Any woman who's ever had a mammography will cheer the work of Dr. Steven Harms at the University of Arkansas for Medical Sciences. His new magnetic resonance imaging (MRI) technique to detect breast cancer does not require the tissue compression necessary for traditional mammography. No more squashing the breast with an unforgiving plate of Plexiglass. Developed by Massachusetts-based Aurora Imaging Technology Inc., the dedicated MRI machine is designed specifically for breast imaging and is contoured for the patient to lie face down. The breasts are suspended away from the chest wall — without compression — in a cushioned device which contains the signal transmitters and receivers for the radio frequencies. Harms' RODEO MRI method is at use in nine medical facilities across the country with an onslaught of additional sites expected in the next year. The first site was in Knoxville, Tenn. RODEO, which stands for ROtating Delivery of Excitation Off-resonance, produces hundreds of three-dimensional, cross-sectional images of the breast. What makes the process superior to mammography is its clear image of cancer when a contrast agent has been injected into the patient. "It's so clear in terms of what you need to do," says Harms. "Medicine is mostly shades of gray. Everything's not black and white. But with MRI, it's more black and white." Once malignant breast tumors reach a certain size, they begin to grow their own blood supply; thus high blood vessel density is a characteristic of cancer. Harms explains that, because of the increase in blood-carrying vessels, tumors appear "very bright" thanks to a contrast agent such as Gadolinium, which is slightly magnetic and accumulates in the abnormal tissue. It then is rapidly eliminated from the body by the kidneys. Harms' procedure also overcomes two problems with previous breast MRI efforts — RODEO is not affected by breast fat and does not mistake ductile milk-delivering tissue, which can also show up brightly, for a tumor. "The thing that's unique about RODEO is that it turns off both the fat and the ductile tissue, and the only thing that's left is the bright signal from the enhancing tumor," he explains. So why doesn't every medical provider that treats women use the RODEO MRI technique? Cost is one reason — as much as 15 times higher than a conventional mammogram. Harms says, therefore, RODEO MRI is not perceived as a replacement for standard mammography screening. However, his lab continues to work on ways to help bring down the cost as well as refine the procedure. Today, RODEO MRI is used to "streamline" diagnostic and treatment options, he explains. "Now we're able to tell patients exactly what's going on with their disease and give them an outline of their choices for treatment and allow them to make those decisions themselves. It's a new world, and a lot of that is due to MRI," he says. "It's affected the ability of patients to participate in their treatment and to get the right treatment the first time." With RODEO MRI, he adds, it's much easier to determine whether the cancer has affected the lymph nodes. Also, effectiveness of chemotherapy can be measured. "If you've ever known anybody to go through chemotherapy, it's not an easy thing, and you don't want to go through all the trauma if it's not doing you any good," he says. With twice the sensitivity of mammography, very few cancers are missed. "It's on the order of one in several thousand," Harms estimates. "In effect, you're able to exclude cancer, which makes a big difference in terms of how much surgery or how much treatment you have to do." For women with a family history of cancer, the RODEO MRI may be worth the money, especially considering some high-risk women choose a "prophylactic mastectomy," when no cancer is present, to eliminate the threat. "We're now doing routine surveillance MRIs just for that reason, to pick up the early cancer and to give people peace of mind," Harms says. An Arkansas native, Harms earned his medical degree at the University of Arkansas and did his early MR work at the State University of New York at Stony Brook. Harms worked alongside Professor Paul C. Lauterbur, who won the 2003 Nobel Prize for his work to introduce magnetic resonance imaging to medicine. After 15 years in Texas at the M.D. Anderson Cancer Center and Baylor University, he returned to the University of Arkansas. He's also with the Breast Center of Northwest Arkansas in Fayetteville. Harms still recalls one return to his home that really changed his life. While in college and home on Thanksgiving break, he learned that his mother had a lump in her breast and an upcoming doctor's appointment. "It turned out it was a breast cancer," he recalls. "At that time you didn't know whether it was cancer or not. You just went to the operating room and if you came out without a breast, you'd know it was breast cancer." The experience "gave me a perspective I probably otherwise wouldn't have had," Harms says. His mom is 82 years old.