Piercing the body with precision

How imaging is aiding the fight against cancer

Bill Snyder
Published: February, 2006

Dennis E. Hallahan, M.D., chairman of Radiation Oncology at Vanderbilt University Medical Center, adjusts a plastic frame that holds the head still during treatment using an image-guided radiation therapy system. The system, called Trilogy, is made by Varian Medical Systems.
Photo illustration by Dean Dixon
The scalpel is giving way to the scan—at least in some cases of cancer.

New imaging technologies are raising hopes that doctors soon will be able to locate tumors with pinpoint accuracy, and track their hour-by-hour response to treatment—without the need for surgery.

Coupled with recent advances in genetics and molecular biology, imaging is speeding the discovery and evaluation of safer, more effective treatments that can stop tumors in their tracks.

“In the past 10 years we’ve made tremendous strides in improving imaging of cancer,” says Dennis E. Hallahan, M.D., chairman of Radiation Oncology at Vanderbilt University Medical Center. “In the near future we will be using functional imaging to image pre-cancer.”

At Vanderbilt, for example, a sophisticated technique called dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is being tested in women with breast cancer.

The goal: to see whether new “targeted” therapies are shrinking tumors by disrupting their blood supplies. If successful, the technique could avoid the need for repeat biopsies, says Tom Yankeelov, Ph.D., director of Cancer Imaging in the Vanderbilt University Institute of Imaging Science.

“Particularly in breast cancer there’s currently no adequate, some would say there’s no non-invasive method at all, to determine whether or not a tumor is responding to treatment,” Yankeelov says.

“It’s really a sad state of affairs,” he says. “Repeat biopsies are not really an option because you have to go under the knife each time—who wants to do that?”

In addition, “biopsies by definition only sample a portion of the tumor. It is entirely possible that you could sample a section of tissue that is free of active disease and miss the sections that are actively proliferating.

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