Optimising Prostate Cancer Diagnostics

Transcription

1 Specialist Urology Training Optimising Prostate Cancer Diagnostics September 2015 Guy s Hospital London, UK

2 29-30 September 2015 Course details Dates September 2015 Venue Robens Suite Guy s Hospital Great Maze Pond London, SE1 9RT Introduction This highly practical two-day course provides an update on the use of mp MRI transperineal and transrectal biopsies in prostate diagnostics. There has been increasing interest in carrying out transperineal prostate mapping biopsies for the assessment of patients with negative TRUS biopsies to better select patients for Active Surveillance and to risk stratify patients with equivocal disease. However, the diagnostic paradigm is changing with the use of MRI prior to biopsy and the introduction of MR fusiontargeted biopsies, but there is still a need to systematically biopsy the apparently normal prostate. At Guy s Hospital we have developed a systematic transperineal sector biopsy protocol, which preferentially targets the peripheral zone with fewer cores than template mapping protocols and less morbidity. Over the last 24 months we have incorporated MR US-Fusion biopsies in our diagnostic and targeted treatment protocols. Day One: Transperineal Sector Biopsies Day One will focus on the basics of TP sector biopsies, using live case studies to demonstrate the procedures, with lectures on technique and how pre biopsy MRi and TP biopsies can be integrated into the diagnostic and prostate cancer management pathway. Day Two: Enhanced Prostate Biopsy Diagnostics Day Two will provide practical instruction of the TP sector biopsy protocol with US stations and the use of biopsy phantoms in the morning. In the afternoon, there will be opportunities for practical demonstrations of currently available transrectal and transperineal prostate biopsy platforms, incorporating the latest MR-US fusion biopsy systems. Who should attend? The masterclass is specifically designed for health professionals that work directly with prostate cancer diagnosis and TP biopsies. This means that consultants, registrars, nurse practitioners, pathologists, radiologists and theatre nurses are all encouraged to attend. The number of available places is limited due to the masterclass involving practical sessions; therefore we strongly advise that you book your place as early as possible. 12 CPD points have also been applied for by the British Association of Urological Surgeons.

3 29 30 September 2015 Overall aims and objectives The purpose of the two-day masterclass is to ensure that attendees leave with a strong understand of the essential prostate anatomy as it relates to both transrectal and transperineal systematic biopsy and the particular impact that MRI targeted biopsies will have on the diagnostic and treatment pathways in prostate cancer. The course directors have structured the programme so that delegates should leave with an insight into the future of precision prostate diagnostics and treatments and have the knowledge necessary to optimise both transperineal and transrectal biopsy protocols using the information from MRI. Format The September Optimising Prostate Cancer Diagnostics Masterclass has a brand new format that allows delegates to watch live surgery cases and presentations before putting the skills that they have been shown into practise. There is also an opportunity to have a Q&A session with expert urologists. Lunch is provided, along with drinks throughout the day. All delegates will receive full comprehensive course materials to take away at the end of the sessions. Course Directors Mr Rick Popert, Consultant Urologist, Guy s and St Thomas Mr Ben Challacombe, Consultant Urologist, Guy s and St Thomas Mr Paul Cathcart, Consultant Urologist, Guy s and St Thomas Course Faculty Dr Ashish Chandra, Consultant Uropathologist, Guy s and St Thomas Professor John Davis, Associate Professor of Urology, MD Anderson Cancer Centre Professor Chris Foster, Consultant Pathologist, HCA Laboratories Ms Janette Kinsella, Prostate Cancer Advanced Nurse Practitioner, Guy s and St Thomas Mr Wayne Lam, SPR Urological Surgery Mr Marc Laniado, Consultant Urologist, Wexham Park Professor Thomas Lynch, Consultant Urological Surgeon, St James s and Trinity College Dublin Dr Alexander Polson, Consultant Histopathologist, Guy s and St Thomas Mr Simon Van Rij Locum Consultant Dr Giles Rottenberg Consultant Radiologist 2

4 29-30 September 2015 Outline Programme Day One: Transperineal Sector Biopsies Day One will focus on the basics of TP sector biopsies, using live case studies to demonstrate the procedures, with lectures on technique and how pre biopsy MRi and TP biopsies can be integrated into the diagnostic and prostate cancer management pathway. Welcome and introduction Overview of the Guy s Sector Biopsy Protocol Live Case 1 30 cc gland Transperineal Sector Biopsy Protocol 24 Core Biopsy Live Case 2 Large 80 cc prostate Patient set up and ultrasound optimisation, equipment set up Sector localisation and sampling methods 32 Core Biopsy Pathological Processing and Reporting The role of multi parametric MRI in the biopsy pathway Live Case 3- MRI Visually directed TP Biopsies Live Case 4 MRI US Fusion Targeted Biopsies Pathological Processing and Reporting Break-out Session Cancer Diagnostic Pathways TPSB in Clinical Practice Negative TRUS Biopsy Active Surveillance and Risk Stratification Primary TPSB and 2 week wait Prostate Pathway The Guy s Experience of MRI US Fusion Targeted Biopsies Alternative TP Biopsy Protocols include Template Mapping Open Forum - Implications for precision targeted and focal therapies Close: 17:00 drinks and meal

5 29 30 September 2015 Day Two: Enhanced Prostate Biopsy Diagnostics Day Two will provide practical instruction of the TP sector biopsy protocol with US stations and the use of biopsy phantoms in the morning. In the afternoon, there will be opportunities for practical demonstrations of currently available transrectal and transperineal prostate biopsy platforms, incorporating the latest MR-US fusion biopsy systems. The day will be broken up in to two parts: 9:00 12:00 Short didactic lectures with breakout sessions will take place during the morning. Practical experience will be gained on pathological processing and the application of targeted and systematic biopsy techniques as demonstrated in Day 1 of the course 13:00 17:00 In the afternoon, there will be practical demonstrations of currently available transrectal and transperineal prostate biopsy systems, incorporating the latest MR-US fusion biopsy systems. There should be at least 4 different Transperineal fusion biopsy platforms using Varian Software, MIM Software, Biopsee (Medcom) and BioJet and it is hoped that TRUS MRI fusion systems will also be available, including UroNav (Invivo), Artemis (Eigen) and Koelis. Delegates will be able to rotate in small groups around each of the platforms providing an overview of the technologies available to deliver targeted biopsies. Refreshments The programme includes lunch, with tea and coffee available throughout the day. Course materials Delegates will receive comprehensive course materials to take away. 4

6 Guy s and St Thomas NHS Foundation Trust Guy's and St Thomas' NHS Foundation Trust is one of the largest Foundation Trusts in the UK. It consists of St Thomas' Hospital, Evelina London Children s Hospital and Guy's Hospital. The Trust provides a full range of hospital services, as well as specialist services including cancer, cardiothoracic, women and children s services, kidney care and orthopaedics. Guy s is a major centre for cancer and renal services with the UK s largest kidney donor programme, and is also a leading centre for genetics, stem cell and allergy research. St Thomas is a leading centre for the treatment of cardiovascular disease, stroke, HIV and dermatology. The Trust has one of the largest critical care units in the UK and one of the busiest A & E departments in London. GSTFT has an annual turnover of 1.2 billion and employs 13,500 staff. Last year the Trust handled: 1,033,000 outpatients 83,000 inpatients 82,500 day case patients 184,000 accident and emergency attendances delivered 6,847 babies 866,000 in community services. 2 million patient contacts per year. The Trust has 665 beds at St Thomas', 288 at Guy's, 144 at the Evelina London Children s Hospital and 64 in the community. We have one of the lowest mortality rates in the NHS in England, including out-of-hours and at weekends. In 2013 the Dr Foster Hospital Guide awarded us Trust of the Year for safe care. About the Urology Department The Urology Department is based at Guy s Hospital. Our award winning Urology Centre at Guy s has allowed us to minimise queuing and bring all the aspects of urological diagnosis together in one place. Robotic surgery using the da Vinci surgical system is used within the Trust to assist with: laparoscopic radical prostatectomy (prostate removal) nephrectomy (kidney removal) pyeloplasty (surgery to remove small blockages in the ureter) cystectomy (bladder removal) The department s typical annual workload comprises of: 20,000 outpatient visits to consultant-led-clinics across Guy s, St Thomas and Lewisham hospitals 2,500 outpatient visits to nurse-led clinics 4,000 day case procedures at Guy s and Lewisham 1,700 inpatient admissions at Guy s with a further 700 stone unit admissions

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