Your car has a GPS. Your phone has one. Your wristwatch might even have one, as well.
And now, so does your prostate.
Kind of.
Doctors at St. Tammany Health System recently unveiled the organization’s new UroNav system, a high-tech blending of MRI imagery with ultrasound-guided images to aid doctors as they biopsy a patient’s prostate, helping them more efficiently detect possible cancer earlier.
In a field in which early intervention is crucial, that’s no small thing.
“For the first time in medical history, we can look inside the prostate now,” said Dr. Joshua Yellin, a radiologist at St. Tammany Health System. “Nothing beats getting to see the architecture of the prostate. That is a direct visualization of a potential problem.”
The UroNav process, at its root, is a team effort involving a patient’s primary care physician, a radiologist, an ultrasonographer and a urologist.
The whole thing starts with a PSA blood test ordered by a patient’s primary care physician. If that test shows an elevated PSA level, which can be suggestive of a prostate problem, MRI images are taken of the patient’s prostate and examined by a radiologist.
“We look in great detail not just at the architecture of a lesion, but we look at other factors that we know are associated with cancer. The end result of that is a score (for) each individual spot or question,” Yellin said. “And that’s a pretty accurate way of diagnosing prostate cancer just based on imaging alone.”
It becomes even more accurate, however, after he turns those images into a three-dimensional model with suspicious areas highlighted. When that 3-D model is combined with the ultrasound, it essentially provides a patient’s urologist with a road map to follow – and a specific target to shoot for – when performing a biopsy to confirm a cancer diagnosis, said Dr. Joshua Sleeper, a urologist with St. Tammany Health System.
“When you do (a traditional) biopsy, it’s basically random samplings,” Sleeper said. “Now, we do have standard areas where we target, but you’re certainly not hitting the entire prostate. And in a lot of men, men who have larger prostates, there’s no way to sample that area.”
With UroNav technology, Sleeper said doctors can target suspicious lesions highlighted for biopsy by the radiologist in areas of the prostate not routinely targeted in a standard biopsy.
“With the vast majority of men who have just an elevated PSA, the ultrasound appears normal,” Sleeper said. “We don’t see an identifiable region or tumor to hit. The UroNav involves overlying an MRI image, essentially giving us a bull’s-eye to hit on the ultrasound image.”
The bottom line: fewer biopsies of a single patient and better accuracy – which is good news for patients.
“There’s been studies that have validated that it does improve detection and it improves detecting of higher-grade cancers,” Sleeper said. “That will certainly play a role in determining treatment options for the patients.”