Conversation With Dr. John Klock and Dr. Jenn Simmons

QT Imaging is at the heart of a fascinating conversation between Dr. Jennifer Simmons and Dr. John Klock, an oncologist, physician, inventor, and longtime developer of medical imaging technologies.

The conversation is especially relevant to women navigating breast health, DCIS, dense breasts, implants, abnormal imaging findings, and safe long-term monitoring.

It also raises a question that deserves far more attention:

Are we doing breast imaging the best way possible or simply the way we’ve always done it?

A career built around challenging the status quo

Dr. Klock has spent decades developing medical technologies designed to make imaging more accessible, less invasive, and more informative.

His philosophy is not that every existing technology is bad. Rather, it is that medical technology evolves and yesterday’s standard does not necessarily have to remain tomorrow’s standard.

He describes how some of the technologies he helped develop initially faced resistance before eventually becoming accepted. That history is important because innovation in medicine takes time and rarely happens without challenging assumptions.

His current focus is QT Imaging, a transmission-and-reflection ultrasound technology designed to create detailed three-dimensional images of the breast without ionizing radiation, compression, or injected contrast.

QTscan has received FDA 510(k) clearance for breast imaging. According to company filings, the system produces reflection- and transmission-mode images and can calculate breast fibroglandular volume and total breast volume.  FDA clearance is not the same thing as FDA approval of a drug, and women should understand exactly what a medical device is cleared to do.

The question isn’t simply “Does mammography work?”

One of the most important points in the conversation is that medical imaging should not be discussed in terms of a single question:

Does this test work?

The better questions are:

• What does it detect well?

• What does it miss?

• How sensitive is it?

• How specific is it?

• What are the false-positive and false-negative rates?

• What happens after an abnormal result?

• How often does an abnormal finding lead to additional imaging?

• How often does it lead to biopsy?

• What are the potential harms?

• Are there safer ways to obtain useful information?

Those questions are particularly important in DCIS. A screening test doesn’t exist in isolation.

An imaging finding can start a cascade: additional imaging → biopsy → pathology → diagnosis → surgery → radiation → medication.

And sometimes that cascade is appropriate and lifesaving. But for DCIS, standard of care often leads to overtreatment. The goal should not be to eliminate diagnosis. The goal should be to make the information we receive from imaging as useful as possible while minimizing unnecessary harm.

What makes QT different?

QT Imaging uses sound rather than ionizing radiation to create three-dimensional breast images.

Unlike conventional mammography, it does not require breast compression. Unlike MRI, it does not require gadolinium contrast.

The technology also generates quantitative measurements, including breast volume and fibroglandular volume. QT Imaging has described its technology as being developed not only for breast imaging but ultimately for broader applications in medical imaging.

But perhaps the most interesting concept discussed in the interview isn’t simply detection. It’s measurement over time.

Could we move from snapshots to trajectories?

This is the part of the conversation that particularly caught our attention at DCIS 411.

Dr. Simmons describes the possibility of bringing women back for repeat imaging and looking at whether a finding is changing.

Is it growing?

Is it stable?

Is it changing in volume?

Is the surrounding breast tissue changing?

Instead of treating every abnormal image as an immediate emergency, could serial quantitative imaging sometimes provide additional information about biology and behavior?

That concept is highly relevant to the evolving conversation around DCIS and active monitoring. A diagnosis tells us what something looks like at one point in time. Biology tells us what it does over time.

Of course, serial imaging does not prove that a lesion is benign or eliminate the need for biopsy when clinically indicated. But measuring change may provide another piece of information for physicians and patients to consider.

And this is an area where more research is needed.

Why this matters for DCIS

DCIS sits directly in the middle of the larger problem of overdiagnosis and overtreatment.

Some DCIS will progress.

Most DCIS will remain stable and may never become invasive cancer during a woman’s lifetime. 

Yet once the word “cancer” appears on a pathology report, the pressure to treat can be enormous, which is why bilateral mastectomy rates for DCIS have doubled in the last 20 years. 

That is why DCIS 411 believes women need access to better information before making irreversible decisions.

Questions we should be asking:

What is my individual risk?

What does my pathology actually mean?

How confident are we that my DCIS will progress?

What are the benefits and harms of treatment?

What happens if I monitor instead?

What imaging options are available to me?

Can my breast be monitored without repeatedly exposing it to ionizing radiation?

Can changes be measured over time?

These aren’t anti-treatment questions. They are informed-consent questions.

Imaging should be about more than cancer detection

Another intriguing idea discussed in the interview is the possibility of looking at the breast as an organ, not simply as a place where cancer may or may not be hiding. Dr. Klock talks about examining breast anatomy, ducts, glands, tissue characteristics, and changes over time.

This aligns with a broader shift that many of us would like to see: from breast cancer detection to breast health.

That doesn’t mean that imaging can tell us why someone developed breast cancer. It doesn’t mean an image can diagnose inflammation or metabolic dysfunction on its own. And it certainly doesn’t mean lifestyle changes can replace appropriate medical care. But it does raise an important question:

What else can we learn about the breast when we stop looking at imaging solely through the lens of “find cancer or don’t find cancer”?

The bigger issue: informed choice

Perhaps the most important message from this conversation has little to do with QT Imaging itself.

It’s about choice.

Women deserve to know what their imaging test can and cannot tell them.

They deserve to understand the potential benefits and limitations of mammography, ultrasound, MRI, and newer technologies.

They deserve to understand what happens after an abnormal result.

And they deserve to participate in decisions about what happens to their bodies.

No imaging technology is perfect.

No screening strategy is risk-free.

And no single approach is right for every woman.

That’s precisely why informed choice matters.

Innovation takes time

Dr. Klock repeatedly emphasizes that disruptive medical technologies often face resistance. That doesn’t automatically mean the new technology is right. It also doesn’t mean criticism is wrong.

New technologies should be questioned. They should be tested. They should be compared. They should undergo rigorous clinical evaluation. And the evidence should determine how they are used. But skepticism should work both ways. We should be willing to question new technologies and longstanding technologies. The fact that something is familiar doesn’t automatically make it optimal. The fact that something is new doesn’t automatically make it better. The science should decide.

A conversation worth watching

For women with DCIS, dense breasts, breast implants, a history of abnormal imaging, or simply an interest in understanding their options, this conversation raises many important questions about where breast imaging is headed.

It also reinforces something we say repeatedly at DCIS 411:

You don’t have to blindly accept the first recommendation you receive.

Ask questions.

Understand your pathology.

Understand your imaging.

Ask about benefits, risks, and alternatives.

Get a second opinion when appropriate.

And remember that informed consent is not a form you sign. It is a process of understanding your choices.

The future of breast health may not be about doing more. It may be about doing better with better technology, better data, better risk assessment and, most importantly, better-informed women.

Watch the full conversation

Watch the full interview with Dr. Jennifer Simmons and Dr. John Klock on YouTube

At DCIS 411, we believe information is power. And when it comes to your breasts, your health and your future, informed consent is nonnegotiable.