Overview

Techniques such as computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET) have provided true breakthroughs in the diagnosis and management of cancer over the last 20 years. Before then, physicians relied on simple touch, X-rays and highly invasive exploratory surgery.

Mayo Clinic has long recognized the potential of imaging technology, and the Cancer Imaging Program works across Mayo departments and divisions as well as within the Cancer Center, to discover and develop new imaging technologies and to use existing technology in revolutionary new ways. Notable accomplishments of the Program include development and exploration of imaging technologies relevant to cancer detection such as MR elastography, CT colonography and breast molecular imaging and establishment of new projects in the area of image-guided tumor therapy.

The annual plans of the National Cancer Institute, published each year with the title "The Nation's Investment in Cancer Research" have repeatedly identified developments in imaging science and technology as "Extraordinary Opportunities for Investment."

This assessment reflects the widening role and future promise of imaging technologies in diagnosis and treatment of cancer and in basic cancer research. Developments in imaging now allow some tumors to be detected long before they are apparent by physical examination. Tissue-characterization techniques and image-guided biopsy methods and image-based staging have virtually eliminated "exploratory" surgery for cancer diagnosis and staging, which was common only a few decades ago. Imaging technology has also had a steadily increasing role in monitoring the effectiveness of medical and surgical cancer therapy, providing targeting information for ablative treatments, and for post-treatment surveillance.

In basic research, ever more powerful non-invasive imaging technologies are now being used to provide in vivo measurements of parameters as diverse as tumor angiogenesis, cellular morphology, tumor metabolism, and gene expression.

The goals of the Program are to:

• Discover and develop new imaging technologies for detecting and managing cancer
• Assess new and existing imaging technologies through clinical research
• Facilitate the integration of state-of-the-art imaging techniques into research and oncologic practice at Mayo Clinic Cancer Center

Cancer Imaging Program researchers focus on four primary themes:

• Advanced Imaging Technology Development — new opportunities in cancer imaging have often hinged on the development of new technologies such as ultrasonography, computed tomography, positron emission tomography, and magnetic resonance imaging. These advances result from basic imaging research involving physics, mathematics, and biomedical engineering. This area of research is one of the specific areas of strength of the Mayo program.
• Imaging For Cancer Detection — translational/clinical research activities that focus on both new and existing imaging technology. Active research programs have pioneered innovative imaging-based screening techniques for lung and colorectal cancer. New molecular imaging techniques in breast cancer (novel camera design) and multiple myeloma and prostate cancer (novel NIS imaging in measles virus treatment trial) are also products of this Program.
• Image-Guided Cancer Therapy — imaging for cancer management at Mayo includes multiple clinical protocols studying various methods for image-guided focal tumor ablation. A group of investigators is pursuing clinical research to develop minimally-invasive image-guided tumor ablation, using radiofrequency and other techniques. An expanding program is devoted to investigate a novel method for non-invasive tumor ablation via MRI-guided, high-powered focused ultrasound. Other projects at the preliminary stages include investigations of tumor-avid radioablation agents, MR imaging techniques for improved staging and treatment planning for prostate cancer, and improved methods for using PET imaging to assess treatment success (early response assessment with FLT PET).
• Imaging Informatics — images are not the final product in medical imaging. Rather, the desired result is information, which is obtained by analysis and interpretation. The importance of advancing this aspect of cancer imaging is recognized by continuing to specifically designate imaging informatics as a focus of activity in the imaging research program. Current research activities in this area are directed at developing methods for tumor segmentation and visualization in 3D data sets, quantitative image analysis, and computer aided-image interpretation. The rapidly-progressing movement to electronic information management in the clinical practice and the shift away from film-based medical imaging has prompted an increasing level of research activity in the areas of image databasing, compression, quantitative aspects of electronic image display, and image perception.