Ph.D., University of Toronto
Magnetic Resonance Imaging (MRI) offers a number of advantages over other imaging methods for detecting breast cancer. It is non-invasive and can provide exquisite high-resolution, three dimensional images which detect cancers based on changes in tissue relaxation parameters, proton density, tissue diffusion, biomechanical properties or tumour angiogenesis. In this context, we have developed MRI technology for a number of clinical and research applications for breast cancer patients. This involves novel MRI pulses sequences, multimodality imaging, mathematical reconstruction methods and novel RF systems for efficient breast screening. We have developed extensive technology to use MRI to guide tissue biopsy and other interventional procedures and fuse imagery from MRI and ultrasound data to give further insight in tissue biology for diagnosis and aid in minimally invasive interventions. A further extension of MR exploits its exquisite motion sensitivity tissue elastography and to allow visualization of ultrasonic fields as it relates to thermal therapy.
Together with researchers from Oncology and Radiology at Sunnybrook Health Sciences Centre, we ran one of the largest studies of breast cancer screening with MRI conducted to date. This study conducted annual screening of 496 high risk women to compare the efficacy of MRI and mammography in the detection of breast cancer in BRCA1/2 positive women. The MRI technology used in this study was developed in our laboratory. This study demonstrated almost three times as many cancers by MRI as detected by mammography. These results, in conjunction with results from subsequent studies from England, Italy and Germany, resulted in the official recommendation of breast MRI for high risk screening by a number of international Cancer Agencies and Radiologic academic bodies. Our team was central to the creation of the Ontario high-risk breast MRI screening programme which was launched in 2011 under the Ontario Breast Screening Programme. In 2004, Dr. Plewes and members of his group founded Sentinelle Medical to manufacture and distribute breast MRI technology worldwide. Dr. Plewes is no longer accepting graduate students.