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Physicians Update

 
Summer 2009

Advanced Imaging Techniques Aid Cancer Diagnosis, Treatment

07/22/2009

Advanced ImagingAs researchers and clinicians continue to expand the limits of what can be done to effectively diagnose and treat cancer, the role of experts in radiological sciences is increasing.

“People who are diagnosed with cancer are living much longer, and it is now more important than ever that we provide a fully integrated, multidisciplinary approach to manage the disease from diagnosis to staging to therapy to therapy-response monitoring,” says Jonathan Goldin, M.D., Ph.D., chief of radiology at UCLA Medical Center, Santa Monica and vice clinical chair in the UCLA Department of Radiology.

UCLA Medical Center, Santa Monica is well positioned to take this leading role, with a full spectrum of advanced diagnosis and treatment modalities. In addition to radiologists and radiotherapists, patients are evaluated and treated by experts that include medical oncologists, pathologists and surgical oncologists, as well as by oncology support staff who address both psychosocial and clinical aspects of cancer care.

Imaging studies and image-guided biopsies play a major role in the diagnosis and staging of tumors. These genetic profiles are a major evolution in the field of cancer diagnosis and a unique feature of UCLA’s program, Dr. Goldin says. Pathologists and radiologists at UCLA have established a partnership to produce an integrated report of their diagnostic findings, and the two departments also plan to open a specialized radiology-pathology outpatient center within the year.

A similar collaborative relationship exists between the Department of Radiology and the Department of Molecular and Medical Pharmacology. Clinicians from each department independently review all cancer-related positron emission tomography–computed tomography (PET-CT) studies performed at UCLA Medical Center, Santa Monica and together produce an integrated profile featuring metabolic and anatomic findings.

Beyond diagnosis, radiologists are also using PET-CT and magnetic resonance imaging (MRI) to evaluate therapeutic response. Previously, three to six months of cancer treatment was often needed before reduced lesion size became evident. Now, highly sensitive PET-CT technologies enable radiologists to detect treatment response based on changes in cell function long before significant changes in tumor size become apparent. This enables clinicians and patients to make earlier decisions regarding future therapeutic strategies.

Imaging TechniquesProgressive treatment options available to oncology patients include minimally invasive, image-guided interventional-radiology procedures, which provide important therapeutic benefits with fewer side effects. These procedures include thermal ablation and cryoablation, which kill cancer cells by heating or freezing them, and embolization, which targets cancer cells by infusing a chemotherapeutic agent directly into the tumor and by blocking its blood supply. A new protocol incorporates the radioactive isotope Yttrium-90 (Y-90) to treat primary and metastatic liver tumors. Using the radioembolization technique, the Y-90 compound delivers a high local dose of cancer-killing radiation from within the hepatic artery.

“Using image-guided ablation and embolization techniques, we can precisely map the tumor location and focus the therapy so that we target cancer cells while minimizing collateral damage to nearby healthy tissues,” explains Christopher Loh, M.D., director of Interventional Radiology at UCLA Medical Center, Santa Monica. He says these procedures are very effective in reducing tumor size, which helps to improve quality of life for patients who are not candidates for surgical intervention. They also are used to prepare patients for curative surgeries.





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