The use of magnetic resonance imaging (MRI) in urology is well established for the evaluation of prostate cancer. Recently, however, MRI has expanded to other areas of urology, including renal tumors, benign prostate hyperplasia (BPH) and voiding dysfunction.
Krishnanath Gaitonde, MD, associate professor of Surgery at the University of Cincinnati Medical Center, will moderate a 30-minute panel discussion on the evolving use of MRI in urology during Sunday morning’s Next Frontier plenary session. The 30-minute discussion, which begins at 11 am in Hall E at Moscone North, is titled MRI: Beyond Prostate Cancer.
“This is a fascinating topic because we are now looking at how MRI can be used to improve and customize the care for patients with other urologic conditions,” Dr. Gaitonde said.
The session’s first presenter, Jeffrey Cadeddu, MD, professor of Urology and Radiology at the University of Texas Southwestern Medical Center, will discuss the application of MRI in kidney tumors. In the past ultrasound and computerized tomography were the modalities of choice, but MRI is emerging as a powerful tool for the detection and characterization of renal masses.
Dr. Cadeddu will discuss how he uses MRI to evaluate the tissue architecture of renal masses and determine if they are malignant or benign, without the need for a biopsy. If a tumor is determined to be malignant, MRI can also help predict its aggressiveness.
“We are moving more toward minimally invasive therapies, including active surveillance for renal tumors that are determined to be low grade with low risk for progression,” Dr. Gaitonde said. “In the past we have often used biopsy to guide those decisions, but now we may be able to use imaging as a surrogate instead of biopsy.”
The second speaker, Claus Roehrborn, MD, professor and Chairman of the Department of Urology at the University of Texas Southwestern Medical Center, will discuss the role of MRI in the management of BPH. Until recently, imaging was considered an optional tool with a limited role in the treatment of BPH. However, MRI has significant potential to aid in the pretreatment workup and management of this condition, Dr. Gaitonde said.
“Dr Roehrborn’s goal is to use this modality to optimize and guide decision making in helping to choose the most appropriate treatment for BPH, based on the architecture of the gland,” Dr. Gaitonde said. “We have a plethora of treatment options, ranging from medical therapy to minimally invasive endoscopic or robotic procedures to traditional open surgery.”
The session’s final speaker, Tim Boone, MD, PhD, professor of Urology and Associate Dean of Weill Cornell Medical College, and Chair of the Department of Urology at Houston Methodist Hospital, will discuss the use of MRI for the evaluation of voiding dysfunction and neurogenic bladder. Neurogenic bladder results from an injury to the central or peripheral nerves that control urination.
Dr. Boone will discuss the use of functional MRI that evaluates activity in the brain during various phases of the micturition cycle.
“The goal is to see if we can identify what specific areas of the brain are associated with neurogenic bladders,” Dr. Gaitonde said. “Once we understand what brain areas are associated with certain cycles of the patient’s voiding activity in neurogenic bladder, there’s a potential for targeting these sites for intervention and drugs.”