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EPAD 2017 - Jochen Walz

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Recent developments in early diagnosis for PCa
Jochen Walz , Chair EAU Section on Urological Imaging (ESUI)

Published in: Health & Medicine
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EPAD 2017 - Jochen Walz

  1. 1. Recent developments in early diagnosis for Prostate Cancer Jochen Walz Institut Paoli-Calmettes Cancer Centre Marseille/France
  2. 2. The history of prostate cancer diagnosis Digital rectal exam Finger guided trans rectal biopsy
  3. 3. The history of prostate cancer diagnosis Randomized sextant biopsy Hodge et al., J Urol 1989; Presti, J Urol 2003; Babaian, J Urol 2000; Philip, BJU Int. 2004; Eskew, J Urol 1997, etc. Randomized multicore biopsy
  4. 4. Limitations of randomized biopsy • Unreliable detection • Need of repeat biopsy when suspicion persists • Risk of overtreatment • Need of confirmatory biopsy for active surveillance Prostate Prostate Prostate
  5. 5. Recent developments in early diagnosis of prostate cancer Magnet resonance imaging of the prostate
  6. 6. Recent developments in early diagnosis of prostate cancer MRI of the prostate: • Independent of chance • Better detection of disease • Detection of significant disease Prostate
  7. 7. Recent developments in early diagnosis of prostate cancer MRI of the prostate: • Better characterization of disease Prostate Randomized core Targeted core
  8. 8. Prostate cancer management based on MRI of the prostate - Improved diagnosis - Less biopsies - Less overtreatment - Better decision making - Targeted treatment Prostate ProstateProstate
  9. 9. Limitations of recent developments in early diagnosis of prostate cancer MRI of the prostate: • Costly = 300-1000,-€ • Time consuming = 25-45 min scanning time • Quality dependant • Experience dependant • Standards and quality assurance necessary Logo of speaker’s organisation
  10. 10. Future perspectives: • Equitable access to high quality MRI • Reinforce quality assurance of image guided prostate cancer management • High quality research evaluating new technologies that allow image guided treatment Logo of speaker’s organisation

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