Collaborating with other thought leaders in the field of advanced imaging, Kromek is working towards the common goal of improving early breast cancer detection for women with dense breasts; developing technology with life-saving potential.
Breast cancer unfortunately affects many families. Early detection helps to save lives, yet it has become very evident that traditional screening based on mammography misses too many cancers in women with dense breasts, which could be up to 40% of women. The cancer tumours are not always clearly visible within the bright, cloud-like structures that appear on the image of a dense breast taken during mammography.
Other supplemental screening modalities, such as MRI or contrast-enhanced mammography (CEM), perform much better at detecting tumours in dense breasts. However, they still come with important barriers including high cost, limited access, allergic reaction risks from contrast agents and logistics issues that slow down large-scale screening.
Molecular Breast Imaging (MBI) has advanced into a powerful complementary screening option for women with dense breasts. Instead of relying on anatomical information, MBI highlights the actual behaviour of cancer cells. Tumours “light up” as they absorb more of the radiotracer injected into the patient’s bloodstream, thus revealing the tumours that are often hidden when using traditional mammography, as shown in the image on the right:
Clinical research shows that combining MBI with mammography increases detection by a factor of 4 compared to mammography alone [1-2]. That means more cancers are found earlier, when treatments are most successful and lives are more likely to be saved.
The positioning of the breast in an MBI scanner is similar to a mammography procedure, and clinicians who have worked with MBI so far indicated that interpreting the scans is relatively straightforward.
The radiotracer used in MBI (99mTc sestamibi) has an excellent safety record, with virtually no medium or severe adverse reactions ever reported across tens of millions of scans performed yearly worldwide.
In contrast, the data on the adverse reactions in the contrast-enhanced techniques, particularly CEM, presents a different picture. While the occurrence of such reactions is low percentwise (a few moderate and less than one severe reaction per 1000 examinations), these figures scale up quickly when applied to millions of women needing the supplemental screening.
Despite its strong clinical performance, MBI has not yet reached widespread adoption in Europe or the UK. Scan times have been longer than mammography, and the radiation dose—while still within screening limits—was higher than decision-makers preferred.
Currently, there are two FDA (USA) approved MBI scanners. It has been adopted by several selected hospitals and practices mostly in the USA but remains largely overlooked elsewhere despite its strong clinical performance.
This is due to two major limitations:
Those barriers are what Kromek has set out to remove by introducing the novel Ultra-Fast MBI technology
In 2018, Kromek launched a project, partially funded by Innovate UK, in collaboration with world-leading partners at University College London and Newcastle Upon Tyne Hospitals NHS Foundation Trust to design an MBI system that is faster, has a lower dose and is suitable for national screening programmes.
The project is led at Kromek by our Principal Physicist Alexander Cherlin, and has resulted in the development of a new, disruptive imaging technology with the potential to overcome current limitations of MBI – the Ultra-Fast MBI, or UFMBI™ [3].
This next-generation technology is built on advanced CZT detector design and smarter imaging methods. The result is a disruptive technology that:
The team are targeting a 7-8 fold improvement in overall system performance, combining dose and time reductions that remove the traditional adoption barriers [4].
We believe every woman deserves the best chance at early detection, regardless of breast density. Ultra-Fast, Low-Dose MBI is how we help make that possible.
As with Kromek’s other detectors used in medical applications, CZT (Cadmium Zinc Telluride) is also a key element of the UFMBI technology. Compared to other common room temperature semiconductors such as Silicon or Gallium Arsenide, CZT is much more efficient at detecting the incoming flux of photons from nuclear medicine radiotracers. Lower doses of radiation are needed to produce the images, therefore, the patients undergoing screening or diagnostic tests are exposed to less radiation. This reduces the risks of radiation exposure, keeping patients as safe as possible.
Furthermore, CZT helps to produce more accurate results to increase confidence in any diagnoses made. This is beneficial not only in early breast cancer detection, but also in the diagnosis of osteoporosis and cardiac conditions.
The UFMBI utilises the latest Kromek detector technology: ultra-high resolution 3D position sensitive CZT detectors. The technology is based on using a machine learning model trained on high fidelity simulated data to process raw pixellated detector data and obtain interaction position with a precision exceeding the physical pixel size by a factor of five or more. More information about the technology can be found in [5].
Across the world, clinical communities are recognising that women with dense breasts deserve supplemental screening. From major initiatives like the US Find It Early Act to the UK BRAID trial, there is growing momentum behind more equitable and personalised breast cancer care.
Kromek’s Ultra-Fast MBI aligns with this movement by giving imaging centres a powerful new tool without the drawbacks of contrast-based techniques. It combines:
Ultra-Fast MBI represents a chance to rewrite the breast cancer screening story for millions of women. Detecting disease when it is still small, reducing anxiety, allowing clinicians to act faster and with greater confidence. That is what better technology should deliver.
To learn more about partnership opportunities or our upcoming trials, connect with our team.
Kromek was featured on BBC Look North with our chief executive, Arnab Basu, explaining how prototype breast imaging technology developed in partnership with Newcastle Hospitals, Newcastle University and University College London (UCL) could improve the detection of cancer in dense breasts.
The prototype of a new machine that can detect tumours in women with dense breast tissue has been developed in Newcastle.
Kromek attended the 6th Workshop on Medical Applications of Spectroscopic X-ray Detectors (SpecXray), hosted by CERN. Here, our collaborator Dr. Thomas Zillhardt from the University of Manchester showcased our joint progress in our funded Quantum Digital Tomosynthesis (QDT) project.
Dr. Deborah Rhodes of Mayo Clinic gives a fascinating talk on the limitations of breast cancer detection in dense breasts, and the potential of MBI and CZT to overcome this
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