Advances In Prostate Cancer Imaging for Better Biopsies - Yale Medicine Explains
August 23, 2023Transcript
- 00:02- The prostrate gland sits in a difficult location,
- 00:05and it's a soft organ.
- 00:06It's not like the skull where it's surrounded
- 00:10by a boney structure and you can pick sort of points
- 00:12and triangulate very well because it's not moving.
- 00:14The prostrate squishes.
- 00:15It rotates.
- 00:16It kind of moves all over in the pelvis,
- 00:18so it's a very difficult thing to biopsy.
- 00:26The normal ultrasound just kind of tells you
- 00:28where the prostrate is,
- 00:29so we're using it just to make sure
- 00:30that we put needles in the prostrate
- 00:32and not somewhere else in the pelvis.
- 00:35The MRI allows us to look inside the prostrate
- 00:38for different lesions.
- 00:39- Both the MR image and the ultrasound
- 00:41show very different visualizations of the anatomy.
- 00:45The challenge is trying to map those two together,
- 00:47those two images.
- 00:53- [Dr. Sprenkle] With the addition
- 00:54of MR-Ultrasound Fusion targeted biopsies,
- 00:57we're able to much more accurately pinpoint
- 00:59those areas that are concerning.
- 01:02- [Dr. Onofrey] The value of merging these two image
- 01:04modalities is to provide accurate biopsy guidance.
- 01:08- [Dr. Sprenkle] That overlapping of fusion technology
- 01:10sounds pretty simple, but it's actually quite complicated
- 01:13for several reasons.
- 01:15One of the main ones is that the prostrate
- 01:17is deformable, so one of the things
- 01:19that we're actually doing in our research here
- 01:21is trying to predict how the prostrate is going to move
- 01:26by understanding how it has moved in the past,
- 01:28and so that we can make sure that we're actually
- 01:32at the lesion and not a few millimeters away from it.
- 01:39- [Dr. Onofrey] We've learned from hundreds of cases
- 01:42that have come prior to this
- 01:43and with some manual training coming from Dr. Sprenkle,
- 01:47we're able to learn how the prostrate will actually deform
- 01:50during this procedure and so we use that to guide
- 01:53the fusion of these two modalities in a constrained way.
- 01:57- As soon as I start talking to these men
- 01:59about a prostrate biopsy, having a prostrate biopsy,
- 02:02sort of empathizing with their discomfort
- 02:04with the idea of having an ultrasound probe in their rectum
- 02:07and a needle getting passed into their prostrate,
- 02:09it becomes clear that we want to do better than that.
- 02:13By being able to improve our Ultrasound-MR Fusion
- 02:17and being able to model the prostrate,
- 02:18we can improve our biopsy technique,
- 02:21so instead of potentially having to do 17 biopsies
- 02:25to collect all the tissue, we can do one.
- 02:28- [Dr. Onofrey] It's extremely fulfilling to actually see
- 02:30these algorithms come out of the lab.
- 02:34It's a great example of translational research,
- 02:36bringing AI machine-learning techniques
- 02:39into the clinic where we could directly improve
- 02:42patient experience and hopefully improve
- 02:44the diagnosis of prostrate cancer.