UNPRECEDENTED ACCURACY FOR PROSTATE DIAGNOSIS AND TREATMENT

Back in 2014 Macquarie University Hospital made a significant investment in equipment that brought about major changes to the diagnosis and treatment of prostate cancer.

Already in use in North America since 2012 , the state-of-the-art dedicated prostate imaging equipment uses advanced 3-tesla (3T) MRI technology to accurately guide biopsies and treatment. The MRI is capable of characterising structures as small as 5mm within the prostate and allows for early detection of cancer. It is currently considered the international ‘gold standard’ for prostate cancer.

This approach provided a major advance in screening because of its ability to pinpoint an exact area of tumour activity, and so provide accurate tissue biopsies by removing the randomness of tissue sampling.

Late in 2013, Macquarie University Hospital performed its first biopsies using the 3T MRI machine.

“We treated countless patients,” said Associate Professor Celi Varol, robotic and minimally invasive uro-oncologist at Macquarie University Hospital. “These biopsies have been highly successful and we can now pinpoint exactly where to target treatment for these patients.”

In addition to its diagnostic function, the advanced 3T MRI equipment has be used in the treatment of prostate tumours – also through its MRI-guided capability. This is done by way of focal laser therapy, which was put into place in December 2013, with the first treatments beginning in early 2014.

“Focal laser therapy allows us to target just the prostate cancer – rather than the whole prostate – and negates the need for either open surgery, robotic surgery or even radiotherapy,” said Associate Professor Varol. “This approach is a ‘game-changer’ regarding the way in which surgeons can now diagnose and treat prostate cancer patients.

“It gives both the patient and the surgeon far greater confidence and certainty that we are going after the right area and doing the right thing as early as possible.”

Until now, prostate cancer diagnosis has been reliant on PSA testing and non-targeted ultrasound-guided biopsy, but the approach has shortcomings.

“For one, PSA levels can become falsely elevated for a number of reasons, including benign prostatic enlargement, a common condition in older men,” said Dr Yang-Yi Ong, radiologist with Macquarie Medical Imaging (MMI). “This can confound accurate diagnosis.

“Similarly, the current random core biopsy samples can lead to the real tumour areas being missed completely, or can underestimate the extent and malignancy of a tumour. Early detection of aggressive tumours is the key. However, with less-than-certain results, patients can be left in limbo for months under a ‘watch and wait’ approach.”

Professor John Magnussen, Head of MMI, explained that when it came out, this imaging equipment brought the latest in technology to Australia and is part of the comprehensive urology services offered by Macquarie University Hospital.

“We are pleased to be able to offer the latest 3T MRI diagnostic and treatment service in Sydney as part of the hospital’s coordinated and integrated management services for prostate cancer patients.

“From early diagnosis through to minimally invasive focal therapy, robotic surgery and ongoing surveillance, the MMI team of expert radiologists, physicians and surgeons offers a multidisciplinary team approach that continue to bring patients the best and latest available care.”