In a new study, medical software developed at UCL could overlay tumor information from MRI scans onto ultrasound images.
This can help guide surgeons conducting biopsies and improve prostate cancer detection.
A team of engineers and medical researchers found that the technology-enabled surgeons to pick up clinically relevant cancers that were missed when using current visual detection methods.
The best approach would be to use both techniques in tandem.
The software is deployed via a system called SmartTarget.
Prostate cancer detection has been improving at a very fast rate in recent years.
The advent of MRI-targeted biopsies, where MRI scans are used to inform surgeons where a tumor lies before they conduct a biopsy (tissue sample), has improved detection rates to close to 90% from 50% in the last five years.
In the current study, the SmartTarget system has further enhanced this technique by allowing a 3-D model of the prostate and cancer to be created for each patient from their MRI scans using advanced image processing and machine learning algorithms.
During a biopsy, this model is fused with ultrasound images to highlight the area of concern, which otherwise does not appear in the ultrasound images, helping to guide the surgeon while conducting the procedure.
Until last year when MRI targeting was introduced, the established way to test for prostate cancer involved taking a biopsy from the prostate without knowing where in the prostate a tumor was likely to be, resulting in close to half of life-threatening cancers being missed.
For the present study, 129 people with suspected prostate cancer underwent two biopsies—one using the SmartTarget system, and one where surgeons could only visually review the MRI scans.
The two strategies combined detected 93 clinically significant prostate cancers, with each of them picking up 80 of these cancers; each missed 13 that the other method picked up.
The researchers say that surgeons’ visual review of MRI scans should be used in tandem with SmartTarget as using this technique enables surgeons to learn to make subtle adjustments such as adapting to the movement of the patient and the prostate as the needle is inserted.
The researchers suggest the new methods could reduce the number of biopsies needed, and reduce the unnecessary surgeries caused by overdiagnosis of less harmful cancers.
The SmartTarget software has been commercialized by SmartTarget Ltd, a company spun out by UCL’s commercialization company UCL Business PLC (UCLB), and the system is already in use by several hospitals in the UK and USA.
The inter-disciplinary study brought together engineers, urologists, and radiologists, supported by the UCL Translational Research Office in project management and navigating the translational and regulatory pathway involved in taking the project from the lab bench to the operating room.
One co-senior author Professor Hashim Ahmed, who began the research in UCL Medicine before moving to Imperial College London.
The study is published in European Urology.
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Source: European Urology.
