Curbing overradiation starts with improving imaging accuracy

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A frequent theme at last month's meeting of the Radiological Society of North America was that radiologists must deal with threats to the future of the imaging industry. One such issue that has received plenty of media attention over the last several years: radiation doses.

As reported in this issue of FierceMedicalImaging, physicians at the David Geffin School of Medicine at UCLA now are using targeted prostate biopsy to diagnose prostate cancer. They are using MRI, combined with real-time ultrasound, to biopsy specific targets of interest, rather than use the older, systemic, "blind" sampling that's been the norm for the past several decades. It promises greater accuracy, particularly in detecting tumors in men who previously have had negative biopsies, and also promises to help in the active surveillance of prostate cancer by giving men more information to determine that a low-risk tumor is actually low risk.

At one particular RSNA session, Peter L. Choyke, M.D., a senior investigator molecular imaging program at the National Cancer Institute, talked about the bigger role MRI is playing in the fight against prostate cancer. Choyke discussed the problem of overtreatment, as well as the fact that many aggressive cancers are discovered too late for treatment to be effective.

"[W]e overtreat indolent disease, we undertreat aggressive disease," Choyke said. "We need to match the right therapy to the right patient, and that's where personalized medicine or imaging will find an important role."

Choyke added that prostate MRI is "unparalleled" in diagnosing prostate cancer, and that MRI can help guide biopsies, differentiate between indolent and aggressive cancers, and lead to image guidance of focal therapies--exactly the kinds of benefits the UCLA MRI/ultrasound fusion biopsy technique promises to provide.

It is becoming increasingly clear that imaging solutions with the potential to improve the diagnosis of prostate cancer and determine which patients are suitable for active surveillance or focal therapy seem to be at hand. With the high fatality rate associated with prostate cancer, and the unwelcome quality of life issues that come with radical prostatectomy, these solutions can't come soon enough. - Mike  @FierceHealthIT