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SPECT-CT system shows promise in breast imaging
May boost accuracy without compression discomfort
Researchers at Durham, NC-based Duke University Medical Center have developed a hybrid imager that could improve detection of breast cancer while also relieving the discomfort associated with traditional breast screening exams such as mammography.
The system, which was developed by Martin Tornai, PhD, an associate professor of radiology and biomedical engineering at Duke University Medical Center, and colleagues, enables patients to lie prone while single-proton emission CT (SPECT) and computed tomography (CT) scans are taken of the breast, producing three-dimensional images.
One advantage of the approach is that the breast does not need to be compressed, so there is no pain associated with the exam. In addition, early observer studies suggest that the technique might offer some distinct advantages over mammography in cancer detection.1 "What we found was that our system is statistically significantly better than standard digital X-ray mammography at detecting small lesions in environments that contain lots of structural components, like the connective glandular tissue that is ever present in all breasts," explains Tornai. "Also, our system could reliably see objects that were 4 mm in diameter, while mammography had a tougher time, only reliably seeing objects about 1cm in diameter."
Because radiotracers are used with dedicated breast SPECT imaging, Tornai sees the technique ultimately being used primarily for women at high risk of developing breast cancer and those for whom another screening modality has produced an indeterminate result. However, he also sees great potential in using the technique to gauge treatment response.
"If a woman is already slated to go for chemotherapy or radiotherapy and/or surgery, the SPECT-CT system could be used to monitor her progress," says Tornai, noting that chemical changes occur long before physical changes due to the effect of treatments. "If we can measure those changes in breast signals due to the effect of treatment, as nuclear medicine-based SPECT can do, then it can be determined if the woman is responding to that particular course of therapy." Tornai stresses that this kind of information can save valuable time, anguish, toxicity, and money.
(Editor's note: Tornai and his research colleagues have established a company, ZumaTek, to commercialize the SPECT-CT system that they have developed. More information about the venture is available at www.zumatek.com.)