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Advances in Breast Imaging at UCSD

UCSD is employing the latest techniques in diagnostic and cancer treatment radiology. These new advances are expected to bring ever-higher levels of diagnostic accuracy and further precision for surgeons, and in some cases reduce the need for surgical approaches. At UCSD, researchers are employing computer-aided diagnostic tools to improve disease definition and literally map the breast cancer for the surgeon prior to surgery. For example:

• UCSD is clinically testing a whole breast tomographic ultrasound unit, as well as other ways of using ultrasound as an adjuvant to mammography in high-risk cases.
  
  
• Radiologists also are experimenting with optical scanners that employ near-infrared light (instead of x-rays) to scan the breast to glean additional information about lesions and hemoglobin (blood flow and oxygen) levels – details not available using mammograms alone. This new approach allows clinicians to distinguish normal from abnormal tissue and to recognize potentially cancerous tissue.
  
  
• A prototype ultrasound CT for breast imaging is being tested at UCSD in a clinical trial supported by Techniscan Medical Systems. UCSD is the only clinical setting testing the device, which measures physical properties of the breast – including tissue hardness and compression – that cannot be measured through other imaging techniques. It is hoped that radiologists will be able to better differentiate between benign and malignant masses with this potential addition to their decision-making tools.
  
  
• UCSD is using the Techniscan prototype device in conjunction with another novel diagnostic approach called breast ultrasound computer-aided diagnosis, which automates a search of vast image databases of sonograms and delivers seven cases most similar to the one presented, along with an analysis of the numerical similarities and outcome of each of those seven cases. This tool is intended to give radiologists an objective “second reader” of sorts, to aid in the decision-making process.

“We get different data from each modality,” said Dr. Chris Comstock. “We evaluate the properties of each diagnostic tool and how they interact differently with the lesion, because different cancers have different levels and properties. It adds information to the decision process.”

Imaging Combined with Non-surgical Removal of Tumors

UCSD also is one of the first sites in the United States to offer MR-guided focused ultrasound to painlessly and noninvasively “zap” cancer cells. The InSightec ExAblate® 2000 is the first system to combine MRI with high-intensity, focused ultrasound to destroy abnormal tissue without making an incision. UCSD is participating in clinical research using the device to treat certain types of cancer, including breast cancer.

“We’re looking at a minimally invasive way to replace lumpectomy and surgery for select cases and asking ourselves, ‘Can this device destroy tumors efficiently and completely?’” said Dr. Comstock.