Project description
Novel breast imaging for precision medicine
Molecular heterogeneity may be responsible for the partial response to treatment observed in many types of cancer, including breast cancer. Precision medicine approaches should make great strides in solving this issue, but require technologies capable of genomic, molecular and physiological characterisation of the different tumours. Towards this goal, the EU-funded BREAST4D project will develop a novel functional imaging modality based on breast computed tomography. The approach involves the continuous acquisition of X-ray breast CT images for a period of minutes, with very high detail; then, following a radiomics-based analysis, a full identification and characterisation of tumour heterogeneity is achieved. The implementation of this novel modality is expected to improve treatment efficacy and response in breast cancer patients.
Objective
The next major step forward in the fight against breast cancer will be the introduction of personalized treatment. Such a precision medicine approach would maximize the rate of complete response, minimize ineffective therapy and morbidity, and eliminate the need for localized breast cancer surgery.
To achieve this, I will create a novel functional imaging modality, 4D dynamic contrast enhanced dedicated breast computed tomography (4D DCE-BCT), capable of characterizing every different genomic, molecular, and physiologic region present in a breast tumor. 4D DCE-BCT will involve putting together the hardware necessary for the continuous acquisition of x-ray breast projections with advanced techniques, for a period of minutes. Combined with new image reconstruction, correction, and processing algorithms, these acquisitions will result in quantitatively accurate 4D images of breast perfusion, with voxels thousands of times smaller, and a temporal resolution 27x and a limiting spatial resolution 6x higher than those in current imaging modalities. Radiomics-based analysis of these images will allow me to fully identify and characterize the tumor heterogeneity, known to result in regions with different therapy resistance.
Complete characterization of the tumor will allow for optimal neoadjuvant treatment planning, maximizing the probability of achieving pathologic complete response (pCR) and minimizing the risk of recurrence. Due to its relative affordability and safety, the use of 4D DCE-BCT for treatment response monitoring throughout treatment will be possible, making treatment adjustments possible, if needed. Finally, I envision that 4D DCE-BCT will be able to predict and determine that pCR is achieved, making surgery to excise any remnant viable tumor cells unnecessary.
The next era in breast cancer treatment is patient-specific care. The advanced imaging developed and introduced in this project will usher in this new era.
Fields of science
Programme(s)
Funding Scheme
ERC-COG - Consolidator GrantHost institution
6525 GA Nijmegen
Netherlands