With "Exact View" Micro Ultrasound, We've Got Prostate Cancer In Our Sights

Thanks for tuning in to the Armor Men’s Health Hour Podcast today, where we bring you the latest and greatest in medical and urology care and the best urology humor out there.

In this segment,  Dr. Mistry and Donna Lee are joined by Hugo Embert of EDAP Techno Medical Services, a European company and global leaders in the therapeutic use of ultrasound technology. Today, Mr. Embert describes the latest technological development in prostate ultrasound imaging: the Exact View ultrasound. This micro ultrasound technology uses high resolution ultrasound imaging to produce an incredibly detailed picture of the prostate. Greater resolution means greater chances of finding prostate cancer, accurately estimating its size and aggression, and identifying the appropriate intervention. When coupled with our revolutionary HIFU (High Intensity Focused Ultrasound) treatment, the Exact View micro ultrasound gives our team the best tools on the market for addressing prostate cancer. If you or someone you love would like to learn more about Exact View micro ultrasound, HIFU, or any other prostate concern, please give us a call today!

This episode was previously aired on 2.6.21. Don’t forget to like, subscribe, and share us with a friend! As always, be well!
 
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Dr. Mistry is a board-certified urologist and has been treating patients in the Austin and Greater Williamson County area since he started his private practice in 2007.

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Transcript

Welcome back to the Armor Men's Health Hour with Dr. Mistry and Donna Lee.

Dr. Mistry: Hello and welcome to the Armor Men's Health Hour. I'm Dr . Mistry, your host, here with my technologically challenged cohost, Donna Lee.

Donna Lee: Every time I sort of hit a button button just a little bit wrong, I have to catch a bunch of [inaudbile].

Dr. Mistry: That's right.

Donna Lee: Sorry. The show continues, and we've...

Dr. Mistry: One day you're going to introduce, and I can't wait to hear what, how I'm called.

Donna Lee: Oh, the ever present, effervescent Dr. Mistry.

Dr. Mistry: Very good. Very good. I'm a board certified urologist. This is a men's health show. The show is brought to you by our urology practice, NAU Urology Specialists. You know, a lot of people don't know what a urologist is. We are the most charismatic, smartest, and most handsome brand of surgeon.

Donna Lee: You're a Wiener fixer.

Dr. Mistry: We are also Wiener fixers. Our practice was started in 2007 . We are now up to four physicians. We have four offices. We have five mid-level providers. We are open and ready to see you in a COVID-safe way.

Donna Lee: That's right. We wipe everything down and in for an extra co-pay we'll wipe you down, too .

Dr. Mistry: That's right. Extra copay .

Donna Lee: That's right. Just a little under the table.

Dr. Mistry: Even though most of us are vaccinated now, because we're frontline workers and essential. Somebody tell my wife I'm essential.

Donna Lee: She, she knows. She just doesn't want you to know that she knows.

Dr. Mistry: She doesn't want me to know that she knows that I know that...

Donna Lee: Get the sore arm vaccination. Is that what it's called now?

Dr. Mistry: No. No, I, I did fine.

Donna Lee: You did?

Dr. Mistry: Yes. I'm strong like bull.

Donna Lee: "I'm strong like my [inaudible]."

Dr. Mistry: This is a show that we've really enjoyed being able to provide for well over a year. We've had amazing listenership. We love all of your questions. We encourage you to send us questions and Donna, how do people send us questions and where can they come see us and how do they make an appointment?

Donna Lee: Right. You can call us during the week at (512) 238-0762. You should have that memorized by now. Our locations are in Round Rock, North Austin, South Austin, and Dripping Springs, Texas. Send us your questions to armormenshealth@gmail.com. We get very excited when we , when we see a new question.

Dr. Mistry: Very excited.

Donna Lee: They're all a little repetitive, but we'll fix it all of your penis problems.

Dr. Mistry: That's okay. I had somebody to interview for a job here and he goes, "I've been listening to the podcast. I think you guys need a Peyronie's center of excellence because you know, every question's about crooked penis."

Donna Lee: It really is. I never knew there were so many men with crooked pee-pees.

Dr. Mistry: You know what I do at the beginning of the year? I take care of all my medical appointments.

Donna Lee: Your personal medical appointments?

Dr. Mistry: That's right. I take care of your medical appointments, like patients, I take care of theirs. Then of course I take care of my own. I like to get my eyes checked.

Donna Lee: And...

Dr. Mistry: Because you know how important it is that I see good.

Donna Lee: Well, I hope so, doing surgery.

Dr. Mistry: That's right. But seeing is more than just our eyes. We use lots of tools.

Donna Lee: Oh boy. Is there a segue coming?

Dr. Mistry: Oh, I was trying.

Donna Lee: Dang.

Dr. Mistry: What was it, was kind of a hard segue?

Donna Lee: It was, it was a wrap around, coming around the long way segue.

Dr. Mistry: Well, there we go.

Donna Lee: But go ahead.

Dr. Mistry: So I want to introduce our guest today, Hugo Embert of Edap TMS, which sends for Techno Med Services?

Hugo Embert: Yeah, Techno Medical Systems.

Dr. Mistry: Techno Medical Systems. Very good. Very good. Now Hugo is a great friend of ours and his technology, as it applies to ultrasound technology for kidney stone breaking, for prostate cancer treatment are things that we use, and this company is based right here in Austin.

Hugo Embert: That's correct. Our, our us headquarters is here in this beautiful city of Austin.

Dr. Mistry: Is there other besides US? That's weird. Well, I mean, we are worldwide now, so people are probably listening to us from other countries.

Donna Lee: In, in Asia and Europe, they're listening.

Hugo Embert: We have other subsidiaries in Japan, so we can try to, we can try to see if they have listeners over there for your podcast. Japan.

Donna Lee: We have that.

Dr. Mistry: What do you mean "if?"

Hugo Embert: Korea.

Donna Lee: I think he's a doubter.

Dr. Mistry: You don't become the second most popular men's health podcast without being [inaudible]? Well, as far as somebody tells me. So over the years, when it came to the diagnosis of prostate cancer, we have used traditional transrectal ultrasound to help find the prostate. Now what's interesting is we've known for many years that you could access and examine the prostate through the rectum. So using a transrectal approach has been kind of standard. And then initially way long ago, and not that long ago, maybe like 30 years ago, the ultrasounds that we could use in the office were hard to use and expensive. So we actually had to do it blind. We would just stick our finger in there and hope we don't poke our finger and stick a needle in there to grab a biopsy. So all of those men out there cringing right now, that's exactly right. It was a cringe-worthy moment.

Donna Lee: You stuck a finger where? In there, in the booty hole?

Dr. Mistry: Underwear? In the, in the booty hole. That's correct. And so, and so then when I came into training, maybe 25 years ago, office-based ultrasound was becoming more commonplace. Now we could finally see the prostate, but no kidding. We were just happy to see something that looked like a prostate. You know, you couldn't make out any details. And men are constantly surprised that you can't use a traditional ultrasound to find prostate cancer.

Hugo Embert: That's correct. The only thing that the, the traditional ultrasound scanner allows you to do is where the prostate is. And then you quote unquote "blindly," we'll stick to 10 to 12 needles to get little samples throughout the prostate. And you try to sample the different parts of the prostate, but it's completely blind. So you can sample next to a very aggressive tumor and miss it completely or under estimate the size or underestimate it's aggressiveness.

Dr. Mistry: And prostates come in different sizes. They're not like eyeballs. I mean, eyeballs are pretty much around the same size, but prostates, they can be small as little as 15 grams or the size of a, you know, a super ball. Or they can be big, they can be as big as a softball. And, but we do the same 12 biopsies. But you could imagine, you know, just by sampling error, a big prostate and a small prostate, if you're just using one of the old timey ultrasounds, you could miss them.

Hugo Embert: That's, that's absolutely correct. And it's , as you said, it can vary from the size of a walnut to the size an orange. And if you take 12 cores and a walnut, yeah, you might be a decent sampling....

Dr. Mistry: But if it's much bigger, much larger, you may, you may miss something. And so then over the last say let's eight to ten years, we've been using MRIs to help us better localize where cancer might be, but then you don't do a biopsy with that MRI. You actually have to take that MRI image and then integrate it with a real-time ultrasound. In our practice, we have to do that in the operating room. It can add expense and confusion and time to the patient. But, but now we have kind of the next generation of this. I thought , Hugo, I could bring you in to talk about kind of what, what we're using in our practice, what we're very excited about, which is the Exact View system for doing prostate ultrasound.

Hugo Embert: Yeah. This is a, this is a very, very new technology that is called micro ultrasound. Exact View is the name of the, is the name of the product. The technology is micro ultrasound and it's a , initially it's a university project from , from Canada, from Toronto, where they were doing a very high, high, high resolution ultrasound imaging to be able to visualize with ultrasound the brain of fetus of mice. So inside of a pregnant mouse, they had this tiny little ultrasound probe to try to visualize what was going on in the brain of the fetus of that mouse. And slowly but surely, and they were able to really book one of the ventricles inside the brain to , to take a sample in there. They tried to find applications and someone said, "Hey, the fetus of a mouse..."

Dr. Mistry: What we possibly do with this?

Hugo Embert: "That's about the size, that's about the size of the , of a prostate." So what you want it , you want to be able to image an organ that is pretty close to the skin. So actually process pretty close to the rectum, the internal rectum skin, and prostate was the, it was the perfect example.

Dr. Mistry: To give people a quick physics exam, you know, here, you can make ultrasound waves very powerful and strong that can cause heat and break up stones and kill cancer. But then you can make the ultrasound rays very fine so that they can, when they bounce against something and bounce back, you can really get very, very detailed images. And we have known in medicine that cancer cells, the , the ultrasound bounces back different. But it's such a small organ and the cells are so small, you have to have incredibly fine ultrasound to be able to get that, that image back to find cancer. And now we have the ability, you know, kind of in theory, to be able to identify cancer just by looking at it using an ultrasound. That's amazing.

Hugo Embert: Yeah. And the, I think all the improvements in the electronics and the computer science as allowed to bring this technology to reality for the prostate imaging. So this micro ultrasound , so where a traditional, traditional ultrasound was giving you a, I would say a portion of a millimeter resolution, now you get down with micro ultrasound to a 70 micron resolution. So you see the tiny details inside the prostate, like the ducts that are inside of the prostate, and typically you see the cancer cells, which are arranged completely differently from the rest of the healthy prostate--all of a sudden, they appear clearly on your ultrasound image. And back to where we're saying before, that randomly poked biopsy can be targeted directly in what you see is the most suspicious area, and you have the best evaluation of the cancer. And if you have the best evaluation, the best diagnosis of the [ inaudible] of the cancer, then you can find the perfect treatment.

Dr. Mistry: Treatment. And it marries perfectly with our focal therapy that we do for high intensity focused ultrasound, that I've ask the listeners to, you know , search our podcast database or calls and ask about. Because being able to see better gives you better diagnosis, better treatment, and ultimately better outcomes, both functionally and from a longevity standpoint. And if you go to your urologist's office and you feel like, "Man, what they're doing seems kind of archaic," get a second opinion, give us a call, make sure there's nothing more advanced cutting edge that we can do to minimize your discomfort and maximize the likelihood of finding something. And we're really excited about the kind of the next step using this technology. Thank you so much for talking about it, Hugo.

Hugo Embert: Thank you.

Dr. Mistry: Donna, how do people get ahold of us?

Donna Lee: Call us at (512) 238- 0762. Send us an email to armormenshealth@gmail.com. Thank you all so much.

Dr. Mistry: Thank you.

The Armor Men's Health Hour will be right back. If you have questions for Dr. Mistry, email him at armormenshealth@gmail.com.