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It's not exactly X-ray vision but many experienced radiologists can see more than 100 shades of gray — a "superhuman" level of sight that helps them pick out tumors in a mammogram. But even with that "power" and the latest digital mammography machines that show thousands of shades of gray, it is still difficult to pick out all of the potential tumor spots because they look so similar to healthy areas.

To help, Dr. Andrew F. Laine, associate professor of radiology and biomedical engineering, and colleagues are wrapping up a multi-year project to develop a digital mammography "spellchecker." Dr. Suzanne Smith, associate professor of clinical radiology, Dr. Edward Nickoloff, professor of clinical radiology, and Yinpeng Jin, one of Dr. Laine's doctoral students, collaborated with him to develop the computer-aided diagnostic tool that points out early lesions that may turn out to be cancerous.

"Many lesions are observable in a radiograph, but they are very subtle. We hope to reduce the number of missed lesions with our approach," says Dr. Laine, who is also director of the Heffner Biomedical Imaging lab. The tool allows radiologists to focus or "hunt" for possible lesions in various views of the mammogram, from coarse to fine levels of detail. Dr. Laine and his lab staff use digital image processing techniques to tear images apart into more simple components, fine tune them and "glue" them back together, resulting in clearer images while retaining the original's wealth of information.

The effort to improve mammography led Dr. Laine and Dr. Smith, director of the Breast Imaging Center at Columbia, into exploring other technologies. They worked with a company, Dobi of Mahwah, N.J., to develop a prototype machine that uses optical imaging, a technique that shines light through tissues enabling detection of blood flow and rates of profusion.

The machine first gently squeezes the breast, to push blood out of the tissue, and takes multiple, near real-time images as it releases the pressure and allows blood to flow back into the tissue. The machine can measure which parts of the tissue receive more blood, such as tumors, because the hemoglobin in blood absorbs light.

The technology has some advantages over X-rays because it does not send radiation into a patient and is more comfortable than a traditional mammogram. It is especially helpful for detecting tumors that are close to the rib cage, which are difficult to ascertain in an X-ray because the bone and tumors both show up as white areas, Dr. Laine says.

Dr. Laine's interdisciplinary projects are fruits of the closer ties that Dr. Philip O. Alderson, James Picker Professor and chairman of radiology, and Dr. Van C. Mow, Stanley Dicker Professor of Biomedical and Orthopedic Bioengineering and chairman of Biomedical Engineering, helped forge between their respective departments in the 1990s. Many of the biomedical engineering faculty members, including Dr. Laine, have joint appointments in radiology and offices in Morningside and Washington Heights to bring them closer to clinicians and basic science researchers.

"We are interested in imaging structures at the molecular, cellular, tissue, and organ levels of analysis. We're working on cutting-edge, interdisciplinary problems of medicine with the goals of early diagnosis, better treatment protocols, and imaging-based therapies," Dr. Laine says.

The research was funded by the U.S. Army and the Whitaker Foundation.

—Matthew Dougherty


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