Joseph Y. Lo, Ph.D.

Associate Professor
Dept of Radiology and Biomedical Engineering,
Duke University Medical Center
Faculty,
Medical Physics Graduate Program
Director,
Biomedical Imaging and Medical Physics Third Year Study Program,
Duke University School of Medicine

Research Interests:
3D tomosynthesis imaging of the breast, prostate cancer intensity-modulated radiation therapy (IMRT), computer-aided diagnosis, image processing

Contact Information:
Carl E. Ravin Advanced Imaging Laboratories
2424 Erwin Rd (Hock Plaza), Ste 302
Durham, NC 27705, USA
Tel: (919) 684-7763
Fax: (919) 684-1491
joseph.lo@duke.edu

updated July 23, 2009

Research Summary:

My lab focuses on the diagnosis and treatment of cancer using advanced imaging techniques. There are 3 main projects: breast tomosynthesis, computer aided diagnosis, and radiation therapy treatment planning.

This work has been supported by 25 grants from the National Institutes of Health / National Cancer Institute, the US Army Breast Cancer Research Program, Siemens Healthcare, Susan G. Komen for the Cure and other sources. I have served as principal investigator (PI) for 20 of those grants, which totalled over $5.75 million, including $3.32 million in the last 5 years alone.

3D Tomosynthesis Imaging of the Breast

While mammography remains the gold standard in breast cancer screening, it has many well known limitations. Dr. Lo leads a team from the Ravin Advanced Imaging Laboratories (see website above) which collaborates closely with Siemens Healthcare to develop breast tomosynthesis, a form of limited-angle tomography using a modified digital mammography system. Tomosynthesis can acquire a 3D image quickly, easily, and at the same dose as a conventional mammogram. Tomosynthesis will improve sensitivity of breast cancer diagnosis by helping radiologists to detect subtle lesions which would otherwise be obscured. In addition, tomosynthesis will also improve specificity since radiologists can better characterize benign cases and thus avoid unnecessary follow-up imaging studies and surgical procedures. For these reasons, tomosynthesis is the most exciting recent development in breast imaging, and the only technology that can actually replace mammography in the near future. Duke is now conducting clinical trials using the first ever Siemens breast tomosynthesis prototype.

Note to patients: This is an investigational prototype system. It is still being tested in research studies and is not yet approved by the U.S. Food and Drug Administration (FDA).

Here are some preliminary images from our on-going studies. This subject presented with a very subtle, indistinct mass as shown in the standard mammogram (left). Even with the magnification view, the mass is still very subtle (middle). The tomo scan easily reveals a spiculated mass which was later biopsied to reveal invasive ductal carcinoma.

Computer-aided Detection/Diagnosis

Second, for over a decade, we have been a leader in computer aided diagnosis (CAD), which is an interdisciplinary field combining elements of medical physics, engineering, statistics, and bioinformatics. We have developed automated detection algorithms which use computer vision techniques to localize suspicious mammographic lesions. We have also designed predictive models which use machine learning and statistical analysis in order to classify mammograms or sonograms as benign versus malignant. During these studies, we compiled one of the largest multi-institution breast cancer databases with approximately 5000 cases.

Optimization of Radiation Therapy

Finally, we are merging expertise from radiology and radiation oncology to address the problem of intensity modulated radiation therapy (IMRT), specifically to improve treatment planning for prostate cancer. Our goal is to improve the efficiency and safety of treatment plans. This new project has been supported by the Wallace H. Coulter Translational Partners Grant Program.

Sample Publications

These are recent papers selected to cover a representative range of topics. For more information, see my curriculum vitae (CV) (PDF file) for a full list of my peer-reviewed papers, grants, and other accomplishments.

Resources and Environment

The Carl E. Ravin Advanced Imaging Labs (RAI Labs) is a group of over 30 faculty, staff and students devoted to research in advanced digital imaging techniques and applications for improved health care. It is part of the Duke Medical Phyiscs Program. Duke Hospital, one of the largest private hospitals in the United States, is licensed for over 1000 beds. The division of breast imaging in the Department of Radiology performs over 450,000 exams each year, approximately 1000 of which are sent to biopsy each year. RAI Labs occupies over 7000 square feet of laboratory and office space. Computer facilities include a variety of workstations, which are connected through a high speed dedicated network to all of the radiology department's clinical image acquisition systems, such as digital chest radiography, magnetic resonance imaging, ultrasound, nuclear medicine, and computed tomography. This network also includes radiographic film digitizers and printers, and a state of the art image archiving and retrieval system.