by Asa Wahlquist
Carolyn Mountford addressed the Annual General Meeting of WISENET in June 1996, on the topic 'Pathology in the Year 2000'. The following article about her work is reprinted with permission from the Sydney University Gazette, April 1996.
When Dr Carolyn Mountford arrived in Australia from Oxford in the late seventies with a background in biophysics, she was told that only scholars who 'were no good at anything' did multi-disciplinary research.
Nearly twenty years later Dr Mountford, the inaugural winner of the Unsung Hero of Science Award, has a hard-won and extraordinarily successful track record in multidisciplinary research. Now a member of the influential Australian Science and Technology Council, she is also the executive director of the Institute for Magnetic Resonance Research - a joint venture between the University of Sydney's Engineering, Science and Medical Faculties and the Royal North Shore Hospital - which last year secured $45 million in funding. The Institute will use diagnostic techniques developed by Mountford and her colleagues, saving the NSW health system more than $50 M over the next ten years. Most importantly, her work will lead to a decrease in the 30,000 Australian lives lost to cancer each year.
But it has not been easy.
'When I first arrived I was told by an eminent Australian scientist: "Australia is too far away to do any cutting edge research, you'll never get any funding for innovative work",' she says.
'I've proved you can do the cutting edge research here, although it certainly is difficult to get funding for it, extraordinarily difficult. I've struggled for 17 years. Our really big grants have come from overseas until now.'
Late last year the Federal Government allocated the Institute $3 million out of its National Innovation Statement, an amount matched by the State Government. And her work continues to attract overseas support. Early this year, the Institute's breast cancer research program won rare funding from the USA of $1.5 million over three years.
Mountford, who has worked at the University of Sydney for the past 15 years, became intrigued 17 years ago with the idea of constructing images of bodily organs using magnetic resonance (MR) and chemicals other than water. The traditional MR imaging techniques use water in the body to create an image, but this does not distinguish between malignant and benign tumours.
'We've been investigating which chemicals in the body change when the cell ceases to be normal and goes through the various pre-invasive stages, becomes malignant and hence life-threatening and then continues to change while secondary tumours grow and the patient finally dies,' she says.
At the time, overseas work was concentrating on phosphorus-based MR, which has also not proved to be diagnostic. Mountford's inspiration was to study proton (or hydrogen) MR which offered researchers 'an abundance of chemical changes' to observe. 'It's a very, very detailed means of monitoring tumour development and progression,' she says.
Her research meant not only was she engaging in multi-disciplinary work with a team of medical specialists and pathologists, she was challenging the orthodoxy both here and overseas. 'Everybody thought we were wrong,' she says.
At first the only lab she could use was in Canberra-one weekend a month , starting at 9pm Friday and finishing at 9am Monday. When the University of Sydney got MR technology, Dr Mountford got the 3am to 9am slot.
'While the medical profession in this country is fantastic to work with, for a while the scientific community gave this project a hard time,' she said.
Her method is now highly accurate in the early detection of thyroid, cervical, breast and ovarian cancer. 'At this stage we are able to take the cells from the patient, usually with a fine needle or during surgery, and we are able to say "these cells are malignant" or "these cells are healthy". In some cases the pathologists can confirm our finding; in some cases the pathologist doesn't know the answer.'
So far MR is proving more accurate than pathology, which is currently the 'gold standard' for early detection of some thyroid cancer, and produces results 'as good as pathology' for cancer of the cervix.
'In the case of breast cancer, a combination of palpation, mammography and pathology get the right answer about 80 per cent of the time, but it means a lot of women are subjected to unnecessary surgery to correctly diagnose the other 20 per cent. Just by analysing cells from a lump in the breast which have been extracted using a needle, MR can confirm if the lump is benign with a 99 per cent certainty.
'It's the level of sensitivity and specificity that is impressive about MR. And, of course, the earlier the cancer is detected the easier it is to treat.'
Overseas work following Mountford's methods has been done on brain and prostate cancer, while local programs have begun on cancer of the testes and the colon.
The next stage will arrive when the whole-body imaging facility opens at the Institute next year. Whole-body imaging gives an MR image of all the organs inside the body, enabling pre-surgery diagnosis.
'To know ahead of the surgeon putting in the scalpel that tumours are benign will be a great step forward.'
The Institute will house three whole-body MR facilities and three vertical bore magnets for the cell sample analysis program and basic research.
Mountford, in reflecting on her success stresses the importance of the team work involved.
'This might have been my idea 17 years ago, and it's my hypothesis and certainly I am driving it, but the real knowledge, the clinical knowledge of pathology and of surgery comes from a group of very dedicated medical specialists and scientists who worked on this program for a long time.
'There has been an enormous number of people who have worked on the project and given their knowledge and educated me and vice versa.'
The woman who was not so warmly welcomed to the world of Australian scientific research, now believes the growing ability of the scientific and medical community to work together well is one of Australia's greatest assets.
'It gives us an enormous start over the rest of the world.'