A collaborative effort by scientists has led to the development of an innovative strategy that can considerably improve the capabilities of medical imaging with safer procedures for the patient.
Medical imaging is a significant part of healthcare today, with imaging techniques such as magnetic resonance imaging (MRI), computed tomography (CT) scanning, and nuclear magnetic resonance (NMR) increasing greatly over the last 20 years. However, continuing problems of image resolution and quality still hinder these techniques because of the nature of living tissue. A solution is hyperpolarization, which involves injecting the patient with substances that can enhance imaging quality by following the distribution and fate of specific molecules in the body but that can be harmful or potentially toxic to the patient.
A team of scientists from Ecole Polytechnique F

Researchers have developed a new device that may result in more comfortable mammography for women. According to a study standardizing the pressure applied in mammography would reduce pain associated with breast compression without sacrificing image quality.

Compression of the breast is necessary in mammography to optimize image quality and minimize absorbed radiation dose. However, mechanical compression of the breast in mammography often causes discomfort and pain and deters some women from mammography screening.

An additional problem associated with compression is the variation that occurs when the technologist adjusts compression force to breast size, composition, skin tautness and pain tolerance. Over-compression, or unnecessarily high pressures during compression, is common in certain European countries, especially for women with small breasts. Over-compression occurs less frequently in the United States, where under-compression, or extremely low applied pressure, is more common.

‘This means that the breast may be almost not compressed at all, which increases the risks of image quality degradation and extra radiation dose,’ said Woutjan Branderhorst, Ph.D., researcher in the Department of Biomedical Engineering and Physics at the Academic Medical Center in Amsterdam.

Overall, adjustments in force can lead to substantial variation in the amount of pressure applied to the breast, ranging from less than 3 kilopascals (kPa) to greater than 30 kPa.

Dr. Branderhorst and colleagues theorized that a compression protocol based on pressure rather than force would reduce the pain and variability associated with the current force-based compression protocol. Force is the total impact of one object on another, whereas pressure is the ratio of force to the area over which it is applied.

The researchers developed a device that displays the average pressure during compression and studied its effects in a double-blinded, randomized control trial on 433 asymptomatic women scheduled for screening mammography.

Three of the four compressions for each participant were standardized to a target force of 14 dekanewtons (daN). One randomly assigned compression was standardized to a target pressure of 10 kPa.

Participants scored pain on a numerical rating scale, and three experienced breast screening radiologists indicated which images required a retake. The 10 kPa pressure did not compromise radiation dose or image quality, and, on average, the women reported it to be less painful than the 14 daN force.

The study’s implications are potentially significant, Dr. Branderhorst said. There are an estimated 39 million mammography exams performed every year in the U.S. alone, which translates into more than 156 million compressions. Pressure standardization could help avoid a large amount of unnecessary pain and optimize radiation dose without adversely affecting image quality or the proportion of required retakes.

‘Standardizing the applied pressure would reduce both over- and under-compression and lead to a more reproducible imaging procedure with less pain,’ Dr. Branderhorst said.

The device that displays average pressure is easily added to existing mammography systems, according to Dr. Branderhorst. EurekAlert

A team of investigators at Children

Scientists at the Cancer Science Institute of Singapore (CSI Singapore) at the National University of Singapore (NUS) and their collaborators have developed a scoring scheme that predicts the ability of cancer cells to spread to other parts of the body, a process known as metastasis. This system, which is the first of its kind, opens up the possibility to explore new treatments that suppress metastasis in cancer patients.

Led by Professor Jean Paul Thiery, Senior Principal Investigator, and Dr Ruby Huang, Principal Associate, both from CSI Singapore, the scientists developed a scoring scheme which monitors the epithelial-mesenchymal transition (EMT) mechanism. This process was shown to play a role in a large number of cancer-related events, including cancer invasion, metastasis, and chemo-resistance. To date, there are no existing tools to systematically quantify the EMT status of tumours. The newly-developed EMT scoring is thus a promising, versatile tool for investigating EMT roles and dynamics in the progression, treatment response and survival across different types of cancer. It can also be integrated with other molecular tests, such as the detection of mutations of cancer genes, to help identify patients at higher risks for treatment failure and decreased survival.

Cancer metastasis is responsible for 90 per cent of cancer deaths. One of the mechanisms of metastasis is through the EMT process, where tumour cells lose adhesion contacts with their neighbouring cells at the primary tumour site, and gain the ability to move to a secondary site. The ability to stay in tight contact is an important feature of epithelial cells whereas the ability to gain movement is a characteristic of mesenchymal cells. Tumour cells which undergo the EMT process lose their epithelial features and gain invasive, migratory properties typical of mesenchymal cells.

The EMT mechanism has a varying impact on different populations of cancer cells as they respond differently to the EMT cues. Not every cancer cell will undergo the same degree of loss of cell adhesion ability or gain the ability to move spontaneously, which is known as motility. As a result, tumours from different patients will exhibit a wide range of differences in the status of their EMT. To determine with precision the EMT status of the tumour, the research team developed a quantitative modelling system.

In this study, the researchers utilised a total of 13,000 samples from publicly available databases containing gene expression information for more than 15 different types of cancers. A computational modelling scheme of EMT was established to define tumours having the most epithelial features and tumours having the most mesenchymal features. Subsequently, the tumours were rated on a continuous spectrum of different EMT scores. Tumours with mixed epithelial and mesenchymal features are at the in-between state. This transitional state signifies cancer cell populations that might become truly mesenchymal. Patients who have tumours at this intermediate state may be at higher risks compared to those with tumours at the epithelial state.

The clinical information from the databases, including patient survival and treatment responses, was compared against the EMT scoring scheme. The research team showed that the EMT scoring they developed has a good correlation with previously published, cancer-specific EMT signatures. They used this scoring scheme to establish an EMT spectrum across various cancers and noted good correlation between cancer cell lines and tumours. The scientists concluded that this scoring scheme may enable the objective and systematic investigation of EMT in cancer progression, survival and throughout the clinical response to therapy. EurekAlert

Researchers in Manchester have investigated a patient-centred approach to assessing the side effects of radiotherapy and have shown that it may be able to improve the detection and management of treatment-related toxicity.
For lung cancer that cannot be removed with surgery, radiotherapy is the primary treatment option. However, it is associated with a range of side effects, including fatigue and inflammation of the oesophagus and lungs.

Current methods to record treatment-related toxicities rely on assessment by health care professionals. Now a team from The University of Manchester and The Christie NHS Foundation Trust