INVASIVE biopsy procedures maybe a thing of the past as new research has emerged in support of ‘virtual biopsies’ to replace invasive clinical biopsies. A multidisciplinary team of radiologists, physicists, oncologists, and computational scientists at the University of Cambridge, Cambridge, UK, have discovered a new advanced computing technique using medical scans that effectively provided more accurate tumour biopsies. By combining CT scans with ultrasound images, a visual guide was generated and allowed doctors to see the complete complexity of a tumour with fewer targeted biopsies.
Patients diagnosed with cancer can be subjected to several biopsies in order to verify the diagnosis and plan for treatment. However, there is an urgent need to not only reduce the quantity of biopsies taken, but also to improve the quality and accuracy of sampled tumour cells via the invasive clinical procedures, especially in patients with ovarian cancer. Early symptoms of high grade serous ovarian cancer can be undetectable, and therefore is often diagnosed at an advanced stage (Stage 3 or 4) with much lower survival rates, which haven’t significantly improved over the last 20 years.
The Cambridge Centre Advanced Cancer Imaging Programme, co–led by Prof Evis Sala, involved a small group of patients diagnosed with advanced ovarian cancer due to have ultrasound-guided biopsies prior to starting chemotherapy. The patients had an initial standard of care CT scan that used X-rays and computing to develop a 3D image of the tumour from several image segments throughout their body.
To identify and map distinct areas and features, the researchers used a process called radiomics. Radiomics utilises intense computing methods to extract further information from detailed images obtained from the CT scanner. The map of the tumour and the ultrasound image of the tumour were merged to create a final image that was used to direct a targeted biopsy procedure. The researchers, using this methodology, were able to successfully record the diversity of the cancer cells within the tumour.
Prof Sala said: “This study provides an important milestone towards precision tissue sampling. We are truly pushing the boundaries in translating cutting edge research to routine clinical care.” Looking to the future, the research team will be carrying out this technique in larger clinical studies.
