Laurence Klotz, MD, presented “Using High Resolution Micro-Ultrasound for Prostate Biopsies for Active Surveillance” during the 29th Annual International Prostate Cancer Update on January 26, 2019 in Beaver Creek, Colorado.
How to cite: Klotz, Laurence “Using High Resolution Micro-Ultrasound for Prostate Biopsies for Active Surveillance” January 26, 2019. Accessed Dec 2024. https://dev.grandroundsinurology.com/using-high-resolution-micro-ultrasound-for-prostate-biopsies-for-active-surveillance/
Using High Resolution Micro-Ultrasound for Prostate Biopsies for Active Surveillance- Summary:
Laurence Klotz, MD, discusses the limitations of multiparametric MRI (mpMRI) targeted prostate biopsy, especially in the active surveillance setting, and how a novel 29 MHz high resolution micro-ultrasound technology could be an improved alternative. Additionally, he describes his experience with this technology at his institution.
Abstract:
While mpMRI targeted biopsy is an improvement from systematic biopsy, this technique still has limitations. Notably, mpMRI does not allow for real-time monitoring, requires an external specialist, and has disadvantages in terms of cost and complexity. Recent data also shows that mpMRI has limitations in the active surveillance setting. In one study, mpMRI demonstrated a 27% false negative rate in patients on active surveillance. Due to the low relative sensitivity of mpMRI for detecting low-volume tumors, there is now a consensus in the urologic community that a negative mpMRI does not preclude the importance of systematic biopsy. The ASIST trial further supports this conclusion.
A novel 29 MHz high resolution micro-ultrasound technology could be the solution to overcoming these limitations. This technology employs a unique system for assigning a risk score to each prostate region, called prostate risk identification using micro-ultrasound (PRI-MUS). A physician can acquire expertise in identifying subtle abnormalities on micro-ultrasound imaging in time by performing a multitude of cases. Clinicians can also use this micro-ultrasound system to biopsy and evaluate patients post-focal therapy or post-partial gland ablation.
During this presentation, Dr. Klotz reviews his experience with and key findings of micro-ultrasound at Sunnybrook Health Sciences Center. He compares these results to other published data on micro-ultrasound, which generally supports that the technology maintains sensitivity in active surveillance populations. Overall, micro-ultrasound could be a welcome disruption in this MRI-targeting era.
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. Klotz 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
Laurence Klotz, MD, is the former Chief of Urology at Sunnybrook Health Sciences Centre and former President of the Urological Research Society and the Canadian Urological Association. He currently serves as Professor of Surgery at the University of Toronto and holds the Sunnybrook Chair of Prostate Cancer Research. Dr. Klotz was the Founding Editor-in-Chief of both the Canadian Journal of Urology and the Canadian Urology Association Journal, and is now Editor Emeritus of the CUAJ. He is the Founder and Chairman of the Canadian Urology Research Consortium (CURC), and is also the Chair of the Global GU Oncology Group.
Dr. Klotz obtained his medical degree from the University of Toronto and completed his residency at the University of Toronto Gallie Program in Surgery. He was a fellow at Memorial Sloan Kettering Cancer Center in New York in uro-oncology.
Dr. Klotz is a widely published uro-oncologist with over 350 publications and several books. His main research interest has been prostate cancer. He has served on the boards of many medical/scientific organizations and journals, including the SUO, Prostate Cancer Canada, the journals Prostate Cancer and Prostatic Diseases, Brazilian Journal of Urology, Italian Journal of Urology, and World Journal of Urology.
Dr. Klotz was awarded the Queen’s Jubilee Medal for meritorious public service in 2012, and the University of Toronto Department of Surgery Lister Prize and the Society of Urologic Oncology Medal in 2013. He received the Harold Warwick Award from the Canadian Cancer Society for ‘outstanding contributions to cancer control’ in 2014. He received the Order of Canada in 2015, and the Richard Williams Award from the AUA in 2016. He received the Dean’s Lifetime Achievement Award from the University of Toronto in 2017.
