Breast, Radiation-Free Mammogram Alternative

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There is a new method that identifies cancerous tumors by blood vessel structure. Around a million women in the Netherlands undergo mammograms for early detection of possible breast cancer. This x-ray is unpleasant and the researchers at TU Eindhoven are working on a breast-friendly method that does not use radiation and is more accurate. It generates 3D rather than the 2D images. Their proof of concept is published in the online journal Scientific Reports. Squeezing the breast tightly between two plates to produce one or more good x-ray photos is the current screening method. Not only is it unpleasant, but not without some risk. The x-rays themselves can be a contributor to the onset of cancer and it is often unclear if the anomaly found is malignant lesion or not. Of the cases, more than 2/3’s occur where something worrying can be seen on the x-ray photos and is a false-positive, after biopsies, and they are not found to be cancer. Now there might be an alternative.

The researchers have cleared a major scientific hurdle towards a new technology in which the patient lies on a table and the breast hangs freely in a bowl. With special echography a 3D image is made of the breast and any cancer is clearly identifiable on the generated images. They expect there to be many fewer false-positive results.

This particular technology builds on the patient-friendly prostate cancer detection method where the doctor injects the patient with harmless microbubbles. An echoscanner allows the bubbles to be monitored as they flow through the blood vessels of the prostate. The presence and location of cancer become visible. So far this method has not yet been suitable for breast cancer because of the excessive movement and size of the breast for accurate imaging by standard echography.

Libertario Demi, Ruud van Sloun and Massimo Mischi, researchers, have now developed a variant of the echography method that is suitable for breast investigation, known as Dynamic Contrast Specific Ultrasound Tomography. With microbubbles it uses the fact that they will vibrate in the blood at the same frequency as the sound produced by the echoscanner and at twice that frequency. You know where the bubbles are located by capturing the vibration.

They are using a phenomenon that Mischi happened upon by chance for the new method. The second harmonic was a little delayed by the gas bubbles and they have now developed a new visualization method. The more bubbles encountered by the sound on its route, the bigger the delay compared to the original sound. Thus they can localize the air bubbles and do so without any disturbance because the harmonic generated by the body tissue is not delayed and therefore discernible. Because the difference can only be seen if the sound is captured on the other side, it makes this method perfectly suited to organs that can be approached from two sides, like the breast.

An international and strong medical team is being put together to start performing preclinical studies. They expect the application in practice is ten or so years away and that the technology developed will probably not operate on a standalone basis, but in combination with other methods, will create a better visualization. Elastography might be a candidate whereby the difference in the rigidity of the tumor and health tissue can be used to detect cancer.

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