The research, conducted in the ongoing MAXIMA project, focuses in particular on enhancing procedures and technologies to detect small and irregular-shaped tumours in dense breast tissue, which are not easy to diagnose using standard breast-cancer-screening techniques. These hidden, early-stage tumours are especially dangerous: diagnosing them early can greatly improve a cancer patient’s chances of recovery and survival.
“Despite recent technological advances such as digital mammography, national screening programmes and the introduction of the computer-aided detection-and-diagnosis systems in clinical routine, detecting cancers hidden in dense breast tissue remains a challenging task,” says the MAXIMA project coordinator Kristina Bliznakova at the Technical University of Varna in Bulgaria. “Unfortunately, contrary to expectations, breast cancer mortality continues to rise in many EU countries, and one of the most important reasons could be related to the limitations of current technology to screen dense breasts.”
Biomedical engineers at the Technical University of Varna, in close collaboration with colleagues from the Katholieke Universiteit Leuven in Belgium and the Università degli Studi di Napoli Federico II in Italy, have set up the MAXIMA research network to address this challenge.
The researchers are developing novel computational models of currently hard-to-diagnose breast tumours. Furthermore, they are creating physical anthropomorphic models, known as phantoms, of breasts and tumours for testing and validation of X-ray imaging techniques, including advanced mammography technologies, such as breast tomosynthesis and phase-contrast imaging.
“To realistically model tumours, we need to know their anatomy, their physical and X-ray characteristics: shapes, absorption and scattering properties. Therefore, we have been segmenting tumours from three-dimensional images enabling us to generate a large database of breast-tumour models which, on completion, will be made available to the whole research community,” Bliznakova says.
The computational models of segmented breast tumours are also being used within MAXIMA to create realistic anthropomorphic phantoms. These physical models of breast tissue and tumours have been developed following an in-depth study to identify suitable 3D printing techniques and materials that will produce accurate imaging results with different X-ray processes.
“Breast phantoms are essential instruments for testing and optimising imaging systems. With our approach, it is easier and less expensive to test different breast-imaging technologies, which will help accelerate the development of optimised imaging, diagnostics and therapy for specific types of breast cancer,” Bliznakova confirms.
From breasts to brains and tortoises
The approach harnesses the project’s development and evaluation of novel simulation software as well as improved 3D printing processes, developed in collaboration with small and medium-sized enterprises that have contributed to new proposals for further research collaboration.
MAXIMA has also played a significant role in the creation of a regional centre of excellence for health in north-eastern Bulgaria, and the establishment of a dedicated simulations laboratory at the Technical University of Varna, which has helped raise the institution’s profile internationally. The project has also improved the scientific and technological capacity of the linked institutions in Bulgaria, Italy and Belgium.
Notably, many of the tools and technologies developed in the project can be applied to other areas of medicine, including the modelling of prostate cancer tumours and the simulation of kidney and brain structures.
Even veterinary care stands to benefit, since the MAXIMA researchers have used their tumour-segmentation software to design a missing part of a tortoise’s shell, which was then 3D printed and attached to the injured reptile.
“MAXIMA has already had a far-reaching impact and continues to produce results,” Bliznakova says. “The project is helping to turn the Technical University of Varna into a true centre for the development of biomedical engineering in the Balkan region.”