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January 28, 2014
Breakthrough scanning know-how that may map a affected person's whole physique can reveal the place most cancers is affecting the bones and information docs in selecting therapies, new analysis reveals.
The new kind of magnetic resonance imaging (MRI) may enhance look after a kind of most cancers referred to as myeloma and scale back reliance on bone marrow biopsies, which could be painful for sufferers and infrequently fail to point out docs how far the illness has unfold.
The analysis can be revealed within the journal at this time (Tuesday) radiology and was carried out by researchers from the Institute of Cancer Research, London, and the Royal Marsden NHS Foundation Trust.
It was funded by Cancer Research UK and the National Institute for Health Research Clinical Research Facility in Imaging, with further funding from the EPSRC.
The new diffusion-weighted whole-body MRI scans confirmed the unfold of most cancers all through the bone marrow of sufferers with myeloma - some of the widespread types of blood most cancers - extra precisely than customary checks. The scans additionally confirmed whether or not the sufferers have been responding to most cancers therapies.
In the research, diffusion-weighted whole-body MRI scans have been carried out in 26 sufferers earlier than and after remedy. In 86% of the instances, skilled imaging docs have been capable of appropriately inform whether or not sufferers have been responding to remedy. Doctors additionally appropriately recognized the sufferers who 80% of the time didn't reply to remedy.
The scanning method allowed docs to pinpoint precisely the place the most cancers was within the bones and the outcomes have been obtainable instantly. Common checks embrace bone marrow biopsies and blood checks, however none of them present precisely the place the most cancers is current within the bones.
The researchers additionally assessed the seen adjustments on the MRI scans with a measurement referred to as the Apparent Diffusion Coefficient (ADC), which data how restricted the motion of water is in tissues. Changes on this measurement appropriately recognized remedy responses in 24 of 25 myeloma sufferers.
The new scan was capable of reveal most cancers in virtually all bones within the physique, with solely the cranium partially troublesome to picture as a result of frequency of steel implants and fillings. The researchers additionally discovered that the brand new strategies are appropriate for extra sufferers than conventional checks; for instance, bone marrow biopsies have been carried out in seven sufferers, however their specimens have been discovered to be insufficient for evaluation. Performing one other biopsy could be traumatic and painful and will not present any new data.
Professor Nandita deSouza, Professor of Translational Imaging on the Institute of Cancer Research and Honorary Consultant at Royal Marsden, mentioned: “This is the first time that we have received information from all bones in the entire body for myeloma in one scan without relying on individual bone x-rays. It allows us to measure the involvement of individual bones and track their response to treatment.
“The results are immediately visible; We can look at the screen and immediately see where the cancer is and how severe it is. The scan is better than blood tests that don't tell us which bones the cancer is in. It also reduces the need for awkward biopsies that do not reveal the extent or severity of the disease. "
Dr. Faith Davies, Member of the Myeloma Targeted Treatment Team at the Institute of Cancer Research and Honorary Consultant at Royal Marsden, said: “Myeloma can affect bones anywhere in the body, which is why this study is so important. We have shown that whole-body MRI scans can closely monitor how myeloma patients are responding to treatment so doctors can make better informed decisions. With this new scan, if a treatment doesn't work, the patient can be switched to new therapies that may be effective much faster.
“This is a small study, so our next step will be to try and refine the technology on more patients. We hope this new tool will help doctors extend the lives of more myeloma patients in the future. ”
Julia Frater, Senior Cancer Information Nurse at Cancer Research UK, mentioned: “It's really important to find better ways to monitor how patients respond to treatment, especially in the case of myeloma, where bone marrow collection can be painful. This research shows how advanced imaging technology could provide a “snapshot” of the complete skeleton to observe the response of tumors in particular person bones. Finding methods to make therapies extra light and enhance the affected person expertise is a significant focus for Cancer Research UK and the analysis we fund. "
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For extra data, contact the ICR press workplace on 020 7153 5380 / [email protected]. For inquiries exterior of enterprise hours, please contact Claire Bithell, Head of Media Relations of the ICR, on 07969 082 520.
Notes for editors
Nearly 4,700 folks within the UK are recognized annually with myeloma, a illness that impacts plasma cells within the blood. These cells develop uncontrollably within the bone marrow and get caught there, disrupting regular blood cell manufacturing. Affected bones could be distributed all through the physique, together with the cranium, ribs, vertebrae, and the bones within the legs and arms.
The obvious diffusion coefficient is a quantitative measure of the unintentional thermal motion of water protons inside tissues. In tumors, water motion is extra restricted as a result of their excessive cell density restricts the motion of extracellular water.
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