Device May Aid Diagnosis of Tumors
Lon Slane knows the statistic: Four of every five women who have biopsies on potentially cancerous breast tissue do not have cancer.
He knows some women with questionable mammograms delay treatment, advised to wait awhile to see what develops.
He knows that doctors - and insurers - would like to find better solutions.
As president of Dilon Technologies Inc., a start-up Williamsburg company developing a new imaging system to help diagnose malignant tumors, Slane thinks he might have one.
"I hate to think of women going through these traumatic, expensive events when they don't have to," Slane said, "and we want to catch this disease as early as we can."
Dilon is working in partnership with the Thomas Jefferson National Accelerator Facility and the University of Virginia to develop the camera device, now about to be tested on breast cancer patients at U.Va.'s hospital. If the imager works, Dilon is planning to build a manufacturing facility in Newport News, possibly in 1999, to produce them.
The device will use nuclear medical imaging, existing technology that allows doctors to pinpoint cancerous tissue. Nuclear imaging of the breasts is known as scintimammography.
To find a tumor, doctors inject a radioactive tracer substance into the patient. The substance accumulates at a higher rate in malignant tissue, which appears as a dark spot on the image.
Scintimammography is gaining acceptance in hospitals locally and nationwide. It typically costs about $300 to $600 - less than the $800 to $3,000 for biopsies - and appears promising for women with dense breast tissue, scar tissue from earlier surgeries or implants that make mammograms difficult to read.
But scintimammography has its critics, and its limits. Cameras currently in use are large and bulky, allowing doctors to take images from limited angles. That can make seeing certain tumors difficult, such as smaller types or those growing tight against the chest wall.
"It can be tough. It can be really hard to tell how deep the lesion is," said David Teates, a radiology professor at the U.Va. Health Services Center who specializes in nuclear medicine.
Dilon's as-yet unnamed device, using technology licensed from Jefferson Lab, has a 3-foot-high body with a camera on an arm that can be maneuvered close to the patient at different angles.
Teates won't begin testing the Dilon device on breast cancer patients until later this month, but he recently tested it on a thyroid cancer patient.
"I could see detail that I couldn't see on standard cameras," he said. "That's exactly what we're looking for in breast cancer patients."
Teates said a possible drawback is that the camera may not be big enough for women with larger breasts. "It may need some reworking there," he said.
Slane, who started his company in 1996, hopes the device will be able to detect tumors as small as 4 millimeters in diameter. Mammography X-rays usually can't go smaller than 7 millimeters, and current nuclear imaging cameras usually no smaller than 1 centimeter, he said.
"Mammography will still be the best screening tool, but if possible abnormalities show up, then we should use it to decide the next step - which may or may not be a biopsy," he said. "The diagnostic accuracy of X-rays is just not very good."
The American Cancer Society estimates that about 180,200 new cases of breast cancer are diagnosed each year in U.S. women and 1,400 cases in men. The disease is the second leading killer of American women, after lung cancer.
In 1995, 15 million mammograms were done in the United States, according to ACS statistics. Five percent resulted in biopsies. Doctors figure those numbers will increase, as the American population grows older, and more women get mammograms younger.
Dilon Technologies currently operates out of Slane's home with a handful of employees and consultants. This month, Slane hopes to move operations to the new Applied Research Center in Newport News, next to Jefferson Lab.
Dilon also has an agreement with the city to build a 25,000-square-foot manufacturing facility in the Jefferson Center for Research and Technology, a business park under development near the research center. He plans to sell each device for roughly $100,000 - about the same as an X-ray mammogram but less than other nuclear imaging devices, he said.
Slane said he hopes to build the plant in about 18 months. He did not disclose the number of new jobs that would be available, but Newport News officials are optimistic.
"It's very promising," said Fred Paris, marketing manager for the Newport News Economic Development Authority. "It's exactly the type of research and development jobs that we're after."
Dilon, Jefferson Lab and U.Va. together won a $75,000 grant from the state's Center for Innovative Technology to develop their product. Slane said he hopes to work with local hospitals that are using scintimammography to test and distribute the device.
Slane also hopes the device will work for other cancer patients, perhaps helping doctors see how far the disease has spread through lymph nodes. "Breast cancer is just the first thing we're working on," he said.