New image analytics offers guidance for Breast Cancer treatment

A new way to analyze magnetic resonance images (MRI) data appears to reliably distinguish between patients who would need only hormonal treatment and those who also need chemotherapy, researchers from Case Western Reserve University report. The analysis may provide women diagnosed with estrogen positive-receptor (ER-positive) breast cancer answers far faster than current tests and, due to its expected low cost, open the door to this kind of testing worldwide.

"Until about 15 years ago, doctors had no way of telling aggressive cancer from non-aggressive, so the majority of women got chemotherapy, which can produce very harsh side effects," he said.
Since then, a genomic test for differentiating between aggressive and nonaggressive cancer was developed. The test requires doctors to send a biopsy sample to a company that analyzes it and assigns a risk score that the doctors then use to guide treatment.
"The test is used frequently in the United States, but it destroys tissue, requires shipping and costs about $4,000," said Madabhushi, who is a member of the Case Comprehensive Cancer Center. "The cost puts the test out of reach for people in middle- and low-income countries."
They discovered differences in gene expression, molecular changes that appeared as changes in textural patterns in the images. They converted the dynamic texture changes into quantitative measurements and used differences in the measurements to determine which patients needed chemotherapy and which did not. In 85 percent of the cases, the conclusions matched those of the genomic test.

"We think the dynamic texture data is robust and reliable," Madabhushi said. "It allows us to compare apples to apples." He expects the test, if further trials validate it, would cost "pennies on the dollar, compared to the $4,000 test." For the patient, the test requires an MRI scan, which many doctors already prescribe for those newly diagnosed with cancer. "So the test, for many, doesn't require the cost of a scan," Madabhushi said. He said a computer and program are the tools needed. No tissue would be shipped. Instead of waiting a week or two for results, the wait would be minutes.