ADVANCED DIAGNOSIS

There is no substitute for an accurate diagnosis! A real difficulty with prostate cancer is that many doctors treat all prostate cancers as if they were the same.  One man’s cancer might be an area of slow-growing cancer in only 5% of the prostate. You might think of that as a “lamb” because it requires minimal therapy. On the other hand, another man might have cancer that involves most of his prostate, with a high Gleason score and a poor genetic profile behaving like “tiger,” a faster growing type of cancer requiring more aggressive treatment. At the Scionti Prostate Center, we use advanced technology to find and characterize each man’s cancer, assess the risk, and provide a personalized pathway to care for every man.

We are proud to offer advanced diagnostics that incorporate the four most important new technologies:

  • Biomarkers
  • 3T Multiparametric MR Imaging & 3D Prostate Mapping
  • Artemis Fusion-Guided Targeted Biopsy
  • Genomics

Biomarkers

Biomarkers—short for “biological markers”—are measurable biological substances that indicate the presence of a particular disease. Many people mistakenly believe that PSA (Prostate Specific Antigen, a protein produced by prostate cells that gets into the bloodstream) is a diagnostic biomarker for prostate cancer. In fact, it’s more like a barometer indicating that there is a problem in the prostate. It is a “yellow warning light” that requires further investigation. When the prostate gland is stimulated or irritated, it releases more PSA chemical. For example, bike riding, having sex, a prostate infection, and prostate cancer can all cause more PSA in the bloodstream. Thus, PSA, by itself is not an accurate biomarker for prostate cancer.

At our center, we use more specific FDA-approved biomarkers to determine if further testing is indicated. These include PSA and Free PSA, PSA/volume = PSA density, and the new PHI (Prostate Health Index) which includes these as well as [-2] pro PSA.  A new 4KScore® Test evaluates the risk of having a high-grade tumor (learn more at http://www.opkolab.com/4Kscore_Test.html)  

Multiparametric MRI & 3D Prostate Mapping

Prostate ultrasound has many uses, but it cannot accurately identify all prostate cancer tumors within the gland. Prostate ultrasound can only detect about 40% of prostate cancers. Multiparametric MRI has been shown to have a sensitivity (detection rate) of over 90% for clinically important prostate cancer when the study is performed with modern equipment and interpreted by highly skilled radiology physicians who have advanced training in the interpretation of these images. Our imaging partners in Sarasota offer advanced Magnetic Resonance Imaging (MRI) with modern MRI equipment, and multiparametric imaging software installed so that excellent quality prostate MRI studies are performed. Multiparametric MRI allows us to see the difference between healthy and cancerous prostate tissue with much higher accuracy than ultrasound. Multiparametric MRI at either 1.5 T or 3T gives us a 3-dimensional (3D) map of the prostate with the location, size and shape of suspected tumor(s). When we integrate the information from biomarkers with MRI imaging, a more precise assessment of the risk of prostate cancer can be made and better advice can be given about the need for a prostate biopsy.

 

Advanced diagnosis with 3T-MRI-Imaging

 

 

The 3T MRI image on the left clearly shows an obvious tumor (outlined in green).
MRI guided fusion biopsy revealed Gleason grade 7 cancer.
The ultrasound exam did not detect this cancer.

 

 

 

Artemis® Fusion Guided Biopsy: Targeted, Painless, Accurate

Prostate cancer can only be definitively diagnosed by means of a needle biopsy for laboratory analysis.  Imaging alone cannot provide the cellular and genetic information we need to formulate a treatment plan. In fact, The Scionti Prostate Center’s position is that it is unethical to put a man through treatment for prostate cancer without a needle biopsy to confirm and characterize the prostate cancer.

Many men fear the traditional TRUS (transrectal ultrasound) guided biopsy that takes 12-14 needles. It is inaccurate up to 51% of the time and cannot accurately identify all the cancerous regions of the prostate gland. Our Center offers a painless targeted biopsy using advanced MRI fusion imaging. This has been referred to as a “Smart Biopsy”.  Confirming the true nature of your cancer (accurate stage, location, extent, grade, genomic analysis) can be accomplished by selectively sampling the areas revealed by 3D MRI prostate mapping. Artemis® technology makes this possible.

artemis-technology

 

 

 

The Scionti Prostate Center utilizes ARTEMIS technology to perform MRI-to-ultrasound precision fusion guided biopsy.
We believe that a Smart targeted biopsy more precisely identifies the size, location and stage of a prostate cancer.

 

 

 

 

MRI-ultrasound-fusion-process-illustration

 

 

This figure illustrates the MRI-to-ultrasound fusion process.
Ultrasound images on the left of the diagram are fused or superimposed on a model of the prostate made from MRI images.
Biopsies can be directed to the MRI abnormalities.

 

 

 

Watch Dr. Scionti Perform an Artemis Biopsy

We guide the biopsy needle to the target area using fusion imaging,a technology built into the Artemis® software that fuses (merges) your multiparametric MRI images with real-time ultrasound in our Center. It has the ability accurately match, point for point, the MRI with real-time ultrasound. This gives a computerized 3D picture of the gland that can be rotated in every direction, revealing a suspicious area from any angle. The new fusion systems allow for precise biopsy visualization, needle guidance and biopsy placement.

 Laboratory Analysis of Your Cancer

 Dr. Scionti uses top pathology labs for genomic analysis of the biopsy samples. This provides him the most detailed evaluation of his patient’s prostate cancer. Our goal is to ensure that you have the best information available to you, because knowledge is the most powerful weapon you have in the fight against prostate cancer.

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