Next generation breast cancer care

By applying PET technology to a standard mammography machine, UW startup PET/X hopes to streamline the treatment process for breast cancer patients, knocking out costs and side effects along the way.

Passion never rests

Every year, nearly 300,000 women are diagnosed with breast cancer — and that’s in the U.S. alone. Some of these women — daughters, mothers, sisters, friends — are able to catch — and eradicate — the disease early. Others aren’t so fortunate; others go through weeks, months, even years of trying one wildly expensive, side effect-riddled treatment after another in search of the one that will work.

Larry MacDonald

Dr. Larry MacDonald

Enter PET/X, a UW startup cofounded by Dr. Paul Kinahan and Dr. Larry MacDonald that’s on a mission to streamline the treatment process for breast cancer patients and not only save them time and money, but more importantly, from suffering. Thanks to PET/X’s positron emission tomography (PET) scanner add-on — which slips onto a standard mammography machine — a far more accurate look at the disease and the efficiency of its treatments is on its way. That means finding that one treatment that will work could happen in a matter of days — a drastic improvement from weeks or months.

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PET/X was one of 18 startup companies to spin out of CoMotion, the UW’s collaborative innovation hub, in 2014, setting a new record for the number of UW startups launched in a single year. PET/X is a current resident of the CoMotion Incubator in Fluke Hall on UW campus, and has received financial support from the Coulter Foundation, the Small Business Technology Transfer Fund and the CoMotion Innovation Fund, a partnership between CoMotion and the Washington Research Foundation.

“Mammography is a good screening tool,” says Larry, research associate professor of radiology. “It does a very good job at capturing an anatomical picture and has led to earlier cancer detection, which is important for effective treatment. But when we started this project, we were looking at developing breast PET imaging that would fill niches that weren’t being met.” One of those niches was assessing therapy in early-stage breast cancer, which whole body scanners have a hard time catching. The solution? Coupling high-resolution PET imaging with the current screening model — mammography — and making it user-friendly enough that it can be used at a standard breast-imaging clinic without the need of a specialized technologist.

Paul E. Kinahan

Dr. Paul E. Kinahan

“PET, which looks at molecular activity, is able to measure the change in the tumor biology much earlier than the tumor changes size or shape,” says Larry. To determine the success of the chosen treatment in a patient, a baseline PET image is taken after the diagnosis but before the first micro-dose of the chosen treatment is administered. A few days later, another PET image is taken. “If the signal has changed, that’s indicative of a response,” says Larry. And if the signal — which shows on the image as bright spots — hasn’t changed, that means the treatment isn’t working, and they can quickly move onto the next option before putting the patient through unnecessary therapy, which is not only costly, but oftentimes has harrowing side effects which can range from nausea, vomiting and fatigue to cardiac disease and organ toxicity.

The project has been more than five years in the making, but by the end of 2015, the PET/X team hopes to see the prototype in action on its first patients. “We believe this is going to make a difference in both the short term and the long term for breast cancer, and we’re fortunate that we’re able to work with great clinical colleagues in oncology and radiology that believe this, too,” says Paul, professor of radiology. “As we go along and see that this really can work, everybody is getting more excited and even more driven to complete it. It’s been really wonderful to be part of it.”


PET_X_PET_SCAN

What is a positron emission tomography (PET) scan?

A PET scan is an imaging test that helps reveal how your tissues and organs are functioning. To obtain the image, a radioactive drug tracer is injected, swallowed or inhaled, and collects in areas of the body that have higher levels of chemical activity, which often points to disease. On a PET scan, the chemical activity (a tumor, in breast cancer’s case) shows up as bright spots. If the chosen treatment is working, the bright spots will diminish. If not, they’ll grow. The PET/X image couples the high-resolution PET scan with a mammogram.


PET_X_MAMMOGRAM

What is a mammogram?

A mammogram is an X-ray image of the breast used to screen for breast cancer. Low energy X-ray beams pass through the breast, and are absorbed in different amounts depending on the density of the material they pass through. Dense materials, such as bone — and in this case, tumors — absorb more of the radiation and show up as white.