Urology, oncology, diagnostic imaging

Ultrasound diagnostic tool could improve non-invasive treatment of prostate cancer

17 October 2007

HistoScanning, a novel processing technology for ultrasonography developed by Belgian company Advanced Medical Diagnostic, shows high accuracy in the characterisation and localisation of prostate cancer foci. This could improve the treatment and monitoring of prostate cancer and help avoid unnecessary invasive procedures.

HistoScanning is a diagnosis support tool designed to detect, visualise and characterise cancers in solid organs. It is used in conjunction with specific commercially available ultrasound systems capable of acquiring and transferring so called volumetric radio frequency (RF) data. The proprietary tissue characterisation algorithms can either be applied to discrete regions of interest or the entire scanned tissue volume. Suspicious areas are highlighted in HistoScanning’s 3D image viewer.

In  study reported in the British Journal of Urology International (BJUI), HistoScanning of the prostate was performed on 29 men scheduled to undergo radical prostatectomy. The results were subsequently compared to the corresponding detailed histology. The study showed that HistoScanning accurately measured the diameter of the largest tumour (r=0.95, p<0.0001) and in all cases correctly attributed the presence of multiple foci, the laterality of the disease and the involvement of the prostate capsula.

Although more extensive trials are needed to fully validate its role in routine clinical practice, experts involved in the study believe that HistoScanning has the potential to address important challenges in the diagnosis, staging, treatment and monitoring of men with suspected prostate cancer.

Mr Mark Emberton of the Division of Surgery and Interventional Science at the University College London and co-author explained: “Today 75% of all biopsies are negative and therefore provide no useful diagnostic information. Due to its geometric and spatial accuracy, HistoScanning shows great potential for directing biopsies and focal treatment to the largest tumour bulk and hence improve procedure efficiency.”

He continued: “The detection and visualisation of multiple foci throughout the prostate and capsula may enhance the staging of lesions and optimise treatment selection.”

Dr. Johan Braeckman, Head of Unit at the Urology Department of the University Hospital Brussels and principal investigator for the study sees two further important uses: “HistoScanning may help reassure men with elevated PSA that they don’t have clinically relevant prostate cancer.”

He further noted: “Men with less aggressive prostate cancers are increasingly offered active surveillance in order to postpone or avoid radical treatment that is associated with the risk of erectile dysfunction and incontinence. HistoScanning may actually facilitate such monitoring and reduce the need for painful and sometimes toxic repeat biopsies.” Braeckman concluded: “It seems that in addition to removing diagnostic uncertainty and patient anxiety, HistoScanning has a realistic potential to save costs in healthcare provision.”

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