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John Boone

Q&A with John Boone, professor of radiology and biomedical engineering at UC-Davis

From the September 2017 issue of DOTmed HealthCare Business News magazine
The University of California-Davis has developed a novel CT scanning technology for breast cancer imaging and is currently in the process of commercializing it under a licensing agreement with Isotropic Imaging. HealthCare Business News spoke to John Boone, who has led the team developing the system, to find out more about how the system was developed and what he thinks ultimately set it apart from other modalities currently on the market.

HCB News: When we think of breast imaging, we usually think of mammography, tomosynthesis, ultrasound, and even MR, before we think of CT. Why is that?
John Boone: Certainly breast CT is one of the newest modalities to be developed for breast imaging. Before 2001 (our first paper in Radiology on this topic), the imaging community thought that CT would have too much radiation dose and insufficient spatial resolution for breast imaging, and that is true using a whole body CT scanner. Several groups around the world, including our group at UC-Davis, have developed dedicated breast CT systems, designed specifically for breast imaging. By imaging the breast alone in the pendent geometry, with a system tailored to breast imaging, both a reduction in radiation dose and an increase in resolution results. Of course, in time, we hope that breast CT will be the first modality that people think of when they think of breast imaging.
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HCB News: What advantages does your system offer in comparison to other breast imaging modalities?
JB: Mammography is the current standard of care, and it is simple, inexpensive, efficient, but lacks sensitivity in women with dense breasts. Tomosynthesis, in truth, offers an improvement in specificity and has its role in both screening and the diagnostic breast examination, but is not a huge leap beyond the performance of mammography.

MRI is at the other end of that spectrum. It is complicated, expensive, and time-consuming, but has excellent sensitivity in finding cancers, and much of this sensitivity can be attributed to the use of injected contrast agent for MRI.

Ultrasound imaging of the breast has experienced renewed interest, but because it is a manual scanning procedure, it is time-intensive, operator-dependent and costly. Ultrasound clearly has a role in the diagnostic breast examination for mass lesions, and the cancer detection rate increases when ultrasound is combined with screening mammography.

Breast CT really falls in-between the extremes of mammography and breast MRI. With contrast injection, we think that breast CT will be equivalent in sensitivity to breast MRI, but because dedicated breast CT scanners will be much less expensive than MRI, and because the breast CT exam is much faster than breast MRI, it offers the benefits of contrast-enhanced breast MRI with much lower cost.

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