Radonc/BME     Medical Image and Computational Analysis Laboratory
Imaging for metastatic breast cancer early detection. Investigators: W. O'Dell, C. Takita, K. Daily, C. Heldermon, J. Lightsey.
Novel applications of conformal stereotactic radiation therapy championed by our clinical colleagues have renewed the clinical motivation for early detection of metastatic cancer to lung, liver, brain and other critical organs. This is especially relevant for patients who by their advanced stage of disease at initial diagnosis are at the greatest risk for developing metastases within the next 2-3 years. We have 2 active surveillance imaging studies for high-risk breast cancer survivors. The first study is funded by the Ocala Royal Dames for Cancer Research, and details of the study can be found here (ORD protocol link).
We have developed a 3D template matching approach to detect and size small metastatic tumors that is objective and more accurate than expert humans and existing commercial CAD systems. The details of the tumor detection and sizing are below.
[A] CT image slice through the chest of a patient with 5 lung mets, 2 of which are apparent at this slice location (arrows).
[B] Schematic of one of our 3D nodule appearance models (aka 'templates'). The variable intensities are at pixel ar due to partial volume effects at this image resolution, slice thickness, and the dimensions of the model.
[C] Map of the correlation values of our 3D templates to the image features in this 3D CT dataset, but shown only on this slice.
The 2 brightest pxiels correspond to the 2 real tumors.
Figure 2. Representative T1-weighted MR images of patients with mets to the brain.
The studies listed above will uncover new information on when and where breast cancer metastases appear and how fast they grow in other organs in the body. Our long-term goal is to use this information to design the optimal surveillance imaging protocol to incorporate into a nationwide clinical trial to test the efficacy of proactive imaging to improve the survival and health outcomes of breast cancer patients at elevated risk for developing future metastases.