12 March, 2019
Dr. Ashley Ross is a nationally recognized expert in prostate cancer. He previously worked as the head of the Urology Prostate Cancer Program at John Hopkins and was an associate professor of urology. Now, he performs MRI-fusion biopsies for Texas Urology Specialists. However, he quickly realized there was a problem with MRI-fusion biopsies that needed to be solved.
Fusion MRI is the combination of an MRI of a patient’s prostate to detect areas of interest to biopsy and an overlay, or a “fusion”, of an ultrasound to guide the urologist to those areas of interest. This ultimately maps out where each biopsy is taken to provide the ability for more targeted treatments. It is the latest technology available in targeting suspicious lesions in the prostate.
Although MRI-fusion biopsies are a major advancement in urology, Dr. Ross new there was a significant issue that needed to be resolved. He explained, “Traditionally, when we biopsy a lesion we place the tissue into a bottle full of preservative called formalin to fix it. The tissues free float in the bottles so we lose track of which end of the tissue is which.” For example, if a biopsied tissue was half in-half out of a detected lesion and a certain percentage of that tissue was diagnosed as positive for cancer, there is no way of knowing if the cancer is actually located in the lesion or not. Only a general idea of the cancer’s location is known. However, if orientation is preserved it can inform the doctor exactly where the cancer is located, if the lesion on the organ is over or underrepresented on the MRI, and more targeted treatment can be performed.
The knowledge of proximal and distal (near and far) ends of the tissue in relationship to the organ is called orientation. The inability to preserve such orientation means that a fusion MRI-biopsy cannot be accurately mapped.
For example, if a biopsied tissue was half in-half out of a detected lesion and a certain percentage of that tissue was diagnosed as positive for cancer, there is no way of knowing if the cancer is actually located in the lesion or not. Only a general idea of the cancer’s location is known. However, if orientation is preserved it can inform the doctor exactly where the cancer is located, if the lesion on the organ is over or underrepresented on the MRI, and more targeted treatment can be performed.
In order to solve this problem, Dr. Ross decided to use a new biopsy collection device by LUMEA, Inc. called the BxBoard™. The BxBoard stores up to 6 needle-core biopsies in site-specific lanes. Using this method, tissue orientation is preserved because the tissue is placed onto a formalin-soaked sponge within a narrow lane that significantly restricts tissue movement during its transit to a lab.
“Tissue is placed sequentially in the BxBoard so I know both exactly where the cores came from and the orientation of each core,” said Dr. Ross. “Using this very simple technique, we can get a better assessment of where the cancer is in the prostate to allow for treatment planning and better treatment decision making for my patients.”
LUMEA has provided other solutions for Dr. Ross and Texas Urology Specialists. Some of these solutions include: the production of high-density scans of slides to allow digital access to tissue, the use of Artificial Intelligence to measure tissue surface area for more accurate involvement percentages, reduced turn-around time, and improved quality of tissue.
LUMEA also provides clinics software that digitizes their workflows, removes the need for faxing, integrates with molecular testing companies for reduced turn-around times, allows for aggregation of biopsy results, and electronically notifies clinics as soon as the diagnosis has been made.
When asked how LUMEA has helped his practice, Dr. Ross explained “The LUMEA platform is fairly extensive and they’ve helped us in many ways. Some benefits are just logistic while others are actually advancing the technology to allow for better diagnosis. All of them are important because they translate to a better diagnosis, faster turn-around time, and better communication with providers, and improved patient care.”Back to news