At Mount Sinai, our Precision Urology™ approach to diagnosing prostate cancer involves the integration of multiple variables and imaging data in a decision support system. This collaboration is key in assuring men with prostate cancer of our commitment to a patient-centric, personalized diagnostic approach and excellent outcome, while minimizing the side effects of treatment. Precision Urology, developed by Dr. Ash Tewari, Chair of the Department of Urology and a world renowned robotic prostate cancer surgeon, reflects our utilization of advanced technologies and incorporation of molecular and genomic analysis to identify markers of aggressive disease. This allows us to rigorously stage disease to determine if intervention is needed and if so, tailor the treatment accordingly.
Precise MD™ is developing new approaches to characterizing an individual’s cancer by combining multiple data sources and analyzing them with mathematical algorithms, offering a more sophisticated alternative to standard approaches. With respect to prostate cancer, The Department of Urology is partnering with the Department of Pathology’s Center for Computational and Systems Pathology to advance the Precise MD approach and mathematically characterize the Gleason score, a grading system that has been used since the 1960s to guide prostate cancer patient’s treatment options and establish their prognosis. In its initial phase, Precise MD will complete a test used to analyze patients, who have had prostatectomies at Mount Sinai Health System, to help determine which of them will likely have a recurrence of cancer and may need additional therapy such as chemotherapy. A second, higher-impact test will follow in 2017, which will be used to characterize prostate cancer in newly diagnosed patients.
Our arsenal of Precision Urology tools and techniques include Artemis, an imaging device that allows 3D prostate visualization and tracking. By fusing multiparametric MRI with real-time ultrasound, abnormal or suspicious areas seen on the MRI can be tracked and targeted during a prostate biopsy. Artemis offers sophisticated recording of actual biopsy sites sampled, which can be reviewed at any time. Mount Sinai is one of a few facilities in New York City with an Artemis device.
3 Tesla (3T) Multiparametric Magnetic Resonance Imaging (MRI)
3T MRI is a state-of-the-art, non-invasive imaging modality that facilitates diagnosing, staging, and pre-operative planning for prostate cancer. Magnetic waves create images of the prostate and surrounding tissue. Using advanced computer algorithms, images can then be processed to predict where prostate cancer lesions are located.
NeuroSAFE™ allows the assessment of surgical margin for absence or presence of cancer intra-operatively, allowing the surgeon to perform adequate nerve sparing and resecting more tissue, if necessary to ensure oncological safety.
Our researchers are working to unravel the genetic factors linked to prostate cancer. Genetic screening can pick up mutations in an individual's genetic code that may increase the risk of advanced prostate cancer. We combine genetic information with advanced imaging and immunohistochemistry to determine prostate cancer risk and staging. We design prostate cancer screening plans tailored to each patient's risk profile.