Prostate cancer is the most common cancer in UK men, accounting for a quarter of all new cases. It is the second largest cancer killer of men in the UK. Needle biopsy remains the standard test for confirming prostate cancer, and determining how aggressive it is. To obtain the sample a needle is inserted into the prostate via the rectum, which is inaccurate, painful and can cause bleeding and sepsis.
Research supported by the UCLH BRC has led to changes in patient care for men with prostate cancer through implementation of less invasive, image-directed treatment and diagnostic strategies, and running clinical trials that use these techniques. Between 2012 and 2016, Professors Dean Barratt and Mark Emberton led a £2.3M project to design, develop, validate and commercialise a UK- and US-government approved software-based device, SmartTarget1.
During standard biopsy procedure, surgeons use ultrasound imaging to locate the prostate and its main areas, but prostate-cancer tumours are invisible in the ultrasound. To improve guidance during biopsy SmartTarget overlays prostate tumour information from magnetic resonance imaging (MRI) scans (obtained before the operation) onto ultrasound images (during the operation). It provides 3-D information on size, shape and location of tumours enabling accurate targeting of tumours that were previously often missed. The SmartTarget biopsy trial (129 patients)2, demonstrated SmartTarget is at least as accurate in detecting clinically-important prostate cancer as visual targeting performed by a trained and highly experienced clinician, and that SmartTarget technology combined with visual targeting maximises detection of clinically important cancers.
With SmartTarget, the biopsy procedure is more efficient, more accurate, less invasive (a lower risk of infection), and cheaper than established techniques. Combining use in clinical trials and routine clinical practice, the technology has been used to guide over 1,200 biopsy/treatment procedures internationally, including the UK and USA. Additionally, in an effort to reduce side-effects many clinical trials have used SmartTarget to deliver minimally-invasive therapy directed only to specific tumours. A new version of the SmartTarget system, SmartBlate, with an updated user interface, has been launched in several countries including the US, Spain, and Ireland, as part of a prostate cancer diagnostic and treatment service run by Focalyx.
References:
- Hu et al. Med. Image Anal. 2015
- Hamed et al, European Urology, 2019
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