Imaging system helps determine chemo efficacy against breast cancer

Using red and near-infrared light, researchers created an imaging system that may help predict which breast cancer patients will benefit the most from chemotherapy.

Allen Cone
Women traditionally undergo a mammogram to determine breast cancer. A new optical imaging system could help determine which patients with a diagnosis will best respond to chemotherapy. Photo by CristinaMuraca/Shutterstock
Women traditionally undergo a mammogram to determine breast cancer. A new optical imaging system could help determine which patients with a diagnosis will best respond to chemotherapy. Photo by CristinaMuraca/Shutterstock

Feb. 12 (UPI) -- A new optical imaging system can help determine which breast cancer patients will best respond to chemotherapy, according to researchers at Columbia University.

Columbia's Andreas Hielscher developed the system, using red and near-infrared light to predict response to chemo as soon as two weeks after treatment begins, according to findings published Monday in the journal Radiology.


"There is currently no method that can predict treatment outcome of chemotherapy early on in treatment, so this is a major advance," Hielscher, a professor of biomedical engineering and electrical engineering at Columbia Engineering and professor of radiology at the university's Irving Medical Center, said in a press release.

Hielscher, the co-leader of the study, also is a member of the Breast Cancer Program at NewYork-Presbyterian/Columbia University Irving Medical Center.

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Breast cancer is the most common cancer in American women, not counting skin cancers, with 12 percent of women developing it in their lifetime, according to the American Cancer Society.

Neoadjuvant chemotherapy helps eliminate active cancer cells before surgery and is given for five to six months before surgery for some women with invasive, but operable, breast cancer.


"Patients who respond to neoadjuvant chemotherapy have better outcomes than those who do not, so determining early in treatment who is going to be more likely to have a complete response is important," said Dr. Dawn Hershman, leader of the Breast Cancer Program at the Herbert Irving Comprehensive Cancer Center at NewYork-Presbyterian/Columbia. "If we know early that a patient is not going to respond to the treatment they are getting, it may be possible to change treatment and avoid side effects."

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For the study, researchers analyzed imaging data collected from June 2011 to March 2016 for 34 people who had invasive breast cancer. Thirteen patients had active cancerous cells -- called pathologic complete response -- and 21 patients did not obtain a pCR.

The new system is a noninvasive way to measure blood flow dynamics in response to a single breath hold. Doctors position a patient's breasts in the optical system, which does not use compression, unlike a traditional mammogram.

"X-ray imaging uses damaging radiation and so is not well-suited for treatment monitoring, which requires imaging sessions every two to three weeks," Hershman said. "MRIs are expensive and take a long time, from 30-90 minutes, to perform. Because our system takes images in less than 10 minutes and uses harmless light, it can be performed more frequently than MRI."

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With the images, researchers look at blood flow in the breasts, vasculature changes and blood's interaction with the tumor.

"This helps us distinguish malignant from healthy tissue and tells us how the tumor is responding to chemotherapy earlier than other imaging techniques can," Hielscher said.

Various aspects of the blood inflow and outflow can distinguish between patients who respond and those who do not respond to therapy.

In the study, the rate of blood outflow can be used to correctly identify responders in 92.3 percent of patients and the initial increase of blood concentration inside the tumor can be used to identify non-responders in 90.5 of the time.

Hielscher and Hershman are planning a larger, multi-center clinical trial and hope to sell their their technology in three to five years.

"If we can confirm these results in the larger study that we are planning to begin soon, this imaging system may allow us to personalize breast cancer treatment and offer the treatment that is most likely to benefit individual patients," Hershman said.

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