncol Biol Phys. 2012 April 1; 82(5): e787 e793. doi:10.1016/j.ijrobp.2011.11.030. Does local recurrence of prostate
More informationGUIDELINES ON PROSTATE CANCER
10 G. Aus (chairman), C. Abbou, M. Bolla, A. Heidenreich, H-P. Schmid, H. van Poppel, J. Wolff, F. Zattoni Eur Urol 2001;40:97-101 Introduction Cancer of the prostate is now recognized as one of the principal
More informationA schematic of the rectal probe in contact with the prostate is show in this diagram.
Hello. My name is William Osai. I am a nurse practitioner in the GU Medical Oncology Department at The University of Texas MD Anderson Cancer Center in Houston. Today s presentation is Part 2 of the Overview
More information2015 myresearch Science Internship Program: Applied Medicine. Civic Education Office of Government and Community Relations
2015 myresearch Science Internship Program: Applied Medicine Civic Education Office of Government and Community Relations Harguneet Singh Science Internship Program: Applied Medicine Comparisons of Outcomes
More information3/23/2017. Significant Changes in Prostate Cancer Classification, Grading, Staging and Reporting. Disclosure of Relevant Financial Relationships
Disclosure of Relevant Financial Relationships Staging and Reporting of Prostate Cancer: Major Changes in 8 th Edition AJCC Staging and CAP Cancer Checklists USCAP requires that all planners (Education
More informationEssentials of Clinical MR, 2 nd edition. 73. Urinary Bladder and Male Pelvis
73. Urinary Bladder and Male Pelvis Urinary bladder carcinoma is best locally staged with MRI. It is important however to note that a thickened wall (> 5 mm) is a non-specific finding seen in an underfilled
More informationAJCC Cancer Staging 8 th Edition. Prostate Chapter 58. Executive Committee, AJCC. Professor and Director, Duke Prostate Center
AJCC Cancer Staging 8 th Edition Prostate Chapter 58 Judd W Moul, MD, FACS Executive Committee, AJCC Professor and Director, Duke Prostate Center Duke University Durham, North Carolina Validating science.
More informationPSA nadir post LDR Brachytherapy and early Salvage Therapy. Dr Duncan McLaren UK & Ireland Users Group Meeting 2016
PSA nadir post LDR Brachytherapy and early Salvage Therapy Dr Duncan McLaren UK & Ireland Users Group Meeting 2016 Differences in PSA relapse rates based on definition used PSA ng/ml Recurrence ASTRO Recurrence
More informationPost Radical Prostatectomy Radiation in Intermediate and High Risk Group Prostate Cancer Patients - A Historical Series
Post Radical Prostatectomy Radiation in Intermediate and High Risk Group Prostate Cancer Patients - A Historical Series E. Z. Neulander 1, Z. Wajsman 2 1 Department of Urology, Soroka UMC, Ben Gurion University,
More informationSupplemental Information
Supplemental Information Prediction of Prostate Cancer Recurrence using Quantitative Phase Imaging Shamira Sridharan 1, Virgilia Macias 2, Krishnarao Tangella 3, André Kajdacsy-Balla 2 and Gabriel Popescu
More informationCurrent Clinical Practice. MR Imaging Evaluations. MRI Anatomic Review. Imaging to Address Clinical Challenges. Prostate MR
BETH ISRAEL DEACONESS MEDICAL CENTER Prostate MR Neil M. Rofsky, MD Harvard Medical School Current Clinical Practice DIGITAL RECTAL EXAMINATION PSA ( ~ 20% False negative) BIOPSY (18-25% False negative)
More informationDiffusion-Weighted Magnetic Resonance Imaging Detects Local Recurrence After Radical Prostatectomy: Initial Experience
EUROPEAN UROLOGY 61 (2012) 616 620 available at www.sciencedirect.com journal homepage: www.europeanurology.com Case Study of the Month Diffusion-Weighted Magnetic Resonance Imaging Detects Local Recurrence
More informationPresentation with lymphadenopathy
Presentation with lymphadenopathy Theo M. de Reijke MD PhD FEBU Department of Urology Academic Medical Center Amsterdam Rationale for RRP in N+ disease Prevention local problems Better survival in limited
More informationOverview. What is Cancer? Prostate Cancer 3/2/2014. Davis A Romney, MD Ironwood Cancer and Research Centers Feb 18, 2014
Prostate Cancer Davis A Romney, MD Ironwood Cancer and Research Centers Feb 18, 2014 Overview Start with the basics: Definition of cancer Most common cancers in men Prostate, lung, and colon cancers Cancer
More informationCancer. Description. Section: Surgery Effective Date: October 15, 2016 Subsection: Original Policy Date: September 9, 2011 Subject:
Subject: Saturation Biopsy for Diagnosis, Last Review Status/Date: September 2016 Page: 1 of 9 Saturation Biopsy for Diagnosis, Description Saturation biopsy of the prostate, in which more cores are obtained
More informationDate Modified: March 31, Clinical Quality Measures for PQRS
Date Modified: March 31, 2015 2015 Clinical Quality s for PQRS # Domain Title Description Type Denominator Numerator Denominator Exclusions/Exceptions 1 Patient Safety Prostate Biopsy Antibiotic Process
More informationProstate cancer ~ diagnosis and impact of pathology on prognosis ESMO 2017
Prostate cancer ~ diagnosis and impact of pathology on prognosis ESMO 2017 Dr Puay Hoon Tan Division of Pathology Singapore General Hospital Prostate cancer (acinar adenocarcinoma) Invasive carcinoma composed
More informationAccuracy of post-radiotherapy biopsy before salvage radical prostatectomy
Accuracy of post-radiotherapy biopsy before salvage radical prostatectomy Joshua J. Meeks, Marc Walker*, Melanie Bernstein, Matthew Kent and James A. Eastham Urology Service, Department of Surgery and
More informationPROSTATE CANCER SURVEILLANCE
PROSTATE CANCER SURVEILLANCE ESMO Preceptorship on Prostate Cancer Singapore, 15-16 November 2017 Rosa Nadal National Cancer Institute, NIH Bethesda, USA DISCLOSURE No conflicts of interest to declare
More informationHow to deal with patients who fail intracavitary treatment
How to deal with patients who fail intracavitary treatment A. Heidenreich Department of Urology Non-surgical therapy of PCA IMRT SEEDS IGRT HDR-BRACHY HIFU CRYO LDR - Brachytherapy Author Follow-up bned
More informationProstate Biopsy in 2017
Prostate Biopsy in 2017 Bob Djavan, MD, PhD Professor and Chairman, Department of Urology, Rudolfinerhaus Foundation Hospital,Vienna, Austria Director Vienna Urology foundation Board member Scientific
More informationEssential Initial Activities and Clinical Outcomes
Essential Initial Activities and Clinical Outcomes Crystal Farrell 1,2 & Sabrina L. Noyes 2, Joe Joslin 2, Manish Varma 2,3, Andrew Moriarity 2,3, Christopher Buchach 2,3, Leena Mammen 2,3, Brian R. Lane
More informationPredictive Models. Michael W. Kattan, Ph.D. Department of Quantitative Health Sciences and Glickman Urologic and Kidney Institute
Predictive Models Michael W. Kattan, Ph.D. Department of Quantitative Health Sciences and Glickman Urologic and Kidney Institute Treatment for clinically localized prostate cancer Trade off: Substantial
More informationWhen PSA fails. Urology Grand Rounds Alexandra Perks. Rising PSA after Radical Prostatectomy
When PSA fails Urology Grand Rounds Alexandra Perks Rising PSA after Radical Prostatectomy Issues Natural History Local vs Metastatic Treatment options 1 10 000 men / year in Canada 4000 RRP 15-year PSA
More informationState-of-the-art: vision on the future. Urology
State-of-the-art: vision on the future Urology Francesco Montorsi MD FRCS Professor and Chairman Department of Urology San Raffaele Hospital Vita-Salute San Raffaele University Milan, Italy Disclosures
More informationPresentation with lymphadenopathy
Presentation with lymphadenopathy Theo M. de Reijke MD PhD FEBU Department of Urology Academic Medical Center Amsterdam Rationale for RRP in N+ disease Prevention local problems Better survival in limited
More informationClinical Prostate Cancer Imaging
Clinical Prostate Cancer Imaging Steven C. Eberhardt, MD Professor and Vice Chair of Clinical Operations Chief of Abdominal and Oncology Radiology UNM Health Sciences Center UNM Comprehensive Cancer Center
More informationQ&A. Overview. Collecting Cancer Data: Prostate. Collecting Cancer Data: Prostate 5/5/2011. NAACCR Webinar Series 1
Collecting Cancer Data: Prostate NAACCR 2010-2011 Webinar Series May 5, 2011 Q&A Please submit all questions concerning webinar content through the Q&A panel Overview NAACCR 2010-2011 Webinar Series 1
More informationGUIDELINEs ON PROSTATE CANCER
GUIDELINEs ON PROSTATE CANCER (Text update March 2005: an update is foreseen for publication in 2010. Readers are kindly advised to consult the 2009 full text print of the PCa guidelines for the most recent
More informationThe Paul Evans Memorial Lecture Functional radiotherapy targeting using focused dose escalation. Roberto Alonzi Mount Vernon Cancer Centre
The Paul Evans Memorial Lecture Functional radiotherapy targeting using focused dose escalation Roberto Alonzi Mount Vernon Cancer Centre Overview Introduction and rationale for focused dose escalation
More informationImproved Detection of Clinically Significant Prostate Cancer Using a Structured Prostate Imaging Reporting Data System (PI-RADS) Template
Improved Detection of Clinically Significant Prostate Cancer Using a Structured Prostate Imaging Reporting Data System (PI-RADS) Template Abstract #17-130 ACR Annual Meeting 2017 Presenting Author: Whitney
More informationACTIVE SURVEILLANCE OR WATCHFUL WAITING
Prostate Cancer ACTIVE SURVEILLANCE OR WATCHFUL WAITING María Teresa Bourlon, MD MS Head, Urologic Oncology Clinic Hemato-Oncology Department Instituto Nacional de Ciencias Médicas y Nutrición Salvador
More informationControversies in Prostate Cancer Screening
Controversies in Prostate Cancer Screening William J Catalona, MD Northwestern University Chicago Disclosure: Beckman Coulter, a manufacturer of PSA assays, provides research support PSA Screening Recommendations
More informationBIOCHEMICAL RECURRENCE POST RADICAL PROSTATECTOMY
BIOCHEMICAL RECURRENCE POST RADICAL PROSTATECTOMY AZHAN BIN YUSOFF AZHAN BIN YUSOFF 2013 SCENARIO A 66 year old man underwent Robotic Radical Prostatectomy for a T1c Gleason 4+4, PSA 15 ng/ml prostate
More informationI have no financial relationships to disclose. I WILL NOT include discussion of investigational or off-label use of a product in my presentation.
Prostate t Cancer MR Report Disclosure Information Vikas Kundra, M.D, Ph.D. I have no financial relationships to disclose. I WILL NOT include discussion of investigational or off-label use of a g product
More informationHigh Intensity Focused Ultrasounds for the treatment of Prostate Cancers Clinical update November D. Maruzzi - L. Ruggera
High Intensity Focused Ultrasounds for the treatment of Prostate Cancers Clinical update November 2014 D. Maruzzi - L. Ruggera HIFU development Second prototype 1995-2000 Integrated Imaging 2006-2010 1993
More informationElevated PSA. Dr.Nesaretnam Barr Kumarakulasinghe Associate Consultant Medical Oncology National University Cancer Institute, Singapore 9 th July 2017
Elevated PSA Dr.Nesaretnam Barr Kumarakulasinghe Associate Consultant Medical Oncology National University Cancer Institute, Singapore 9 th July 2017 Issues we will cover today.. The measurement of PSA,
More informationProstate Cancer Incidence
Prostate Cancer: Prevention, Screening and Treatment Philip Kantoff MD Dana-Farber Cancer Institute Professor of fmedicine i Harvard Medical School Prostate Cancer Incidence # of patients 350,000 New Cases
More informationRisk Migration ( ct2c=high)
Risk Migration ( ctc=high) Prostate Cancer Over- Detection, but Selective Treatment Active Surveillance Peter R. Carroll, MD, MPH Department of Urology University of California, San Francisco February,
More informationImaging of prostate cancer local recurrences : why and how?
Imaging of prostate cancer local recurrences : why and how? Olivier Rouvière Department of Urinary and Vascular Imaging Hospices Civils de Lyon Lyon - France 1. Preliminary Remarks Preliminary Remarks
More informationPET imaging of cancer metabolism is commonly performed with F18
PCRI Insights, August 2012, Vol. 15: No. 3 Carbon-11-Acetate PET/CT Imaging in Prostate Cancer Fabio Almeida, M.D. Medical Director, Arizona Molecular Imaging Center - Phoenix PET imaging of cancer metabolism
More informationProstatectomy as salvage therapy. Cases. Paul Cathcart - Guy s & St Thomas NHS Trust, London
Prostatectomy as salvage therapy Cases Paul Cathcart - Guy s & St Thomas NHS Trust, London Attributes of brachytherapy appeal to young men who place high utility on genitourinary function At risk of
More informationDepartment of Urology, Cochin hospital Paris Descartes University
Technical advances in the treatment of localized prostate cancer Pr Michaël Peyromaure Department of Urology, Cochin hospital Paris Descartes University Introduction Curative treatments of localized prostate
More informationChemotherapy for Urological Cancers
Chemotherapy for Urologic Cancers Matthew Rettig, MD Associate Professor Department of Medicine Division of Hematology-Oncology Department of Urology Medical Director, Prostate Cancer Program Institute
More informationHealth Screening Update: Prostate Cancer Zamip Patel, MD FSACOFP Convention August 1 st, 2015
Health Screening Update: Prostate Cancer Zamip Patel, MD FSACOFP Convention August 1 st, 2015 Outline Epidemiology of prostate cancer Purpose of screening Method of screening Contemporary screening trials
More informationda Vinci Prostatectomy
da Vinci Prostatectomy Justin T. Lee MD Director of Robotic Surgery Urology Associates of North Texas (UANT) USMD Prostate Cancer Center (www.usmdpcc.com) Prostate Cancer Facts Prostate cancer Leading
More informationPLACE LABEL HERE. ACRIN 6659 Registration/Eligibility Institution
A0 ACRIN 6659 Registration/Eligibility No Case No Instructions: For potential study participants, Part 2 must be completed before Part 1 If any of the answers, for Part 2, vary from the prompts provided
More informationOsher Mini Medical School for the Public
Osher Mini Medical School for the Public Education Research Patient care Education Practice Basic science research First human studies Research Patient care Clinical studies Lifetime risk Prostate
More informationAccepted for publication 3 January 2005
Original Article RACIAL DIFFERENCES IN PSA DOUBLING TIME AND RECURRENCE TEWARI et al. In a multi-institutional study authors from the USA and Austria attempt to determine if there are differences in several
More informationWhen radical prostatectomy is not enough: The evolving role of postoperative
When radical prostatectomy is not enough: The evolving role of postoperative radiation therapy Dr Tom Pickles Clinical Associate Professor, UBC. Chair, Provincial Genito-Urinary Tumour Group BC Cancer
More information2018 OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY. MEASURE TYPE: Process
Quality ID #102 (NQF 0389): Prostate Cancer: Avoidance of Overuse of Bone Scan for Staging Low Risk Prostate Cancer Patients National Quality Strategy Domain: Efficiency and Cost Reduction 2018 OPTIONS
More informationDong Hoon Lee, Kyo Chul Koo, Seung Hwan Lee, Koon Ho Rha, Young Deuk Choi, Sung Joon Hong and Byung Ha Chung
Jpn J Clin Oncol 2013;43(5)553 558 doi:10.1093/jjco/hyt041 Advance Access Publication 11 April 2013 Low-risk Prostate Cancer Patients Without Visible Tumor (T1c) On Multiparametric MRI Could Qualify for
More informationRole of MRI in the diagnosis and management of prostate cancer
For reprint orders, please contact: reprints@futuremedicine.com Role of MRI in the diagnosis and management of prostate cancer Andreas G Wibmer*,1, Hebert Alberto Vargas 1 & Hedvig Hricak 1 Multiparametric
More informationHow do I control (monitor) patients receiving TRT after prostate cancer treatment
How do I control (monitor) patients receiving TRT after prostate cancer treatment Anthony J. Bella MD, FRCSC Greta and John Hansen Chair in Men s Health Research Division of Urology, Department of Surgery
More informationThe utility of magnetic resonance imaging and spectroscopy for predicting insignificant prostate cancer: an initial analysis
Original Article PREDICTING INSIGNIFICANT PROSTATE CANCER WITH MRI AND CLINICAL VARIABLES SHUKLA-DAVE ET AL. The utility of magnetic resonance imaging and spectroscopy for predicting insignificant prostate
More informationD. J. Margolis 1, S. Natarajan 2, D. Kumar 3, M. Macairan 4, R. Narayanan 3, and L. Marks 4
Biopsy Tracking and MRI Fusion to Enhance Imaging of Cancer Within the Prostate D. J. Margolis 1, S. Natarajan 2, D. Kumar 3, M. Macairan 4, R. Narayanan 3, and L. Marks 4 1 Dept. of Radiology, UCLA, Los
More information2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY
Measure #104 (NQF 0390): Prostate Cancer: Adjuvant Hormonal Therapy for High Risk or Very High Risk Prostate Cancer National Quality Strategy Domain: Effective Clinical Care 2016 PQRS OPTIONS FOR INDIVIDUAL
More information