New test for breast tumors: Water ultrasound imaging seems as accurate as mammography

Detroit Free Press (MCT) - You're lying face down on a massage table, your breast encased in a water bath through an opening in the table. Tiny ports from a surrounding ring fire ultrasound waves. There are no X-rays. There is no pain. There is no holding still for 20 minutes or more.

And in the time it takes to finish reading this paragraph, you will have safely and cheaply completed a high-definition, 360-degree mammogram, courtesy of an ultrasound imaging machine in experimental stages at the Karmanos Cancer Institute. Its inventors think it will soon become the preferred method for detecting and monitoring breast tumors.

The machine is still in trials, but so far, its developers at Karmanos and Wayne State University report its ability to detect tumors is as good as mammography, traditional ultrasound and potentially MRIs. It's called Computerized Ultrasound Risk Evaluation, or CURE.

For breast cancer patient Lesley Glenn, 39, of Detroit, those seconds in the CURE machine provided a moment of peace in a cancer battle that started in late June. A lump in her right breast proved to be a malignant, advanced tumor.

"It just felt like you were soaking in the bathtub. It's like when you go to a spa, you know, and sit in a hot tub," she said.

Glenn, who is still undergoing chemotherapy, is one of 240 metro Detroit women in Karmanos' first clinical trial for CURE. The premise was simple: Can CURE's hands-free ultrasound image provide the same quality as mammograms, traditional ultrasounds and MRIs?

"It stood up pretty well," said Dr. Peter Littrup, a Karmanos radiologist and CURE co-inventor. The results were so promising, he said, that the team is applying for approval from the Food and Drug Administration for the machine. They hope to have it within six months. Meanwhile, they are trying to commercialize the product.

"It's a one-stop full evaluation for breast diagnosis and follow-up," he said.

The data is quickly ready for a radiologist to interpret, and because CURE is inexpensive, pain-free and radiation-free, Littrup said it can be used more often than other imaging methods to watch tumors, even weekly.

A decade ago, the machine was just sketches, a plan to deal with shortcomings in cancer detection, he said. Current imaging methods miss about 15 percent of tumors, said Neb Duric, professor and project director for CURE at Karmanos Cancer Institute.

In women with dense breasts, who are more likely to get breast cancer, the false negative rate jumps to 50 percent. False positives are a problem too, he said, and sometimes lead to unnecessary biopsies.

For women at higher risk of cancer, doctors may suggest yearly mammograms as early as age 30, he said, and for most women, yearly exams begin at age 40. While a mammogram doesn't use a large amount of radiation, it's still 10 extra years of exposure, he said.

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For Detroiter Deborah Shavers, 59, who is also in the trial, there is a more mundane benefit to CURE.

"There was no pain whatsoever. I hope it becomes the norm for people coming to have a mammogram. They hurt," she said.

Shaver's Karmanos oncologist, Dr. Amy Weise, who is not involved in developing CURE, said the most important thing about any new technology is accuracy. It has to be as good or better than what it's trying to replace.

"We do need new imaging modalities," she said. "I'm anxious to see what the results of the clinical trial are."

Duric and Littrup are also examining the role of CURE in monitoring whether chemotherapy is working to reduce the size of tumors. Right now, MRI is the most revealing technology, but it is very expensive. An MRI machine and its maintenance costs millions, said Duric. They expect CURE to sell for about $400,000.

"That's where we eventually want to go, but you have to crawl before you walk," said Littrup.

Duric believes the low cost and low maintenance will make CURE an inexpensive way to conduct large-scale breast cancer screenings as part of public health projects.

Glenn was anxious before the procedure, but she said the water ultrasound was "way less uncomfortable" than a standard mammogram.

Glenn has 2 ˝ months of chemotherapy left, but she's hopeful.

"I hope the Lord will bless me with good health. You never know if it will come back," she said.

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© 2008, Detroit Free Press.