Diagnostic tests and scans

Our comprehensive diagnostic service covers all modalities including pathology, radiology and genetics, led by nationally recognised consultants and supported by dedicated on-site clinical teams.

Pathology tests

Pathology

Within our network of state-of-the-art centres, we offer a comprehensive pathology service covering many different specialities, including breast, prostate and gynaecology. We use the latest proven screening and diagnostic techniques, conducted by experienced clinicians.

The pathology tests available at GenesisCare are listed below and you can read more on our patient site.

What we offer

Radiology tests

Radiology

Our expert nuclear medicine physicians, radiographers and radiologists use the latest-generation technology to perform and interpret the scans. As well as established methods of scanning, we also use innovative solutions to identify disease and plan your treatments, such as PSMA PET/CT for prostate cancer and fMRI to examine the brain.

The radiology services available at GenesisCare are listed below and you can read more on our patient site.

What we offer

Genetic and genomic testing

Genetic and genomic testing

We’re pioneering the use of genomic profiling in the diagnostic pathway for all solid tumours, leukaemias, lymphomas or sarcomas.

We also offer BRCA-1 and BRCA-2 genetic testing for breast and ovarian screening.

MR imaging in neuro-oncology

Multi-modal MR imaging guides cognitive and neurological outcomes for patients with primary brain tumours and brain metastases.

Functional MRI

Functional MRI (fMRI) is a non-invasive imaging technique that is able to indirectly measure brain activity using fluctuations in brain energy demands related to neural signalling.1

We use fMRI to locate eloquent brain tissue related to speech, vision, movement, etc., as well as guide neurosurgical planning and tailor surgery for intrinsic brain tumours to avoid neurological deficit and improve patient outcomes. With the increasing neuro-oncological benefits of surgery for brain tumours, fMRI offers potential further applications to measure brain recovery processes to optimally stage and monitor treatments.2

Generally, fMRI shows high agreement with clinical gold standard tests, such as the amytal test and intraoperative direct brain stimulation, but importantly offers the advantage of being safe and non-invasive.

Diffusion tensor imaging

In addition, patients are offered a complementary MRI technique called diffusion tensor imaging (DTI). This imaging scan provides assessment of tissue microstructure and we use tractography to provide a 3D visualisation of neural tracts and the brain’s connectivity. This provides additional information about the location of important pathways for speech, movement, vision and other behaviours important for patient quality of life, whereas conventional MRI techniques provide only anatomical information.

These innovations that preserve quality of life are crucial to our approach to neuro-oncology which is to treat the whole patient, and not just the tumour. We are the first private service to offer this to our patients in the UK.

 

DTI determines proximity of language tracts

fMRI determines proximity of language activity

Refer to us

Oxford

Phone: 01865 224 865

Email: oxford.enquiries@genesiscare.co.uk

If you would like further information about our neuro-oncology service, please contact:

Email: rem@genesiscare.co.uk

References:

  1. Glover et al., 2011; Neurosurg Clin N Am; 22(2):133‑139.
  2. Brown et al., 2016; JAMA; 316 (4):401-409.

Functional MRI (fMRI)

A non-invasive MRI technique, able to predict certain cognitive and neurological outcomes after surgery.

A non–invasive MRI technique, fMRI is used to locate eloquent brain tissue related to speech, vision, movement, etc., It is used to guide neurosurgical planning and tailor surgery for intrinsic brain tumours to avoid neurological deficit and improve patient outcomes.

fMRI offers potential further applications to measure brain recovery processes, to optimally stage and monitor treatments.

We are the first private service to offer this to our patients in the UK.

In addition, patients are offered a complementary MRI technique called diffusion tractography imaging which provides additional information about the location of important brain pathways.

⁶⁸Gallium PSMA

The diagnostic gold standard for our prostate Theranostic service

Currently, all patients undergoing 177Lutetium PSMA therapy at GenesisCare are required to have a ⁶⁸Gallium PSMA PET/ CT scan.

PET/CT is a powerful modality used to detect metastases, stage cancers and, in the case of Theranostics, prepare for peptide receptor radionuclide therapy such as 177Lutetium PSMA therapy.

In recent years, various radio-labelled PSMA ligands have been investigated for PET. ⁶⁸Gallium PSMA is an effective radiotracer for use in diagnosis of prostate cancer, due to its increased specificity with low PSA levels and sensitivity to tumour, lymph and bone metastases. This is when compared to other radiotracers such as 11C Choline and 18F-fluoromethylcholine. PET with ⁶⁸Gallium PSMA is also superior to traditional bone imaging and can differentiate between bone damage caused by cancer and other causes, such as osteoporosis.2,3

References

  1. Farolfi A et al. 2019. Eur Urol Oncol
  2. Calais J et al., 2019; Lancet Oncol
  3. Fendler WP et al., 2019; JAMA Oncol

Transperineal Vector prostate biopsy

Transperineal Vector prostate biopsy is a novel and innovative technique for prostate cancer assessment. We are the first healthcare provider in the UK to offer this procedure which is available at our centre in Cambridge at our UrologyHub clinic.

The quality of well-established MRI US fusion transperineal template prostate biopsies under general anaesthesia is based on the high accuracy of the software, a fixed stepper mounted probe permitting minimal distortion of the prostate and visual tracking of needle by the template grid in-line with the US plain.

More recently introduced local anaesthetic TP biopsies use minimal numbers of entry points but require a mobile probe to allow inline needle tracking, which leads to distortion of the prostate, making visual or fusion targeting more difficult, as well as causing more discomfort for the patient.

VTRAX electromagnetic needle tracking, which provides needle trajectory tracking without direct view, allows the delivery of the benefits of the classic fusion TP biopsy technology, yet, through only two locally anaesthetised entry points whilst the probe and fusion can remain stable.

Get in touch

Call now to find out more about our Vector prostate biopsies at our Cambridge UrologyHub and refer a patient.

Evidence base of transperineal Vector prostate biopsy

We have evaluated TP Vector prostate biopsy since its introduction using patient reported outcome measures (PROMS) and oncological outcomes.

The procedure is extremely well tolerated. So far, no episode of retention has been reported and only one patient requested antibiotics for a minor urine infection.

Detection rates of targets are 95% with the highest ISUP grading or core length in the targets.

The new vector biopsies appear to deliver the high accuracy of established transperineal fusion technology with indication of improvement in tolerability and side-effects.

Procedure

Patients with an indication for TP biopsy based on PSA, rectal examination and MRI are offered vector prostate biopsy.

  • Stepper-mounted ultrasound probe is placed in the rectum and local anaesthetic injected into the perineum
  • The US image set is fused with the MRI
  • A needle sheath with a VTRAX sensor is inserted into the perineum
  • The trajectory of the needle is tracked in an electromagnetic field – a circle shows when the needle trajectory cuts the sagittal US plane, which can then be directed onto the lesion of interest for biopsy
  • Targeted and systematic biopsies are taken

Consultants

Prof Christof Kastner

PhD FRCS(Urol) FEBU

Consultant Urologist

Specialises in prostate cancer

GenesisCare Cambridge