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futurity_medicine 00608.txt

#3d scan quickly shows if chemo kills liver cancer New 3d scans of liver cancer quickly show if chemotherapy is working, precisely measuring living and dying tumor tissue, researchers report. The findings are the first roof of principlethat 3d MRI technology accurately measures tumor viability and death. Researchers hope to prove that the technology, when used before and after chemotherapy, is faster and better than current tools for predicting patient survival. Liver cancer kills nearly 20,000 Americans each year, and is much more prevalent outside the United states, where it is among the top-three causes of cancer death in the world. ur high-precision 3d images of tumors provide better information to patients about whether chemoembolization has started to kill their tumors so that physicians can make more well-informed treatment recommendations, says Jean-Francois Geschwind, interventional radiologist at Johns hopkins university and the project senior scientist. A series of studies involved 140 patients with either primary liver cancers or metastatic tumors that were caused by cancers spreading from elsewhere in the body. The patients underwent chemoembolization, chemotherapy aimed directly at a tumor. Dead and live tissue Unlike standard methods to assess tumor response, based on two-dimensional images and tumor size, the 3d technology distinguishes between dead and live tissue, giving an accurate assessment of tumor cell death. The new technology builds on standard two-dimensional imaging and uses computer analytics to evaluate the amount of so-called contrast dye absorbed by tumor tissue. The dye is injected into patients before their MRI scan to enhance image production. Researchers say live tissue will absorb more dye than dead tissue, affecting image brightness, which can also be measured for size and intensity. Geschwind, a professor of radiology, says that knowing the true extent of tumor response to chemoembolization is particularly important for patients with moderate to advanced disease, whose liver tumors might initially be too large or too numerous to surgically remove. In the first study, researchers compared the standard imaging method and the newly developed technology in 17 Baltimore men and women with advanced liver cancer. All were treated with surgery or liver transplantation after chemoembolization. Low error margin The research team used existing MR analysis techniques as well as the new 3d method, to compare the radiologistsanalyses with pathologic review of tumor samples after therapy and surgical removal. The error margin of the new 3d image analysis, they say, was low (at up to 10 percent) when predicting the amount of dead tumor tissue found by pathologists. The standard 2d method deviated by as much as 40 percent from actual values. In a series of additional studies, researchers used the standard and new imaging techniques to analyze the MRI scans of more than 300 liver tumors in some 123 other men and women also from the Baltimore region. All patients were treated at Johns Hopkins Hospital between 2003 and 2012, and each received pre-and post-chemoembolization MRI scans to assess the effects of therapy on the tumors. The 3d technology improved accuracy removes a lot of the guesswork that now goes into evaluating treatment outcomes, Geschwind says. The new assessment takes seconds to perform, he adds, so radiologists can provide almost instantaneous treatment advice. Geschwind and colleagues plan further software refinements to the new approach before training more physicians to use it. He also plans to study how it can affect treatment decisions and whether these therapy choices help people live longer. The software used in the MRI scans was developed at Johns Hopkins and at Philips Research North america. The findings were presented at a recent San diego meeting of the Society of Interventional Radiology. The french Society of Radiology, Philips Research North america, the National institutes of health, and the Rolf W. Günther Foundation for Radiology and Radiological Sciences helped support the study. Source: Johns Hopkin J

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