Local doctor tests new diagnostic tool

Elasticity imaging correctly identified 17 out of 17 malignant lesions.
By WILLIAM K. ALCORN
VINDICATOR STAFF WRITER
BOARDMAN -- Led by Dr. Richard G. Barr, radiologists at Southwoods X-ray and Open RMI here found that in preliminary studies a new ultrasound technique, called elasticity imaging, could eliminate the need for many breast cancer biopsies.
Developed by Siemens Ultrasound in California, elasticity imaging -- basically a computer software program that runs on a standard ultrasound machine -- can distinguish between cancerous and noncancerous breast lesions, said Dr. Barr, of Campbell.
The ability to tell the difference between malignant and benign lesions is important in limiting the number of breast biopsies because, according to the American Cancer Society, 80 percent of breast lesions biopsied are found to be benign.
"Siemens came to us to move elasticity imaging into being useful clinically, and I believe we have done that," Dr. Barr said. "If our results can be reproduced in a large, multicenter trial, this technique could significantly reduce the number of breast biopsies required."
Dr. Barr presented the findings of the elasticity imaging research Monday at the annual meeting of the Radiological Society of North America in Chicago.
Dr. Barr is a professor of radiology at Northeastern Ohio Universities College of Medicine in Rootstown and a partner in Radiology Consultants, the group that owns Southwoods X-ray and Open RMI at 250 DeBartolo Place.
Accuracy
In an interview, Dr. Barr said elasticity imaging correctly identified cancerous and harmless lesions in nearly all of the cases studied locally over the last three years.
Radiologists here used the elasticity imaging technique in correlation with a routine ultrasound exam to study 166 lesions identified and scheduled for biopsy in 99 patients. Ultrasound-guided biopsies were performed on 80 patients with 123 lesions. The biopsies showed that the elasticity imaging correctly identified all 17 malignant lesions and 105 of the 106 benign lesions, Dr. Barr said.
While mammography is the standard breast cancer screening exam, screening with magnetic resonance imaging (MRI) or ultrasound may be more effective for high-risk patients or women with dense breast tissue. MRI and standard ultrasound depict more breast lesions than mammography, but are less effective at distinguishing benign from malignant lesions, resulting in a high number of invasive biopsies, according to the American Cancer Society.
With elasticity imaging, cancerous lesions, which are stiffer or harder tissue, create a larger image than the less stiff and softer noncancerous lesions, said Dr. Barr, an adjunct assistant professor of chemistry at Youngstown State University. He is also a staff radiologist, director of ultrasound and breast imaging, and co-director of the vascular laboratory at Forum Health Western Reserve Care System.
Multinational trial
Dr. Barr said elasticity imaging will be tested over the next year in a multinational trial in which 2,000 patients scheduled for biopsies will be pretested with regular ultrasound and elasticity imaging, and then the results compared.
"We'll be working at sites in London and Paris, and five centers in the United States, including Southwoods," Dr. Barr said. "The hope is that we can confirm the accuracy of the elasticity imaging, recently approved by the Federal Drug Administration, in a large test so that physicians and radiologists and patients have confidence in the process.
"If the large trial confirms our work here, it looks very promising that elasticity imaging will be a big new tool in the toolbox for diagnosing cancer," he said.
alcorn@vindy.com