Aurora Imaging rides wave of interest in breast MR

The popularity of breast MR is growing and so are the prospects for Aurora Imaging Technology, the world's only maker of MR scanners dedicated to this application.

Company execs believe their installed base will come close to doubling over the year, from 15 at the end of 2005 to between 25 and 30 by the end of 2006. That would be a huge leap forward.

The Aurora system struggled - unsuccessfully - to gain traction for the better part of a decade. It now operates at 1.5T, but the beta unit, installed in 1996 at at the University of Texas's breast imaging center, operated at just one-third of that field strength. The ensuing 10 years brought one problem after another to the maker of Aurora, Advanced Mammography Systems. Publicly held AMS merged in 1997 with Advanced NMR to become Caprius, then sold its breast MRI assets two years later to a private investment firm.

Only last year did the Aurora MR scanner start gaining recognition as a premier imaging system. By then, it had been overhauled to run at 1.5T with an extended field-of-view. Three acquisitions take five minutes each. Patients are on and off the table in 20 to 30 minutes.

The evolution of Aurora to this level of performance is in tune with changing attitudes about breast MR.

"In the past, it might have been nice to offer breast MR, but it was not seen as a need to have it," said Debbie Thomas, vice president of marketing for Aurora. "Now we are seeing the idea of breast MR cross that threshold with peer-reviewed articles documenting its benefits."

The Aurora system is optimized for breast imaging, featuring a field-of-view that captures not only the axilla, but tissue in and well beyond the chest wall. Some images even show the heart.

Driving image quality is a novel technique called bilateral RODEO (Rotating Delivery of Excitation Off-resonance). The proprietary pulse sequence allows fat-suppressed magnetization transfer contrast. RODEO, applied after contrast injection, reduces signal from normal ductal tissue and avoids false-positive enhancement from benign lesions and dense fibroglandular tissue.

Aurora excels at detecting ductal carcinoma in situ and lobular breast cancer, two types of cancer that are difficult to pick up with x-ray mammography, said Dr. Steven Harms, Aurora's medical director who developed RODEO while at the University of Arkansas, He said DCIS accounts for between 30% and 40% of all breast cancers and lobular for another 10%.

"Because of its high contrast and spatial resolution, our machine can reliably see and determine the extent of both types of cancer," he said.

Aurora is designed to handle all body types. No breast is too small or too large, according to Harms.

"We actually imaged a male breast," he said.

Advanced reconstruction software provides 3D renderings and split-screen displays featuring different presentations of the data. The North Andover, MA, company even developed its own CAD solution.

Harms and Thomas hope to parlay Aurora's capabilities into increasing sales. In the distant past, the company tried to win customers with low-cost product. Early configurations listed for about $500,000. The modern configuration lists for $1.3 million, about as much as any other high-field system. Thomas calls Aurora the better deal.

"With this, you are getting the whole package designed specifically for breast imaging with CAD software and biopsy capabilities," she said. "You don't have to go further and buy add-on components."

The company fields three sales people bolstered by two U.S. distributors, one in Arkansas and the other in North Carolina. The first installations of the modern breast scanner were at sites along the eastern seaboard of the U.S., but systems lately have begun to fan out, going into Texas, Washington, and California. The company's sole offshore system, operating in Taiwan, may be joined later this year by a second, also in Taiwan.

The company may also crack the European marketplace on the heels of a CE mark obtained last year. An Aurora scanner is scheduled for delivery to an Italian site later this year. Two European distributors, one in Italy and another in Germany, should help further open that market. The company is also seeking distributors in the U.K., Greece, Israel, Saudi Arabia, and the United Arab Emirates.