UroNav: A Powerful New Technology Improves Prostate Cancer Detection
Urologists affiliated with Memorial Hermann Katy Hospital now offer high-tech prostate imaging using the next-generation UroNav fusion biopsy system, ensuring that men with suspicious prostate findings benefit from more targeted and accurate biopsies and the possibility of earlier diagnosis and treatment. Recent studies of UroNav have shown positive predictive values above 90 percent.
“Before the availability of UroNav, physicians depended on transrectal ultrasonography (TRUS) to perform prostate biopsies,” says Steve Dinwiddie, director of imaging services at Memorial Hermann Katy Hospital. “With TRUS, the urologist locates the prostate gland and uses a biopsy needle to capture four samples across the top third of the gland, four in the middle third and four in the bottom third, for a total of 12 biopsy samples. They’re hoping that one of the samples will detect cancer cells, but with TRUS biopsies cancer goes undetected about 80 percent of the time. With UroNav, we have a game changer.”
“(UroNav) provides a much higher level of confidence than TRUS, which translates to earlier detection and earlier treatment when needed. Accurate biopsies help improve the prostate cancer cure rate.”
- Ramesh Krishnan, M.D.
UroNav fuses MRI images of the prostate taken before biopsy with ultrasound-guided images during the biopsy, providing excellent views of the prostate and any suspicious lesions. The crucial step between MRI and biopsy is DynaCAD, a workstation linked to the MRI. Images can be transferred directly from the MRI to DynaCAD for quick processing and customized 3-D views of the prostate.
“MRI shows radiologists the outline of the prostate gland, which allows them to determine whether the gland is enlarged or looks abnormal in any way,” Dinwiddie says. “DynaCAD examines the volume of prostate cells and points out cells that look suspicious, then locates any other similar suspicious cells. It allows the radiologist to rotate the 3-D image and pinpoint actual lesions within the prostate.”
With the patient under anesthesia in the surgical suite, the urologist uses an ultrasound rectal probe equipped with a biopsy needle connected to the UroNav. The UroNav system allows the physician to locate the suspicious cells precisely and view the trajectory of the biopsy needle in advance for accurate targeting.
Urologist Ramesh Krishnan, M.D., who is affiliated with Memorial Hermann Katy Hospital and Memorial Hermann Memorial City Medical Center, has been using UroNav for diagnosis and treatment for about a year.
“My experience has been excellent,” he says. “The procedure is very easy to do, sensitive and accurate, and much more comfortable for the patient than TRUS biopsies done in the office. It provides a much higher level of confidence than TRUS, which translates to earlier detection and earlier treatment when needed. Accurate biopsies help improve the prostate cancer cure rate.”
Dinwiddie’s enthusiasm about UroNav comes in part from personal experience.
"A little over a year ago my PSA was elevated, and my family physician was concerned,” he says. “He referred me to a urologist, who concluded that I needed a biopsy. I knew we were getting the UroNav so I decided to wait. After analysis by DynaCAD, the radiologist gave me a score of 2 based on the Prostate Imaging Reporting and Data System (PI-RADS). Biopsy is recommended with PI-RADS scores of 3 or 4, so thanks to DynaCAD, I didn’t need a biopsy.”
UroNav is recommended for patients with a PI-RADS score of 3 or higher, negative prior TRUS biopsies with a continued elevation or rising PSA, or positive digital rectal examination with a negative TRUS biopsy. The technology is also available at the Memorial Hermann Cancer Center-Texas Medical Center.