Using nuclear medicine to create an advanced imaging system, Assistant Research Professor of Radiology Martin Tornai hopes to make breast cancer detection procedures more effective and less painful.
"We are building a system specifically dedicated to breast imaging," said Tornai. "The potential exists to detect smaller tumors and catch cancer progression earlier in its course, which means that patients could begin their therapies earlier."
Current methods of detection use light X-rays to boost the chances of detecting a tumor. However, in order to make these light-penetrating X-rays effective, the patient's breasts have to be compressed. Tornai explained that this is a very painful procedure and added that most women cannot endure it for very long.
The use of nuclear medicine could eliminate this step. As a result of these advancements, some women may soon be able bypass the uncomfortable pressure of mammograms.
"There is no need for the breast to be compressed as the camera rotates around a freely suspended breast with the woman lying prone on a special bed," he said.
Taking multiple snapshots of the breast in this manner will allow researchers to mathematically reconstruct a three-dimensional image and greatly boost the chances of noticing a malignant lesion. The nuclear medicine technique Tornai plans to use is called SPECT, or single photon emission computed tomography.
This technique, pioneered by Duke Professor of Radiology Dr. Ronald Jaszczak, distributes a biologically active substance, labeled with a radioactive isotope, through the body.
The labeled substance collects in the cell's power plant, the mitochondria, and enables researchers to detect areas of the body where the cells are working abnormally-at increased or decreased metabolic rates.
Since cancer cells are constantly reproducing, their metabolic activity is high, allowing researchers to spot the tumors that absorb the labeled compounds at a greater frequency than normal tissues.
Tornai said nuclear medicine will likely allow detection of tumors down to one centimeter in diameter with high certainty.
SPECT also allows for what Tornai termed the light bulb effect. "If the tumor is malignant, it will light up," he said. "But a benign tumor that is not functionally active will not be picked up."
Markus Holzhauer, a clinical associate in radiology, emphasized the importance of this capability, pointing out that one of the greatest current challenges for the field of breast imaging is the difficulty in differentiating between benign and malignant tumors.
Tornai said the new system is not meant to replace current detection methods, but simply to serve as an additional option for women for whom traditional methods of diagnosis are ineffective.
Currently, detection problems arise when using traditional X-rays on women with particularly large or dense breasts as well as women who have had implants.
Tornai explained that with the new technology's use of more penetrating gamma rays this is not as great of a concern. Tornai's biomedical research will be funded by a $210,000 grant from the Whitaker Foundation.
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