Breast CT scanner for earlier cancer detection

Project: Research project

Description

DESCRIPTION (provided by applicant): Breast cancer is a disease with high
incidence in the U.S. and elsewhere, and population-level methods of fighting
this disease are aimed primarily on screening, using mammography for early
detection. The median size of breast cancer found using mammography is
approximately 11 mm. Based on extensive preliminary studies involving computer
simulations, physical measurements, and cadaver breast imaging, we have found
that breast CT may be able to routinely detect much smaller breast tumors, in
the 3 to 5 mm range. Importantly, the radiation dose of breast CT performed at
80 kVp was found in detailed studies to be comparable to that of mammography.
It is not possible to image the breast alone on a live woman using a clinical
CT scanner. Therefore, in this Bioengineering Research Partnership proposal, we
have teamed with scientists from around the country to design, build, and test
a CT scanner designed to image the breast. A team comprised of medical
physicists, physicians, mechanical and electrical engineers, and breast cancer
advocates will collaborate on the design of the breast CT scanner. Cone beam
flat panel technology will be used to produce a scanner capable of 10 second
breast scanning, and the scanner development will also include a breast
immobilization system (acrylic cylinders), a breast CT table, a fast
reconstruction computer, and a computer workstation customized for efficient
viewing breast CT images. The scanner will be built, tested, and optimized at
UC Davis over a period of 3 years involving 9 specific aims. After the breast
CT scanner is tested in a brief phase I trial (2 specific aims), it will be
moved to the breast imaging clinic for a phase II trial where approximately 120
women will be imaged (4 specific aims). This phase II trial will evaluate the
efficacy of breast CT for the early detection of breast cancer in a group of
women likely to have breast cancer (BIRADS 4 & 5). Additionally, the breast
image data will be studied for its utility in automating the analysis of the
normal breast architecture, and for computerized cancer detection. In year 5 of
the proposed research, two specific aims utilize the breast CT data and
corresponding mammography images (on -240 breasts) to evaluate the ideal
observer performance and human (mammographer) detection performance attributes
of the breast CT scanner. At the end of the proposed research involving 17
specific aims, the potential of breast CT will have been evaluated both
qualitatively and quantitatively. A tested, high quality prototype breast CT
scanner would be ready to be enlisted in a phase III trial (beyond the scope of
this proposed research), if further testing is warranted. Performance data
acquired in the present study would allow the proper design (power, etc.) of a
phase III trial. If breast CT lives up to its enormous potential based on
initial imaging, breast cancer would be detectable far before metastases occurs
- for example, a 3 mm tumor contains only 2 percent of the cell count of an 11
mm lesion, and a 5 mm lesion contains only 9 percent of the cell count. Based
on a 100 day volume doubling time, detection of a 5 mm lesion would lead to
0.93 year earlier detection, and routine detection of 3 mm lesions would result
in 1.5 year earlier detection over mammography. Surgical removal of early
cancers will effectively result in cure for the majority of women screened
using this technology. While breast CT would probably improve cancer detection
in all women, some women may have risk factors (dense breasts, genetic markers,
etc.) that particularly warrant screening using breast CT. The Phase II trial
will shed more light on this issue.
StatusFinished
Effective start/end date9/1/028/31/07

Funding

  • National Institutes of Health: $1,200,000.00

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Early Detection of Cancer
Breast
Mammography
Breast Neoplasms
Cell Count
Research
Technology
Bioengineering
Neoplasms

ASJC

  • Medicine(all)