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The future of breast cancer diagnosis

Posted by: , Posted on: - Categories: National Physical Laboratory (NPL)

As the UK’s National Metrology Institute, the National Physical Laboratory (NPL) provides the measurement capability that supports the UK’s prosperity and quality of life. NPL is leading the way in providing the measurement science that underpins research and development within the healthcare sector and is committed to tackling some of the world’s biggest health challenges.

Earlier this year, NPL, in partnership with HM Treasury, hosted a series of Innovation Webinars to showcase the untapped and exciting innovative science and technology residing in the UK’s public sector and how it can be harnessed to boost UK industry. Nearly 400 people attended across the series and links to the recorded webinars can be found on our events page.

One example of ground-breaking innovation showcased was a pioneering ultrasound breast imaging system, developed by Professor Bajram Zeqiri, an NPL Fellow in Ultrasound and Head of Science for the Medical and Marine Physics. Here Professor Zeqiri explores his team’s journey in developing this innovative new technology:

In the UK, around 1,000 women die every month from breast cancer. Through the National Breast Screening programme, 3 million women are annually invited for X-Ray mammography (XRM), but the technique has issues particularly with younger women whose breast density is high. Of the 3 million invited for screening, only around 75% of women accept which could be partly due to the discomfort of the compression procedure.

Like all cancers, early and accurate detection and diagnosis increases survival rates and leads to significantly lower treatment costs. Inaccuracies in current screening methods means only 20% of suspicious mammograms reveal cancer. These scans naturally trigger further tests with over 90,000 unnecessary biopsies per year being carried out. There is therefore a need for more specific diagnostic methods able to diagnose cancers accurately in order to reduce the number of biopsies, coupled with more effective population screening methods, particularly for younger women. In cost terms, the annual cost to the NHS due to false positives is estimated to be £38m with each case individually costing £1,800.

To support earlier diagnosis and treatment of breast cancer, I led a team at NPL in developing a research platform for imaging breast tissue, using Ultrasound Computed Tomography (UCT). The platform works by transmitting ultrasonic waves through the breast, which are then detected by novel NPL-developed sensors resulting in maps of ultrasound attenuation in tissue. It is well established that cancers have higher ultrasonic attenuation than background breast tissue, making them readily detectable.

Using the laboratory platform, we have proven that UCT using the new NPL sensors creates quantitative images of breast phantoms mimicking inclusions such as cysts and malignant cancers. Our UCT system generates near artefact-free maps of the attenuation coefficient of simple test objects. The first in-person studies of ultrasound attenuation have recently been completed.

In comparison to XRM, this new technology is less invasive, more comfortable and, completely safe as it eliminates risks associated with exposure to ionising radiation. The new technology is also game changing in many ways, its quantitative nature will support the efficient use of AI to compare scan results with the reference library of images linked to known pathologies and other clinical data, promising fewer false positives and improved diagnostic confidence. Additionally, due to its safety and operator independence, it could be deployed at a range of sites, clinical and non-clinical.

This research is important to the future of breast cancer diagnosis and patient outcomes, helping the NHS to increase the proportion of patients diagnosed at stages 1 and 2 from 50% to 75% by 2028 as set out in the NHS’ Long Term Plan. Our technology can support delivery of the new faster diagnosis standard (due in 2020), developed to ensure most patients receive a definitive diagnosis or ruling out of cancer within 28 days of referral, as well as supporting an integrated approach to care as an integral tool for NHS Rapid Diagnostic Centres.

The research platform continues to be studied and is currently being used to optimise the imaging technique. This will establish ways in which the clinical performance of any eventual device could be improved. We are currently connecting with appropriate partners in order to access funds to build a Mark II version of our breast imaging system which will be used for clinical trialling. This will gain important evidence of the clinical potential of the system (for measurement on real cancer sufferers with a range of clinical conditions).

NPL is committed to supporting the government’s drive to make the UK a great place to work and do business, unleashing new innovative ways of building, making and doing things. All underpinned by the confidence measurement science provides.

The expertise found within science laboratories across the country is driving ground-breaking research and development and is a driving force in helping the UK become a leading science superpower.

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