Mass General researchers use metabolomic imaging to accurately diagnose tumors
Pathology laboratories may soon find it possible to identify prostate cancer without a biopsy. A new technology under development at Massachusetts General Hospital demonstrates the potential to improve the accuracy of prostate cancer diagnosis. Some studies have demonstrated that nearly a quarter of initial biopsies of the prostate gland may generate false-negative results because the biopsy specimen failed to extract cells from existing cancerous tumors.
To improve the detection of prostate cancer, researchers at Massachusetts General Hospital (MGH) are investigating a new technique that may give doctors a way to locate even small tumors and to provide an accurate determination of a prostate tumor’s prognosis without using a biopsy.
In a report published in the January 27 online issue of Science Translational Medicine, the MGH researchers say they are using spectroscopic analysis of the biochemical makeup of prostate glands to map the location and size of prostate tumors. Though the technique is still in the developmental stage, they hope to move the technique to clinical trials within two years.
The study’s senior author is Leo L. Cheng, M.P.P., Ph.D., who is Assistant Professor of Radiology and Pathology at Harvard Medical School. He works in the MGH Imaging and Pathology departments.
In the published study, researchers described how metabolomic imaging utilizing a clinical magnetic resonance scanner helped them locate tumors in prostate glands previously removed from cancer patients.
The research builds on a 2005 study in which Cheng and his colleagues found that magnetic resonance spectroscopy could distinguish prostate cancer from benign tissue. Using a malignancy index extracted from the spectroscopy information, researchers were also able to more accurately forecast of a tumor’s prognosis than traditional pathology studies.
According to an abstract of the new study on the Science Translational Medicine website, “This calculated malignancy index is linearly correlated with lesion size and demonstrates a 93 to 97% overall accuracy for detecting the presence of prostate cancer lesions, suggesting the potential clinical utility of this approach.”
An article in the February 1 issue of Science Daily quoted Cheng, saying, “Collectively analyzing all the metabolites measurable with a 7-Tesla MR scanner maps out prostate cancer in a way that cannot be achieved by any other current radiological test or by analyzing changes in a single metabolite. It detects tumors that cannot be found with other imaging approaches and may give us information that can help determine the best course of treatment.”
Pathologists will recognize how this technology may radically change the way prostate cancer is diagnosed. It could significantly reduce the need for a prostate biopsy and perhaps eventually make the procedure obsolete. Current estimates are that about one million prostate biopsies are done each year in the United States. Prostate biopsies represent a significant part of the test volume for many clinical pathology laboratories. A significant decline in the number of prostate biopsies collected annually would dramatically alter the work flow and revenue base for many pathology laboratories.