SmartTarget’s CEO Bruce Lynn commented: “ The new home for SmartTarget’s leading ultrasound fusion technology will provide it with added investment and support as well as an innovative vehicle for allowing more patients to benefit from it .”

Intuitive Fusion’s CEO Fernando Bianco commented: “ The acquisition of the SmartTarget IP is a major milestone for Intuitive Fusion as it incorporates this leading fusion technology into our Focalyx Suite. The acquired and licensed technology is being upgraded to also support delivery of focal therapy procedures and will be at the core of the Focalyx Fusion platform .”

UCLB Associate Director and SmartTarget board director Marina Santilli commented: “ I am delighted by the opportunity offered by Intuitive Fusion for the deployment of UCL’s technology, through its established partnership with SmartBlate LLC, a provider of end to end diagnostic and treatment services for prostate cancer patients. SmartBlate’s existing reach will deliver patient benefit immediately to a larger audience in the US whilst Intuitive Fusion cements new partnerships to deploy their unique and innovative technology model in Europe .”

Development of the SmartTarget technology at UCL was supported by funding from the Health Innovation Challenge Fund, a parallel funding partnership between the UK Department of Health and the Wellcome Trust. The research was also part-funded by the National Institute for Health Research (NIHR) University College London Hospital Biomedical Research Centre (BRC).

About SmartTarget Ltd:  A spinout of UCL SmartTarget is dedicated to providing high accuracy, easy-to-use and affordable medical image fusion solutions for guiding prostate cancer biopsy and minimally-invasive cancer treatments. Its unique technology is based on research by scientists and engineers within UCL’s Centre for Medical Image Computing (CMIC), one of the world’s leading academic groups in the field of medical image processing and analysis.

About Intuitive Fusion LLC:  Based in Miami, Intuitive Fusion will deploy Focalyx Fusion with its dedicated client SmartBlate LLC, a service company that provides prostate cancer diagnosis and treatment services protocols that precisely destroy cancer within the prostate while sparing healthy tissue.

About UCL Business Ltd (UCLB):  UCL Business Ltd (UCLB), part of UCL Innovation and Enterprise, is a leading technology commercialisation company that supports research and innovations arising from UCL, one of the UK’s top research-led universities. UCLB has a successful track record and a strong reputation for identifying and protecting promising new technologies and innovations from UCL academics. It invests directly in development projects to maximise the potential of the research and manages the commercialisation process of technologies from laboratory to market.

SmartTarget once again supported UCL’s “ MRI Masterclass for the Diagnosis and Management of Prostate Cancer ” at the UCLH Education Center in London. The course content featured “ Using MRI imaging to guide prostate biopsy ” which included demonstrations of the SmartTarget MRI-TRUS fusion system in breakout sessions.

SmartTarget is back at BAUS 2019 for the biggest urology event on the calendar. If you are attending, stop by and visit us at Stand 560.

SmartTarget was also featured in the “MRI for the Prostate & Targeted Biopsy” skills course with the presentation on fusion biopsy (using the system) given by Urological Surgeon Dr. Tim Dudderidge of Southampton Hospital. He underscored the ease of use with the design of the interface that includes touchscreen capability so he can use it when he is scrubbed in. He also highlighted the value of the procedure reports which was a useful resource at MDT meetings.

The event is always a great chance for us to catch up with our partners and associates in the urology field and learn about some of the latest developments. It was encouraging to hear host Dr. Hashim Ahmed talking even more positively about the benefits of having a fusion system in your practice.

SmartTarget presented its MRI TRUS fusion technology to the Cambridge Prostate mpMRI & Biopsy Course at Cambridge University this week. This event had a particularly European flavor to it with about half the attendees flying over from the continent. This balance might be due to the event’s accreditation by the European Accreditation Council for Continuing Medical Education or by the fact that the organizer, Dr. Christof Kastner, is a sort of walking pan-European being a German, living in England who practices in Italy.

We also got a chance to attend a number of the presentations. The first day included an entire segment on “AI and Imaging”. This area is of particular interest to SmartTarget as its algorithms are based on machine learning techniques, and furthermore one of the technology’s inventors, Yipeng Hu, is currently conducting research on more advanced applications of machine learning to further facilitate the prostate diagnosis process.

Dr. David Bonerkamp remarked that, “You have been hearing about the potential for AI applications in imaging for years now and many of you might be asking where all the tools are?” Suffice it to say that technology in the medical sector does progress at an appropriately more measured pace to ensure safety and efficacy. But also, these are non-trivial problems being addressed and a have some significant criteria to meet in order to meet the “gold standard” of status quo cognitive approaches. While the tabloids regularly print stirring headlines about robots taking over jobs, it’s clear that in the medical field, as AI becomes more integrated into the diagnostic and treatment systems, its role will be more complementary and substitutive. First, “belt and braces” solutions will use AI to double check the clinician and see if the system identifies something of interest that the human might have missed. Second, the tools will provide efficiency to streamline the human process by reducing tiresome and error-prone legwork so the human can focus their finite cognitive energies on the trickier interpretation and decision making.

Healthcare In Europe has published an overview of the SmartTarget biopsy study performed at UCLH. The article included commentary by co-inventor of the technology and co-senior author Dr. Dean Barrat (photo above) as well as co-senior author and Dean of UCL Faculty of Medical Sciences Professor Mark Emberton, Dean of UCL Faculty of Medical Sciences commented: ‘ With this study we now have hard data showing that SmartTarget is as good as a group of experts in targeting tumours in the prostate, and have a glimpse of how clinicians and computers will be working together in the future .’

SmartTarget attended the American Urological Association conference in Chicago, USA this past week to meet with a range of companies with whom we are forging growing partnerships especially in the focal therapy arena. Companies ranging from Sonacare (whose Sonablate system we integrated with a couple of years ago) to new innovators like MediFocus (who are adapting their pioneering thermal ablation technology for use in focal therapy and whose CEO William Jow hosted SmartTarget – see photo).

Perhaps the most encouraging news at the event was the strong consensus that the USA market needs to move away from TR biopsy to TP. TR has dominated for years with clinicians compensating for the risks of infection with routine prescriptions of follow-up antibiotic regimes. But the significant number of complications which arise anyway as well as the growing sensitivity to antibiotic resistance from over-use is driving the intensified consensus and push toward TP.

Professor Hashim U. Ahmed hosted the 2019 Prostate Imaging and Focal Therapy Masterclass at Imperial College supported by SmartTarget demonstrating its high accuracy MRI-TRUS fusion system. The extra precision of its patented deformable bio-mechanical model of the prostate is of particular interest to focal therapy providers and clinicians as accuracy, ie. focus, is in the very name of the therapy. If you are only going to ablate part of the prostate, you want to do everything possible to make sure that you get the right part.

SmartTarget joined leading clinicians, academics, and innovators at the annual European Urological Association conference in Barcelona. At the stand, we demonstrated the SmartTarget MRI TRUS fusion system and met with a range of people in the industry.

We also had the opportunity to attend a number of presentations to hear about the latest developments. While the pursuit of ever more data and evidence continues, the support for mpMRI in diagnosis and focal therapy continues to grow. Professor Mark Emberton of UCL provided an update to the current the role of mpMRI in his plenary session talk as reported in UroToday :

• “Professor Mark Emberton, from University College in London, Great Britain, provided his insights on how mpMRI of the prostate has become a “ game changer ” in the last several years as part of the prostate cancer plenary session at the 2019 European Association of Urology (EAU) annual meeting in Barcelona, Spain. He specifically focused on the use of pre-biopsy MRI to aid in the diagnosis of prostate cancer…He noted that practice guidelines often lag behind evidence , and it has only recently been that some European guidelines have changed to state that mpMRI should be offered as a first line investigation for men with suspected prostate cancer prior to biopsy. Emberton believes that MRI is the single most important test in 2019 for the risk-stratification of localized prostate cancer…The data suggests that there are several potential benefits. First, fewer clinically significant prostate cancers will be missed . Also, importantly, less insignificantly cancers will be diagnosed, thereby minimizing overtreatment of disease . It also leads to fewer unnecessary biopsies, fewer needle deployments, more representative pathology, and less adverse effects. He presented data from the PRECISION trial which showed that men who only underwent mpMRI targeted biopsy, as opposed to standard biopsy, had less hematuria, fevers, hematochezia, erectile dysfunction, and pain . He next went on the argue that utilizing mpMRI as a risk-stratification tool to determine who requires biopsy also leads to cost reductions across healthcare systems .”

Focal therapy is becoming more and more accepted and prominent at the show with a range providers showcasing their technology. Professor Hashim Ahmed of Imperial College provided an overview of the current status of focal therapy and some of the latest developments underscoring the momentum of evidence for its efficacy.

Television station CBS Philadelphia in the USA produced a short feature over-viewing the SmartTarget system which includes some brief demonstrations of the system in action as well as some commentary from the Director of UCL’s WEISS (Wellcome / EPSRC Centre Interventional and Surgical Sciences) Centre David Hawkes who was both a contributor to the development of the system as well as an early trial patient having been diagnoses with prostate cancer.

UCL has also posted its own coverage of the report on its website .

The recent issue of European Urology featured the article “ The SmartTarget Biopsy Trial: A Prospective, Within-person Randomised, Blinded Trial Comparing the Accuracy of Visual-registration and Magnetic Resonance Imaging/Ultrasound Image-fusion Targeted Biopsies for Prostate Cancer Risk Stratification “, Sami Hamid , Ian A. Donaldson , Yipeng Hu, Rachael Rodell , Barbara Villarini , Ester Bonmati, Pamela Tranter, Shonit Punwani, Harbir S. Sidhu, Sarah Willis, Jan van der Meulen, David Hawkes, Neil McCartan, Ingrid Potyka, Norman R. Williams, Chris Brew-Graves, Alex Freeman, Caroline M. Moore, Dean Barratt , Mark Emberton , Hashim U. Ahmed.

The study describes the results of medical software developed at UCL that overlays tumour information from MRI scans onto ultrasound images can help guide surgeons conducting biopsies and improve prostate cancer detection.

A team of engineers and medical researchers found that the technology enabled surgeons to pick up clinically relevant cancers that were missed when using current visual detection methods. The best approach would be to use both techniques in tandem, according to the findings published in European Urology .

The software is deployed via a patented system called SmartTarget®.

The advent of MRI-targeted biopsies, where MRI scans are used to inform surgeons where a tumour lies before they conduct a biopsy (tissue sample), has improved detection rates to close to 90% from 50% in the last five years.

Now, the SmartTarget system has further enhanced this technique by allowing a 3D model of the prostate and cancer to be created for each patient from their MRI scans using advanced image processing and machine learning algorithms.

During a biopsy, this model is fused with ultrasound images to highlight the area of concern, which otherwise does not appear in the ultrasound images, helping to guide the surgeon while conducting the procedure.

Until last year when MRI targeting was introduced, the established way to test for prostate cancer involved taking a biopsy from the prostate without knowing where in the prostate a tumour was likely to be, resulting in close to half of life-threatening cancers being missed.

• “ Prostate cancer detection has been improving at a very fast rate in recent years, and this technology pushes the science forward even further, enabling clinicians to pick up prostate cancer quickly so that patients can access the right treatment early enough ,” – Co-Senior Author Professor Hashim Ahmed, who began the research in UCL Medicine before moving to Imperial College London.

For the present study, 129 people with suspected prostate cancer underwent two biopsies – one using the SmartTarget system, and one where surgeons could only visually review the MRI scans. Funded by the UK Department of Health and Wellcome Health Innovation Challenge Fund, the study was conducted at UCLH.

The two strategies combined detected 93 clinically significant prostate cancers, with each of them picking up 80 of these cancers; each missed 13 that the other method picked up.

The researchers say that surgeons’ visual review of MRI scans should be used in tandem with SmartTarget as using this technique enables surgeons to learn to make subtle adjustments such as adapting to the movement of the patient and the prostate as the needle is inserted.

• “ We developed the SmartTarget system to equip surgeons with vital information about the size, shape and location of prostate tumours during a biopsy that is otherwise invisible on ultrasound images,” “The software provides them with a clear target. As MRI-targeted biopsies require a very high degree of expertise and experience, we hope that the imagery displayed by SmartTarget will help to bring high accuracy prostate cancer diagnosis to a much wider range of patients and hospitals .” – Co-Senior Author Dr. Dean Barratt (UCL Medical Physics & Biomedical Engineering and UCL Centre for Medical Image Computing), who invented and led the development of the SmartTarget system.

The researchers say the new methods could reduce the number of biopsies needed, and reduce the unnecessary surgeries caused by over diagnosis of less harmful cancers.

The SmartTarget software has been commercialised by SmartTarget Ltd, a company spun out by UCL’s commercialisation company UCL Business PLC (UCLB), and the system is already in use by several hospitals in the UK and USA.

The inter-disciplinary study brought together engineers, urologists and radiologists, supported by the UCL Translational Research Office in project management and navigating the translational and regulatory pathway involved in taking the project from the lab bench to the operating room.

• “ There has been much discussion and speculation in the media recently on the degree to which computers and artificial intelligence will be integrated into clinical care. Studies such as this one are extremely important as they provide valuable evidence on the performance of a new technology in the clinical setting.  With this study we now have hard data showing that SmartTarget is as good as a group of experts in targeting tumours in the prostate, and have a glimpse of how clinicians and computers will be working together in the future for the good of the patient .” – Co-Senior Author Professor Mark Emberton (Dean, UCL Medical Sciences)