New imaging technique is good at finding early cancer in mice, but NIH release skimps on translation to human patients

Our Review Summary

This news release sets out to describe a novel technical enhancement to magnetic resonance imaging (MRI) technology using a fibronectin-targeting contrast agent that has the potential to detect micrometastases (breakaway tumor cells that can spread) and to help predict how aggressive the spreading cancer is likely to be. The release deserves good marks for packing in a great deal of information about how cancer spreads and how this technology might potentially play a role in facilitating earlier detection. Nevertheless, we had some significant concerns with how the findings are presented to readers. Most troubling is that the release fails to note that the work was done in mice until about two-thirds of the way through. It’s simply misleading not to acknowledge that the research involved mice somewhere high up in the release rather than burying it far down in the document.

Another nugget missing from the early paragraphs is that it’s the “enhancement” (i.e. a new contrasting agent) rather than “MRI” itself that is of interest and novelty here. That could confuse readers who at first glance may be led to believe that standard MRI can now help physicians find these early new seeds of cancer, as well as predict their level of severity and presage their conquest.

Surprisingly, there is also no mention of the scientists’ claims that the work was the first demonstration of the effectiveness of this form of molecular MRI/contrast agent technology in the detection of breast cancer micrometastases. And there is little or no real quantification related to the sensitivity and specificity of the detection method, particularly as compared to current gold standard imaging or use of other biomarkers to detect breast cancer spread.

So despite some notable strengths, this release’s omissions and lack of attention to the most important findings and details make it overall a confusing and potentially misleading account of the research.

Why This Matters

Metastases have been recognized as the major cause of death in breast cancer patients for at least half a century, and scientists have expended vast resources in an effort to: a) detect them early enough to begin new or systemic treatments; and b) figure out which tumor types are most likely to spread; and c) find and exploit biomarkers likely to give the earliest possible clue to spread. Thus, the results of new research such as the work from the National Institutes of Health and Case Western Reserve described in this release have the potential to alter the landscape of breast cancer diagnosis and therapy, and eventually improve outcomes for breast cancer patients. The biology of metastases is complex, however, and readers need information that is carefully put in context and in a realistic time frame with respect to clinical application.