Generally, when you go to a physician, they're
answering two basic questions are they re detecting disease, which is often screening
procedure like mammography and the other one is a diagnosis question, that is, is there
something going on, is this a problem or not. So what we re going to deal with mostly is
the diagnostic question. They would sense an abnormality and they were try to figure
out whether it s a dangerous condition or not.
What's happen in recent years, a lot of new information about how the body controls
cancer growth as come to be understood.
We understood from a long time ago that generally they ways cancer begins is, go through life
are about DNA starts to accumulate mistakes and these mistakes turn on oncogenes and these
oncogenes produce uncontrolled growth in the cells. People have known that for a long time.
What's knew, what they haven t known till recently is that the microenvironment around
these cells are the epigenetic factors how important they are. And that generally determines
whether cells actually develop into a dangerous tumor or not. So what happens is that the genetic
factors that we re interested in are generally biochemistry surrounding a cell and also surprisingly
for some, the biomechanical environment surround a cell. So, you can think of cells like children
and they're on a playground, which are like monkey bars and the monkey bars are the extracellular
matrix of the cells crawl through on the way to their job. The hands on the cells, we can
think of them as sensors, not only are they grabbing on, but they're feeling the environment
that they're in. And that happens is that if this environment is normal, then the cells
are quite happy. They re all stretched out on their little matrix and they re feeling
quite good about things there and they re in homeostasis. If the environments too soft,
then they actually start to ball up and they die and that's because they're not in the
right environment that they experience, but interestingly if the environment because too
stiff, like with inflammation, and these are normal cells, then typically what happens
is the cells will, through the focal adhesion points, they'll be a cascade of events and
the cells will start to produce proteins that react to the problem at hand. So this is a
very normal sort of responsive cells, if they re normal cells. The things would healing
inflammation. But then what happens if these are cancer cells, in which the oncogenes are
turned on, then the stiffening environment turns on the oncogenes even harder and that
makes the cells pull harder and that turns the oncogenes on harder, so there's a positive
feedback. People are understanding that this is the environment in which cells start to
progress into a tumor at that point. What people discovered is that women who have dense
breasts generally means that they have a high density of extra cells in the matrix and glandular
tissue are four to six times more likely to develop breast cancer in their lifetime. So
the mechanical environment of these cells is very important and elasticity imaging can
measure that and sense that. 0:03:26.469,0:03:23.400 This really an extension of something that s been used for thousands of years. It was when medicine began.
The Ancient Greeks discovered something called
palpation and it's used today in a clinical exam where a physician will put their hands
on a patient and feel for lumps. It's the first line of defense a lot of times in a
lot of breast cancer cases. What we do with ultrasound is we use the ultrasonic signal
to basically do palpation but with much higher sensitivity and with some spacial resolution.
So that we can show physicians an image and this image will then have the ultrasound image
which is the structure of the breast tissue. We can turn on a dopler where we can look
at blood flow techniques and then we apply the elasticity imaging technique in perfect
registration and that shows us the stiffness. It turns that if you have a malignancy versus
a benign tumor, the malignancy will extend much larger than what you see on an ultrasound
image on a mammogram and that extension is the desmoplastic reaction that tells the physician
that there's something extra going on that could be malignancy. If it's a benign condition,
they're about the same size. That's a really nice clinical feature that people use.
The other thing that we re beginning to look at, which we're very excited about is can we track
the progress of tumor while it s being treated and we think this is another area and we've
just begun a joint project with the people across the street at Provena, in the cancer
center there. Where human and pathologists and radiation physicist to look at some of
our cell structures and decide whether we can track the progress of radiation therapy using this method.
Well, from a patient's point of view, I think patients would like
this procedure quite a bit because we can use normal ultrasound equipment and we don't
have change really the way, from a patient's point of view, it appears that we re scanning
the tissue. The way we ve been using it in a clinical environment is a patient has an
abnormality, the physician has decided that they should have a biopsy. So they use ultrasound
generally to do the needle biopsy, and while they are doing that procedure, we just acquire
data for our methods. So it s low cost, there's not a brand new technology that s required.
It s mostly how to use ultrasound in new ways that makes it more effective.