The early detection of breast cancer is becoming a priority in healthcare policy of an increasing number of countries. A large number of women (about 1 out of eight) will develop a breast cancer, which is the second leading cause of mortality from cancer. On the other hand, early detection of breast cancer leads to very high cure rate. In the end of the seventies, the introduction of X-ray mammography breast cancer screening every 18 to 28 months (depending on the country) offered an important advancement against breast cancer development.  By permitting early detection of this illness, a reduction of the order of 29% in the mortality by breast cancer was achieved, according to the analysis of the first clinical data.

Morphologic methods, like conventional X-ray mammography or echography show lesions, not cancers. Moreover, breast cancer is very often characterized by low contrast structures in the domain of low energy X-rays, which leads to a new sensitivity.  In particular, for the 40% of women having dense breasts X-ray mammography misses about 50% of cancers. This is particularly unfortunate if we consider that breast densification is often associated to estrogen treatment, which could be related to a significantly higher risk of breast cancer. Moreover the lack of specificity of these imaging methods leads to a high rate of false positive and to a large number of unnecessary biopsies.

The introduction of magnetic resonance techniques, in addition to the previous methods, may bring a better sensitivity, but apparently does not improve its specificity. With severe limitations in frequent benign pathologies, like fibroadenoma and fibrocystic disease, and with difficulties of interpretation in glands previously submitted to surgery, we may anticipate that the number of false positive will be substantially larger than with X-ray mammography uniquely.

CERIMED proposes an approach based on the ClearPEM®, a dedicate positron emission camera for mammography couples with an advanced ultrasound device with echographic and elastographic measurement capabilities developed by the company Supersonic Imagine based in Aix-en-Provence. Images will benefit from the fusion of the information specific to each one of the modalities and will combine altogether molecular, morphological and anatomical imaging information. A view of the machine is shown in Fig.1.

                    Fig.1 ClearPEM-Sonic installed at the University Hospital Timone (France).

ClearPEM-Sonic is a 1.3 M€ project which has been labeled by the Pole of Competitiveness OPTITEC (“Pole de Compétitivité Photonique, Systèmes Complexes d’Optique et d’ Imagerie”) of the region PACA (Provence-Alpes-Cote d’Azur). This international and multidisciplinary project groups the following partners, including two companies in France and Portugal:

1. The European Organisation for Nuclear Research (CERN), an intergovernmental organization based in Geneva, Switzerland
2. The Vrije Universiteit Brussel (VUB), Brussels, Belgium
3. The Laboratório de Instrumentacão e Física Experimantal de Partículas (LIP), Lisob, Portugal
4. The Université de la Mediterranée (Aix-Marseille II), Marseilles, France
5. Assistance-Publique-Hopitaux de Marseille (AP/HM), Marseilles, France
6. Institut Paoli – Calmettes (IPC), Marseilles, France
7. Laboratoire de Mécanique et d’Acoustique (LMA), CNRS, Marseilles, France
8. The Universita degli studii di Milano-Bicocca, Milano, Italy
9. The Universiteit Gent, Gent, Belgium
10. Supersonic Imagine, Aix-en-Provence, France
11. PETsys-Medical PET Imaging Systems S.A, Oeiras, Portugal.

The ClearPEM-Sonic is an essential tool for the future activity of CERIMED in Marseilles. The large international consortium, which is directly or indirectly (Crystal Clear Collaboration) associated to this project represents eventually a first and important step towards the European deployment of CERIMED. Moreover, the development of public- private partnerships, as well as incentives for joint industrial ventures is fully consistent with the CERIMED industrial strategy.