Could Field Cycling Imaging be the next frontier in breast cancer detection?
A medical imaging prototype, termed Field Cycling Imaging (FCI), recently hit the headlines for detecting breast tumor material more accurately than current imaging methods. In this interview, we speak with Lionel Broche (University of Aberdeen, UK), who is leading the development and industrialization of this innovative technology.
FCI is a new and specialist type of low-field MRI scan pioneered in Aberdeen. The FCI scanner follows in the footsteps of the full body MRI scanner, also invented at the University around 50 years ago which has gone on to save millions of lives around the world.
Broche discusses how FCI technology can measure the dynamics of water and lipid molecules non-invasively, its potential impact in the diagnosis and treatment of different cancer types as well as opportunities for healthcare institutions to get involved in trials involving FCI.
Could you explain how FCI technology works and how it differs from existing imaging methods in detecting cancer spread?
FCI derives from MRI, but it has the particularity to change the main magnetic field rapidly during the image acquisition, typically within 10–30 ms. This allows measuring the T1 relaxation time of tissues over a wide range of magnetic fields, our latest generation of FCI scanner reaches between 200 mT and 0.2 mT. This is not something that can be done with conventional MRI technologies, so we had to revisit most of the design rules to create FCI systems.
The interest of this approach resides in the fact that the variations of T1 with the magnetic field, also termed the T1 NMR dispersion, are directly related to the molecular dynamics of the compounds that generate the signal. Studying the T1 NMR dispersion profile therefore informs us about the dynamics of water and lipids in the tissues, and hence tissue remodeling processes. Using this, FCI can characterize molecular dynamics with time scales ranging from milliseconds down to hundreds of nanoseconds, which is not accessible by other MR methods to date.
In particular, FCI research in cancer shows signals that are linked to the activity of aquaporins, a trans-membrane protein that is overexpressed in cancer cells and is responsible for the transport of water through the cell membrane [1, 2]. Their activity modifies the dynamics of water, which is visible from FCI at least in breast cancer and brain glioma. These are recent findings and the results from collaborations with other research groups (University of Torino in Italy and INSERM U1205 in France), showing a real potential for FCI technology in cancer.
What cancer types have FCI scanners been tested on so far and are there plans to expand its application to other cancer types?
So far, we have conclusive evidence that FCI can detect and characterize breast cancer, brain glioma, sarcoma and colorectal cancers [3, 4]. The first two are known to provide field-cycling signals linked to the activity of aquaporins, from in vitro and ex-vivo experiments. We are planning to observe this in vivo and to determine how variable and specific this signal is with different types of tumors. We have also found clinically relevant tissue contrast mechanisms in sarcoma in a collaboration with the University of Warmia and Mazury in Poland, and we are now working with them and the University of Edinburgh (UK) to publish our latest findings in colorectal cancer in which discriminative signals can also be seen at very low fields.
Can Field Cycling Imaging more accurately outline breast tumors than MRI?
Read our news coverage of this research.
We are now exploring the possibilities of FCI in liver, prostate and ovarian cancer, but also in other pathologies such as stroke. FCI opens up a new and exciting field of research. Hence, the difficulty is to decide on the research direction to take, since FCI is likely to offer novel and relevant information in many pathologies.
How could an FCI scanner impact early diagnosis and treatment planning for cancer patients?
I can see several applications, although others may emerge as we progress with this technology. At first sight, FCI maps offer different levels of tissue contrast at various fields, so tumors can be made easier to spot and to delineate by selecting the correct field. This opens possibilities for dedicated, low-field MRI systems, for instance. However, it is also possible to use all these images together to extract the T1 NMR dispersion of tissues, which provides additional and quantitative information.
In breast cancer, the T1 NMR dispersion is linked to the invasiveness of the tumor so FCI may also provide functional information, with application in treatment planning whereby FCI images could inform on the viability of the tumor after treatment. It may also be possible to visualize the effect of a drug that modifies water dynamics, such as Doxorubicin as published by Ruggiero et al [5], or any drug that targets aquaporins as suggested by Petit et al [1]. This could directly monitor treatment efficacy in vivo, to adapt a therapy to the tumor response during treatment and eventually interrupt a treatment if no effects are seen on the tumor activity.
What are the next steps for integrating this technology into clinical practice?
We have built a new generation of FCI systems that can be placed within a hospital, although this is still a research device and not a clinically certified system. The aim of this new generation of FCI scanners is to enable clinical research in this field. We aim to disseminate the FCI scanners at other hospital sites to help other groups to start their own research projects in FCI, with support from a research network to replicate and interpret their results. We are therefore looking for clinical partners who are interested in working with our FCI system, or in acquiring an FCI system in their premises, to take part or lead clinical research projects in oncology or other pathologies where tissue remodelling is likely to lead to important changes in water or lipid dynamics.
What timeline do you anticipate for its widespread adoption?
This is a difficult question! The history of MRI seems to show a trend of 10 years from the first demonstration to the market, although MRI is a well-established technology with a strong distribution network. I do hope that FCI can reach the clinics within that time frame.
Do you have any final thoughts or closing remarks?
It is interesting to note that the principles used in FCI, namely fast field-cycling nuclear magnetic resonance (FFC-NMR), have been developed since the early days of NMR. FFC-NMR is indeed an old technique, which has gained a lot of momentum over the last 15 years with many applications in porous materials, polymers, ionic liquids, biomaterials, the food industry or even within the history of art. FCI is therefore in an unusual position where the technology is new but the physics principles are well-established. Therefore, we can rely on decades of excellent theoretical and experimental work developed in this field, opening up many possibilities for medical applications.
I am also lucky to inherit from the legacy of excellent researchers in MRI research from the University of Aberdeen (UK), most of all Professors David Lurie and Jim Hutchison, who created the first FCI systems and have explored this technology for over two decades before current clinical trials could be possible. I think that this is a good example of how unpredictable scientific research can be, and of how important it is to transmit and disseminate our efforts.
Interviewee profile:
Dr Lionel Broche is Senior Research Fellow in medical and physics engineering at the University of Aberdeen and is currently leading the development and industrialization of a new MRI-based technology called FCI. His work aims to discover new disease biomarkers using variable fields below 0.2T, to exploit the underlying physical phenomena for clinical research and applications, and to disseminate FCI technology. With more than 15 years of experience in this field, Dr Broche has collaborated with NHS consultants and academic biologists over the last 7 years to design and conduct clinical trials using FCI, with exciting prospects in pathologies such as stroke, cancer, osteoarthritis or fibrosis. He is a member of the AMT centre for low-field MRI in Aberdeen and of the Open-Source Imaging Initiative e.V. for the dissemination of MRI and imaging technologies.
References:
- Petit M, Leclercq M, Pierre S et al Fast-field-cycling NMR at very low magnetic fields: water molecular dynamic biomarkers of glioma cell invasion and migration. NMR Biomed. 35(6):e4677 (2022).
- Ruggiero MR, Ait Itto H, Baroni S et al. Role of transmembrane water exchange in glioma invasion/migration: in vivo preclinical study by relaxometry at very low magnetic field. Cancers. 14(17):4180 (2022).
- Mallikourti V, Ross PJ, Maier O et al.. Field cycling imaging to characterise breast cancer at low and ultra-low magnetic fields below 0.2 T. Commun. Med. 4(1):221 (2024).
- Masiewicz E, Ashcroft GP, Boddie D et al. Towards applying NMR relaxometry as a diagnostic tool for bone and soft tissue sarcomas: a pilot study. Sci Rep 10, 14207 (2020).
- Ruggiero MR, Baroni S, Bitonto V et al. Intracellular water lifetime as a tumor biomarker to monitor doxorubicin treatment via FFC-relaxometry in a breast cancer model. Front. Oncol. 11:778823 (2021).
The opinions expressed in this article are those of the author and do not necessarily reflect the views of Oncology Central or Taylor & Francis Group.