By Mary Jo Feldstein, St. Louis Post-Dispatch, September 21, 2006

A local company has developed a scanning system that allows physicians to more accurately detect and treat prostate cancer, a leading cause of death among men.

The new technology, introduced by Envisioneering Medical Technologies of Overland, allows physicians to generate a full 3-D image of the prostate, manipulate the image and take precise biopsies of targeted tissue.

With TargetScan 3D, physicians can obtain a better view of the prostate and more-accurate biopsy results in less time than with traditional equipment, said Robert Mills, the president of Envisioneering.

Several academic medical centers, including Washington University''s School of Medicine and New York University''s School of Medicine, are studying TargetScan.

"I think this holds the potential to substantially change the way we treat prostate cancer," said Dr. Gerald Andriole, director of the Prostate Study Center at Barnes-Jewish Hospital and a Washington University professor who is studying TargetScan.

During his lifetime, a man has about one chance in 10 of being diagnosed with prostate cancer. It''s the second-leading cause of cancer death in men.

With traditional equipment, the scan device is inserted into the rectum and then moved by the physician. As physicians move the device to observe different areas of the prostate, they take samples for biopsy. Physicians attempt to obtain samples from throughout the prostate, but the process is not exact.

By contrast, TargetScan 3D takes a complete image while remaining stationary, so physicians no longer have to guess if they''re taking samples from a variety of locations. TargetScan 3D also displays the image on a screen and maps it out using numerical and alphabetical coordinates.

That combination of features allows physicians to know exactly where they''ve sampled and where any malignant samples originated, Mills said.

Without precise sampling, cancers can be missed or appear more advanced, both of which can lead to inappropriate treatment. "We''re not able to do our best job for that patient either way," Andriole said.

Men diagnosed with prostate cancer have several treatment options -- ranging from doing nothing to complete removal of the prostate -- depending on their age and the cancer''s severity. Picking the best treatment can be daunting, especially when information about the cancer is incomplete.

When Robert Cerwin, 59, went in for a recent check-up, a blood test showed an elevated PSA level, a common indicator of prostate cancer. His physician recommended he see a specialist for a traditional scan and biopsy.

After hearing about TargetScan, Cerwin chose Andriole, one of only a few local physicians using the new technology. "In my mind, it was a simple decision," said Cerwin, of Town and Country.

TargetScan gave Andriole better information about where Cerwin''s cancer was located and how far it had progressed. Andriole will use that information during surgery to limit damage to sensitive nerve bundles and minimize complications such as decreased sexual function.

Mills is starting to sell the technology, which received Food and Drug Administration approval last year, to community physicians. He also has signed a distribution deal with Brachy-Sciences, a maker of medical equipment based in Connecticut.

The TargetScan system costs about $70,000, but biopsies conducted with the equipment can garner higher payments from Medicare and insurers. Mills said most physicians will pay for the machine after 100 to 125 procedures.