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Massachusetts Institute of Technology - Improving the accuracy of cancer diagnoses - Spectroscopy technique could help better identify breast tumors

A new diagnostics protocol developed at MIT and Case Western Reserve University (CWRU) claims it could help doctors more accurately diagnosis between cancerous and non-cancerous tumors.  The new methodology works upon spectroscopic detection of tiny Calcium (Ca) deposits as a "tell-tale" sign of breast cancer.  Whilst present techniques can still demonstrate in the majority of cases mirco-calcifications signal feedback through mammography - the follow-up biopsy in ca. 15-25% cases does not unfortunately reveal the Ca tissue deposits, thus, leading to an inconclusive diagnosis.  In the majority of cases - if the aforementioned scenario is played-out - the patient has to subsequently undergo a more invasive surgical procedure.

Alternatively the MIT-CWRU method utilises a special scope of spectroscopy to accurately locate the micro-calcifications during the biopsy, which could dramatically reduce the rate of inconclusive diagnosis.  The research findings appear in the Proceedings of the National Academy of Sciences - 24th December 2012.  The researchers claimed they found that the new spectroscopy technique had a success rate of ca. 97%.  The researchers continue to speculate that the spectroscopic approach could be easily adapted into current biopsy practices - as stated by Ishan Barman, an MIT Post-doctorate.

'An arduous procedure'

Typically micro-calcifications form when Ca from the blood-stream is deposited onto degraded proteins and lipids left behind by injured and dying cells.  Micro-calcifications are rarely found in other forms of cancer - apart from breast cancer tumors - as stated by a senior author in the research - Maryann Fitzmaurice, senior research associate and adjunct associates professor of pathology and oncology at CWRU.  Unfortunately, among women when micro-calcifications are spotted during a routine mammography examination - only ca. 10% will turn-out to have cancer - making the follow-up biopsy extremely critical.

Such a traditional procedure undertakes the following clinical steps:-

  1. A radiologist first takes X-rays from 3 different angles to pictorially locate the micro-calcifications
  2. The radiologist then inserts a needle into the potential cancerous tissue and removes 5-10 blood samples
  3. A pathologist then takes-over and examines the suspected cancerous tissue for micro-calcificationsDCN Corp® - Photo-micrograph of a Ca micro-calcification associated with breast cancer tumors.  Credit - Image courtesy of the MIT and Case Western Reserve University (CWRU), USA, researchers
  4. If not present, the radiologist persists again, after taking a new round of X-rays

It is the second attempt as stated by Fitzmaurice, which in the majority of cases unfortunately proves to be unfruitful.  Fitzmaurice says - "If they don't get them on the first occasion they usually don't get them at all" and "It can become a very long and arduous procedure for the patient, with a lot of extra X-ray exposure, and in the end they still don't get what they are after, in 1 out of 5 patients."

Positively in the past 7 years - researchers between MIT and CWRU have been working on developing a spectroscopic technique, that can accurately analyse the tissue that the radiologist is about to biopsy - revealing within seconds whether the tissue actually contains micro-calcifications.  Initially the MIT-CWRU team began with employing Raman spectroscopy, which employs light to measure energy shifts in (bio-)molecular vibrations - revealing precise molecular structures.  Raman spectroscopy can offer detailed information - particularly about the chemical composition of a tissue, and so ideal for accurate identification of micro-calcifications.  However, on average Raman equipment is extremely expensive and it is complained that analysis times can take a long time.  Therefore, in the new study - the researchers employed another spectroscopic technique - known as diffuse reflectance spectroscopy, which can give results as accurate as Raman spectroscopy.  Diffuse reflectance spectroscopy proves to be more appealing, because it provides information within seconds - enabling a radiologist to quickly move the needle if it is in the wrong location.

Distinctive spectroscopic signatures

As a technique diffuse reflectance spectroscopy works by sending light towards the tissue, then capturing and analysing the reflected light after its interaction with the cancerous tissue sample.  In total the MIT-CWRU team examined 203 tissue samples from 23 patients - within minutes of the tissue sample's removal.  Each of the 3 types of tissue - healthy, lesions without micro-califications, and lesions with micro-calcifications - have subtle differences in the eventual spectrographic signature, which can be employed to distinguish among the different tissue compositions.  Interestingly by analysing these distinct patterns - the researchers managed to create a computer algorithm that can identify the tissues with a typical success rate of ca. 97%.

The alteration of a tissues light absorption are most likely to be caused by the level/concentration of specific proteins - elastin, desmosine and isodesmosine - that are often cross-linked with Ca deposits in diseased tissue.  The next phase of R&D optimisation for the MTI-CWRU team, is to test their needle and spectroscopy set-up in patients as the biopsies are being undertaken in real-time.  Original article available here

As with another MIT nano-citation "MIT: Nanoparticles amplify cancer tumor signals - easier to detect in the urine" - DCN Corp strongly believes it has discovered a scope of SERS thin film media, which could prove to be a more accurate, cost-effective and an easier to integrate cancerous tumor methodology.  DCN Corp's methodology becomes even more interesting when carefully considering the number of steps it would take to provide both the doctor or patient a straight Yes and/or No answer onto the detection of a breast cancer tumor.  Moving forward - if you or your colleagues are interested in making the above a reality - please ensure to contact the company as soon as practicably possible.