Diagnostic tests and scans

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.

• Biopsy  (Fine needle aspiration), core biopsy, image-guided biopsy, TRUS biopsy, transperineal biopsy)
• Blood testing
• Colposcopy
• Cystoscopy
• Smear test
• Urine cytology tests
• Urodynamic tests

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.

• CT
• Digital X-ray
• Digital mammography
• Fluoroscopy
• MRI (Including fMRI and mpMRI)
• PET/CT (Including PSMA PET/CT and SPECT/CT)
• Ultrasound (Including transrectal ultrasound and transvaginal ultrasound)

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

We provide genetic testing to patients undergoing cancer treatment at GenesisCare, if their clinician feels it's appropriate. We do not offer genetic testing outside of a treatment pathway.

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

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.

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

References:

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

Our advanced imaging techniques and treatments help us to provide the best possible care and personalise your patient’s treatment to meet their exact needs. At GenesisCare, we aim to provide PET/CT scans within 48 hours of referral and send the results within 24-48 hours of completing the scan.

At GenesisCare, we offer a range of radioisotopes used with PET/CT scans at our Oxford and Windsor centres.

The key types of PET/CT scans we offer are:

• ⁶⁸Gallium PSMA PET/CT
• ¹⁸F PSMA PET/CT 
• ¹⁸F FDG PET/CT 
• ⁶⁸Gallium Dotatate PET/CT

At GenesisCare, we aim to provide PET/CT scans within 48 hours of referral and send the results within 24-48 hours of completing the scan.

At GenesisCare, we are proud to have our own onsite radiopharmacy at our Windsor centre. A significant obstacle when using PET/CT scans is obtaining the radiopharmaceuticals used in some of the scans. This is made especially difficult due to the short half-lives of some of the radiotracers. 

Having our own radiopharmacy eliminates this difficulty as we can produce our own 68Gallium PSMA and 68Gallium Dotatate labelled radioisotopes onsite.  This means we can provide our patients with fast access to the diagnostics scans essential to their treatment, without delay.

We provide fast access to our comprehensive cancer treatment pathways if needed, with treatment often starting within days of diagnosis.

Our range of advanced and innovative imaging techniques provide highly precise and detailed scans that help guide our diagnosis and treatment pathways, so we can achieve the best possible outcome for your patient.

Our purpose-built centres at Oxford and Windsor have been awarded the Macmillan Quality Environment Mark (MQEM) and offer some of the UK’s most advanced cancer therapies. Our highly experienced multidisciplinary teams will care for your patient from their very first scan through to treatment and aftercare.

We offer a complete care plan that is designed to support your patient physically and emotionally, including exercise medicine and wellbeing therapies in partnership with Penny Brohn UK.

By using different radiotracers, we can diagnose and monitor a range of cancers.

If you’re a consultant and would like to work more closely with us and provide diagnostics or treatment, you can apply for practising privileges at one of our centres. 

Find out more about applying for practising privileges

Our advanced imaging techniques and treatments help us to provide the best possible care and personalise your patient's treatment to meet their exact needs. At GenesisCare, we aim to provide radionuclide scans, including SPECT-CT scans, within five working days of referral and send the results within 24-48 hours of completing the scan.

Radionuclide imaging is highly useful in clinical oncology, collecting precise information to help our expert consultants guide diagnosis and treatment pathways.

The key types of scans we offer, which are available with or without a SPECT-CT, are:

• ^99mTc HDP bone scan
  
• ¹²³I whole body scan
  
• ^99mTc DMSA renal scan 

The range of these scans with optional SPECT-CT enables us to detect and monitor a wide variety of conditions, including cancers. 

These scans are available at our Windsor centre. 

We know how important time is when it comes to cancer diagnosis and treatment, which is why we provide access to the essential scans your patient needs, without delay.

Our range of advanced and innovative imaging techniques provide highly precise and detailed scans that help guide our diagnosis and treatment pathways, so we can achieve the best possible outcome for your patient.

Our purpose-built centre in Windsor has been awarded the Macmillan Quality Environment Mark (MQEM) and offers some of the UK's most advanced cancer therapies. Our highly experienced multidisciplinary teams will care for your patient from their very first scan through to treatment and aftercare. Scan results are shared with you, the referring clinician, to help decide the next steps in your patient's treatment plan.

We offer a complete care plan that is designed to support your patient physically and emotionally, including exercise medicine and wellbeing therapies in partnership with Penny Brohn UK.

At GenesisCare, we have a wide range of scans that can be used with SPECT-CT, where required. 

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 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 centres in Cambridge and Windsor at our UrologyHub clinics.

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.

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.

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

Prof Christof Kastner

PhD FRCS(Urol) FEBU

Consultant Urologist

Specialises in prostate cancer

GenesisCare Cambridge

Mr Philip Charlesworth

BM DM FRCS (Urol.)

Consultant Urological Surgeon

Specialises in prostate cancer and bladder cancer

GenesisCare Windsor