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Improving Breast Cancer Outcomes through Innovation in Ultrasound technologies

On World Health Day, Professor Bajram Zeqiri, Fellow in Ultrasound and Head of Science for the Medical and Marine Physics at NPL talks about the future of breast cancer diagnosis

“As the UK’s National Metrology Institute, NPL provides the measurement capability that underpins the UK citizens quality of life. NPL is leading the way in providing the measurement science that supports collaborative research and development within the healthcare and life sciences system in order to tackle some of our biggest health challenges.

In the UK, around 1,000 women die every month from breast cancer. Through the National Breast Screening programme, 3 million women are annually invited for X-Ray mammography (XRM), but the technique has issues particularly with younger women whose breast density is high. Of the 3 million invited for screening, only around 75% of women accept which could be partly due to the discomfort of the compression procedure.

Like all cancers, early and accurate detection and diagnosis increases survival rates and leads to significantly lower treatment costs. Inaccuracies in current screening methods means only 20% of suspicious mammograms reveal cancer. These scans naturally trigger further tests with 90,000 unnecessary biopsies per year being carried out. There is therefore a need for more specific diagnostic methods able to diagnose cancers accurately in order to reduce the number of biopsies, coupled with more effective population screening methods, particularly for younger women. In cost terms the annual cost to the NHS due to false positives is estimates to be £38m with each case individually costing £1,800.

To support earlier diagnosis and treatment of breast cancer, I am leading a team at NPL in developing a research platform for imaging breast tissue, using Ultrasound Computed Tomography or UCT. The platform works by transmitting ultrasonic waves through the breast, which are then detected by novel NPL-developed sensors resulting in maps of ultrasound attenuation in tissue. It is well established that cancers have higher ultrasonic attenuation than background breast tissue, making them readily detectable.

NPL-breast-scanner.pngUsing the laboratory platform, we have proven that UCT using the new NPL sensors creates quantitative images of breast phantoms mimicking inclusions such as cysts and malignant cancers. Our UCT system generates near artefact-free maps of the attenuation coefficient of simple test objects. The first in-person studies of ultrasound attenuation have recently been completed.

In comparison to XRM, this new technology is less invasive, more comfortable and, completely safe as it eliminates risks associated with exposure to ionising radiation. The new technology is also game changing in many ways, its quantitative nature will support the efficient use of AI to compare scan results with the reference library of images linked to known pathologies and other clinical data, promising fewer false positives and improved diagnostic confidence. Additionally, due to its safety and operator independence, it could be deployed across a range of screening and diagnostic sites.

The research platform continues to be studied, and is currently being used to optimise the imaging technique. This will establish ways in which the clinical performance of any eventual device could be improved. Though engaging with NHS clinical academic partners we have now identified three key applications for the technology going forward as having the greatest potential for improving outcomes:

  1. Breast Density Assessment
  2. Neoadjuvant Therapy Response Assessment
  3. Breast disease diagnosis through measurement and imaging of the acoustic properties of breast tissue.

We are exploring funding opportunities to enable us to build a Mark II system which will be used for clinical trialling in the NHS. This will gain important evidence of the clinical potential of the system across a number of different clinical settings or pathways."

Find out more about our work in this area. 

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07 Apr 2021