In medical science’s battle against cancer, malignant tumors of the pancreas are a major challenge.
Part of the problem comes down to location. The pancreas is obscured within the body’s viscera and doesn’t yield to inspection the way other sites do, making early detection difficult. The organ also sits atop numerous blood vessels. With pancreatic cancer’s biological tendency to spread, this provides an easy route to colonize distant parts of the body.
As a result, pancreatic cancer is often discovered late, after symptoms arise and the disease has spread. Only about 7% of patients with the disease survive five years after diagnosis. In recent memory, it has claimed the lives of prominent figures such as technology baron Steve Jobs and beloved "Jeopardy!" host Alex Trebek.
“We have lost so many good people,” said Syed Rahmanuddin, M.B.B.S., assistant research professor of diagnostic radiology and head of the 3D Oncologic Imaging Center at City of Hope. “The cure is important, but so is early diagnosis. If we diagnose patients in the early stages, treatment is more likely to be successful.”
With this very motivation at heart, Dr. Rahmanuddin is spearheading a new initiative to establish the National Pancreatic Cancer Imaging Repository at City of Hope. Starting with 3D images of the institution's own patients and state-of-the-art software, he intends to build out a library with data from tens of thousands of patients. This cache will become a key resource that pancreatic cancer researchers can use to advance studies encompassing early detection and much more.
An in-depth view
The imaging repository is shaped by City of Hope’s facilities and expertise.
The suite of precise 3D imaging technologies includes the computed tomography (CT) scan, with a computer assembling signals from a rotating X-ray beam into cross-sections of the body, and the magnetic resonance imaging (MRI), which eliminates any radiation dose by using radio waves and strong magnetic fields to see inside the body.
Dr. Rahmanuddin leaps from interrogating structure with those technologies to gaining insight into cellular functions through a technique called perfusion imaging.
Because pancreatic cancer cells show a revved-up metabolism even compared to other tumor types, taking multiple images in the first few minutes after a dye is introduced can help profile the cancer’s activity. This functional information, extending imaging into the fourth dimension, is one source of clues in Dr. Rahmanuddin’s investigations into how the disease can be discovered before damage is done.
To gather all this data into a usable form, the repository will employ an advanced picture archiving and communication system, enabling secure storage and remote retrieval of images and associated data.
Building up the repository is a team effort, connecting Dr. Rahmanuddin with other experts at City of Hope and the Translational Genomics Research Institute, an Arizona-based affiliate of City of Hope, including William D. Boswell, M.D., chair and professor of diagnostic radiology at City of Hope; Yuman Fong, M.D., City of Hope’s Sangiacomo Family Chair in Surgical Oncology; Pejman Motarjem, M.D., assistant clinical professor of diagnostic radiology at City of Hope; and Daniel D. Von Hoff, M.D., distinguished professor at TGen.
The launch of the imaging repository is made possible through seed funding awarded by City of Hope’s provost and chief scientific officer, Steven T. Rosen, M.D. He sees this early boost as an investment with a potentially huge payoff.
“Syed is a very talented investigator, and his three-dimensional constructions of organs have great possibilities to help us understand disease progression and response to therapy,” said Dr. Rosen, who is also City of Hope’s Irell & Manella Cancer Center Director’s Distinguished Chair and Morgan & Helen Chu Director’s Chair of the Beckman Research Institute. “This project fits in beautifully with our ultimate goals of providing the finest care for patients and their families while making discoveries that benefit all of humanity.”
Potential for a new paradigm
In addition to the thousands of images in City of Hope’s library, talks about potentially contributing to the repository are underway with more than a dozen cancer research institutions around the world.
The National Pancreatic Cancer Imaging Repository may help drive progress against a disease for which advances are urgently needed. Dr. Fong, who chairs the steering committee for the initiative, believes that it could fundamentally alter how some researchers tackle pancreatic cancer, shifting from studies that each query a single hypothesis to explorations that mine big data for a far more complex approach.
“The future of cancer research is going to be built on having repositories of images like this,” said Dr. Fong, who is professor and chair of surgery at City of Hope. “It’ll be exciting to be able to ask a lot of questions, more universally, and tying the images to genomics and other data at the cellular level is where we’re going to find the most discoveries.”