25-05 Brian Wodlinger, PhD "Micro-Ultrasound for Prostate Cancer Imaging"

Dr. Brian Wodlinger presents the latest developments in micro-ultrasound technology as a high-resolution alternative to MRI for prostate imaging. He discusses its applications, clinical validations, advantages over MRI, training, AI integration, and future directions. 00:00 Opening Remarks - Neal Berke, CEO Prostate Forum 01:57 Dr Wodlinger 25:01 Q&A 📌 Key Highlights 1. What is Micro-Ultrasound? • A new, real-time imaging modality operating at 29 MHz, offering 70-micron resolution. • Designed to overcome the limitations of conventional ultrasound (low sensitivity) and MRI (access, cost, claustrophobia, contraindications). 2. Why It Matters • Real-time imaging of prostate ducts (the origin of most cancers). • Enables office-based imaging, reducing reliance on expensive or delayed MRIs. • Can identify cancers missed by MRI, including small or non-contrast-enhancing lesions. 3. Validation & Clinical Trials • Validated through collaboration with UCLA, UHN Toronto, and others. • Optimum Study (multi-national, randomized, 680+ patients): o Proved micro-ultrasound is non-inferior to MRI/ultrasound fusion. o Micro-ultrasound showed higher sensitivity and NPV than MRI in some cohorts. • Studies in active surveillance and focal therapy planning also promising. 4. Applications • Screening men with elevated PSA. • Performing targeted and systematic biopsies. • Monitoring patients under active surveillance. • Guiding focal therapies (e.g., laser, cryotherapy). • Post-treatment recurrence detection and surgical planning. 5. Training & Usability • Exact Imaging offers a free, structured training program for physicians. • Over 300 systems in use worldwide, 100+ in the U.S., many in California. • Imaging and interpretation primarily performed by urologists, not radiologists, in the U.S. 6. Artificial Intelligence • AI is in development for image interpretation assistance. • Partner institutions include UCLA, UBC, University of Florida, and Queens University. • Focus on making image interpretation easier and more consistent. 7. Commercial Status • FDA-cleared since 2017. • Covered under existing ultrasound reimbursement codes. • Approximate system cost: $200,000, much less than MRI. 💬 Audience Q&A – Key Themes • Availability & Reimbursement: Already in clinical use; reimbursed as ultrasound. • Training Confidence: Robust program ensures urologists achieve diagnostic quality results. • Imaging Limitations: Cannot yet replace biopsy; histology still required. • AI & Second Opinions: AI tools and expert reading services developing; referrals possible. • Testicular Imaging & Other Uses: Promising for testicular pathology and residual volume scans. • Focal Therapy Implications: May strengthen support for focal therapy as a standard option. • Awareness & Education Gaps: Group emphasized need for early screening and better public communication (esp. PSA testing in men 50+). Mentioned • Website: exactimaging.com o Includes physician finder and contact info ([email protected]) • Follow-up Studies: MUSIC-AS and MUSIC-Screen (for surveillance and screening) ==== About the Prostate Forum ====== Prostate Cancer? You are not alone. The Prostate Forum of Orange County (prostateforum.org) is an all- volunteer organization that has been providing support to prostate cancer patients for more than thirty years. Our goal is to listen, to inform, and to educate, so that people learn to advocate for themselves and become active collaborators with their medical teams in managing their own treatment. The Forum hosts monthly online support meetings (via Zoom) on the second and fourth Tuesday of most months, beginning at 5:00 pm Pacific Time. At the Newly Diagnosed Group, every 2nd Tuesday at 5:00 pm Pacific Time, get help understanding your Prostate Cancer diagnosis. Learn what it means. Talk about your options. At the Advanced/Recurrent Group Group every 4th Tuesday, beginning at 5:00 pm Pacific Time, share your concerns and experiences, and find out what other Prostate Cancer warriors are saying and thinking. Learn about resources, advances, and breakthroughs - advanced treatment options are improving all the time. Monthly Presentations Experts in the treatment and management of Prostate Cancer share their knowledge and experience with us on the fourth Thursday of most months. All meetings are free and are open to anyone affected by prostate cancer – patients, family, friends. Our website address is: www.prostateforum.org