Groundbreaking method could reshape current diagnosis and treatment

MORGANTOWN, W.Va. – Healthcare providers agree that the importance of regular mammograms cannot be overstated; yet, for women with denser breast tissue, traditional X-ray imaging can fail to identify some tumors. In a recent West Virginia University clinical test, a new 3-D breast scanning system developed at WVU has proven successful in finding difficult-to-detect breast lesions.

A leading cause of cancer-related death among women, breast cancer is often difficult to diagnose in women with denser breast tissue, as traditional X-ray imaging can fail to identify small tumors. The current second-line screening method for women with denser breasts and higher risk factors is MRI (magnetic resonance imaging). False positive results are common in MRI, however, which can result in the unnecessary biopsy of benign lesions.

WVU’s Breast-PET (positron emission tomography) imaging system uses the physiology of the breast measured with a radioactive agent to produce 3-D images.

“Since diseased tissue, such as tumors, often has different physiology than normal tissue, it is possible to visualize breast tumors more effectively, even in dense breasts,” Raymond R. Raylman, Ph.D., professor of radiology and vice chair of radiology research at the WVU School of Medicine and the Mary Babb Randolph Cancer Center, said. “Since Breast-PET produces three-dimensional images, we do not have the problem of overlaying tissue obstructing tumors, and the breast does not have to be compressed.”

“This technique has the potential to replace or at least supplement breast-MRI as the second-line method for imaging these hard to interpret cases, due to PET’s low false positive rate compared to MRI,” Dr. Raylman continued. “In addition to detecting some hard-to-image lesions, we were able to see disease infiltrations into areas not seen on mammograms in this study. In the future, such findings could be used by physicians to help improve treatment planning.”

The WVU system is the only 3-D PET imaging device designed to also perform biopsies and is also the only system that has the demonstrated ability to measure metabolic activity of tissue, including tumors. For patients in treatment for known breast lesions, the Breast-PET scan can be combined with full-body PET imaging to see if cancer is spreading beyond the breast.

“In addition to detecting tumors, we have the capability to measure the changes in tumor tissues in response to treatments, like chemotherapy,” said Raylman.  “We could potentially tell fairly early on if a treatment is being effective in attacking the disease. If it is not, the treatment plan can be altered. Currently, it can take weeks to months to determine if a therapy is working.” 

Raylman’s team is continuing development of Breast-PET. The system will eventually gain the ability to perform tomographic X-ray images of the breast (CT scans). The combination of PET and CT will allow clinicians to better determine the size, shape, position and metabolic activity of suspicious breast lesions.

“The work of Dr. Raylman and the team that developed this leading-edge technology will make a worldwide impact,” Scot Remick, M.D., director of the Cancer Center, said. “This is a prime example of WVU research shaping the future of cancer diagnosis and treatment.”

The study, authored by a team of WVU researchers led by Raylman, appears in the current issue of the “Journal of Medical Imaging and Radiation Oncology.”
 
For more information on the WVU Mary Babb Randolph Cancer Center, visit www.wvucancer.org.