Prostate Cancer
Urology Associates Offering New Fusion Biopsy
Urology Associates, PC, introduced targeted MR/US fusion biopsy in late January, becoming the first urology practice in the state to offer the new technology to patients with elevated and/or rising PSA levels.
Traditional prostate cancer screening methods have drawbacks to finding the cancer early. This new method by Invivo, which debuted in the fall of 2013 at the American Urological Association meeting after nearly a decade of research that was principally conducted at the National Cancer Institute, creates a detailed, three-dimensional view of the prostate to guide precision biopsies and allow for clear visualization of the biopsy needle.
“We are confident that this new technology will bring new hope to patients and equip our healthcare providers with the latest technology to identify and target suspicious prostate lesions,” said David Morris, MD, of Urology Associates.
The UroNav fusion biopsy system allows physicians to target the suspicious areas while reducing the number of tissue samples acquired by fusing pre-biopsy magnetic resonance images of the prostate with ultrasound-guided biopsy images in real time. After a prostate MRI, radiologist use DynaCAD for Prostate to visualize and evaluate suspicious lesions. If there is a focal lesion of concern, physicians have the patient return for biopsy. Using images from the ultrasound, which are sent to the UroNav workstation where the MRI data has already been uploaded, the software fuses the two so that whenever the probe is moved, the virtual MRI moves in the exact same way for incredible clarity of the target. The biopsy procedure only requires local anesthesia and generally takes less than 20 minutes.
Prostate cancer is the most common form of cancer in American men after skin cancer. The latest statistics from the American Cancer Society indicate one in six men will be diagnosed with prostate cancer during their lifetime.
Blood Test for Prostate Cancer
Vanderbilt researcher William Mitchell, MD, PhD, and colleagues in Germany and Canada have demonstrated a method for detecting ‘cell-free’ tumor DNA in the bloodstream. The group published their findings in the January issue of Clinical Chemistry.
In the large retrospective study of blood samples, serum was collected from more than 200 patients with prostate cancer and more than 200 controls. The samples included PSA levels and prostate tissue biopsy grading, known as the Gleason score. The researchers used a “liquid biopsy” to accurately distinguish prostate cancer from normal controls without prior knowledge of the genetic signature of the tumors, and they did so with more than three times the sensitivity of current PSA screening. They reported the technique distinguished prostate cancer from normal controls with 84-percent accuracy and differentiated cancer from benign hyperplasia and prostatitis with an accuracy of 91 percent.
“Based on the reported data and work in progress, I believe the ‘liquid biopsy’ will revolutionize cancer diagnostics, not only before a patient begins therapy but also following patient responses to therapy,” said Mitchell, the paper’s corresponding author and professor of Pathology, Microbiology and Immunology. “Since cell-free DNA has a relatively short half-life in the circulation, sequencing of cell-free DNA soon after therapy may be used to detect minimal residual disease in solid tumors,” he added.
The method is called ‘liquid biopsy’ because it quantifies the inherent chromosomal instability of cancer and can be followed as a function of time without having to do an invasive tissue biopsy. It’s been known for many years that dying cells, including tumor cells, shed DNA into the bloodstream. But only recently has technology, notably “next-generation sequencing,” made it possible to reliably distinguish and quantify cancer-specific DNA from normal controls by the identification and chromosomal location of billions of specific DNA fragments present in blood as cell-free DNA.
