Non-invasive Approach in the Fight Against Prostate Cancer
Magnetic Resonance Imaging Spares Patients Unpleasant Diagnostic Procedures
Sandro Benini | 09-09-2015
On the occasion of prostate cancer month, Medical Solutions features the story of Jorge Fernández de la Torre who uses magnetic resonance imaging in the detection of prostate cancer. The fact that his facility can also offer the exam without using an invasive endorectal coil has increased patient acceptance.
Photos: Marcelo Kahn
Low patient acceptance of rectal prostate examination is particularly high in Latin American cultures. Until recently, magnetic resonance imaging (MRI) to help detect prostate cancer has involved inserting an endorectal coil.
Using a body coil placed only on the pelvis makes the procedure more comfortable for the patient. Mexican radiologist Jorge Fernández de la Torre has implemented this approach to help the early detection of prostate cancer at his hospital in the city of Monterrey.
According to Dr. Fernández de la Torre, his results show that more men are now accepting the diagnostic procedure and its reliability at this site appears comparable with the conventional rectal approach.
Hospital San José in Monterrey, Mexico, is part of Tec de Monterrey, one of the country’s most prestigious universities. It is a general hospital with 200 beds, but it is widely known for its work in diagnosing and treating prostate cancer. The insidious thing about this disease – which is the most frequent form of cancer in men – is the fact that it often remains undetected for a long time.
Avoiding Unpleasant Diagnostic Methods
A major reason is that many patients find the diagnostic methods unpleasant or even humiliating, as the hospital’s chief radiologist Dr. Jorge Fernández de la Torre explains. “The shame experienced with a rectal examination of the prostate is particularly high in the Mexican and Latin American cultures,” he says. This holds true for a simple digital prostate exam as well as for more advanced diagnostic procedures like magnetic resonance imaging (MRI) with the aid of a rectal probe.
Introduction of a New Approach
MRI has grown to become a mainstay in the diagnosis and management of prostate cancer.1 Until recently, however, the examination usually involved a special probe (an MRI coil) inserted into the rectum in order to acquire the images. This is exactly where a new approach, as implemented by Dr. Fernández de la Torre in his hospital in Monterrey, comes into play. Instead of using the endorectal MRI coil, he applies only a standard surface coil, placed on the pelvis like a collar. This is possible thanks to the high element density of Siemens Tim® technology, which provides excellent signal-to-noise ratio (SNR).
Increased Patient Acceptance
Using only external body coils offers more comfort to the patient and physicians all over the world have shown that the reliability appears to be comparable to the invasive approach.2 According to Dr. Fernández de la Torre, the introduction of this approach in Mexico showed corresponding results.
Motivated by Personal Experience
The radiologist’s motivation in seeking innovative diagnostic possibilities is based on very personal experience: “My mother died of cancer shortly after I started college. Watching her suffer really stirred up my emotions. I would like to save other people from a fate like hers,” the doctor says.
Hope of Establishing a New Standard Method
Thanks to state-of-the-art equipment, such as the MRI system, a PET/CT scanner, and a SPECT scanner, Hospital San José has an integrative approach to diagnosing and treating all kinds of cancers – a unique approach in northern Mexico. A tour through the radiology department and the patient rooms shows that the hospital is modern, clean, and bright. Dr. Fernández de la Torre now hopes to make the non-invasive prostate MRI examination standard in the early detection of prostate cancer, eventually leading to a lower mortality rate. This would certainly be the type of the medical success he dreamed when he was a college student.
About the Author
Sandro Benini was born in Zurich, Switzerland in 1967. He has a Master's degree in German and Italian Literature and Linguistics from the Universities of Zurich and Bologna, Italy. After working for several Swiss magazines and newspapers, he has been a Latin American correspondent for the Swiss daily newspaper Tages-Anzeiger for seven years.
1Lee DJ, Ahmed HU, Moore CM, Emberton M, Ehdaie B (2014). Multiparametric magnetic resonance imaging in the management and diagnosis of prostate cancer: current applications and strategies. Current Urology Reports 15:390.
2Kim BS, Kim TH, Kwon TG, Yoo ES (2012). Comparison of pelvic phased-array versus endorectal coil magnetic resonance imaging at 3 Tesla for local staging of prostate cancer. Yonsei Medical Journal 53:550-556.
The statements by Siemens’ customers described herein are based on results that were achieved in the customer's unique setting. Since there is no "typical" hospital and many variables exist (e.g., hospital size, case mix, level of IT adoption) there can be no guarantee that other customers will achieve the same results.