https://engineering.wustl.edu/news/Pages/Seeking-to-reduce-biopsies-for-breast-tumors-through-novel-imaging-technology.aspx1003Seeking to reduce biopsies for breast tumors through novel imaging technology<img alt="" src="/news/PublishingImages/Fig.5[1]%20-%20Quing%20Zhu%20Biopsy%20story.jpg?RenditionID=1" style="BORDER:0px solid;" /><div id="__publishingReusableFragmentIdSection"><a href="/ReusableContent/36_.000">a</a></div><p>In American women, breast cancer is the most common cancer and the second-leading cause of cancer death. While routine screening helps to detect breast cancer, existing technology frequently identifies suspicious lesions that turn out not to be cancer. In fact, up to 80 percent of the biopsies performed reveal the suspicious areas are not cancerous.</p><p>A team of scientists at Washington University in St. Louis is evaluating a noninvasive imaging technique that could help radiologists differentiate cancer from benign tumors and thereby significantly reduce unnecessary biopsies, health care costs and stress for patients. Quing Zhu, professor of biomedical engineering in the School of Engineering & Applied Science and of radiology in the School of Medicine, and Steven Poplack, MD, professor of radiology at the School of Medicine's Mallinckrodt Institute of Radiology and a breast-imaging radiologist at the Siteman Cancer Center at Barnes-Jewish Hospital and the School of Medicine, received nearly $2 million from the National Cancer Institute at the National Institutes of Health (NIH) to investigate the technique and its effectiveness over the next five years.</p><p>Zhu uses ultrasound-guided diffuse light tomography, an imaging method that relies on near-infrared light to get a better look at the blood vessels within the suspicious mass. Her unique approach uses a commercial ultrasound transducer and near-infrared optical imaging sensors mounted on a hand-held ultrasound probe. The ultrasound locates the mass in the breast, and optical sensors take images of the total hemoglobin concentration in the mass. Hemoglobin, which is carried by red blood cells, absorbs the near-infrared light. A higher level of hemoglobin raises suspicion for cancer, while lower levels reduce suspicion.</p><blockquote>"What we're targeting is how this technology assists the existing technology, such as X-ray and ultrasound by adding more information to reduce the benign biopsies," Zhu said. "The advantages to this method are that the sensitivities are quite high, but the resolution is not quite as good as other technologies, so our goal is to add functional information to existing technologies to reduce the number of biopsies performed without compromising cancer detection."</blockquote><p>Zhu, a pioneer of combining ultrasound and near-infrared imaging modalities for cancer diagnosis and treatment assessment, and her team recently performed a retrospective study of 288 patients with breast tumors to assess the potential clinical impact of their technique on the decision of whether or not to perform a biopsy. Using a conservative threshold for the total hemoglobin present in the tumors as well as the clinical evaluation by two radiologists, Zhu's team found that the number of referrals for biopsy would have been reduced by 45 percent with the optical imaging technique.<br/></p><p>To test the method, Zhu and Poplack's team is planning a clinical trial that will involve about 300 patients recruited from the Joanne Knight Breast Health Center at Siteman Cancer Center. The patients will have undergone mammograms that have identified suspicious lesions and will be referred for biopsies. When breast tumors are identified through imaging, they are rated on a scale of 2 to 5, with 2 being benign and 5 being highly suggestive of cancer. Biopsies are generally performed on a tumor rated 4 (suspicious) or higher, although the majority of abnormalities that are sent for biopsy are found to be benign.<br/></p><p>"Before the biopsy, these patients will have the ultrasound-guided diffuse light tomography scan," said Poplack, also the Ronald and Hannah Evens Endowed Chair in Women's Health at Barnes-Jewish Hospital. "We'll ask the radiologist to decide how suspicious the tumor is based on conventional imaging, then we'll give them the information from the diffuse light tomography and ask if their assessment changed."<br/></p><p>In addition, a smaller group of patients will undergo conventional imaging <g class="gr_ gr_49 gr-alert gr_spell gr_inline_cards gr_disable_anim_appear ContextualSpelling multiReplace" id="49" data-gr-id="49">then</g> a contrast-enhanced mammogram (CEM), in which patients receive an iodine-based injection prior to mammography. In general, cancerous tumors absorb the iodine-based material more than benign tumors or normal breast tissue. Similar to the adjunctive use of diffuse light tomography, radiologists will determine if their initial assessment changed upon reading the results of the contrast-enhanced mammogram.<br/></p><p>Zhu and Poplack will compare the results of both the ultrasound-guided diffuse light tomography scan and the contrast-enhanced mammogram to determine if either method could be used to eliminate the need for some biopsies and how frequently the two technologies agree.<br/></p><p>"One of the nice things about optical imaging is that you have very objective criteria," Poplack said. "We can calculate the hemoglobin concentration — an objective number — and based on previous experience, establish rules that say below this concentration, the likelihood of cancer is really low, and above this concentration, the likelihood is really high."<br/></p><p>The optical imaging technology presents no harm to patients and is very inexpensive to use, Poplack said.<br/></p><p>"It has a lot of potential and promise as a diagnostic application, and that's why we want to evaluate this technology in a clinical trial," he said.<br/></p><p>The research team includes Mark Anastasio, professor of biomedical engineering in the School of Engineering & Applied Science; Catherine Appleton, MD, associate professor of radiology and chief, section of breast imaging; Matthew Covington, MD, assistant professor of radiology; Ian Hagemann, MD, PhD, assistant professor of pathology & immunology and of obstetrics & gynecology; and Catherine Young, JD, MD, assistant professor of radiology, all at the School of Medicine. <br/></p><p><br/></p><SPAN ID="__publishingReusableFragment"></SPAN><p><br/></p><p><br/></p><span> <div class="cstm-section"><h3>Collaborators<br/></h3><div style="text-align: center;"><div> <br/> </div><div><div><div style="text-align: center;"> <img src="/news/PublishingImages/Zhu_Quing_15.jpeg?RenditionID=3" alt="Mark Anastasio" style="margin: 5px;"/> <br/><span style="caret-color: #343434; color: #343434; text-align: center;"><a href="/Profiles/Pages/Pratim-Biswas.aspx"><strong></strong></a><a href="/Profiles/Pages/Quing-Zhu.aspx"><strong>Quing Zhu</strong></a></span><br/></div></div></div><div style="text-align: left;"><ul style="padding-left: 20px; caret-color: #343434; color: #343434;"><li>Pioneer of combining ultrasound and near infrared (NIR) imaging modalities for clinical diagnosis of cancers and for treatment assessment and prediction of cancers<br/></li></ul></div> <br/> <div style="text-align: center;"> <img src="/news/PublishingImages/Poplack.jpg?RenditionID=3" alt="Mark Anastasio" style="margin: 5px;"/> <br/><span style="caret-color: #343434; color: #343434; text-align: center;"><a href="https://siteman.wustl.edu/doctor/poplack-steven/" rtenodeid="3"><strong></strong><strong>Steven Poplack, MD</strong></a></span></div></div><div style="text-align: left;"><ul style="padding-left: 20px; caret-color: #343434; color: #343434;"><li>Research interest: Breast imaging technology development, breast image-guided interventional technology development, integration of new breast imaging technologies, breast cancer screening<br/><br/></li></ul></div></div></span>This ultrasound image shows a breast mass (at arrow) highly suspicious of cancer. A biopsy revealed ductal carcinoma in situ, the earliest form of breast cancer with low risk of becoming invasive. (Radiology, Aug. 2016) Beth Miller 2019-01-14T06:00:00ZWashU scientists plan to use a new imaging technique to get a better look at breast tumors and reduce unnecessary biopsies.<p>​Up to 80 percent of the biopsies performed reveal the suspicious areas are not cancerous <br/></p>
https://engineering.wustl.edu/news/Pages/partnership-aims-to-advance-innvation.aspx1001New partnership aims to advance innovation in mechanobiology<img alt="" src="/Profiles/PublishingImages/Genin_Guy.jpg?RenditionID=2" style="BORDER:0px solid;" /><p>The National Science Foundation’s Science and Technology Center for Engineering MechanoBiology (CEMB) and the Alliance of Advanced Biomedical Engineering (AABME) have announced a collaboration agreement to mutually support biomedical engineering and linked disciplines including mechanobiology. The CEMB and AABME will leverage their respective networks to inspire interactions and deepen shared knowledge in biomedical engineering, mechanobiology and other related fields. </p><p>Through the partnership, both organizations will connect stakeholders from their communities to foster cross-disciplinary scientific discovery. They will mutually encourage technical and instructional networking among scientists, engineers <g class="gr_ gr_26 gr-alert gr_gramm gr_inline_cards gr_run_anim Punctuation only-ins replaceWithoutSep" id="26" data-gr-id="26"><g class="gr_ gr_26 gr-alert gr_gramm gr_inline_cards gr_run_anim Punctuation only-ins replaceWithoutSep" id="26" data-gr-id="26"><g class="gr_ gr_26 gr-alert gr_gramm gr_inline_cards gr_run_anim Punctuation only-ins replaceWithoutSep" id="26" data-gr-id="26">and</g></g></g> technicians. Each organization will also highlight information and events from their partner, and they will rely on each other to recruit and link subject matter experts through panels, technical meetings, web platforms and other avenues for scientific exchange.</p><p>“This is a unique opportunity to leverage a major international organization to broaden the impact of our work,” said Guy Genin, co-director of CEMB at WashU. “We are excited to build this partnership with AABME and ASME.” </p><p>“Emerging areas of biomedical engineering are an important focus at ASME, especially for areas, like mechanobiology, where we need to enable a future workforce,” said Christine M. Reilley, director of business development in healthcare at ASME. “We are thrilled to have CEMB working with us to engineer solutions to the most pressing healthcare challenges of our times.” <br/></p><p>AABME, the American Society of Mechanical Engineers’ (ASME) bioengineering initiative, aims to stimulate biomedical innovation by bringing together and providing resources for the biomedical engineering community. AABME is a forum for engineers, biologists, clinicians, scientists <g class="gr_ gr_28 gr-alert gr_gramm gr_inline_cards gr_run_anim Punctuation only-ins replaceWithoutSep" id="28" data-gr-id="28"><g class="gr_ gr_28 gr-alert gr_gramm gr_inline_cards gr_run_anim Punctuation only-ins replaceWithoutSep" id="28" data-gr-id="28"><g class="gr_ gr_28 gr-alert gr_gramm gr_inline_cards gr_run_anim Punctuation only-ins replaceWithoutSep" id="28" data-gr-id="28">and</g></g></g> researchers striving to advance human health. CEMB is a multi-institutional network based at the University of Pennsylvania, Washington University in St. Louis and several other university partners. The CEMB aims to embolden the study of mechanical forces in molecules, cells, and tissues in plants and animals. </p><p><g class="gr_ gr_23 gr-alert gr_spell gr_inline_cards gr_run_anim ContextualSpelling ins-del multiReplace" id="23" data-gr-id="23"><g class="gr_ gr_23 gr-alert gr_spell gr_inline_cards gr_run_anim ContextualSpelling ins-del multiReplace" id="23" data-gr-id="23"><g class="gr_ gr_23 gr-alert gr_spell gr_inline_cards gr_run_anim ContextualSpelling ins-del multiReplace" id="23" data-gr-id="23">AABME’s</g></g></g> goal to connect key players in the bioengineering arena intersects with CEMB’s goal to stimulate innovation and create a new generation of scientists within the field of mechanobiology. <br/></p><p>To learn more about the two institutions and the scientific fields they support, visit <a href="https://aabme.asme.org/">aabme.asme.org</a> and <a href="https://cemb.upenn.edu/">cemb.upenn.edu</a>.<br/></p>Guy Genin, Harold and Kathleen Faught Professor of Mechanical Engineering2019-01-10T06:00:00ZThe Center for Engineering MechanoBiology and the Alliance of Advanced Biomedical Engineering will work to foster cross-disciplinary scientific discovery.<p>The Center for Engineering MechanoBiology and the Alliance of Advanced Biomedical Engineering will work to foster cross-disciplinary scientific discovery.<br/></p>
https://engineering.wustl.edu/news/Pages/rudy-named-to-national-academy-of-inventors.aspx1000Rudy named to National Academy of Inventors<p>​The National Academy of Inventors (NAI) Fellows Program highlights inventors who demonstrate a “prolific spirit of innovation.” <br/></p><img alt="" src="/Profiles/PublishingImages/Rudy_Yoram.jpg?RenditionID=2" style="BORDER:0px solid;" /><p>This year's picks from Washington University in St. Louis are nothing if not prolific.</p><p>Between them, <a href="/Profiles/Pages/Yoram-Rudy.aspx">Yoram Rudy</a>, of the School of Engineering & Applied Science, and <a href="https://pathology.wustl.edu/directory/jeffrey-gordon-md/">Jeffrey I. Gordon</a>, MD, of Washington University School of Medicine in St. Louis, have published nearly 780 papers in peer-reviewed journals and hold more than 30 patents.</p><p>Last year, <a href="https://medicine.wustl.edu/news/medical-school-faculty-named-national-academy-inventors/">three faculty members were inducted into the NAI</a>. Other NAI fellows at Washington University include Chancellor Mark S. Wrighton, Provost Holden Thorp <g class="gr_ gr_31 gr-alert gr_gramm gr_inline_cards gr_run_anim Punctuation only-ins replaceWithoutSep" id="31" data-gr-id="31">and</g> Jennifer K. Lodge, vice chancellor for research.</p><p>Gordon and Rudy will join the more than 145 new fellows in April when they will be inducted officially at a ceremony to be held at the <a href="https://academyofinventors.org/annual-meeting/">Eighth NAI Annual Meeting</a> in Houston.<br/></p><h2>Yoram Rudy</h2><p>Rudy's inventions have changed the way cardiologists measure deadly irregular heartbeats. His labs noninvasive, painless cardiac imaging technology, electrocardiographic imaging (ECGI), led to the CardioInsightTM device and related technologies. Together, these innovations work to provide more detailed heart rhythm information than standard lead EKGs without the need for — or risks associated with —  catheter placement.</p><p>In 2015, Medtronic acquired CardioInsight Technologies, Inc, a non-invasive cardiac electrical mapping system that enables better patient outcomes and reduced cost of delivery of care by improving diagnosis, evaluation and personalized treatment planning for patients with cardiac arrhythmias. The CardioInsight Mapping Vest captures cardiac electrophysiological data non-invasively from a patient, and the CardioInsight Workstation combines CT scan data with data from the vest to create personalized, 4-D cardiac maps.</p><p>Rudy is the Fred Saigh Distinguished Professor of Engineering and also a professor of biomedical engineering at the School of Engineering & Applied Science. He also holds appointments in medicine, cell biology & physiology, radiology and pediatrics at the School of Medicine. Beyond his teaching duties, he serves as the director of the Cardiac Bioelectricity and Arrhythmia Center.</p><p>After earning a master's degree in physics from the Technion in Haifa, Israel, Rudy went on to study medicine and then earn a <g class="gr_ gr_34 gr-alert gr_gramm gr_inline_cards gr_run_anim Punctuation multiReplace" id="34" data-gr-id="34">PhD</g> in biomedical engineering from Case Western Reserve University.</p><p>In 2004, he joined Washington University. He has been a visiting professor in computational medicine at Oxford University since 2014.</p><p>Rudy holds eight <g class="gr_ gr_35 gr-alert gr_gramm gr_inline_cards gr_run_anim Punctuation only-del replaceWithoutSep" id="35" data-gr-id="35">patents,</g> and is a member of the National Academy of Engineering of the United States of America. He has received numerous awards for his innovations, including the National Institutes of Health Merit Award, the Biomedical Engineering Society Distinguished Lectureship Award, and the Heart Rhythm Society Distinguished Scientist Award.<br/></p>FUSEhttps://fuse.wustl.edu/two-faculty-members-named-national-academy-of-inventors-fellows/?_ga=2.7716786.1018925473.1546871913-1457637254.15458368552019-01-08T06:00:00ZYoram Rudy was one of two WashU faculty members named to the National Academy of Inventors this year.<p>Yoram Rudy, along with a faculty member from the School of Medicine, were named to the National Academy of Inventors. <a href="https://fuse.wustl.edu/two-faculty-members-named-national-academy-of-inventors-fellows/?_ga=2.7716786.1018925473.1546871913-1457637254.1545836855">>>Read the full article</a><br/></p>
https://engineering.wustl.edu/news/Pages/Flu-virus-is-a-master-shape-shifter.aspx994In the media: Flu virus is a master shape-shifter<img alt="" src="/news/PublishingImages/media%20hit.jpg?RenditionID=1" style="BORDER:0px solid;" /><p>​An influenza virus infecting a single cell can produce offspring with a wide variety of shapes, maximizing the virus’s chance of escaping attack by antiviral therapies.</p>Antibodies and vaccines target proteins on the surface of a viral cell. But the flu virus can quickly swap out one set of proteins for another, making the virus notoriously difficult to track and treat.<div><br/>Michael Vahey at Washington University in St Louis, Missouri, and Daniel Fletcher at the University of California, Berkeley, developed a strain of the flu virus and attached fluorescent markers of a specific colour to each type of the virus’s surface proteins. The researchers infected cells with this virus and allowed it to replicate for one generation — this ensured there was not enough time for significant genetic mutation to occur. The cells produced viral particles with a vast assortment of marker combinations, suggesting that the virus can assemble different structures without undergoing genetic mutations.<br/><br/></div><div>New antiviral therapies could be designed to target more than one surface protein and thus more effectively treat the flu virus, the authors say. <br/><br/></div><div>Cell (2018)<p><br/></p></div><span> <div class="cstm-section"><h3 style="margin-top: 0px; font-family: "open sans", sans-serif; font-size: 1.34em; text-align: center; border-bottom-width: 1px; border-bottom-style: solid; border-bottom-color: #b0b0b0; padding-bottom: 12px;">Michael Vahey<br/></h3><div style="caret-color: #343434; color: #343434; text-align: center;"> <img src="/Profiles/PublishingImages/Vahey,%20Mike.jpg?RenditionID=3" alt="" style="margin: 5px;"/> <br/></div><div style="caret-color: #343434; color: #343434;"><ul><li>Assistant Professor<br/></li><li>Research: Developing imaging methods and microfluidic technologies to understand infectious diseases, with an emphasis on studying how viruses like influenza A navigate and shape their hosts in order to replicate.<br/></li></ul><p style="text-align: center;"> <a href="/Profiles/Pages/Michael-Vahey.aspx">View Bio</a></p></div></div></span><br/>Influenza particles (artificially coloured) swap the proteins on their surfaces with ease. Credit: Eye of Science/SPLNaturehttps://www.nature.com/articles/d41586-018-07583-82018-12-20T06:00:00Z​Cells infected with the versatile pathogen churn out viral particles with many different shapes.<p>​Cells infected with the versatile pathogen churn out viral particles with many different shapes. <a href="https://www.nature.com/articles/d41586-018-07583-8">>> Read the full article on Nature</a><br/></p>
https://engineering.wustl.edu/news/Pages/Edging-closer-to-personalized-medicine-for-patients-with-irregular-heartbeat.aspx992Edging closer to personalized medicine for patients with irregular heartbeat<p>​In 2015, then President Barack Obama launched a precision medicine initiative, saying that its promise was "delivering the right treatments, at the right time, every time to the right person." A biomedical engineer at Washington University in St. Louis has answered the call by making a significant step toward precision medicine for patients with a life-threatening form of irregular heartbeat by determining in which patients a commonly used drug treatment would be most beneficial. <br/></p><img alt="" src="/news/PublishingImages/iStock-818783862.jpg?RenditionID=1" style="BORDER:0px solid;" /><div id="__publishingReusableFragmentIdSection"><a href="/ReusableContent/36_.000">a</a></div><p>​Jonathan Silva, associate professor of biomedical engineering in the School of Engineering & Applied Science, was part of an international team that determined which patients would benefit the most from a commonly used drug treatment.<br/></p><p>The results of the research are published online in <em>Circulation Research</em> Dec. 18.<br/></p><p>Silva teamed with lead author Wandi Zhu, a doctoral candidate in his lab, and collaborators from the University of Pavia in Italy. Together, they investigated the efficacy of the drug mexiletine on patients with a genetic mutation that <g class="gr_ gr_54 gr-alert gr_gramm gr_inline_cards gr_run_anim Grammar multiReplace" id="54" data-gr-id="54">cause</g> Long QT Syndrome Type 3, a disorder that arises from the heart's inability to properly repolarize, leading to irregular heartbeats — or arrhythmia. The drug has been given to Long QT Syndrome patients for <g class="gr_ gr_52 gr-alert gr_gramm gr_inline_cards gr_run_anim Grammar only-ins doubleReplace replaceWithoutSep" id="52" data-gr-id="52">decade</g> but was ineffective, sometimes even harmful, for a majority. Silva's team wanted to learn why.<br/></p><p>Traditionally, researchers have only been able to look at certain variables in the heart. The approach by Silva's lab was to create a statistical model that connected the variable properties of a patient's phenotype, or the physical expressions of a genetic trait. Using fluorometry, a technique that measures changes in a fluorescent molecule's environment, they understood the nanoscale interaction of mexiletine within the heart's sodium channel.<br/></p><p>"What that told us was there was one part in particular, in the Domain III voltage-sensing domain, that was really correlated to the drug effect," Silva said. "While theories before us had linked the regulation of drug block to a certain conducting state of the channel, we tied it to a particular part of the channel. This improved understanding of how the channel works and how this part affects drug block allowed us to make this prediction on whether or not patients would respond."<br/></p><p>To test their theory, Silva and his team looked at 15 different mutations from patients who were diagnosed with Long QT 3 syndrome and found a very strong correlation with one of the sodium channel's electrical gates known as the Domain III <g class="gr_ gr_43 gr-alert gr_spell gr_inline_cards gr_run_anim ContextualSpelling ins-del multiReplace" id="43" data-gr-id="43">voltage sensing</g> domain, but not with the traditional variables that are used.<br/></p><p>"That gave us a lot of confidence that the domain three voltage-sensing domain is controlling the patient's response to the drug," he said.<br/></p><p>The team then applied its theory to blinded data of eight patients from the Priori group in Italy. When Silva's team members sent their predictions back to the researchers, they discovered they had predicted correctly for seven of the eight patients.<br/></p><p>Next, the team plans to conduct a larger clinical trial of its method.<br/></p><p>"Now that we have strong evidence that this part of the channel is regulating the drug block, we want to use a similar approach for a much larger set of patients," he said. "We want to see if we can take these methods that are applicable to a rare disease and use a similar approach to understand how commonly prescribed drugs affect more common arrhythmias."<br/></p><SPAN ID="__publishingReusableFragment"></SPAN><p> Zhu W, Mazzanti A, Voelker T, Hou P, Moreno J, Angsutararux P, Naegle K, Priori S, Silva J. "Predicting Patient Response to the <g class="gr_ gr_41 gr-alert gr_spell gr_inline_cards gr_run_anim ContextualSpelling ins-del multiReplace" id="41" data-gr-id="41">Antiarrythimic</g> Mexiletine Based on Genetic Variation: Personalized medicine for Long QT Syndrome." <em>Circulation Research</em>, Dec. 18, 2018. <a href="https://www.ahajournals.org/doi/10.1161/CIRCRESAHA.118.314050" style="background-color: #ffffff;">https://www.ahajournals.org/doi/10.1161/CIRCRESAHA.118.314050</a>.</p><p>This research was supported by AHA Predoctoral Fellowship 15PRE25080073 (WZ) and NIH R01 HL136553 (JRS), NIH R01 HL126774 and AHA Postdoctoral Fellowship 18POST34030203 (PH), and Training Grant T32 HL007081 (JM).<br/></p> <br/> <div>​<br/> <div class="cstm-section"><h3>Jonathan Silva<br/></h3><div style="text-align: center;"> <strong><a href="/Profiles/Pages/Jonathan-Silva.aspx"><img src="/Profiles/PublishingImages/Silva_Jon.jpg?RenditionID=3" alt="" style="margin: 5px;"/></a><br/> </strong> </div><div style="text-align: center;"> <ul style="text-align: left;"><li><span style="font-size: 1em;">Associate Professor</span><br/></li><li><span style="font-size: 1em;">Expertise: Cardiac Arrhythmia, Molecular Imaging, Engineered Cardiomyocytes, Computational Models, Augmented Reality</span><br/></li></ul><p><a href="/Profiles/Pages/Jonathan-Silva.aspx" style="font-size: 1em; outline: 0px;">View Bio</a></p></div></div></div>Beth Miller 2018-12-18T06:00:00ZBiomedical engineer Jon Silva led an international team that determined which patients would benefit the most from a commonly used drug treatment. <p>​Biomedical engineer Jon Silva led an international team that determined which patients would benefit the most from a commonly used drug treatment. <br/></p>