Memorial Hermann Sugar Land Leads The Way With New Prostate Cancer Screening Technology

UroNav Cart 3.0

COVER STORY | By M.G. Angulo
Photos by Alisa Murray Photography –

Memorial Hermann Sugar Land Hospital consistently strives to provide Fort Bend County residents with premier health care services, so when technology that can enhance such services is introduced, Memorial Hermann strives to be at the forefront. The hospital now offers the UroNav Fusion Biopsy System for diagnosing prostate cancer.

“Memorial Hermann is committed to practicing cutting-edge medicine,” said Dr. Zachary Mucher, a urologist affiliated with Memorial Hermann who specializes in diseases of the genitourinary tract, including prostate cancer. “To my knowledge, Memorial Hermann Sugar Land is the only hospital in Fort Bend County to offer this technology.”

Better Diagnostic Tools Leading to Better Outcomes

The traditional prostate cancer screening services — namely Prostate-Specific Antigen (PSA) tests and Digital Rectal Exams (DRE) — have been used for some time now, but unfortunately both of these methods can be unreliable. When men have an elevated PSA level or an irregular DRE, they undergo a prostate biopsy, which is the most reliable screening method. However, such a biopsy, often called a blind biopsy, requires the physician to remove tissue from about 12 quadrants of the prostate without being able to look inside it while performing the biopsy.

Although this is an effective method for prostate cancer detection, it has its limits. Only the tissue gathered can be analyzed, meaning the biopsy could collect tissue samples that are adjacent to the tumor without actually penetrating the tumor itself, resulting in missed detection. Even the Transrectal Ultrasound-Guided Prostate biopsy (TRUS), the current biopsy standard, has limitations, including poor image resolution or the biopsy needle passing through tumor-free areas of the prostate, again missing tumor detection. 

The UroNav Fusion Biopsy System brings the effectiveness of an MRI to urology. Patients undergoing this method start with a Multiparametric MRI image of their prostate gland, which detects suspicious lesions in the prostate. The MRI image is then fused with an ultrasound image to help pinpoint questionable areas of the prostate for needle biopsy.

Due to its ability to fuse pre-biopsy MR images of the prostate with ultrasound-guided biopsy images in real time, UroNav provides unbeatable clarity of the prostate and suspicious lesions, as well as clear visualization of the biopsy needle.

“UroNav better identifies areas of concern within the prostate that warrant biopsy,” Dr. Mucher summarized. “MRI fusion biopsy is the newest and most significant advancement in prostate biopsy technology. It significantly improves detection of prostate cancer compared to traditional prostate biopsy. Also, it is performed under anesthesia, which is much better tolerated for most patients.”

How UroNav Works

Dr. Kyle Keyes and Dr. Zachary Mucher.

UroNav combines electromagnetic tracking and navigation — similar to the GPS in a car — with an onboard computer and a real-time imaging interface in one easy-to-use, mobile workstation. A tiny tracking sensor is attached to a transrectal ultrasound probe that generates a small electromagnetic field, which helps determine the location and orientation of the biopsy needle. A sophisticated algorithm then maintains the fusion of MRI and ultrasound images, even during movement.  In short, the procedure does not require complex mechanical devices or time-consuming routines.

Additionally, the capabilities of this new technology are considerably noteworthy. Not only can UroNav pinpoint suspicious areas more accurately and reduce the number of tissue samples required during biopsy, it may also reduce the risk of infection, bleeding and pain, as well as shorten the recovery period following a biopsy.

Dr. Kyle Keyes, an affiliated physician who specializes in urology, is proud UroNav has been added to the hospital’s services. “This new technology improves the chances of finding clinically significant cancer and reduces the chance of missing important cancers,” he said. “It improves patient care, specifically men’s health.”

Prostate Cancer Screening is Paramount

The Centers for Disease Control and Prevention (CDC) reports that aside from non-melanoma skin cancer, prostate cancer is the most common cancer among men in the United States. It is also one of the leading causes of cancer death among men.

Statistics indicate that nearly one of nine men will be diagnosed with prostate cancer in their lifetime, and each year, nearly 175,000 men are diagnosed with prostate cancer in the United States. The CDC reports that in 2016, the latest year for which incidence data is available, 11,970 cases of prostate cancer were reported in Texas.

Risk factors for prostate cancer vary, and some are unavoidable, such as age, genetics and ethnicity. One in six Caucasian men and one in five African-American men will be diagnosed in their lifetime, noted Dr. Mucher.

“Over 30,000 men die from prostate cancer each year,” stressed Dr. Keyes. “And this is preventable.”

For this reason alone, prostate health and care is paramount to Memorial Hermann, which is evident in the hospital’s affiliated urologists, radiation oncologists, radiologists, medical oncologists, pathologists and cancer specialists who form a team dedicated to advanced prostate care from diagnosis to treatment.

No man is excited to undergo the exam that is part of prostate cancer screening, Dr. Mucher admits, however, staying consistent with screening is worth the anxiety of the annual appointment. Studies estimate between 17 and 50 percent of men with prostate cancer, detected by PSA tests, had tumors that would not result in symptoms during their lifetime.

Since prostate cancer may cause no symptoms, and possible symptoms are often due to other problems, such as an enlarged prostate, urologists affiliated with Memorial Hermann urge men to err on the side of caution and tell their doctor if they experience any of the following:

  • Pain during urination
  • Frequent urination, especially at night
  • Pain in the upper thighs, hips or lower back
  • Not being able to urinate
  • Blood in the semen or urine
  • Painful ejaculation

There is no doubt that accurate biopsies help improve the prostate cancer cure rate, so the recent studies of UroNav, reporting positive predictive values above 90 percent, is substantially changing how urologists diagnose and treat prostate cancer.  “Prostate cancer is the most common cancer in men,” said Dr. Mucher.  “It is very treatable if caught early, so screening with yearly prostate exam and PSA blood tests are important for men between age 50 and 75. High-risk patients may begin screening earlier. It’s important to speak with your physician about prostate cancer screening.”