PRESS-NEWS.org - Press Release Distribution
PRESS RELEASES DISTRIBUTION

Prostate cancer now detectable by imaging-guided biopsy

Findings may end 25-year era of blind biopsy

2012-12-10
(Press-News.org) Ground-breaking research by a UCLA team of physicians and engineers demonstrates that prostate cancer can be diagnosed using image-guided targeted biopsy.

Traditionally found only by blind biopsy, a procedure that dates from the 1980s, prostate cancer now appears detectable by direct sampling of tumor spots found using Magnetic Resonance Imaging (MRI) in combination with real-time ultrasound, according to the UCLA study released Dec. 10, 2012 early online for the January 2013 issue of The Journal of Urology®.

The study indicates that the MRI and ultrasound fusion biopsy, which is much more accurate than conventional blind biopsy, may lead to a reduction in the numbers of prostate biopsies performed and allow for early detection of serious prostate cancers.

The study involved 171 men who were using active surveillance to monitor slow growing prostate cancers or men who had persistently elevated prostate specific antigen (PSA) --a protein produced by the prostate that can indicate the presence of cancer – but had prior negative biopsies. The UCLA biopsies were done in about 20 minutes in an outpatient clinic setting under local anesthesia.

Elevations in serum PSA level trigger nearly all of the one million prostate biopsies performed in the United States every year. Annually, about 240,000 new cases of prostate cancer are discovered. Thus, about 75 percent of the biopsies are negative for cancer. However many of those men with negative biopsies but elevated PSA levels may still harbor malignant tumors that were missed by conventional biopsies, said study senior author Dr. Leonard S. Marks, a professor of urology and director of the UCLA Active Surveillance Program.

"Early prostate cancer is difficult to image because of the limited contrast between normal and malignant tissues within the prostate," Marks said. "Conventional biopsies are basically performed blindly, because we can't see what we're aiming for. Now, with this new method that fuses MRI and ultrasound, we have the potential to see the prostate cancer and aim for it in a much more refined and rational manner."

The new targeting process is the result of four years of work funded by the National Cancer Institute and based in the Clark Urology Center at UCLA.

Since the mid-1980s, prostate cancer has been diagnosed using trans-rectal ultrasound to sample the prostate. Unlike most other cancers, prostate cancer is the only major malignancy diagnosed without actually visualizing the tumor as a biopsy is done, Marks said.

With the advent of sophisticated MRI, imaging the prostate improved and provided a picture of tumors within the organ. However, trying to biopsy the prostate with the patient inside the MRI has proved to be cumbersome, expensive and time consuming. Thus the fusion process evolved, permitting the targeted biopsy to be done in a clinic setting.

In this study, the volunteers undergo MRI first to visualize the prostate and any lesions. That information is then fed into a device called the Artemis, which fuses the MRI pictures with real-time, three-dimensional ultrasound, allowing the urologist to see the lesion during the biopsy.

"With the Artemis, we have a virtual map of the suspicious areas placed directly onto the ultrasound image during the biopsy," Marks said. "When you can see a lesion, you've got a major advantage of knowing what's really going on in the prostate. The results have been very dramatic, and the rate of cancer detection in these targeted biopsies is very high. We're finding a lot of tumors that hadn't been found before using conventional biopsies."

Prostate cancer was found in 53 percent of 171 study volunteers. Of those tumors found by the fusion biopsy technique, 38 percent had a Gleason score of greater than seven, which indicates an aggressive tumor, more likely to spread than tumors with lower scores. Once prostate cancer spreads, it's much more difficult to treat and survival decreases.

Robert Meier, a 58-year-old high school art teacher from Visalia, enrolled in Marks' study after three prostate biopsies all came back negative for cancer despite climbing PSA levels.

In 2008, Meier tore his rotator cuff and as part of his pre-surgery exam, blood tests were done. His PSA was at six – four or lower is considered normal. His doctor sent him to an urologist, who performed tests to rule out everything else that could be causing high PSA levels, including infection and an enlarged prostate. The doctor found nothing. Meanwhile Meier's PSA climbed to eight.

A biopsy was performed and was negative. Meier's PSA jumped to nine and yet another biopsy came back negative. When his PSA reached 11.7, another round of biopsies was ordered.

"These biopsies can be extremely painful and I was put in the hospital several times so they could be done under general anesthesia," Meier said. "It takes about a month to recover."

And like his PSA levels, Meier's anxiety was also rising. If he didn't have prostate cancer, why were his levels going up?

After a second opinion in Santa Barbara and months of being tested and treated with a medicine designed to shrink his prostate and lower PSA, Meier was referred to UCLA and Marks in 2011. By then his PSA was nearly 18, up more than 10 points in three years. An MRI revealed a prostate lesion and he underwent a biopsy using the Artemis device. He did have cancer, and it was aggressive.

"Dr. Marks told me that I had a cancer that could spread and it needed to come out now," Meier said. "He told me that at my relatively young age and the severity of the tumor, I had no choice."

Meier's prostate and 24 nearby lymph nodes were removed robotically at UCLA in February by Dr. Arnold Chin, assistant professor of urology. Follow up tests show that Meier is cancer free today.

"This program works," Meier said. "I had jumped through all these hoops and had all these tests with two different doctors and they found nothing. It took UCLA to determine that I had an aggressive cancer that could have killed me. I feel like I was in very good hands at UCLA."

The UCLA study team included doctor-scientists from urology, radiology, pathology, the Center for Advanced Surgical and Interventional Technology (CASIT) and biomedical engineering.

"Prostate lesions identified on MRI can be accurately targeted with MR-Ultrasound fusion biopsy in a clinic setting using local anesthesia," the study states. "Biopsy findings correlate with the level of suspicion on MRI. Targeted prostate biopsy has the potential to improve the diagnosis of prostate cancer and may aid in the selection of patients for active surveillance and focal therapy."

### The study was supported by the National Cancer Institute (RO1CA158627). The MRI and ultrasound fusion technology used in the study is described in a video posted here.

http://www.youtube.com/watch?v=IcLwL2dcK5o END


ELSE PRESS RELEASES FROM THIS DATE:

Targeted prostate biopsy has potential to improve diagnosis of prostate cancer

2012-12-10
New York, NY, December 10, 2012 – Diagnosis of prostate cancer remains imperfect. Current methods of prostate biopsy are limited by over detection of slow-growing tumors and under detection of clinically relevant cancers. Investigators at the University of California-Los Angeles Department of Urology have found that a new technique of targeted biopsy in a clinic setting, using local anesthesia, may improve diagnosis and aid in selecting which patients are suitable for active surveillance and which need focal therapy (noninvasive techniques for destroying small tumors within ...

Renewables and storage could power grid 99.9 percent of the time

Renewables and storage could power grid 99.9 percent of the time
2012-12-10
Renewable energy could fully power a large electric grid 99.9 percent of the time by 2030 at costs comparable to today's electricity expenses, according to new research by the University of Delaware and Delaware Technical Community College. A well-designed combination of wind power, solar power and storage in batteries and fuel cells would nearly always exceed electricity demands while keeping costs low, the scientists found. "These results break the conventional wisdom that renewable energy is too unreliable and expensive," said co-author Willett Kempton, professor ...

Secrets of gentle touch revealed

Secrets of gentle touch revealed
2012-12-10
Stroke the soft body of a newborn fruit fly larva ever-so-gently with a freshly plucked eyelash, and it will respond to the tickle by altering its movement—an observation that has helped scientists at the University of California, San Francisco (UCSF) uncover the molecular basis of gentle touch, one of the most fundamental but least well understood of our senses. Our ability to sense gentle touch is known to develop early and to remain ever-present in our lives, from the first loving caresses our mothers lavish on us as newborns to the fading tingle we feel as our lives ...

Temple scientists target DNA repair to eradicate leukemia stem cells

2012-12-10
(Philadelphia, PA) – Despite treatment with imatinib, a successful drug that targets chronic myeloid leukemia (CML), a deadly type of cancer, some patients may continue to be at risk for relapse because a tiny pool of stem cells is resistant to treatment and may even accumulate additional genetic aberrations, eventually leading to disease progression and relapse. These leukemia stem cells are full of genetic errors, loaded with potentially lethal breaks in DNA, and are in a state of constant self-repair. Now, scientists at Temple University School of Medicine may have ...

Bugs without borders

2012-12-10
Researchers show that the global epidemic of Clostridium difficile 027/NAP1/BI in the early to mid-2000s was caused by the spread of two different but highly related strains of the bacterium rather than one as was previously thought. The spread and persistence of both epidemics were driven by the acquisition of resistance to a frontline antibiotic. Unlike many other healthcare-associated bacteria, C. difficile produces highly resistant and infectious spores. These spores can promote the transmission of C. difficile and potentially facilitates its spread over greater geographical ...

What it is to be a queen bee?

What it is to be a queen bee?
2012-12-10
Queen sweat bees 'choose' the role of their daughters, according to a new study published in BioMed Central's open access journal Frontiers in Zoology. The amount of food provided for the developing larvae determines whether the daughter becomes a worker or a new queen. The sweat bee Halictus scabiosae are a primitive eusocial insect. Eusocial insects have a hierarchical society with a division of labor between reproductive queens and males, and workers. However for H. scabiosae all the adults have retained the ability to reproduce, although their role in the nest may ...

Brain study shows why some people are more in tune with what they want

2012-12-10
Wellcome Trust researchers have discovered how the brain assesses confidence in its decisions. The findings explain why some people have better insight into their choices than others. Throughout life, we're constantly evaluating our options and making decisions based on the information we have available. How confident we are in those decisions has clear consequences. For example, investment bankers have to be confident that they're making the right choice when deciding where to put their clients' money. Researchers at the Wellcome Trust Centre for Neuroimaging at UCL ...

Engineered immune cells produce complete response in child with an aggressive pediatric leukemia

2012-12-10
By reprogramming a 7-year-old girl's own immune cells to attack an aggressive form of childhood leukemia, a pediatric oncologist has achieved a complete response in his patient, who faced grim prospects when she relapsed after conventional treatment. The innovative experimental therapy used bioengineered T cells, custom-designed to multiply rapidly in the patient, and then destroy leukemia cells. After the treatment, the child's doctors found that she had no evidence of cancer. Pediatric oncologist Stephan A. Grupp, M.D., Ph.D., of The Children's Hospital of Philadelphia, ...

Leukemia patients remain in remission more than 2 years after engineered T cell therapy

2012-12-10
ATLANTA -- Nine of twelve leukemia patients who received infusions of their own T cells after the cells had been genetically engineered to attack the patients' tumors responded to the therapy, which was pioneered by scientists in the Perelman School of Medicine at the University of Pennsylvania. Penn Medicine researchers will present the latest results of the trial today at the American Society of Hematology's Annual Meeting and Exposition. The clinical trial participants, all of whom had advanced cancers, included 10 adult patients with chronic lymphocytic leukemia treated ...

Reduced intensity regimen prior to marrow transplant better for older leukemia patients

2012-12-10
COLUMBUS, Ohio – A new study led by researchers at the Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James) shows that preparing older acute myeloid leukemia (AML) patients for bone marrow transplants with a reduced intensity conditioning regimen appears to be associated with higher rates of disease-free survival relative to the more typical treatments usually given to such patients. The study was presented at the 2012 American Society of Hematology (ASH) Annual Meeting in Atlanta, ...

LAST 30 PRESS RELEASES:

Discovery of bacteria's defence against viruses becomes a piece of the puzzle against resistance

Pre-eclampsia is associated with earlier onset and higher incidence of cardiovascular risk factors

Warwick astronomers discover doomed pair of spiralling stars on our cosmic doorstep

Soil conditions significantly increase rainfall in world’s megastorm hotspots

NK cells complexed with bispecific antibody yield high response rates in patients with lymphoma

Planetary health diet and mediterranean diet associated with similar survival and sustainability benefits

Singapore launches national standard to validate antimicrobial disinfectant products

Molecular stool test could improve detection of tuberculosis in adults with HIV

Suspected fibrocartilaginous embolus in Asian small-clawed otter (Aonyx cinereus)

Enhancing heat transfer using the turbulent flow of viscoelastic fluids

Exercise as an anti-ageing intervention to avoid detrimental impact of mental fatigue

UMass Amherst Nursing Professor Emerita honored as ‘Living Legend’

New guidelines aim to improve cystic fibrosis screening

Picky eaters by day, buffet by night: Butterfly, moth diets sync to plant aromas

Pennington Biomedical’s Dr. Leanne Redman honored with the E. V. McCollum Award from the American Society for Nutrition

CCNY physicists uncover electronic interactions mediated via spin waves

Researchers’ 3D-printing formula may transform future of foam

Nurture more important than nature for robotic hand

Drug-delivering aptamers target leukemia stem cells for one-two knockout punch

New study finds that over 95% of sponsored influencer posts on Twitter were not disclosed

New sea grant report helps great lakes fish farmers navigate aquaculture regulations

Strain “trick” improves perovskite solar cells’ efficiency

How GPS helps older drivers stay on the roads

Estrogen and progesterone stimulate the body to make opioids

Dancing with the cells – how acoustically levitating a diamond led to a breakthrough in biotech automation

Machine learning helps construct an evolutionary timeline of bacteria

Cellular regulator of mRNA vaccine revealed... offering new therapeutic options

Animal behavioral diversity at risk in the face of declining biodiversity

Finding their way: GPS ignites independence in older adult drivers

Antibiotic resistance among key bacterial species plateaus over time

[Press-News.org] Prostate cancer now detectable by imaging-guided biopsy
Findings may end 25-year era of blind biopsy