RSNA13 research roundup: Focused ultrasound with MR effectively treats breast cancer

A new breast cancer treatment technique and developments in face transplantation surgery were among the research highlights presented at the Radiological Society of North America's annual conference in Chicago on Wednesday.

The use of focused ultrasound under MR guidance could offer a safe, effective was of treating breast cancer, according to Italian researchers. MR-guided focused ultrasound ablation is a technique that uses acoustic energy from high-intensity focused ultrasound to heat and destroy diseased tissue. It is non-invasive, allows for a quick recovery time, and provides for a precise measurement of temperature changes during the procedure (which is important since a temperature that is too low is ineffective, and one that's too high could be dangerous).

In their study, the researchers, led by Alessandro Napoli, an assistant professor of radiology at Sapienza University in Rome, assessed the safety of the technique in 12 patients with invasive ductal breast cancer before surgical removal of the cancer and biopsy of the lymph nodes.

None of the patients experienced significant complications during or after the procedure, and in 10 patients a post-surgical evaluations showed no cancer in the treatment area.  "This procedure allows for safe ablation of breast cancer," Napoli said in an announcement. "At pathology, no significant viable tumor was found in the specimens from those 10 patients."

The treatment failed in the other two patients because of a transducer malfunction.

Napoli said that more research will be needed on the technique before it can be adopted as a stand-alone option for treating breast cancer.

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Researchers at Brigham and Women's Hospital in Boston have found that blood vessels in face transplant recipients reorganized themselves, helping them understand how blood penetrates into the transplanted tissue.

Doctors now have performed full face transplants four patients at Brigham and Women's since 2011. Part of the procedure involves connecting a patient's major arteries and veins to those from a donor face or facial allograft.

In a study presented today, researchers led by Frank J. Rybicki, director of the hospital's Applied Imaging Science Laboratory, and Kanako Kumamaru, M.D., used 320-detector row dynamic computer tomography angiography (CTA) to study facial allografts on three patients one year after the procedure.

"The key finding of this study is that after full face transplantation, there is a consistent, extensive vascular reorganization that works in concert with the larger vessels that are connected at the time of surgery," Kumamaru said in a statement.

The researchers noted that their findings could improve surgical planning and assessment of potential complications. For example, previous literature has recommended joining multiple arteries and veins to ensure adequate blood flow, which adds a significant amount of time to the procedure.

"Our findings support the simplified anastomosis for full transplant procedure that, in turn, can potentially shorten the operative time and reduce procedure-associated complications," Rybicki said.

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Patients screened more frequently for breast cancer had a significantly lower rate of cancer that spread to the lymph nodes compared to women who went longer intervals between screening exams, according to research presented today.

In a retrospective study conducted at Northwestern Memorial Hospital, researchers looked at 332 women identified with breast cancer between 2007 and 2010. They were divided into three groups based on the length of time between screening--less than 1.5 years, 1.5 to three years, and more than three years.

The researchers found that women in the less than 1.5-year interval group had the lowest lymph-node positivity rate at 8.7 percent, while the rates for the 1.5 to three-year and over three-year groups increased to 20.5 percent and 15.4 percent respectively.

"Our study shows that screening mammography performed at an interval of less than 1.5 years reduces the rate of lymph node positivity, thereby improving patient prognosis," co-author Lilian Wang, an assistant professor of radiology at Northwestern University/Feinberg School of Medicine, said, according to an announcement. "We should be following the guidelines of the American Cancer Society and other organizations recommending that women undergo annual screening mammography beginning at age 40."

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