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New 3-D scanner IDs cancers mammograms miss

May 28, 2010 12:00:00 AM PDT
One in eight women will develop breast cancer at some point in her lifetime, but more than a quarter of them have dense breast tissue, which means standard mammograms don't always find the tumor. A new experimental 3-D scanner is showing promise for identifying cancers that other diagnostic tools like mammograms can't. For Aloma Sibley, books offer a unique window to places and people she's never known.

A few months ago, a unique scanner gave her a high resolution view of something far more important -- the breast cancer in her own body.

"I could see the tumor, and that was very helpful to me in accepting the diagnosis, to see the tumor for real," said Sibley.

The images came from a new prototype cone beam CT scanner. X-ray beams and a digital detector rotate around the breast, taking 300 pictures in ten seconds.

"Once it has all that information, it can reconstruct the breast in any angle or any way that you want without losing any properties of resolution," said Carl D'orsi, M.D., director of Breast Imaging Research at the Emory Winship Cancer Institute in Atlanta, Ga.

Researchers say 3-D images from the scan may pick up tumors about 5 millimeters across -- the size of a pea.

"It is wonderfully exciting not only for me, but for other women," said Sibley.

Now, just one month after a successful lumpectomy, Sibley is on her way to a full recovery. She is grateful for the technology that gave her a brighter future.

The breast CT prototype at Emory is one of five in the United States. A similar study trial is being conducted at UC Davis. In the next study, researchers will study the effectiveness of the new CT scanner in detecting how tumors are responding to chemotherapy.

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BACKGROUND:

Nearly 200,000 women were diagnosed with breast cancer in 2009, and more than 40,000 women died of the disease, according to the National Cancer Institute. Second only to lung cancer, breast cancer is the second leading cause of cancer death in American women. As in other cancers, early detection is key to successful treatment of breast cancer.

DETECTION:

The most common tests performed to screen for breast cancer are mammograms and clinical breast exams. A mammogram is essentially an X-ray of the breast that can detect tumors that are too small to pick up in a manual exam. Mammograms are less likely to find tumors in women younger than 50. A clinical breast exam is a manual exam performed by a physician. If a doctor finds a lump or anything unusual, ultrasound may be used to aid in diagnosis of breast cancer.

Magnetic Resonance Imaging, or MRI, uses a magnet, radio waves and a computer to create a series of pictures of the breast. This type of screening has been shown to be more sensitive than mammography in finding tumors in women with a high inherited risk of breast cancer, although false positives are common with MRI.

A CT, or computerized tomography, scan is an X-ray technique that gathers information about the body in 2-dimensional cross-sections. While not yet used routinely to evaluate the breast, doctors in some cases use CT scans to assess whether or not breast cancer has moved into the chest wall. A CT scan may also be ordered to examine other parts of the body where cancer has spread.

3-D CT FOR BREAST CANCER:

Radiologists at Emory University are conducting three studies using a new CT technology that utilizes cone-shaped X-ray beams and a digital flat panel detector to produce 3-D images. In one trial, they are comparing the new breast CT scan with diagnostic mammography as a tool for detecting cancer. In a second trial, they are comparing CT scans enhanced with contrast dye with MRI in the evaluation of newly diagnosed breast cancers. In another study, they are examining the effectiveness of breast CT scans in tracking how tumors are responding to chemo treatment. The new technology enables researchers to reconstruct a breast image from any angle and use computer processing to focus in on calcification. The CT may end up being used alone for routine screenings or in combination with other technologies for cancer diagnosis and treatment.


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