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This video provides information on the importance of MRI exams for detecting and treating prostate-related diseases, including prostate cancer, and emphasizes the need for ethical and evidence-based medical practices. The expert also discusses the different uses of MRI, including targeted biopsies and staging cancer. They note that early diagnosis is critical for planning treatments and monitoring progress, and stress the importance of monitoring patients with prostate cancer and judicious use of treatment options. The video also addresses the importance of providing complete clinical information to radiologists in planning treatment or biopsy. Finally, the expert emphasizes the need to consider the patient's benefit and highlights the usefulness of imaging exams for diagnosis, but acknowledges their prohibitive cost for some patients.

  • 00:00:00 In this section, the speaker discusses the various diseases that can affect the prostate gland, including enlargement, prostate cancer, prostatitis, and prostate abscesses. They highlight the importance of understanding the complexity of evaluating and treating prostate-related diseases, as well as the need for ethical and evidence-based medical practices. The speaker also explains that the risk of developing prostate-related illnesses may increase with age and sexual activity, and emphasizes that unnecessary medical procedures such as ultrasounds should be avoided for younger individuals.
  • 00:05:00 In this section, the speaker discusses the importance of MRI exams for the diagnosis and treatment of prostate cancer. He explains the use of the Gleason scale to characterize and classify cancer cells and how MRI helps to orient who should get a biopsy. The speaker also emphasizes the usefulness of MRI in studying the prostate and its adjacent structures, including the seminal vesicles and deferential ducts. He explains that prostate cancer has a higher survival rate and a lower mortality rate compared to other cancers, especially when the diagnosis is given at an advanced age. However, the speaker reminds viewers to get checked from the age of 40 to detect any abnormalities or warning signs of cancer in time.
  • 00:10:00 In this section, a urologist describes the discovery of a cyst in the prostate of a young patient which cannot be removed due to the risk of complications. Additionally, the video shows various images of different prostate conditions found through MRI tests, including calcification and prostate cancer of varying grades. The expert notes that while an MRI can bring peace of mind to patients, it does not necessarily benefit their treatment plan, and sometimes a diagnosis of cancer can be of a low enough grade to not require treatment.
  • 00:15:00 In this section, the speaker discusses the importance of using both a magnetic resonance imaging (MRI) scan and a prostate cancer risk calculator before making a decision about whether a prostate biopsy is necessary. The calculator asks whether the patient has had an MRI, as the scan can aid diagnosis when there is suspicion of cancer without prior biopsy. The MRI is also useful in determining treatment options and monitoring the patient's progress. The speaker emphasizes that these diagnostic tools are crucial since prostate cancer is often asymptomatic in its early stages.
  • 00:20:00 In this section of the video on prostate exams, the speaker discusses the role of magnetic resonance imaging (MRI) in detecting prostate cancer. While clinical suspicion of prostate cancer is based on rectal exams and prostate-specific antigen levels, MRI can help detect tumors through a biopsy procedure. The efficacy of the biopsy in detecting cancer depends on its ability to locate cancerous tissues, and MRI-guided biopsies are more effective than those guided by ultrasound or performed blindly. The speaker also mentions the importance of improving the efficacy of biopsies to detect cancer while minimizing complications. The MRI can also help identify which patients do not need a biopsy, which can prevent unnecessary invasive procedures.
  • 00:25:00 In this section of the video, the speaker discusses the different uses of magnetic resonance imaging (MRI) for the diagnosis and treatment of prostate cancer. According to the speaker, MRI is a more effective tool for targeted biopsies than ultrasound. MRI is also used for staging the cancer and determining the extent of its spread beyond the prostate gland. The speaker notes that unfortunately, many patients in Peru arrive at hospitals in advanced stages of the disease due to a lack of education and healthcare promotions. MRI is critical for planning treatments, monitoring the patient's progress, and checking for local invasions and metastases. Getting diagnosed early and using MRI for treatment plans can help avoid the need for radiation therapy.
  • 00:30:00 In this section, the speaker talks about the importance of monitoring patients with prostate cancer and the criteria for deciding whether or not to give treatment. Patients with an antigen level less than 10 and a glison less than 7, as well as those with clinical stage tumors smaller than T2, may be placed into active surveillance instead of receiving treatment. The speaker emphasizes that follow-up is still necessary even after treatment or surveillance and discusses the importance of the MRI exam in prostate cancer diagnosis and monitoring. The speaker also highlights the need for urologists to be familiar with the PIRADS scale and to ask for specific values in MRI reports to better evaluate patients.
  • 00:35:00 In this section, the speaker discusses the importance and interpretation of prostate exams and MRIs. They explain that a high score on a prostate MRI does not necessarily mean cancer but instead means there is a need for a biopsy, and the exam is not cheap. The speaker emphasizes the importance of the final score of 5 as well as the unit used to measure tissue density. They recommend that patients with a high risk of cancer observe a PIRADS 3 before undergoing a biopsy, and the speaker explains the standard of taking 12 biopsy samples in sextants, with two samples in each area. The speaker also discusses how to prepare for a prostate MRI and the information that should be included in the information sent to the doctor ordering the MRI.
  • 00:40:00 In this section, the speaker discusses the importance of providing complete clinical information to radiologists before conducting an MRI exam, especially if a patient has a family history or previous biopsy. The MRI can help locate lesions and identify whether they are cancerous based on their density and high pi-rads score. The speaker explains that the prostate is divided into 36 regions and shows a map sectorial that a radiologist can use to identify regions with the highest probability of cancer. The MRI can also provide information about the size and extension of a lesion, which could indicate whether it is invasive or not. With proper guidance from a radiologist and the use of MRI and ultrasound technology, the speaker and other urologists can conduct biopsies more accurately and avoid unnecessary invasive procedures.
  • 00:45:00 In this section, the speaker emphasizes the importance of putting the patient's benefit ahead of the doctor's when it comes to medical examinations, such as prostate exams. They explain that while transrectal ultrasound can be done in some cases, MRI is a much more efficient and effective method, especially for detecting small prostate cancer. They also clarify that contrast is not typically used in prostate MRI as the gland does not filter much blood, making it difficult to discern tissue with contrast. Lastly, the speaker recommends the use of MRI for identifying prostate issues but notes that the cost of the exam may be prohibitive for some patients.
  • 00:50:00 In this section, the speaker discusses the usefulness of imaging exams such as MRI and ultrasound in the diagnosis of prostate cancer. He explains how MRI has a high recommendation grade in some hospitals because it can help determine if a biopsy is needed, reducing the number of unnecessary biopsies for negative results. However, since not all places in Peru have the capacity for MRI, ultrasound remains a fundamental tool for decision-making in biopsy collection. He also compares the benefits of tomography and MRI, explaining that while tomography is better suited for some aspects of urological imaging, MRI is the superior method for prostate and sexual gland evaluations.
  • 00:55:00 In this section, the doctor explains the importance of using MRI for prostate exams and the justification for a biopsy if the results show a high suspicion of cancer. He also emphasizes that MRI helps with decision-making by providing clear evidence for the need for a biopsy. The doctor has been using MRI for over five years and has seen an improvement in diagnostic capabilities and a reduction in unnecessary biopsies. The webinar was organized by Infosalud and the Diresa Apurimac and was well-received by participants. The next webinar will be focused on cystoscopy in men.

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