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Duke Radiologist to Study Breast Imaging

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Duke Health News 919-660-1306

DURHAM, N.C. - Martin Tornai, assistant professor of radiology, has been awarded a biomedical engineering research grant from the Whitaker Foundation, providing almost $210,000 over three years to investigate developing a novel nuclear medicine imaging system to detect breast cancer.

Currently, breast imaging is primarily done using X-rays to provide a two-dimensional, or "projection" image. Such mammograms on a regular basis for women over age40 are proven to reduce deaths from breast cancer by detecting tumors early in the course of the disease. While mammograms are very sensitive, detecting 85 percentof breast lesions, they are not very specific for breast cancer. In fact, only 30 percent of patients who have biopsies due to mammogram findings actually have breastcancer.

Nuclear medicine's ability to provide three-dimensional images of tissue function, which is frequently altered in cancers, offers a way to reduce the number of womenwho undergo biopsies, said Tornai. Nuclear medicine techniques like SPECT, or single photon emission computed tomography, detect how a radioactive, biologicallyactive substance is distributed in the body.

Building on pioneering work by Duke researchers to create and develop SPECT, an effort led by Ronald Jaszczak, professor of radiology and biomedical engineering,Tornai's new grant is part of a broad effort at Duke to improve breast cancer imaging. Tornai said researchers hope SPECT improves upon two-dimensional nuclearmedicine imaging of the breast, which already has been tested at Duke and elsewhere.

"Nuclear medicine projection images for breast cancer are pretty good - selectivity and specificity are both above 90 percent for tumors greater than 1 cm," he said."Three-dimensional SPECT, however, should be able to detect smaller tumors, improve localization of the tumor and provide better contrast, if we can design somethingto image the specific organ. These advantages could facilitate catching the disease earlier."

Tornai and his colleagues at Duke are working on all aspects of designing and building an organ-specific nuclear medicine imaging device, from the components andelectronics of the detectors themselves to models and computer codes to test their ideas. Through his grant, Tornai will design a system to move the camera that detectsthe radiation emitted from the breast so that it can look at the breast from many angles, ultimately enabling a 3-D image.

"Right now we're early in the development stages of this organ-specific nuclear medicine imaging system, and this grant is not for studies with patients," Tornai said. "Ifand when the breast imaging system is fully developed, it won't replace mammograms, but instead would offer women with inconclusive results an alternative tobiopsies."

The nuclear medicine technique might also become a preferred screening method for women with very dense or large breasts, he said.

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