Michael Harbut, M.D., MPH

MANHATTAN BEACH, CA – Michael Harbut, M.D., MPH, co-director of the National Center for Vermiculite and Asbestos-Related Cancers (NCVAC) at the Barbara Ann Karmanos Cancer Institute in Detroit, MI, and chief of the Center for Occupational and Environmental Medicine Wayne State University, announced the use of a new technology to aid in the diagnosis of asbestos-related lung disease. The announcement was made at the Asbestos Disease Awareness Organization’s annual conference, Saturday, March 28, in Manhattan Beach, CA.

"Radiographic approaches developed by Carmen Endress, M.D., FACR, Associate Professor of Radiology, Wayne State University School of Medicine and radiologist at the NCVAC, allow us to visualize lesions caused by asbestos exposure in three dimensional detail and often at a much earlier stage than that of the current standard radiographic techniques," said Harbut.

Carmen Endress, M.D., FACR

This new approach involves taking images obtained on the 64-slice high resolution CT scan and enhancing them using the Vitrea® imaging software program developed by Vital Images, Inc.

Coronal oblique color-coded 3D CT image

Coronal CT Image with segmented color fibrosis

Click here for Dr. Harbut's presentation with slides.

Harbut explained, "The benefits of this new approach include the possibility of earlier detection; better differentiation between patients with scarring on the lungs and other diseases; assistance in determining why some people who have thickening on the covering of the lungs have uncontrolled, unrelenting pain; and potentially increased success in the overall diagnosis and treatment of asbestos-related disease.

According to Harbut, this approach could also have a significant public-health impact.

“If we can identify the ‘sentinel’ or first cases of asbestosis or lung cancer at an early stage, then we can help identify asbestos exposures in places where it might not have previously been suspected. Such identification of early detection could help to reduce the death rate from asbestos-related diseases."

Harbut added that this new technology approach to chest radiography could also help reduce cases of fraud which have been reported in asbestos litigation, due to the clarity and sophistication of the images that can help identify which cases are asbestos-related and which are not.

Dr. Endress added, "It’s my sincere hope that with this new approach and enhanced technology we will help reduce the death rate caused by asbestos-related diseases, reduce the suffering by patients and their loved ones, and make a significant contribution to medicine."

The use of this technology in the diagnosis and treatment of asbestos-related cancers and high-malignancy potential asbestos-related diseases represents another first for Karmanos Cancer Institute scientists and physicians. Previously, NCVAC researchers were among the first to discover the value of osteopontin – a tumor marker of mesothelioma – and published this finding in the New England Journal of Medicine. Karmanos workers have also reported the potential value of soluble mesothelin-related peptide, another tumor marker, in screening for mesothelioma.

Michael Harbut, M.D., MPH, Chief of the Center for Occupational and Environmental Medicine, is co-director of the National Center for Vermiculite and Asbestos-Related Cancers at the Barbara Ann Karmanos Cancer Institute, in Detroit, MI. In response to the United States Environmental Protection Agency's (EPA) identification of major sources of public asbestos exposure in Michigan, and to address the need for early diagnosis and aggressive treatment of asbestos-related diseases, the Barbara Ann Karmanos Cancer Institute and the Center for Occupational and Environmental Medicine (COEM) affiliated with Wayne State University, joined forces to establish The National Center for Vermiculite and Asbestos-Related Cancers (NCVAC). COEM has had a long interest in asbestos-related diseases and the Karmanos Cancer Institute is heavily involved in both clinical and basic research on asbestos-related cancers enabling the two centers to rapidly bring together the expertise and resources necessary to study the problem immediately.

Media Results

• Karmanos offers new tech to detect asbestos-related diseases - Model D
• New technique uses color and 3-D to identify asbestos-caused disease faster and more accurately. - Andrew Schneider Invest
• Karmanos Offers New Tech To Detect Asbestos-Related Diseases  - WWJ.com
• New Tool May Assist in Earlier Detection of Asbestos-Related Diseases - EHS Today
• New tool in the radiography approach will assist in earlier detection of asbestos-related diseases - News-Medical.Net
• New Tool in the Radiography Approach Will Assist in Earlier Detection of Asbestos-Related Diseases - PR-Canada.Net
• 3D plus CT improves imaging of asbestos-related diseases Copyright © 2009 AuntMinnie.com - Article Below:
  
  By Erik L. Ridley
  AuntMinnie staff writer
  April 16, 2009
  
  Advanced visualization analysis of MDCT images shows promise for improving the accuracy of imaging asbestos-related lung disease, according to physicians at the Barbara Ann Karmanos Cancer Institute in Detroit.
  
  
  "By bringing the radiography of asbestos-related disease into the 21st century, we will reduce a lot of human suffering and save a lot of money," said Dr. Michael Harbut, co-director of the institute's National Center for Vermiculite and Asbestos-Related Cancers (NCVAC). Harbut discussed the use of 3D for asbestos imaging at the Asbestos Disease Awareness Organization's (ADAO) annual conference last month in Manhattan Beach, CA.
  
  Asbestos-related disease has traditionally been imaged using a plain posteroanterior and lateral chest film exam. These radiographs are read using the B-reader system, a network of physicians certified by the U.S. government for reviewing asbestos images. However, the method has been associated with high reader variability and is fraught with the potential for fraud in legal cases, Harbut said.
  
  The Karmanos Cancer Institute typically uses 64-slice CT instead of performing chest radiography for asbestos-related disease. Led by NCVAC radiologist Dr. Carmen Endress, the institution has also begun utilizing advanced visualization software (Vitrea, Vital Images, Minnetonka, MN) on challenging cases. The software has provided valuable information in several applications, including identifying, tracking, and quantifying pulmonary fibrosis, he said.
  
  
  Coronal CT image with segmented color fibrosis (left) and segmented thin-section color CT with fibrosis (right). All images courtesy of Dr. Michael Harbut of the Barbara Ann Karmanos Cancer Institute.
  
  Also, 3D software has proved handy in evaluating and monitoring pleural and pericardial plaques and in determining the cause of intractable pleural pain, he said.
  
  "In asbestos-related disease, the most recent studies have shown that 40% of patients have some type of chest pain, which is likely noncardiac," he said. "A significant percentage of these patients go on to have intractable pleural pain that basically lasts forever and requires narcotics. Through the use of this technology, we think we've identified at least one of the mechanisms for intractable pleuratic pain."
  
  
  Plaques on coronal oblique color-coded 3D CT image.
  
  
  Computed quantification of pleural plaque.
  
  The institute also believes that CT with advanced visualization software will help in identifying malignant lesions, although researchers do not yet have enough data to prove it, Harbut said.
  
  Earlier diagnosis
  
  In one recent case involving a worker at the Smithsonian Institution, the CT scan showed what appeared to be very early-stage asbestos-related disease.
  
  "We [then] took his film and processed it through the [advanced visualization software] and found there to be more fibrotic change than we would expect," Harbut said. "It gave us one more piece of evidence in the diagnostic process to encourage me to tell people at the Smithsonian that they should really undertake screening of their remaining workers with similar exposure."
  
  One downside to using 3D has been the time required to use the software; processing one patient can take anywhere from 20 minutes to an hour. However, the institute is working on automating aspects of that process, he said.
  
  The technology might have its most significant contribution in reducing human suffering, Harbut said.
  
  "I have a patient with intractable pleural pain who had a pleurectomy already, and we were trying to decide what to do with him because he has very advanced asbestosis," he said. "He's oxygen-dependent, he's got pleural plaques, and intractable pleural pain. We processed his film using the Vitrea system and found a pleural plaque rubbing on the internal aspect of the rib, creating a bony erosion."
  
  
  Volume-rendered oblique coronal CT image with plaques leading to rib erosions.
  
  The software was able to obviate the need for another thoracoscopy and the use of narcotics. Instead, the patient was prescribed Marinol, and he was able to avoid the side effects of narcotics, he said.
  
  "We also saved the system at least $15,000," Harbut said.