Breast cancer patients reported fewer moderate or marked side effects if they were treated with radiotherapy to part of the breast or a reduced dose to the whole breast, according to new findings from a major study. The IMPORT LOW study of 2,016 women in 41 centres in the UK has already shown that partial breast and reduced dose radiotherapy was as effective as whole breast radiotherapy in controlling the cancer at five years, and women in the partial breast and reduced dose groups reported fewer side-effects, including less change in the appearance of the breast. These latest results, which focus predominantly on side-effects affecting the breast and also body image reported during the five years following radiotherapy, show that over half of patients in the study did not report moderate or marked side-effects at any point and that most side-effects reduced over time. The number of side-effects reported per person were fewer in the partial breast and reduced dose groups compared with the whole breast radiotherapy group. The IMPORT LOW trial was coordinated by the Clinical Trials and Statistics Unit at The Institute of Cancer Research, London, and funded by Cancer Research UK.
The Institute of Cancer Researchwww.icr.ac.uk/news-archive/women-report-fewer-adverse-side-effects-from-partial-or-reduced-breast-radiotherapy-reveals-major-study
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By no means are only elderly people at risk from heart diseases. Physically active individuals can also be affected, for example if a seemingly harmless flu bug spreads to the heart muscle. Should this remain undetected and if, for example, a builder continues with his strenuous job or an athlete carries on training, this can lead to chronic inflammation and in the worst case even to sudden death. Professor Eike Nagel and his 12 co-workers at the Institute for Experimental and Translational Cardio Vascular Imaging of Goethe University Frankfurt are developing better ways to predict and diagnose heart diseases. In recent years, the researchers have taken the lead in the development of a procedure that is still very new in heart scans. Nagel explains the advantages: “With the help of magnetic resonance imaging, we can look right inside the heart muscle.” Blood flow to the heart muscle is visualized and shows whether there are any constrictions of the arteries supplying the heart. Experts can also spot whether the heart muscle is scarred, inflamed or displays any other anomalies. The comparatively fast method makes it possible to examine patients at an early stage and may prevent cardiac insufficiency or even a heart attack. “Diseases such as HIV, kidney damage, rheumatic diseases or tumours often affect the heart either directly or as a side effect of therapy,” says Nagel, describing groups potentially at risk. The cardiologist is convinced: “Nowadays we can treat or even cure so many diseases, but the heart suffers too and this should be carefully monitored as it mostly remains undetected.” MRI is a non-invasive and gentle examination technique, which is less risky but just as efficient as an examination using a conventional heart catheter, where a thin tube is pushed in the direction of the heart through an artery. Nagel’s research group was recently able to demonstrate this in a large international multi-centre study that was met with international acclaim. The Institute for Experimental and Translational Cardio Vascular Imaging also has state-of-the-art computer tomography equipment at its disposal that can produce three-dimensional images of the heart. These especially reveal calcium deposits and plaques in the artery walls which could rupture and trigger a sudden heart attack. “This allows us to determine the risk of a heart attack and the need for therapy fast and at an early stage, which can then be non-invasive,” says Nagel. Which technique is best for which patient is one of the research topics Nagel’s group is evaluating. In some patients, both may be needed and the Institute is optimally equipped to answer most aspects of heart disease thanks to its deep insight into the heart. Nagel finds these rapid advances in imaging over the last decades fascinating: “Nowadays we can spot the slightest changes and literally get a clear picture of the heart’s condition.”
Goethe Universitäthttps://tinyurl.com/ycvjvutf
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A new study has found a way to identify men with locally advanced prostate cancer who are less likely to respond well to radiotherapy. Led by Professor Catharine West, The University of Manchester team created a method of selecting prostate cancer patients who would benefit from treatments which target oxygen deficient tumours. The study was funded by Prostate Cancer UK Prostate Cancer UK with support from the Movember Foundation, and NIHR Manchester Biomedical Research Centre and published in eBiomedicine . Tumour hypoxia is associated with a poor prognosis in prostate cancer: the lower the oxygen, the greater the resistance to treatment and the more likely a tumour will spread. The researchers identified a 28-gene signature, which accurately identifies hypoxic tumour tissue in patients with prostate cancer which invades nearby structures The signature was derived using analysis of human cells in the lab and patient survival data. The signature was validated using data from across the world in eleven prostate cancer cohorts and a bladder cancer phase III randomized trial of radiotherapy. According to cancer.net, the 5-year survival rate for most men with local prostate cancer is almost 100%. 98% are alive after 10 years, and 96% live for at least 15 years. For men diagnosed with prostate cancer that has spread nearby, the 5-year survival is around 70%.
“Until now, there has been no clinically validated method of selecting prostate cancer patients who would benefit from hypoxia modifying treatment Professor Catharine West„
For men diagnosed with prostate cancer that has spread to other parts of the body, the 5-year survival rate is 29%. According to Cancer Research UK , over 11,000 still die from the disease every year. In 2014, 13% of all male cancer deaths were from prostate cancer. Professor West is based at the Manchester Cancer Research Centre- a world renowned partnership between The University of Manchester, The Christie NHS Foundation Trust and Cancer Research UK. She said: “Ninety percent of prostate cancer patients are diagnosed with localised cancer, which have a highly variable course of disease progression. “And we know that combining hypoxia-targeting treatment with radiotherapy has been shown to improve local control of tumours and survival of patients in head and neck and bladder cancers.” She added: “This study has built on work to identify possible ways for measuring hypoxia in prostate cancer using gene signatures. “Until now, there has been no clinically validated method of selecting prostate cancer patients who would benefit from hypoxia modifying treatment.
University of Manchesterwww.manchester.ac.uk/discover/news/study-paves-the-way-for-better-treatment-of-prostate-cancer/
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Cuff devices for blood pressure measurement are inconvenient, and mobile device apps for blood pressure measurement that are now being introduced may lack accuracy. To solve this problem, a team of Michigan State University scientists have created a new app and hardware for smartphones to measure blood pressure with accuracy that may rival arm-cuff devices. The technology also includes a discovery of a more convenient measurement point. “We targeted a different artery, the transverse palmer arch artery at the fingertip, to give us better control of the measurement,” said Anand Chandrasekhar, MSU electrical and computer engineering doctoral student and the lead author. “We were excited when we validated this location. Being able to use your fingertip makes our approach much easier and more accessible.” The approach uses two sensors: an optical sensor on top of a force sensor. The sensor unit and other circuitry are housed in a 1 centimetre-thick case attached to the back of the phone. Users turn on the app and press their fingertip against the sensor unit. With their finger on the unit, they hold their phone at heart level and watch their smartphone screen to ensure they’re applying the correct amount of finger pressure. “A key point was to see if users could properly apply the finger pressure over time, which lasts as long as an arm-cuff measurement,” Ramakrishna Mukkamala, MSU electrical and computer engineering professor and senior author said. “We were pleased to see that 90 percent of the people trying it were able to do it easily after just one or two practice tries.” Internationally, this device could be a game-changer. While high blood pressure is treatable with lifestyle changes and medication, only around 20 percent of people with hypertension have their condition under control. This invention gives patients a convenient option, and keeping a log of daily measurements would produce an accurate average, discounting an occasional measurement anomaly, Mukkamala added. The research team will continue to improve accuracy and hopes to pursue more comprehensive testing based on the standard protocol of the Association for the Advancement of Medical Instrumentation. The scientists are already making inroads to build improved hardware. Future iterations could be as thin as 1 millimetre and be part of a standard protective phone case. Michigan State Universitymsutoday.msu.edu/news/2018/new-blood-pressure-app-and-hardware-rivals-arm-cuff-accuracy/
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Canon Medical Systems Corporation (formerly Toshiba Medical) has been awarded the Green Apple Environmental best practice award. The Green Apple awards, a Green Organisation initiative, are part of an annual international campaign to recognise, reward and promote environmental best practice around the world. Canon Medical Systems Corporation was proclaimed Gold Winner in the category Innovation, for its Aquilion ONE Genesis CT scanner. The exclusive awards ceremony was held in the Palace of Westminster, London. Awards were presented in various categories, such as Carbon, Energy Efficiency, Manufacturing and Waste management.
The award winning CT Scanner, Aquilion ONE Genesis, is a smaller and lighter Premium CT system than its predecessors, thus requiring less power. Designed for an installation space of just 19 m2, Aquilion ONE Genesis Edition can be installed in most existing CT rooms, avoiding costly renovations. The open Gantry structure with short bore facilitates access from the front and rear of the gantry.
With regard to the exposure dose for the patients, Aquilion ONE Genesis applies the latest dose reduction technologies and reconstruction algorithms, such as PUREViSION detector technology and FIRST. Its advanced detector technology converts almost 100% of incident X-ray photons for maximum dose efficiency. FIRST is the world’s first fully integrated Iterative Reconstruction Technology in Premium CT, resulting in the lowest dose levels technically achievable today.
Henk Zomer, Senior Manager Computed Tomography, says: “It is a great honour for us to receive this award, that shows that Canon Medical’s environmentally innovative products are highly rated internationally. We endeavour to contribute to society with our medical systems while improving the efficiency of medical services, and we vigorously promote our environmental conservation activities.”
“Green Apple Awards” are a prestigious global recognition of environmental best practice issued by “The Green Organisation” – an international, independent, non-profit, non-political, non-activist environment group that was established in 1994 to recognize, reward and promote environmental best practice around the world.
https://eu.medical.canon
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New research has estimated that each year five babies in every 1,000 born in England suffer a condition or sign linked to brain injury. The study, conducted by researchers at the Neonatal Data Analysis Unit at Imperial College London and Chelsea and Westminster Hospital NHS Foundation Trust, analysed data on babies born between 2010 and 2015 to assess the number that may have sustained brain injury at or soon after birth. The researchers used routinely recorded NHS data and so were able to measure the incidence rate of brain injury in newborns without any additional workload for doctors or nurses. Ultimately, this research could lead to a better understanding of how to prevent brain injury in preterm and full term babies. Dr Chris Gale, lead author and Clinical Senior Lecturer in Neonatal Medicine at Imperial College London and Consultant Neonatologist at Chelsea and Westminster Hospital NHS Foundation Trust, said: “Brain injury at or soon after birth is a serious problem, as it can lead to long-term conditions later in life such as cerebral palsy, blindness, deafness and learning deficits. A proportion of these cases could be avoided.” Neena Modi, Professor of Neonatal Medicine at Imperial College London and Head of the Neonatal Data Analysis Unit, said: “Before now UK health services did not have a standard definition of brain injury in babies and there has been no systematic collection of data for this purpose. Professor Modi added: “With colleagues, and in collaboration with the Department of Health, we have devised a practical way to measure the incidence rate of brain injury in babies.” Published in the journal Archives of Disease in Childhood, the research estimated that 3,418 babies suffered conditions linked to brain injury at or soon after birth in 2015, which equates to an overall incidence rate of 5.14 per 1,000 live births. For preterm births (babies born at or less than 37 weeks) the rate was 25.88 per 1,000 live births in 2015, more than seven times greater than the rate for full term births, which was 3.47 per 1,000 live births. It is often not known whether a baby has suffered brain injury until later in life. Therefore, the new standardized definition of brain injuries in newborn babies, developed by a group of experts convened by the Department of Health, consists of a range of conditions and signs that are known to be related to brain injury. These include seizures or fits, bleeding within the brain, stroke just before or at birth, infections like meningitis, and damage caused by oxygen deprivation. The research, commissioned by the Department of Health, is the first to present estimates for the number of babies with brain injuries based on a definition that includes multiple conditions in one measure. It is also the first time this estimate has been made using data gathered routinely during day-to-day clinical care on neonatal units. The use of routine data required no additional work for clinical staff and provides a valuable way to measure the effectiveness of interventions to reduce brain injury. As part of a drive to make England a safer place to give birth, the Department of Health has set a target of reducing the number of babies that incur brain injury during or soon after birth by 20% by 2020 and to halve them by 2030. Using these new estimates this equates to lowering the incidence of babies with brain injury to four per 1,000 live births by 2020 and to 2.5 babies per 1,000 live births by 2030. Overall, the research found that the most common type of condition that contributed to brain injuries was damage caused by lack of oxygen to the brain, called hypoxic ischemic encephalopathy; this is seen mainly in full term babies. For preterm babies, the largest contributor to brain injuries is from bleeding into and around the ventricles of the brain, a condition called periventricular hemorrhage. Dr Gale added: “Being able to measure how common brain injuries are allows health professionals and researchers to focus on reducing these devastating conditions. This includes the consistent use of treatments that reduce the risk of brain injuries in preterm infants, such as steroids and magnesium sulphate given to the mother before birth. “This measure will also help us to evaluate other interventions, for example, making sure that as many preterm babies as possible are born at hospitals with advanced neonatal services on site, which we know reduces the risk of brain injury. “The next step is to use routine data to understand the long-term effects of these conditions on the children and their families.”
Imperial College Londonhttps://tinyurl.com/ycnbqzlo
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Biomedical engineers at the University of California, Davis, have developed a new technique for measuring blood flow in the human brain, which could be used in patients with stroke or traumatic brain injury, for example. The new technique, based on conventional digital camera technology, could be significantly cheaper and more robust than prior methods. “Our setup is very promising, and the cost should be lower,” said Wenjun Zhou, a postdoctoral researcher working with Vivek Srinivasan, associate professor at the UC Davis Department of Biomedical Engineering. If you shine a light into a cloudy solution, light particles, or photons, will be scattered in different directions. An experimental technique called diffuse correlation spectroscopy, or DCS, uses essentially this approach to look inside someone’s skull. Laser light is shined on the head; as photons from the laser pass through the skull and brain, they are scattered by blood and tissue. A detector placed elsewhere on the head, where the photons make their way out again, picks up the light fluctuations due to blood motion. These fluctuations provide information about blood flow. The light signal is very weak, and the further it passes through the skull and brain tissue, the weaker it gets. So DCS requires a number of very sensitive, expensive single photon counting detectors. Boosting the light going in risks burning the patient’s skin. Zhou and Srinivasan took a different approach, based on the fact that overlapping light waves will reinforce or cancel each other out, like overlapping ripples on a pond. They first split the light beam into “sample” and “reference” paths. The sample beam goes into the patient’s head and another, stronger, reference beam is routed so that it reconnects with the sample beam before going to the detector. This boosts the signal, meaning that instead of needing about 20 photon-counting detectors that cost a few thousand dollars each, the researchers could use a single CMOS-based digital camera chip for a fraction of the price. “The strong reference light enhances the weaker signal from the sample,” Zhou said. They call the method interferometric diffusing wave spectroscopy, or iDWS. An added advantage is that they do not need to turn off the room lights while making measurements with iDWS, Zhou said. Eventually, they may even be able to monitor brain blood flow outdoors, under bright sunlight. So far, the team has tested their device by making brain recordings from volunteers in the laboratory. They are working with Dr. Bruce Lyeth and Dr. Lara Zimmermann in the UC Davis Department of Neurological Surgery to validate and adapt the technology for eventual use in neurocritical care. UC Davis has applied for a provisional patent on the technology. Other authors on the paper are graduate student Oybek Kholiqov and postdoctoral researcher Shau Poh Chong. Srinivasan also holds an appointment at the Department of Ophthalmology and Vision Science, UC Davis School of Medicine. The work was funded by grants from the National Institutes of Health.
University of California – Daviswww.ucdavis.edu/news/new-technology-measuring-brain-blood-flow-light
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Massive banks of genetic information are being harnessed to shed new light on modifiable health risks that underlie common diseases. University of Queensland researchers have pioneered a method to integrate data from multiple large-scale studies to assess risk factors such as body mass index (BMI) and cholesterol levels, and their association with diseases including type two diabetes and heart disease. Professor Jian Yang, from UQ’s Institute for Molecular Bioscience and Queensland Brain Institute, said the new method was more powerful than earlier techniques and enabled scientists to identify risk associations that were difficult to detect in smaller samples. “Identifying new risk factors provides an avenue to look at diseases from a different angle,” Professor Yang said. “For example, LDL-cholesterol is known to be a risk factor for cardiovascular disease, but we were surprised to see that it actually lowers your risk of type two diabetes. “Discoveries like this could have significant implications for medical research, the pharmaceutical industry and public health policy.” The study looked at seven known health risk factors and more than 30 common diseases, in genetic data from more than 400,000 people. Professor Yang said the method identified 45 potentially causal associations between health risk factors and diseases. “Some of these associations – such as the link between BMI and type 2 diabetes and cardiovascular disease – have already been confirmed in randomized controlled trials, which validates our methods,” Professor Yang said. “Others identified in this study provide candidates for prioritization in future trials, and fundamental knowledge to understand the biology of the diseases. “For example, we identified a highly significant risk effect of HDL-cholesterol on age-related macular degeneration.” Professor Yang said the method was particularly valuable where clinical trials to investigate associations would be impractical or even unethical. “Years of education is one trait we looked at in the study, and it had a protective effect against most diseases, particularly for Alzheimer’s and coronary artery disease – but it is something that needs to be carefully investigated in the future,” Professor Yang said.
University of Queenslandhttps://tinyurl.com/y9lfo963
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Siemens Healthineers and ScreenPoint Medical have agreed to partner to develop artificial intelligence-based applications for breast imaging. This collaborative arrangement also includes the acquisition of a strategic minority stake in ScreenPoint Medical by Siemens Healthineers. The partnership intends to leverage the superior expertise of Siemens Healthineers in breast imaging as well as that of ScreenPoint Medical in mammography decision support to develop innovative clinical applications for breast cancer screening and diagnosis. Professor Nico Karssemeijer, CEO of ScreenPoint Medical, explains, “together with Siemens Healthineers, we can bring our expertise in AI into the entire screening and diagnostic pathway, starting from risk stratification to image acquisition and diagnosis.” “The aim of our collaboration with ScreenPoint Medical is to expand precision medicine by providing automated clinical decision support that makes it easier and faster to distinguish between healthy and tumour tissue, thus increasing diagnostic accuracy,” adds Dr. Pete Schardt, head of X-ray Products at Siemens Healthineers. “Working with strong partners such as ScreenPoint will help us drive personalized breast care pathways with new applications based on deep learning and artificial intelligence.” Both companies pool their individual strengths in their strategic partnership. ScreenPoint Medical’s current, highly innovative mammography reading software, Transpara, is available for a variety of mammography systems. It enables clinical decision support and computer-aided detection for higher reading accuracy. It has been proven to help radiologists better detect breast cancer with mammography and reduce variations between different users – both aspects integral in expanding precision medicine. Transpara is cleared for clinical use for CE-countries with the digital mammography and reading portfolio of Siemens Healthineers. In the coming months, ScreenPoint plans to attain regulatory approvals for the Transpara solution in further clinical applications and countries. Siemens Healthineers has a long-standing history of innovations in breast imaging and a comprehensive portfolio of systems across ultrasound, mammography and MRI as well as the accompanying reading solutions. The latest addition in mammography, Mammomat Revelation, offers the highest depth resolution on the market with a unique 50-degree wide angle for tomosynthesis. Automated and precise breast density measurements allow for instant risk stratification. On the reading side, Syngo.BreastCare offers advanced visualization for 2D and 3D mammography with automatic workflows and Artificial Intelligence (AI)-based tomosynthesis reading.
www.siemens-healthineers.comwww.screenpoint-medical.com
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In 2017, an estimated 252,710 new cases of invasive breast cancer were diagnosed in women and 2,470 cases were diagnosed in men. Many of these diagnoses are made using X-ray mammography. Although standard and widely used, X-ray imaging for breast cancer suffers from both low sensitivity (50-75%) and the use of ionizing radiation that cannot be considered completely safe. While X-ray mammography is widely used and is still the recommended method for routine screenings, its use is limited by the patient’s age, weight or body mass index, the breast tissue itself, whether or not hormone replacement therapy is being used, and other issues. In addition, its accuracy — particularly when used in younger women — has been called into question. Other imaging techniques, such as MRI and ultrasound, are sometimes suggested, but neither is an effective replacement for X-ray mammography. Optical imaging methods, on the other hand, have attracted increasing interest for breast cancer diagnosis since both visible and infrared light are highly sensitive to tissue composition. Tumours are characterized by a high volume of blood due to the increased vascularization that occurs as tumours grow. OM (Optical Mammography) can be used to measure blood volume, oxygenation, lipid, water and collagen content for a suspicious area identified through standard X-ray imaging. Collagen measurements are particularly important since this species is known to be involved in the onset and progression of breast cancer. One major disadvantage to OM imaging is the poor spatial resolution that has been achieved to date. Breast cancer tumours larger than 1 centimetre are very dangerous and more likely to lead to death, so a successful screening technique must be able to resolve smaller lesions. This remains a problem with OM imaging as a stand-alone technique, but combining OM with other imaging methods shows some promise. A possible advantage to OM, however, is that only gentle pressure need be applied to the breast tissue, in stark contrast to the standard technique for X-ray imaging. In fact, breast compression tends to reduce blood volume in the tissue, which would interfere with the OM image, so some three-dimensional OM detectors being developed use no compression at all but, rather, surround the breast tissue with rings of light sources and detectors. While poor spatial resolution of OM methods remains a challenge, the method does show promise for use in pre-surgical chemotherapy. As Edoardo Ferocino, Politecnico di Milano, Italy, co-author of the work explains, “This technique is able to provide information on the outcome of chemotherapy just weeks after beginning treatment, or possibly even sooner.” Ferocino’s group is planning clinical studies to explore the use of OM to monitor and predict the outcome of chemotherapy. The investigators in Milan are working with a larger consortium on a project known as SOLUS, “Smart Optical and Ultrasound Diagnostics of Breast Cancer.” This project is funded by the European Union through the Horizon 2020 Research and Innovation Program and aims to combine optical imaging methods with ultrasound to improve specificity in the diagnosis of breast cancer. The Optical Societywww.osa.org/en-us/about_osa/newsroom/news_releases/2018/diagnosing_breast_cancer_using_red_light/
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