Software that fuses ultrasound and MRI images for guidance of prostate biopsies can help surgeons find clinically significant prostate cancers that would have otherwise been missed, according to research published on 6 December in European Urology.
A team of engineers, urologists, and radiologists from the University College London (UCL) evaluated SmartTarget, a software application developed at UCL that employs image processing and machine-learning algorithms to overlay tumor information from MRI scans onto ultrasound images.
"We developed the SmartTarget system to equip surgeons with vital information about the size, shape, and location of prostate tumors during a biopsy that is otherwise invisible on ultrasound images," explained co-senior author and lead developer Dr. Dean Barratt, from UCL Medical Physics and Biomedical Engineering and UCL Centre for Medical Image Computing.
Before the advent of MRI-targeted biopsies, clinicians were forced to conduct biopsies without knowing the whereabouts of suspected tumors. That shortcoming resulted in as many as 50% of malignant cancers going undetected. Now, with MRI targeting, surgeons can see a tumor’s location prior to biopsy, which, in turn, has increased cancer detection rates to approximately 90%, the authors noted.
The group tested SmartTarget in a study involving 129 patients with suspected prostate cancer at UCL Hospital. All patients received two biopsies: one using SmartTarget and one in which surgeons could only visually review the MRI exams.
The combination of both strategies detected 93 clinically significant prostate cancers; each picked up 80 cancers (86%) and missed 13 (14%) that the other method found. As a result, SmartTarget should be used in tandem with the visual review of MRI scans by surgeons, the team said. SmartTarget also enables surgeons to learn to make subtle adjustments, such as adapting to patient and prostate movement as the needle is inserted, according to the group.
"With this study, we now have hard data showing that SmartTarget is as good as a group of experts in targeting tumors in the prostate and have a glimpse of how clinicians and computers will be working together in the future for the good of the patient," said study co-senior author Dr. Mark Emberton in a statement from UCL.
The study was funded by the U.K. Department of Health and Social Care and the Welcome Health Innovation Challenge Fund. SmartTarget was developed by UCL researchers and has been commercialized by SmartTarget, a spin-off company from UCL's commercialization company UCL Business.
