Urologic Cancer Clinical Advances
UF Health makes clinical strides against urologic cancers
UF Health making Clinical Advances for Urologic Cancers
UF Health cancer researchers and clinicians have been making clinical advances in the battle against urologic cancers, such as improved precision for prostate imaging and ablation and improved diagnosis and management of incidental kidney tumors with artificial intelligence.
TRUS biopsy simulation to improve precision for prostate imaging and ablation
Since the 1980s, the standard prostate biopsy technique has been transrectal ultrasound-guided biopsy, or TRUS. Recommendations for biopsy are most commonly driven by elevated values of prostate-specific antigen. “This is essentially a random, non-targeted and non-specific biopsy technique,” said Thomas F. Stringer, M.D., an associate professor of urology in the UF College of Medicine. “A falsely negative biopsy misses existing cancer and may delay diagnosis and treatment as well as impact survival.”
The false-negative rate for TRUS-guided prostate biopsy is often quoted to be nearly 20% but has been reported as high as 47%. A principal challenge for accuracy for TRUS is that two-dimensional imaging requires mentally reconstructing in real time the complex 3D interactions between the handheld ultrasound device, the handheld biopsy probe and the prostate in order to accurately guide the biopsy probe to the intended location. Cancerous areas of the prostate may be undersampled and cancer-free areas may be oversampled. READ MORE
Researchers using AI to improve the diagnosis and management of incidental kidney tumors
About 70,000 new kidney tumors are diagnosed in the United States every year, most of them found incidentally on a CT scan or an MRI. Most are small, <4 cm in diameter, and there is no reliable way to predict with imaging alone whether a kidney mass is cancer or not. Unlike other tumors that are amenable to biopsy, renal mass biopsy has a fairly high nondiagnostic rate.
“The reason it matters is that up to 20% of these tumors can be noncancerous,” explained Russell S. Terry, Jr. M.D., an assistant professor and director of minimally invasive surgery education and new technologies in UF College of Medicine’s department of urology. “If we remove people’s kidneys or part of their kidneys for 100% of these small masses, then up to 20% of the surgeries might be unnecessary.” READ MORE
Multidisciplinary specialty care benefits patients with genitourinary cancers
At UF, patients with genitourinary cancers can receive multidisciplinary care from specialists in urology, medical oncology, radiation oncology and any other expert they need in one environment, as part of a group effort.
“For the more complicated cases, we enlist surgical specialists from our top-notch thoracic, lung and liver transplant, acute care surgery and cardiac surgery groups,” explained Padraic O’Malley, M.D., M.Sc., FRCSC, a clinical assistant professor in the UF College of Medicine’s department of urology. “We provide both robotic surgery and open surgery, and we can handle surgeries that would not be possible in some other centers.” READ MORE