Keynote Presentation

Dr. Donald Plewes

Senior Scientist and Director of Imaging Research,

Sunnybrook Health Sciences Center, University of Toronto

Biography

Dr. Plewes is a member of the Discipline of Imaging Research at Sunnybrook Health Sciences Centre; one of the largest North American academic centres devoted to basic and applied research in medical imaging. Dr. Plewes has written more than 130 publications in peer-reviewed journals or books on various topics in medical imaging and been invited to speak at national and international conferences on more than 100 occasions. He holds 23 patents in concepts related to his research. Dr. Plewes served as the Associate Chairman of the Department of Medical Biophysics of the University of Toronto from 1989 to 1995 and was the Director of Imaging Research from 2004-2006. Dr. Plewes has served on several federal study sections including the NIH, the US Army Breast Cancer Research Initiative, the Small Business Innovation Research, the National Cancer Institute of Canada, and the Canadian Institutes of Health Research. He is a member of the American Association of Physicists in Medicine, the Society of Magnetic Resonance in Medicine, and the Institute of Electrical and Electronics Engineers. He was the Associate Editor of Medical Physics from 1987-1991 and serves as a reviewer for a number of scientific journals. The main research interest of the Plewes Group is the physics of medical imaging with applications to oncology. In 1991 Dr. Plewes acted as Program Director for the National Digital Mammography Development Group, a National Institutes of Health funded consortium of researchers from academia and industry conducting research on digital mammography. In parallel, Dr. Plewes has been devoted to applications of MRI to oncology in general and breast cancer in particular. This includes the application of breast MRI as a means for screening of hereditary breast cancer, the technology of MRI guided breast intervention, fusion of MRI and ultrasound for improved breast imaging, MRI Elastography, MRI guided thermal therapy and the application of MRI to improve breast conserving surgery. This research brings together a wide range of technology for improved breast MRI and MRI guided intervention. In 2001, Dr. Plewes’ group as part of a large team of oncologists and radiologists presented a landmark study which demonstrated the superiority of MRI as a screening tool for hereditary breast cancer. The current research focus is improvements in breast MRI and 1.5 and 3.0 Tesla and the integration of breast MRI for surgical planning and guidance. In 2004 Sentinelle Medical Inc, (http://www.sentinellemedical.com/), was founded to manufacture MRI instrumentation for breast cancer detection, diagnosis and intervention. More details information regarding the full range of research and publications can be found at http://www.sw.ca/research/groups/dbp.

Keynote Talk

MRI Surveillance for High Risk Breast Cancer:

Clinical, Technical and Commercial Development

Breast cancer remains a severe public health issue impacting 1 in every 9 North American women. While this risk is daunting, there are other subgroups at even greater risk. Specifically, women who express the BRCA1 or BRCA2 gene mutations, while small in number, are known to be at a substantially greater risk approaching 85%. In this group, several studies have shown that mammography is less effective as a screening tool than in the general population where mammography is found to be effective at reducing mortality. Starting in 1997, we began recruiting high risk patients into a study that compared the sensitivity of MRI, mammography, ultrasound and clinical breast examination. This work demonstrated a 2.5 improved sensitivity for MRI (84%) compared to mammography (30%) or ultrasound (36%), results which have been replicated by other international groups. Based on these studies, the American Cancer Society recommended in March of 2007, that breast screening with MRI should be used as an adjunct to mammography in all women with an approximately 20–25% or greater lifetime risk. In order to achieve high quality breast MRI, specialized technology is needed to give the best results while providing a comfortable and efficient experience for the patient. In order to address these needs, our laboratory has devoted the past several years optimizing the technical elements of breast MRI. After several years of optimization, Sunnybrook stimulated the formation of a medical device start-up, Sentinelle Medical Inc (SMI) to further develop and commercialize this technology. Based in Toronto, SMI started with 2 employees in 2004 and grew to 55 employees by end of 2007. FDA, Health Canada and ISO certification was awarded on three products while parallel strategic partnerships with two major MRI equipment manufactures have been formed. In this address, we will review the clinical and technical elements of breast MRI, how these evolved through the early stages of development and recount the path to start-up commercialization.