Our radiation sciences team includes members of the departments of radiology, radiation oncology, and medical physics. Our clinical research is focused on developing the latest state-of-the-art technologies for cancer diagnosis and treatment.
We participate in the activities of all disease management teams at Memorial Sloan-Kettering, and we collaborate with basic science researchers working in the laboratory.
Among our recent research accomplishments:
Learn more about the work of our radiology staff.
- We are evaluating breast magnetic resonance imaging (MRI) and positron emission tomography (PET) scanning for the detection and staging of early-stage disease, and are exploring MRI as an interval screening modality for women at high risk of developing breast cancer. We are also studying the costs of these more intensive surveillance strategies. A recent advance was our description of the utility of spectroscopy as a means of improving the specificity of biopsy recommendations. Radiology. 2007 Oct;245(1): 80-87. [PubMed Abstract]
- Our work with endorectal ultrasound (ERUS) in the preoperative staging of early-stage disease is currently directed at developing a treatment-oriented staging system and assessing the ability of ERUS to stratify tumors by substaging. An IRB-approved pilot project, “Evaluating the Response to Preoperative Chemotherapy and/or Radiation Therapy for Rectal Cancer Using Three-Dimensional Transrectal Ultrasound (3-D TRUS),” has been initiated.
- Several members of our team are collaborating in an active IRB-approved protocol “A Pilot Evaluation of Radioimmunodetection of 124-Iodine-Labeled Humanized A33 Antibody (124-I-huA33) in Patients with Colorectal Cancer.” The protocol has assessed the safety of a single 10 mg IV dose of 124-I-huA33 for tumor targeting in colorectal cancer patients for the purposes of staging, detection of recurrence, evaluation of response to therapy, and, possibly, for delivering tagged therapeutic agents directly to a cancer via radioimmunoguided surgery. Patients have been accrued and preliminary data analyzed.
- We are engaged in an NCI-sponsored prospective trial comparing the accuracy of PET and computed tomography (CT) in evaluating rectal cancer response to preoperative chemoradiation, based on pathologic assessment of tumor in surgical specimens. Long-term follow-up of patients has been undertaken to determine if PET findings are predictive of outcome, and if patients with complete pathologic response to preoperative chemoradiotherapy have an improved prognosis.
- Our team is also conducting an innovative study of ex-vivo molecular polyp imaging using 18-F fluorodeoxyglucose PET (FDG-PET) imaging that aims to determine the protein- and gene-expression signatures of premalignant colorectal polyps.
- We showed that MRI and spectroscopy have utility for predicting insignificant prostate cancer. BJU Int. 2007 Apr; 99(4):786-93. [PubMed Abstract]
- We demonstrated that imaging features and the degree of enhancement of renal cortical tumors on CT can help differentiate tumor subtypes. Radiology. 2007 Aug;244(2):494-504. [PubMed Abstract]
- We found that endorectal MRI improves the prediction of seminal vesicle invasion in prostate cancer. Radiology. 2007 Jan; 242(1):182-8. [PubMed Abstract]
- We showed that MRI reveals clinically significant local recurrence of prostate cancer after radiotherapy at the site of the primary tumor. Int J Radiat Oncol Biol Phys. 2007 Sep 1;69(1):62-9. [PubMed Abstract]
Head and Neck Cancers
- Our investigators are evaluating the use of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in patients with squamous cell head and neck cancer. Our findings indicate that the method can be used to predict treatment responses during initial analyses and to differentiate between hypoxic and nonhypoxic nodes.
- In characterizing the histology of metastatic tumor tissue from patients with thyroid cancer whose disease is radioactive iodine-refractory (RAIR) and can be monitored using positron emission tomography (PET), we have found that such tumors form a clinically aggressive subset. Our findings could improve our understanding of thyroid cancer progression and could also spur the development of novel targeted therapies for RAIR disease. Cancer. 2008 Jul 1;113(1):48-56. [PubMed Abstract]
- We have also developed a new quantitative tomography imaging method for assessing the absorbed radioiodine dose to normal organs in thyroid cancer patients who have been treated with iodine therapy. J Nucl Med. 2007 Jan;48(1):143-9. [PubMed Abstract]
- We have found that PET imaging using radiolabeled fluorodeoxyglucose can be used to exclude locoregional disease with high accuracy in patients with squamous cell head and neck cancer who have had chemoradiation. Our results provide a basis to avoid neck dissection in these patients. J Nucl Med. 2008 Apr;49(4):532-40. [PubMed Abstract]
- We have found that PET-FDG can provide staging information and help the detection of recurrent disease in patients with biliary cancer. In patients with potentially resectable tumors, FDG-PET identified occult metastatic disease and changed management in nearly one-fourth of all patients. J Am Coll Surg. 2008 Jan;206(1):57-65. [PubMed Abstract]
- In a phase II study of patients with unresectable primary liver cancer who underwent hepatic arterial infusion chemotherapy, we found that DCE-MRI could serve as a biomarker of treatment outcome. Noninvasive imaging of tumor microvasculature by DCE-MRI could be used to assess global tumor perfusion before treatment, as well as changes in tumor permeability after treatment, both of which are predicative of survival. Ann Oncol. 2009 Jun 2. [PubMed Abstract]
- We have evaluated the usefulness of carbon nanotubes for in vivo imaging using whole-body PET scans of radiolabeled nanotubes in mice. The nanotubes accumulated in the kidney, liver, and spleen with rapid blood clearance, suggesting that they could be used to deliver short-lived radionuclides in diagnostic applications. PLoS One. 2007 Sep 19;2(9):e907. [PubMed Abstract]
- We used functional imaging to analyze the diagnostic and predictive value of FDG-PET imaging in NHL. The results suggested that PET imaging can identify tumor grade. This has become important in the evaluation of possible histological transformation of follicular lymphoma to diffuse large B cell lymphoma (DLBCL). J Clin Oncol. 2005 Jul 20;23(21):4643-51. [PubMed Abstract]
- We led a large risk-adapted treatment program for DLBCL. These data demonstrated that predictive value of functional imaging is strongly influenced by the chemotherapy regimen and timing of scans. Despite a high risk of interim positivity on PET scan, long-term outcome can reach 70 to 80 percent. We are now examining if fluoro-L-thymidine PET will be superior to FDG-PET for prognostication.
- Our team conducted a series of imaging trials in the treatment of relapsed/refractory Hodgkin lymphoma. The results showed that positive functional imaging prior to high-dose therapy with autologous stem cell rescue (HDT/ASCR) was associated with a poor long-term outcome. This finding led to a risk-adapted study in which patients with a negative functional imaging after second-line chemotherapy proceed directly to HDT/ASCR. Preliminary results support the notion that conversion of residual functional imaging positivity to negativity is associated with improved outcome.
- Our team is developing novel optical imaging techniques, with an emphasis on reflectance confocal microscopy, for the noninvasive diagnosis and management of skin cancer. We have demonstrated the feasibility of bedside, noninvasive, quasi-histologic assessment of suspicious skin lesions with this technique. We are currently assessing the diagnostic utility of this technology.
- We showed that T cells transduced to express a human norepinephrine transportive gene can be quantitatively imaged in vivo with radiolabeled MIBG by PET or single-photon emission CT (SPECT). Cancer Res. 2007 Dec 15;67(24):11959-69. [PubMed Abstract]
- We used FDG-PET and uni-dimensional, bi-dimensional, and three-dimensional measurements of lung tumors to prospectively assess the effects of stopping and restarting gefitinib or erlotinib in patients with acquired resistance to erlotinib or gefitinib. Clin Cancer Res. 2007 Sep 1;13(17):5150-5. [PubMed Abstract]
- We demonstrated that the FDG-PET standardized uptake value (SUV) is an independent prognostic factor from clinical TNM (tumor, node, metastasis) stage, but SUV does not add to the prognostic significance of pathologic TNM stage. J Thorac Cardiovasc Surg. 2007 Jun;133(6):1419-27. [PubMed Abstract]
Upper Gastrointestinal Cancers
- We demonstrated that preoperative PET scans influence management of patients with biliary cancer. J Am Coll Surg. 2008 Jan; 206(1):57-65. [PubMed Abstract]
Learn more about the work of our radiation oncology staff.
- Our group has defined the feasibility of delivering postoperative radiation with standard-of-care treatment plans to women who choose immediate reconstruction after mastectomy. Int J Radiat Oncol Biol Phys. 2008 Jan 1;70(1):43-50. [PubMed Abstract]
- We have retrospectively analyzed our experience with inflammatory breast cancer, and have documented favorable long-term results with both local control and survival using combined modality therapy that includes a lower and better-tolerated radiation dose following neoadjuvant chemotherapy and mastectomy.
Head and Neck Cancers
- After thyroid cancer patients are treated with surgery, radioiodine therapy may be used. Physicians have found that administration of recombinant TSH protein is as effective as, and much better tolerated than, traditional thyroid hormone withdrawal in preparing patients for radioiodine therapy. Cancer. 2008 Jul 1;113(1):48-56. [PubMed Abstract]
- Our investigators are evaluating the use of intensity-modulated radiation therapy (IMRT) for treatment of head and neck cancers. Our preliminary analysis of IMRT in patients whose primary cancer is in an unknown primary site suggests that this method has acceptable toxicity and encouraging efficacy. Int J Radiat Oncol Biol Phys. 2008 Mar 15;70(4):1100-7. [PubMed Abstract]
- In exploring our experience with IMRT in patients with recurrent head and neck cancer, we have observed that this method better predicts better locoregional tumor control when compared to conventional radiotherapy. Int J Radiat Oncol Biol Phys. 2007 Jul 1;68(3):731-40. [PubMed Abstract]
- IMRT also achieved encouraging locoregional tumor control in patients with advanced laryngeal and hypopharyngeal cancer. Int J Radiat Oncol Biol Phys. 2007 Oct 1;69(2):459-68. [PubMed Abstract]
- We demonstrated that intensity-modulated radiation therapy (IMRT) in a soft tissue sarcoma in an extremity provides excellent local control in a group of patients with high-risk features. (The five-year actuarial local control rate was 94 percent.) This finding suggests that the precision with which the IMRT dose is distributed has a beneficiary effect in sparing normal tissue and improving local control. J Clin Oncol. 2008 Jul 10;26(20):3440-4. [PubMed Abstract]
- We found that involved-field radiation therapy (IFRT) was not associated with a significant risk of failure in lymph node regions not included in the tumor volume and remains an acceptable method of treatment that allows for dose escalation while minimizing toxicity. J Clin Oncol. 2007 Dec 10;25(35):5557-61. [PubMed Abstract]
- We demonstrated that treatment with doses of 80 Gy or more using three-dimensional conformal radiotherapy leads to a favorable five-year overall survival rate (36 percent) with an acceptable toxicity profile in patients with early-stage non-small cell lung cancer. Cancer J. 2007 Jul-Aug;13(4):238-42. [PubMed Abstract]
- Alpha particles are high-energy radiations capable of killing in the range of one to three cells. We are developing new therapeutic approaches in which alpha particles are targeted to cancer cells using monoclonal antibodies.
- We have shown that the monoclonal antibody E4G10, when coupled to an alpha particle-emitting isotope, selectively targets cells in newly formed tumor blood vessels. Our experiments in mice suggest that alpha-particle immunotherapy to tumor vasculature, alone or in combination with sequential chemotherapy, could be an effective approach to cancer therapy. PLoS One. 2007 Mar 7;2(3):e267. [PubMed Abstract]
- We have also developed a molecular nanogenerator that releases alpha particles inside cancer cells. Our initial clinical study of a CD33-targeted generator in leukemia patients shows that this therapeutic strategy is feasible and safe and shows anticancer effects.