Day 1 :
Keynote Forum
Carmen I Bigles
Coqui Pharma,USA
Keynote: Coqui-pharma solving the impending global shortage of molybdenum -99
Time : 09:00-09:30
Biography:
Carmen I Bigles is CEO of Coquí Radio Pharmaceuticals, Corp. a company with the goal of establishing a medical radioisotope production facility in the U.S. As co-owner of Caribbean Radiation Oncology Center, she learned that many patients were being misdiagnosed due to a global shortage of 99Mo. She sought to learn more about the Mo-99 industry and ultimately decided to establish a domestic source of the isotope. She earned a Bachelor’s degree in Mathematics from Inter-American University in San Juan and subsequently her Master’s degrees in architecture and suburban and town planning from the University of Miami.
Abstract:
Coquí Radio Pharmaceuticals Corp. is a medical isotope company dedicated to the production of Molybdenum-99, which is used in 20 million procedures each year in the U.S. The Puerto Rican company is based in Coral Gables, Fla., with the mission to bring the foremost medical isotope production facility to the Western Hemisphere and to create a commercially scalable, reliable supply of medical diagnostic and therapeutic radioisotopes in the U.S. This presentation will give an overview of the medical isotope 99Mo and its uses in modern medicine and explore the potential effects of an impending global shortage as nuclear reactors around the world begin to go offline. Carmen will give a thorough overview of Coquí Pharma and its mission to solve the impending shortage crisis as well as explain the technology the firm will employ at its medical isotope production facility.
Keynote Forum
Joerg Traub
Surgic Eye GmbH, Germany
Keynote: 3D interventional nuclear medicine imaging and therapy monitoring
Time : 09:30-10:00
Biography:
Joerg Traub has completed his PhD from TU Munich with highest distinction. After graduation, he was a co-founder of Surgic Eye GmbH. He is CEO and President of Surgic Eye, an innovator in the field of mobile nuclear imaging during therapy, for the past 8 years. He has published more than 50 peer-reviewed journals and full paper conference papers. He is co-inventor of more than 10 patents and has been serving as reviewer in several medical imaging and computer assisted surgery journals and conferences. rn
Abstract:
Radio-guided surgery is defined as any surgical procedure which utilizes a radiation detection device in a real-time fashion within the operating room for the identification of a radioisotope administered to a patient prior to the time of attempted detection and with the sole purpose of assisting in the successful performance of that surgical procedure. There is a wide application domain in the surgery room for sentinel lymph node marking, marking of primary tumors and also injection of radio-isotopes for selective internal radiation therapy.
Keynote Forum
Karl R Aigner
Medias Klinikum GmbH & Co KG, Germany
Keynote: High intra-arterial drug exposure for advanced head and neck cancer patients
Time : 10:00-10:30
Biography:
Karl R Aigner is Medical Director of the Department of Surgical Oncology in Medias Klinikum Burghausen (Bavaria)/Germany. He had his surgical training inrncardiovascular surgery at Friedrich-Alexander University in Erlangen. At Justus-Liebig University Giessen, he specialized in surgical oncology, focusing on vascularrntechniques of drug delivery such as Implantofix and Jet Port Catheters, and in 1981 first performed a technique of isolated perfusion of the liver with heart-lungrnmachine in man. Furtheron, he developed various techniques of segmental vascular isolation of body segments and organs, and the stopflow technique withrnadequately designed catheters. In 1982, together with Prof. Stephens from Sydney, he initiated the biannual International Congress of Regional Cancer Treatmentrn(ICRCT) and from 1987 to 1991 was President of the International Society for Regional Cancer Therapy. From 1985 to 1998, he was Managing Editor of thernInternational Journal Regional Cancer Treatment. He is author of numerous publications and book chapters, lectured and performed teaching operations onrnvascular perfusion techniques and oncological surgery in Europe the United States and Asia.
Abstract:
Introduction: Standard treatment for tumors of the head and neck are radiochemotherapy and surgery. In far, advanced orrnrecurrent cases surgery may be impossible or mutilating and side-effects from irradiation in terms of nerve damage and mouthrndryness are not reversible. In order to avoid toxicity and permanent tissue and nerve damage, we performed a study withrncarotid artery infusion and chemofiltration for simultaneous detoxification.rnMaterial & Methods: Carotid artery infusion was accomplished either via angiographic catheters in Seldinger’s technique orrnby means of end-to-side implantation of Jet Port Allround catheters into one or two carotid arteries respectively. Intra-arterialrninfusion time of a three-drug combination consisting of Cisplatin, Adriamycin and Mitomycin in 7 to 10 minutes short termrninfusions generates local drug levels eighty- to hundred-fold higher than during systemic chemotherapy. A total of 26 patientsrnwere included in the study, 18 patients in clinical stage IV, 5 in stage III and 3 in stage II respectively. For follow-up control andrndetermination of adverse effects, blood work (hemoglobine, white blood count, platelets, cardiac, kidney and liver enzymes),rnperformance scale, pain score, survival rate, hospitalization and side-effects were noted.rnResults: Five out of 26 patients died from their disease, one after a car accident. The average follow-up time was 45 months.rnStage IV patients who died had an average survival time of 11 months after onset of therapy. Surviving patients have notrnreached the median survival rate yet and are still alive on an average of 43 months after onset of therapy. There was no relevantrnhematologic toxicity (WHO Grade I – II) and there was no neurotoxicity. Vital parameters such as the ability to speak orrnto swallow usually improved after the second or third out of five treatment cycles. The major surgical complication was therndissection of the carotid artery in three cases.rnConclusion: Regional chemotherapy for advanced cancers of the head and neck area in terms of intra-arterial infusion withrnchemofiltration induces rapid tumor shrinkage without relevant toxicity and substantially improves quality of life.
Keynote Forum
Barry J Allen
University of Western Sydney
Keynote: Targeted radio-immunotherapy for metastatic prostate cancer
Time : 10:00-10:30
Biography:
Prof Barry Allen, DSc, OA, is an internationally recognized expert on Targeted Alpha Therapy (TAT) for cancer. He was successful in developing new preclinical agents for the treatment of melanoma, leukaemia, breast, prostate, pancreatic, ovarian and colorectal cancers, leading to world first phase 1 trials of intralesional and systemic TAT for metastatic melanoma. Prof Allen’s contributions to medical physics were recognized on his inclusion in the 50 outstanding medical physicists at the 50th Anniversary Conference on Medical Physics in 2013. He was appointed an Officer in the Order of Australia in 2015. He has published some 340 refereed publications
Abstract:
Prostate cancer claimed an estimated 136,500 lives globally in 2011. Recurrent disease is usually treated with androgen deprivation therapy (ADT), which provides outstanding early but transient control of progression. The tragedy here is that the benefits of ADT are lost within 2 years for most men as the cancer progresses to an incurable “late-stage†castrate resistant form of the disease (CRPC) with median survival of ~18 months. The minimal residual disease states derived from prostatectomy and ADT provide clear windows of opportunity for an effective systemic adjuvant therapy with minimal side effects. Targeted alpha therapy (TAT) is such a therapy, where antibodies specific for cancer biomarkers are labelled with alpha-radionuclides to more efficiently kill cancer cells with reduced adverse events. The success of systemic TAT in clinical trials for advanced metastatic melanoma indicates efficacy with minimal side effects. rnImproved molecular profiling of tumours now allows for therapies like TAT to be personalized for the patient’s cancer, leading to the next generation of adjuvants for the treatment of minimal residual disease states following prostatectomy and ADT. This paper examines the preclinical and clinical efficacy of TAT with c595 and J591 monoclonal antibodies, labelled with beta or alpha emitting radioisotopes, and its potential as an adjunctive therapy for the management of residual prostate cancerrn
Keynote Forum
Marc Griffiths
University of the West of England, UK
Keynote: The impact of new hybrid imaging technology on the nuclear medicine workforce: Opportunities and challenges
Time : 10:30-11:00
Biography:
Marc Griffiths is an Associate Dean within the Faculty of Health and Applied Sciences at the University of the West of England, Bristol and completed his Professional Doctorate in 2014. His Professional Doctorate evaluated the impact of the introduction of new hybrid imaging technology on the nuclear medicine workforce. He has published a number of papers in peer reviewed journals related to the development of the nuclear medicine workforce and associated factors, including mentorship, education and training competencies. His works are closely with education commissioners and is involved in healthcare workforce planning and scenario modeling.
Abstract:
Health professionals across the world now work within an environment of flux and uncertainty, which inevitably presents new opportunities and challenges for the workforce in terms of developing new skills and knowledge. The introduction of any new hybrid imaging technology may require appropriate staff training, considerations for service redesign and patient workflow dynamics, as part of the change process. Staffing a modern hybrid imaging environment requires a skilled and competent workforce, who should have the opportunity to further develop their working practice and clinical service provision. Balancing the needs of effective service delivery, workforce development and holistic patient-centric care requires careful planning and collaboration with a range of healthcare professionals. Introducing new hardware and software technology requires appropriate social frameworks, which may include ensuring clarity of role and responsibilities in order that the emerging relationship with the patient is maintained. There is a potential danger of ‘patient objectification’ during high technology examinations, such as hybrid imaging techniques and the subsequent dehumanization process that may occur. Creating an environment where workforce flexibility is present, in terms of understanding the position of new technology within the patients’ journey and a greater understanding of the need to reshape the delivery of such clinical services, is paramount to the ongoing development of hybrid imaging within the modern healthcare domain.
- Nuclear Medicine
Radiology& Medical Imaging
Chair
Hiroshi Kobayashi
Chiba University, Japan
Session Introduction
Marc Griffiths
University of the West of England, UK
Title: The impact of new hybrid imaging technology on the nuclear medicine workforce: Opportunities and challenges
Biography:
Dr Marc Griffiths is an Associate Dean within the Faculty of Health and Applied Sciences at the University of the West of England, Bristol and completed his Professional Doctorate in 2014. His Professional Doctorate evaluated the impact of the introduction of new hybrid imaging technology on the nuclear medicine workforce. He has published a number of papers in peer reviewed journals related to the development of the nuclear medicine workforce and associated factors, including mentorship, education and training competencies. Marc works closely with education commissioners and is involved in healthcare workforce planning and scenario modelling.
Abstract:
Health professionals across the world now work within an environment of flux and uncertainty, which inevitably presents new opportunities and challenges for the workforce in terms of developing new skills and knowledge. The introduction of any new hybrid imaging technology may require appropriate staff training, considerations for service redesign and patient workflow dynamics, as part of the change process. Staffing a modern hybrid imaging environment requires a skilled and competent workforce, who should have the opportunity to further develop their working practice and clinical service provision. Balancing the needs of effective service delivery, workforce development and holistic patient-centric care requires careful planning and collaboration with a range of healthcare professionals. Introducing new hardware and software technology requires appropriate social frameworks, which may include ensuring clarity of role and responsibilities in order that the emerging relationship with the patient is maintained. There is a potential danger of ‘patient objectification’ during high technology examinations, such as hybrid imaging techniques, and the subsequent dehumanization process that may occur. Creating an environment where workforce flexibility is present, in terms of understanding the position of new technology within the patients’ journey and a greater understanding of the need to reshape the delivery of such clinical services, is paramount to the ongoing development of hybrid imaging within the modern healthcare domain.
Carina Mari Aparici
University of California San Francisco, USA
Title: Real-time molecular probe-directed intraprocedural biopsies
Time : 10:45-11:05
Biography:
Dr Mari Aparici, MD is an Associate Professor in Residence at UCSF. She is a Nuclear Physician with residencies in both Europe (Barcelona) and US (Stanford), and with Molecular imaging fellowships from Stanford University. She is a physician-scientist in the development of Molecular Imaging. She has about 20 years of clinical and research experience in the field, and 10 years of a leadership position as Chief Nuclear Medicine at the San Francisco VAMC as part of her faculty position at UCSF. She has published 100 papers in reputed journals and has been serving as an editorial board member of repute.
Abstract:
The clinical management of lesions suspicious for malignancy relies not only on diagnosis of benign versus malignant potential but also tumor grading, immunohistochemical and genetic information. Pathological analysis remains the gold standard for definite diagnosis. Hence, a carefully performed biopsy with low risk of complication is crucial. Compared to open biopsy, image-guided biopsies are minimally invasive and confer several advantages including low morbidity, low complication rate and cost savings. FDG-PET/CT has shown higher diagnostic accuracy than conventional imaging CT in characterizing tumor in initial staging, treatment response evaluation and follow-up. PET/CT guided biopsies may allow early histologic diagnosis and staging before morphologic changes are evident. PET/CT biopsy can therefore rule out/in malignancy in early stage of disease and re-stage different types of cancer. Non-real-time PET/CT biopsies have used the image co-registration of a prior PET with a intraprocedural CT. However, this method is inaccurate in time and space, takes long time and requires special software. The aim of this study is to report the initial experience of utilizing the real-time intraprocedural PET/CT guided biopsies, including feasibility and technical requirements.
Sarah Abdulla
Norwich Radiology Academy,Norfolk and Norwich University Hospital, UK
Title: Progression or pseudo progression? A review of nuclear imaging of post-treatment glioblastoma
Time : 11:05-11:25
Biography:
Dr Sarah Abdulla is a 4th year radiology registrar at the Norwich Radiology Academy, a centre with a track record in research. She completed her medical education at Cambridge University and University College London. She has published in Clinical Radiology and is currently a reviewer for a peer-reviewed journal.
Abstract:
Glioblastoma is a brain tumour in adults with poor median survival despite multimodality treatment. Efficacy of therapy for glioblastoma is assessed by clinical response and imaging features, mainly on magnetic resonance imaging (MRI). There is a subset of treated patients with imaging features in keeping with “progressive disease” but who then show stabilization or resolution despite no change in their treatment regime. It is thought that the “pseudo progression” is due to non-tumoural factors and incorrect diagnosis could lead to an inappropriate change of effective therapy. Conventional MRI is inadequate for differentiating tumour progression from pseudoprogression and nuclear imaging is increasingly being shown to be more sensitive and specific, especially with the development of new biomarkers such as 11C-methionine (C-Met), O-(2-[18F]fluoroethyl)-L-tyrosine (18F-FET) and 3,4-dihydrocy-6-[18F]-fluoro-L-phenylalanine (18F-FDOPA). This is a review of the current research into radiological assessment of post-treatment GBM with nuclear medicine, specifically differentiating between tumour progression and pseudoprogression.
Hiroshi Kobayashi
Chiba University, Japan
Title: Gene expression and functions specific to acidic cancer nests
Time : 11:25-11:45
Biography:
Hiroshi Kobayashi received his PhD in Biochemistry from University of Tokyo in 1974. After his Post-doctoral training at Colorado University Medical Center, he started to study adaptation strategies of microorganisms to acidic environments at Chiba University in 1978. His research is focused on mammalian cell functions under acidic conditions from 1996 at Graduate School of Pharmaceutical Sciences, Chiba University. He retired in March 2012 and is a Professor Emeritus at Chiba University after his retirement. He works as an Associate Editor of International Immunopharmacology published by Elsevier B.V. from 2014.
Abstract:
Solid cancer nests are often acidified, which induces cytosolic acidification. Many metabolic processes may decline as cytosol is acidified and alternative processes are argued to work in acidic cancer nests to compensate the decrease in activities of the processes functioning at alkaline pH. We investigated the expression of 24,000 genes in cancer cells at pH 7.5 and 6.6 and found approximately 700 genes whose expression increased under acidic conditions, while expression of approximately 850 genes decreased at acidic pH. We found a protein named CTIB whose level was the same at pH 7.4 and 6.3, but it was essential for cell proliferation only at pH 6.3. Our result and reports by other groups suggest that mammalian cells have genes whose functions are required under acidic conditions but their expression is not affected by acidosis. Our study with specimens from cancer patients showed that different acidosis-dependent genes were expressed in different cancers. The analyses of acidosis-dependent genes specific to each cancer may be useful for diagnosis of carcinogenesis and cancer progression, because cancer nests are acidified with the cancer progression. The anti-cancer drugs whose target molecules function at acidic pH may show a clinical superiority because such drugs are less effective on cells in normal alkaline tissues, such as the body immune systems.
Saeed Shanehsazzadeh
University of Mons, Belgium
Title: Biodistribution assessment of 68Gallium radiolabeled PEGcoated superparamagnetic iron oxide nanoparticles in normal mice
Time : 11:45-12:05
Biography:
Shanehsazzadeh has completed his Ph.D. at the age of 33 years from Tehran University of medical sciences and postdoctoral studies from Biospion. He is the assistant professor of NSTRI, Tehran, Iran. He has published more than 40 papers in reputed journals and now he is doing his postdoc at Umons, Belgium in nano
Abstract:
Objectives: The purpose of this study is to evaluate the biodistribution of polyethylene glycol (PEG) coated superparamagnetic iron oxide nanoparticles radiolabeled with 68Ga in normal mice after intravenous administration of this probe. Materials and methods: Three mice were sacrificed at specific time intervals (5, 15, 30 and 60 and 120 minutes post-injection) and the percentage of injected dose per gram of each organ was calculated by counting of each organ of mice. Results: The biodistribution data revealed high amount uptake by liver and spleen (51.70 and 16.92 %ID/g by liver and spleen at 30 minutes, respectively and these values were 60.62 and 12.65 %ID/g at 120 minutes post injection). The clearance of other organs was fast. Conclusion: These results suggest that 68Gallium radiolabeled PEGylated superparamagnetic iron oxide nanoparticles (68Ga-PEG-SPIONS) has susceptibility for applying in Positron emission tomography- Magnetic resonance Imaging (PET-MRI) as a theranostic agent for detection of liver and spleen malignancies.
Karen Knapp
University of Exeter Medical School, UK
Title: Dual Energy X-ray Absorptiometry: Beyond Bone Mineral Density
Time : 12:05-12:25
Biography:
Karen Knapp is an Associate Professor in Musculoskeletal Imaging at the University of Exeter. Combining a passion for research and education with her clinical background, Karen utilises research-led teaching to inspire students. With a background in teaching undergraduate and post-graduate students and supervising PhD students, Karen is keen to engage at all levels of higher education. Karen’s primary research interest is in bone health, osteoporosis and associated pathologies, along with developing and testing computer aided detection (CAD) software in vertebral fracture patients. Karen is actively involved in the National Osteoporosis Society and the Society and College of Radiographers.
Abstract:
Osteoporosis is a common musculoskeletal disease in the western world characterised by reduced bone mineral density (BMD) and micro-architectural deterioration, resulting in an increased risk of fragility fracture. Dual energy x-ray absorptiometry (DXA) is the gold standard for the diagnosis of osteoporosis and provides an important element of fracture risk assessment. However, DXA is not a perfect tool and many patients diagnosed with low or normal bone mineral density (BMD) will still suffer a fragility fracture. This presentation look at the use of DXA beyond the measurement of BMD and how additional techniques such as vertebral fracture assessment, trabecular bone score and the use of clinical risk factors can provide better identification of those requiring treatment for fragility fractures. Consideration of the use of total body scans will also be covered, along with the precision errors associated with DXA across a range of population sizes. The presentation should provide clinicians with an understanding of the strengths and weaknesses of DXA underpinned by the current evidence-based.
Joerg Traub
Surgic Eye GmbH, Germany
Title: 3D interventional nuclear medicine imaging and therapy monitoring
Biography:
Joerg Traub has completed his PhD from TU Munich with highest distinction. After graduation, he was a co-founder of Surgic Eye GmbH. He is CEO and President of Surgic Eye, an innovator in the field of mobile nuclear imaging during therapy, for the past 8 years. He has published more than 50 peer-reviewed journals and full paper conference papers. He is co-inventor of more than 10 patents and has been serving as reviewer in several medical imaging and computer assisted surgery journals and conferences.
Abstract:
Radio-guided surgery is defined as any surgical procedure which utilizes a radiation detection device in a real-time fashion within the operating room for the identification of a radioisotope administered to a patient prior to the time of attempted detection and with the sole purpose of assisting in the successful performance of that surgical procedure. There is a wide application domain in the surgery room for sentinel lymph node marking, marking of primary tumors and also injection of radio-isotopes for selective internal radiation therapy.
Yicheng Ni
KU Leuven, Belgium
Title: OncoCiDia: A Novel Depersonalized Combination of Targeted Chemo- and Radio-Theragnostics for the Management of Solid Malignancies
Biography:
With a prior MD, upon receiving his PhD in 1995, Yicheng Ni initiated and heads a Theragnostic Lab at KU Leuven, Belgium. Being currently titled with full professor and Bayer Lecture Chair, he has published over 200 SCI journal papers, book chapters and patents, trained numerous PhD students, served as editor or reviewer in academic journals, and received tens of honors including Herbert M Stauffer Award (1993) and Elliott Lasser Award (2009). His academic career has been marked with innovative, translational, cost-effective and longstanding research. OncoCiDia introduced here presents one of his multiple inventions
Abstract:
Imaging and contrast media research has enabled discovery of small molecular necrosis-avid compounds (NACs) for the diagnosis of myocardial infarction and therapeutic assessment of tumor ablation with MRI, nuclear scintigraphy and optical imaging1,2. The in vivo affinity of NACs to necrosis appears orders of magnitude higher than antigen-antibody, ligand-receptor and biotin-avidin interactions in vivo. Based on a soil-to-seeds hypothesis3, this stroma targetability is extended from diagnostic to theragnostic utilities by combined use of vascular disrupting agents (VDAs) such as CA4P to formulate a novel pan-anticancer approach, namely a small-molecular sequential dual targeting theragnostic strategy3. The dual targeting properties and conjugated iodine-131 that emits both beta and gamma radiations provide solid cancers (Onco) with both tumoricidal (Ci) and imaging diagnostic (Dia) effects, hence an acronym OncoCiDia3. Instead of directly attacking multimutant and refractory cancer cells (seeds) as in other cancer therapies, OncoCiDia selectively destroys and radioactively sterilizes the tumor microenvironment (soil)4. Multicenter preclinical investigations on the efficacy, safety, formulations and dosimetry suggest that this novel and unconventional anticancer strategy may present a relatively simple, workable, affordable and generic solution for diverse cancer problems, and deserve further exploitation3,4. References: 1Ni Y, et al. Invest Radiol 2005; 40: 526-35. 2Ni Y. Current Medical Imaging Reviews 2008; 4: 96-112. 3Katholieke Universiteit Leuven-Oncocidia http://vimeo.com/44871398 . 4Li J, et al. Radiology 2011; 260:799-807.
Mohamed hamdy Ibrahim
GMU University and GMC hospital, UAE
Title: Could ambulatory blood pressure Monitoring be a routine investigation for Patients with mild cognitive impairment?
Biography:
My name is Mohamed hamdy Ibrahim, Egyptian, born on 1/11/1975. I have been graduated form, FACULTY OF MEDICINE, AIN SHAMS UNIVERSITY, CAIRO, EGYPT. I joined the neuropsychiatry residency at Ain shams university Cairo, Egypt from 2001 till 2003, finished my MD in neurology and got my doctorate by 2008. I have been assigned as lecturer of neurology and my main concern was in the field of NEUROVASCULAR INTERVENTIONAL RADIOLOGY. I finished my fellowship in interventional neurology at ZURICH University, Switzerland as F.I.N.R. by 2013. Now I am an Assistant clinical professor of neurology, GMU University and GMC hospital, Ajman, united Arab of emirates (UAE) SINCE 2010. I had some publications in many journals as OPEN JOURNAL OF MEDICAL IMAGING (OJMI), The Egyptian Journal of Radiology and Nuclear Medicine, the European Journal of Neurology, Neurology of India. In addition I am Member of World Federation of Interventional and therapeutic Neuroradiology (WFITN), Member of ESMINT (European Society of Minimal Invasive Neurological Therapy). Member of European Society of Neuroradiology Diagnostic and Interventional (ESNR)
Abstract:
To study the ambulatory measured blood pressure (ABPM) profile in normotensive patients with mild cognitive impairment (MCI). Patients and Methods: The study was designed as a case control study including 50male patients with mild cognitive impairment in the age group of 30 - 50 years old. The control group included 30 volunteers with no cognitive impairment and in the same age group (30 - 50 years old) and same gender. Mini-mental estate examination, office and ABP monitoring (ABPM) and brain MRI scans were done for cases and controls. Results: Thirty patients (60%) with MCI revealed a non-dipper blood pressure pattern. Sleeping systolic blood pressure and sleeping systolic load were significantly higher in patients with MCI than in normal volunteers (p = 0.01). MRI brain showed more white matter lesions (WMLs) in patients with MCI than in normal volunteers; however, this didn’t reach significance level (p = 0.056). Conclusion: MCI in normotensive young adult patients could reflect an abnormal circadian blood pressure rhythm. Ambulatory blood pressure monitoring could be an essential investigation in young adult MCI patients.
Timo Joensuu
Docrates Cancer Center, Finland
Title: Multimodality approach in the treatment of metastatic prostate cancer
Biography:
Timo Joensuu is one of the leading European experts in prostate cancer with vast experience in both patient care and clinical studies. His special interests in the field of prostate cancer are multi-modality diagnostics, both internal and external radiotherapy and drug treatments. Timo Joensuu can well be called as one of the Nordic pioneers in radiotherapy. Joensuu is one of the founders of Docrates Cancer Center, the only Nordic private cancer center providing all aspects of cancer diagnostics and treatments under one roof. The patient-centric care model is a driving force in his medical work, resulting among other things active participation on the patient organizations’ work both home and abroad.
Abstract:
Androgen deprivation has been the only treatment recommended by guidelines for metastatic prostate cancer. The radiotherapy and radiopharmaceuticals like Samarium are used mainly as pain killers. Hormonal therapies are well established but the problem is that castration resistant disease eventually emerges and then our patients are expected to survive about two years. Our personalized clinical practice has been to combine different treatment modalities in primarily metastatic prostate cancer in order to decrease the number of cancer cells as low as possible. Diagnostic procedures we start with ermpMRI of the prostate which will be done in most cases already before biopsies, followed by NaF-PET-CT and/or choline-/PSMA-PET-CT. First goal is to get PSA down (<1). All men receive mamillar irradiation with 12 gy, 6/9 MeV. We combine LHRH analogs or Degarelix with bicalutamide plus zoledronic acid or denosumab and if it appears that we do not reach our first target we combine Docetaxel and most recently we have included also abiraterone/enzalutamide to the systemic therapy per need. Immediately, when our goal has been achieved we start radical VMAT radiotherapy of the prostate. We fuse all of our primary scannings with doseplanning-CT and try to irradiate also bone metastases including also the lymph nodes to the target volumes. In addition some patients have received samarium intensified by mitoxantrone. The good feasibility of this multimodality approach and follow up-results will be presented
Priyanka Debta
SOA UNIVERSITY, ODISHA
Title: Nuclear medicine as a unique diagnostic medical imaging
Biography:
Dr. Priyanka Debta has completed her M.D.S. in Oral Pathology and Microbiology (2006-2009) from Deemed University S.P.D.C., Sawangi, Maharashtra, INDIA. She has done research in the field of immunological cells infiltration in carcinoma and in odontogenic cysts & in forensic odontology. She has participated in national and international conferences and presented papers and posters. Presently she is working in I.D.S., SOA UNIVERSITY, BBSR, Odisha, India. Her studies and reports have been published in the national/international reputed journals. She is a dedicated, resourceful and innovative instructor for her students that helps in intellectual growth by creating an atmosphere of mutual respect and open communication.
Abstract:
Nuclear medicine is a new weapon against cancer cases for scanning as well as for treatment. While CT uses X-rays to deliver cross-sectional anatomical images PET spots cancerous cell by making visible their metabolism through tracers (radioactively labeled substances the patient is injected with). In the last fifteen years PET/CT has been successfully employed to assess how patients respond to chemo- and radiotherapy. Before treatment starts, patients undergo a PET examination in order to evaluate the malignancy and the extent of the tumor by measuring the tissue’s uptake of the radioactive tracer in relation to the administered dose and the body weight. After chemo- or radiotherapy- or a combination of both – a second PET examination is performed in order to evaluate the treatment outcome. The amount of tracer substance that can still be visualized now informs on how much the metabolic activity of the tumor as well as the extent of the cancerous areas have been reduced. The conventional imaging (CT) techniques, although very accurate in staging, have a low specificity in the assessment of therapy response in oncology. By contrast, PET allows to safely and precisely assessing the efficacy of chemotherapeutic or radio-therapeutic treatment in a non-invasive manner.
Carmen I Bigles
Coquà Pharma, USA
Title: Coqui-pharma solving the impending global shortage of molybdenum -99
Biography:
Carmen I Bigles is CEO of Coquà Radio Pharmaceuticals, Corp. a company with the goal of establishing a medical radioisotope production facility in the U.S. As co-owner of Caribbean Radiation Oncology Center, she learned that many patients were being misdiagnosed due to a global shortage of 99Mo. She sought to learn more about the Mo-99 industry and ultimately decided to establish a domestic source of the isotope. She earned a Bachelor’s degree in Mathematics from Inter-American University in San Juan and subsequently her Master’s degrees in architecture and suburban and town planning from the University of Miami.
Abstract:
Coquà Radio Pharmaceuticals Corp. is a medical isotope company dedicated to the production of Molybdenum-99, which is used in 20 million procedures each year in the U.S. The Puerto Rican company is based in Coral Gables, Fla., with the mission to bring the foremost medical isotope production facility to the Western Hemisphere and to create a commercially scalable, reliable supply of medical diagnostic and therapeutic radioisotopes in the U.S. This presentation will give an overview of the medical isotope 99Mo and its uses in modern medicine and explore the potential effects of an impending global shortage as nuclear reactors around the world begin to go offline. Carmen will give a thorough overview of Coquà Pharma and its mission to solve the impending shortage crisis as well as explain the technology the firm will employ at its medical isotope production facility.
- Radiation Therapy
Radiation Oncology & Cancer
Interventional Radiology
Chair
France Carrier
University Of Maryland, USA
Session Introduction
Raoul Saggini
G. d'Annunzio University, Chieti, Italy
Title: Extracorporeal shock wave therapy: An emerging treatment modality for retracting scars of the hands
Time : 12:55-13:15
Biography:
Raoul Saggini has graduated in Medicine and Surgery in 1979, specializing in Orthopedics and Traumatology (1982), Physical Therapy and Rehabilitation (1985) at the University of Florence and "Sports Medicine" at the University "G. d'Annunzio", Chieti, (1997). He is an ordinary University Professor in Physical Medicine and Rehabilitative in the University degli Studi G. D’Annunzio Chieti since 2003. He is the President of Physiotherapy degree course in the University of Medicine and Surgery of the University “G. D’Annunzio” in Chieti and currently the Director of Physical Medicine and Rehabilitation service of ’University of Chieti by University Centre of Medicine of Sport University of Chieti and Director of the Postgraduate School of Physical Medicine and Rehabilitation, University "G. d'Annunzio" of Chieti. He is also the President of Faculty of Physiotherapy of University “G. d’Annunzio” of Chieti.
Abstract:
Prolonged and abnormal scarring after trauma, burns and surgical procedures often results in a pathologic scar. We evaluated the efficacy of unfocused shock wave treatment, alone or in combination with manual therapy, on retracting scars on the hands. Scar appearance was assessed by means of the modified Vancouver Scar Scale; functional hand mobility was evaluated using a range of motion scale, whereas a visual analogue score was implemented for detecting any improvements in referred pain. Additionally, biopsy specimens were collected for clinico-pathologic correlation. For each active treatment group, statistically significant improvements in modified Vancouver Scar Scale were recorded as early as five treatment sessions and confirmed 2 weeks after the last treatment session. Analogous results were observed when assessing pain and range of movement. Histopathological examination revealed significant increases in dermal fibroblasts in each active treatment group as well as in neoangiogenetic response and type-I collagen concentration.
Michael Friebe
Otto-von-Guericke-University, Germany
Title: Intraoperative Radiation Delivery Concepts placed and monitored with handheld SPECT/US Hybrid Imaging Techniques
Time : 13:15-13:35
Biography:
Michael Friebe has been involved in diagnostic imaging and image guided therapeutic products and services, as founder / innovator / CEO investor, and scientist. Dr. Friebe currently is a Board Member of two startup R&D companies, as well as investment partner of a medical technology startup-fund. Dr. Friebe is an affiliated professor with the chair for Computer Aided Medical Procedures (CAMP) at TU München, and full professor of Image Guided Therapies at the Otto-von-Guericke-University in Magdeburg, Germany. He is listed inventor of more than 60 patent applications and the author of numerous papers.
Abstract:
Intraoperative radiation therapy (Low dose and high dose nuclear and electronic brachytherapy) is a potential therapy option for local tumours, and oligometastatic cancer treatment. The main benefits are that it can deliver the cell-killing radiation (beta or gamma rays) through small incisions - after surgical treatment or removal - and that it spares healthy tissue of radiation exposure. Radiation protection issues, and accurate dose measurement and quality assurance are the main issues to be resolved. Imaging for placement and therapy verification are essential tools allowing the therapist to accurately determine the tumour location, to place the therapy catheter, and subsequently to quantify and measure the dose delivered and maybe even get a confirmation on the cell killing effects. The talk will give a short overview of some of the current technologies used (Re-188, Y-90, Ir-192, miniature X-ray tubes) and the shortfalls and possible solutions of these therapy approaches particularly when combined with functional (SPECT) and anatomical imaging (US) hybrids and combinations with MRI imaging.
France Carrier
University Of Maryland, USA
Title: Chemopotenetiation By Low-Dose-Fractionated Radiation Therapy
Time : 13:35-13:55
Biography:
Dr. France Carrier is a tenured Associate Professor in the Department of Radiation Oncology at the University of Maryland, School of Medicine in Baltimore, MD, USA. Her laboratory focuses on basic and translational cancer research with emphasis on molecular events underlying cancer progression and most specifically DNA damage responses. She is particularly interested in the activation of RNA binding proteins, HDACIs and Low Dose Fractionated Radiation Therapy. She is a National Institutes Health funded investigator and has published more than 60 peer reviewed articles and book chapters. Her papers have been cited more than 6,500 times.
Abstract:
The emerging concept of chemopotentiation by Low Dose Fractionated Radiation Therapy (LDFRT) is not fully understood but builds on the phenomenon of low-dose hyper-radiosensitivity (HRS). This new paradigm allows the use of full dose systemic chemotherapy safely in combination with LDFRT, where the low-dose radiation sensitizes the tumor to subsequent chemotherapy. Using a RT2 PCR Profiler Array we identified Dual Oxidase 2 (DUOX2), an enzyme functioning in the production of hydrogen peroxide, as a major mediator of chemopotentiation by LDFRT. Down regulation of DUOX2 increased radioresistance at every radiation doses tested. In addition, our data indicate that Reactive Oxygen Species increase up to 3.5 fold in cells exposed to LDFRT and a modified regimen of Docetaxel, Cisplatin, and 5’-fluorouracil (mDCF). Furthermore, inhibition of NADPH oxidase abrogated the killing efficiency of this combined regimen in human gastric cancer cells. Taken together these data suggest that chemopotentiation by LDFRT may be due, at least in part, to increased ROS production (DUOX2) without upregulation of the DNA repair machinery. These data thus provide a rationale for further explorations of potential clinical applications of LDFRT, such as in Whole abdominal radiotherapy, as a chemopotentiator for advanced and metastatic gastric cancers.
Walter Noordzij
University of Groningen,The Netherlands
Title: Ra-223-For the treatment of symptomatic osseous metastases in patients with metastatic castration resistant prostate cancer
Time : 13:55-14:15
Biography:
Walter Noordzij has completed his medical training in nuclear medicine, along with a PhD in cardiac sympathetic innervation, at the department of Nuclear Medicine and Molecular Imaging at the University Medical Center Groningen. Besides his work as a nuclear medicine physician, he is the coordinator of the research lines ‘nuclear intervention’ and ‘medical education’.
Abstract:
More than 90% of patients with metastatic, castration-resistant prostate cancer have radiological evidence of bone metastases, which are a major cause of death, disability, decreased quality of life, and increased treatment cost among these patients. Radium-223-dichloride is a targeted alpha emitter that selectively binds to areas of increased bone turnover in bone metastases and emits high-energy alpha particles of short range (<100 µm). As a bone-seeking calcium mimetic, radium-223 is bound into newly formed bone stroma, especially within the microenvironment of osteoblastic or sclerotic metastases. The high-energy alpha-particle radiation induces mainly double-stranded DNA breaks that result in a potent and highly localized cytotoxic effect in the targeted areas. The short path of the alpha particles also means that toxic effects on adjacent healthy tissue and particularly the bone marrow, may be minimized. A phase 3 study showed that radium-223 significantly prolonged overall survival in patients who had castration-resistant prostate cancer and bone metastases, with a 30% reduction in the risk of death, as compared to placebo. The median survival was longer among patients who received radium-223 than among those who received placebo, the difference being 3.6 months. This presentation will provide an overview of the present literature, first experience in our academic center, and future perspectives of this radiopharmaceutical.
Osman Beton
Title: The practical value of technetium-99m-ΜΙΒΙ SPET to differentiate between ischemic and non-ischemic heart failure presenting with exertional dyspnea
Time : 14:15-14:35
Biography:
Osman Beton has completed his MD from Trakya University School of Medicine and Post-doctoral studies from Ankara University School of Medicine, Departement of Cardiology. He is the Director of Catheterization Laboratory and Co-director of Heart Failure Program in Cumhuriyet University School of Medicine, Heart Center, Department of Cardiology. He has published more than 20 papers in reputed journals.
Abstract:
Objective: We aimed to differentiate ischemic heart failure (HF) from non-ischemic HF in patients presenting with non-acute onset exertional dyspnea using technetium-99m methoxyisobutylisonitrile gated single photon emission tomography (99mTc-MIBI gSPET) imaging. Subjects & Methods: 179 consecutive patients with exertional dyspnea without concomitant chest pain referred to 99mTc-MIBI gSPET imaging were included in this study. All patients had a newly diagnosed HF with reduced ejection fraction (HFrEF). Imaging findings were compared between ischemic HF and non-ischemic HF groups. Results: Of the 179 patients, 127 had ischemic HF and 52 had non-ischemic HF. There was no difference between ischemic and non-ischemic groups in terms of age, gender, body mass index, any smoking history, diabetes mellitus, history of hypertension and hyperlipidemia. Global dysfunction of left ventricule was more common in non-ischemic HF group than ischemic HF group (82.7% vs. 41.7% respectively, P<0.001) . Presence of severe (3+/4+) ischemia and large perfusion defect were higher in ischemic HF group compared to non-ischemic HF group (45.7% vs. 15.4%, P<0.001 and 23.6% vs. 3.8%, P=0.003, respectively). Summed stress score (SSS), summed rest score and summed difference score were higher in ischemic HF group compared to non-ischemic HF group (P<0.001, P<0.001, and P=0.021, respectively) . In multivariate analysis, absence of global dysfunction (P<0.001, OR=10.338, 95%CI: 3.937-27.405) and SSS (P<0.001, OR=1.208, 95%CI: 1.090-1.339) were the independent predictors of ischemic HF. Absence of global dysfunction had 58.3% sensitivity and 86.7% specificity for diagnosis of ischemic HF at gSPET imaging in patients presenting with newly diagnosed HF and exertional dyspnea without concomitant chest pain (AUC=0.705, 95%CI:0.632-0.771, P<0.001), whereas SSS>8 had 65.4% sensitivity and 75.0% specificity (AUC=0.732, 95%CI:0.661-0.795, P<0.001). Conclusion: Absence of global dysfunction and SSS on SPET imaging were the independent predictors of ischemic etiology of HF presenting with dyspnea without concomitant chest pain. These findings had a low sensitivity, but acceptable specificity.
Jawa Zabah Muhammad
National hospital Abuja, Nigeria
Title: Radionuclide shuntography for evaluation of V-P shunt in hydrocephalus
Time : 14:35-14:55
Biography:
Jawa Zabah Muhammad is a Senior Consultant in Nuclear Medicine and European Board Certified in Nuclear Medicine. He has dual specialist qualifications in Nuclear Medicine and Radiology and received his training at the Stellenbosch University. He is a fellow of the College of Radiologist of Nigeria, fellow of the South African College of Nuclear Physicians, fellow of the European Board of Nuclear Medicine. He has presented papers at various national and international conferences. In 2013, his research presentation received an award of distinction at the IMIC conference in Vienna, Austria. He is the Chief Editor of the MDCAN Journal of Medical Sciences.
Abstract:
Background: Radionuclide shuntography is a safe, simple and non-invasive functional imaging technique for determining V-P shunt tube patency and analyze changes in CSF with minimal radiation burden. This is particularly useful in children with hydrocephalus in whom V-P shunt is inserted to divert CSF drainage. V-P shunts are permanent treatment option for children with hydrocephalus and radionuclide shuntography is becoming a very popular technique because of the increasing numbers and survival of children with shunt-treated hydrocephalus. Objective: The aim of this study is to analyze and document the usefulness of shuntography in the evaluation of V-P shunt in children with hydrocephalus. Method: All shuntograms performed in our institution between 2008 and 2015 were included in this study. Radionuclide shuntography was performed with Tc99m DPTA injected into the shunt reservoir and images acquired using a dual headed MEDISO camera. A normal shuntogram is considered as free flow of radiotracer from site of injection to the distal end of shunt tube with evidence of spillage into the peritoneum. Results: A total of 56 children were studied comprising of 32 males, 24 females with age ranges between 5-11 yrs. Different patterns of results were found, normal functioning shunt, total blocked tube due to mechanical defects, partial block tube due to infection or inflammatory debris and overflow of CSF. About 45% of our patients with suspected V-P tube malfunction had partial blockage. Conclusion: Patients who are diagnosed with a partial tube blockage will require only flushing of the tube and antibiotics treatment, while mechanically block tube will require replacement. This distinction is critical considering the cost of replacement of tube and manpower time for surgery.There are currently no existing protocols for radionuclide shuntography, but critical attention to details, observation of strict aseptic technique and close collaboration between the nuclear medicine physician, pediatricians and neurosurgeons would improve diagnostic accuracy, this paper will also highlight this aspect.form site of injection to the distal end of shunt tube with evidence of spillage into the peritoneum. Results: A total of 56 children were studied compressing of 32 males, 24 females with age ranges between 5-11yrs. Different patterns of results were found, normal functioning shunt, total blocked tube due to mechanical defects, partial block tube due to infection or inflammatory debris and overflow of CSF. About 45% of our patients with suspected V-P tube malfunction had partial blockage. Conclusion: Patients who are diagnosed with a partial tube blockage will require only flushing of the tube and antibiotics treatment, while mechanically block tube will require replacement. This distinction is critical considering the cost of replacement of tube and manpower time for surgery. There are currently no existing protocol for radionuclide shuntography, but critical attention to details, observation of strict aseptic technique and close collaboration between the Nuclear medicine physician, Pediatricians and Neurosurgeons would improve diagnostic accuracy, this paper will also highlight this aspect.
Chinedu Simeon Aruah
National Hospital Abuja, Nigeria
Title: Anemia in cancer patients undergoing radiotherapy and chemotherapy in National Hospital Abuja, Nigeria
Time : 14:55-15:15
Biography:
Chinedu Simeon Aruah graduated in 2004 from University of Nigeria Nsukka (UNN) where he obtained MBBS Nigeria, and enrolled for residency training in Radiation Oncology at the National Hospital Abuja, Nigeria, qualified in 2014 and got inducted as a Fellow of West African College of Surgeons (FWACS) Radiation Oncology in March 2015. He won National Hospital Abuja Research Grant 2013 during his dissertation work. He has a Master’s degree in Public Health (MPH) from University of Nigeria Nsukka (UNN). He found an NGO Pathfinder Healthcare Foundation (PHF) to create cancer awareness among rural dwellers. He is currently working at the National Hospital Abuja, Nigeria as a Researcher and Consultant Radiation Oncologist with interest in Public Health.
Abstract:
Introduction: Many cancer patients present with anemia prior to radiotherapy and chemotherapy or may experience anemia/ worsening of anemia at some point during treatment. Aims & Objectives: The aim of the study was impact of anemia in cancer patients undergoing Radiotherapy and Chemotherapy. Methodology: 201 cancer patients of both sexes with histopathologically confirmed malignancies (solid cancers). Patient’s pretreatment Hb was taken. Patients were distributed into Radiotherapy, Chemotherapy and Chemoradiation. Their Hb was measured once every 2 weeks. The blood film pictures of the patients were examined. The whole process was terminated after 3 consecutive Hb reading or after week 6. Anemia was classified into: Less than 10 g/dl (Severe anemia), 10-10.9 g/dl(moderate anemia), 11-12 g/dl (mild anemia) and 12 g/dl and above (no anemia). Results & Analysis: Out of 201 cancer patients, 86.1% were female and 13.9% were male. Age range, 25-75 years, 100 patients were on Chemotherapy, 63 patients on Radiotherapy and 38 patients on Chemoradiation. The prevalence in anemia in cancer patients undergoing radiotherapy and chemotherapy was found to be 63% as shown by blood film picture (i.e., average of 72%, 42.9% and 73.7%). At the end of therapy, 62% (100) patients on Chemotherapy and 55.6% (63) patients on Radiotherapy had their Hb level between 11-12 g/dl, 39.5% (38) cancer patients on Chemoradiation arm had Hb value of 10-10.9 g/dl. At P-value>0.05, there was no statistical significance on distribution of mean Hb, standard deviation based on sex and treatment type. Conclusion: Prevalence of anemia in the study group was found to be 63% while 37% had adequate hemoglobin (Hb) after the therapy as reflected in the blood film picture. At 95% confidence interval, Chemotherapy had greatest impact on Hb level during therapy. Thus Chemotherapy: 9.60-10.62 g/dl, Radiotherapy: 11.52-12.13 g/dl and Chemoradiation therapy: 10.98-11.36 g/dl.
- Workshop On Intraoperative Cell Killing Radiation – New Approaches Using Nuclides, Photodynamic Therapy, Photons
Session Introduction
Michael Friebe
Otto-Von-Guericke-University, Germany
Title: Minimal-Invasive And Image-Guided Radiation Therapy Products – How Important Is 'Affordable' And 'Intuitive' As Value Proposition?
Time : 15:55-16:25
Biography:
Michael Friebe has been involved in diagnostic imaging and image guided therapeutic products and services, as founder /innovator / CEO investor, and scientist. Dr. Friebe currently is a Board Member of two startup R&D companies, as well as investment partner of a medical technology startup-fund. Dr. Friebe is an affiliated professor with the chair for Computer Aided Medical Procedures (CAMP) at TU München, and full professor of Image Guided Therapies at the Otto-von-Guericke-University in Magdeburg, Germany. He is listed inventor of more than 60 patent applications and the author of numerous papers.
Abstract:
Innovative university based medical technology product development is largely dependent on the availability of external research funding from industry or public / private non-profit institutions. Research by definition is highly speculative and comes with a great risk of failure, which makes it largely unattractive for industry. Government and other non-profit funding agencies require that uncertainty and the reviewers of the programs also like to see a high-tech component and a great amount of scientific complexity. So, there is a clear focus on expensive complexity in current research funding.Especially in the medical technology segment there is a need for innovative tools and devices however, that also enable new minimal invasive radiation therapy therapies. Medical doctors as the users of that technology do appreciate easy to use devices with a low error margin as the final use of the product is on a sensitive living patient. Additionally, the healthcare system has yearly decreasing funds available, developing countries cannot afford the systems made for the developed world, and complexity also requires dedicated support and application staff. The talk will highlight some of the attributes and value propositions that to be developed medical technology devices should have. These may not always be considered scientifically 'cool' from a funding perspective, but that are faster applicable, and more widely useable than the complex and expensive high-tech devices that are often proposed.These features could open new market segments and increase the speed acceptance of new therapies.
Alfredo Illanes
OvG University, Germany
Title: Photodynamic therapy: an attractive but complex multivariable process
Time : 16:25-16:55
Biography:
Alfredo Illanes is a researcher at the Chair of Catheter Technologies of the OvG University, Magdeburg. After obtaining a master degree in Signal Processing with applications in cardiac signals, he received a Ph.D. at INRIA, Rennes, France, in the area of electrocardiogram (ECG) signal processing and modeling in 2008. Since then, he has been involved in several applied research projects in the field of biological signal and image processing and modeling as assistant professor at the Engineering Faculty of the Southern University of Chile. His current main research interests involve biosignals feature extraction and parametrical modeling in biological processes.
Abstract:
Photodynamic therapy (PDT) is a minimally invasive therapeutic procedure consisting in a photochemical reaction that involves three main components: a photosensitizer, oxygen and light at an appropriate wavelength. These components interact with each other and with the tissue resulting in a reaction having as main objective to generate Reactive Oxygen Species (ROS), which can rapidly cause significant toxicity in the cells. If one of the main components involved in PDT is not there, then the reaction will not take place and then no ROS can be generated. Despite that photodynamic effects has been first described in the early 1900s and that since the 80s PDT has been largely studied involving the generation of more than 250 trials, where essentially, all types of solid tumors have shown positive response, PDT has not yet been currently introduced in clinical practice for tumor therapy. The complex and still hardly understood dynamical relationship between the involved variables, which makes the process difficult to monitor and optimize can be the major reason of that. This work intends to describe, in a systemic point of view, the process behind PDT in order to understand the time/spatial variant characteristics that make this process difficult to control, and therefore, difficult to assess in terms of dosimetry. The focus will be pointed on the dynamical relationship between variables and parameters and on how they vary on time and on space, analyzing the time constants involved in the process, as well as, the existing techniques for monitoring these dynamical changes.
Joerg Traub
SurgicEye GmbH, Munich, Germany
Title: 3D interventional nuclear medicine imaging and therapy monitoring
Time : 16:55-17:25
Biography:
Joerg Traub has completed his PhD from TU Munich with highest distinction. After graduation he was co-founder SurgicEye GmbH. He is CEO and President of SurgicEye, an innovator in the field of mobile nuclear imaging during therapy, for the past 8 years. He has published more than 50 peer-reviewed journal and full paper conference papers, is co-inventor of more than 10 patents and has been serving as reviewer in several medical imaging and computer assisted surgery journals and conferences
Abstract:
Radio-guided surgery is defined as any surgical procedure which utilizes a radiation detection device in a real-time fashion within the operating room for the identification of a radioisotope administered to a patient prior to the time of attempted detection and with the sole purpose of assisting in the successful performance of that surgical procedure. There is a wide application domain in the surgery room for sentinel lymph node marking, marking of primary tumors and also injection of radio-isotopes for selective internal radiation therapy. A commonly used radiation detection system during radio-guided surgery is a handheld gamma probe. The use of imaging during surgery is in general not facilitated since it is only available in a few high-tech operating rooms. Freehand SPECT was introduced as a technology for 3D radio-guided surgical procedures such as sentinel lymph node biopsy. In addition to the information provided by conventional gamma probes, freehandSPECT allows a 3D reconstruction and a visualization of the distribution of radioactivity in the region of interest. freehandSPECT is combined with a navigation system facilitating precise guidance to radioactive marked lesions, provides depth measurement, and an intuitive augmented reality visualization. A summary of currently available clinical data on the use of freehandSPECT will be provided for sentinel lymph node biopsy of various malignancies, and for radio-guided localization of primary tumors. A comprehensive technology review of mobile SPECT solutions will be provided along with advanced features e.g. image fusion with diagnostic ultrasound or with a cone beam CT in an interventional radiology suite
Alexander van Oepen
Otto-von-Guericke University, Germany
Title: Radionuclide based intraoperative irradiation - current and future approaches
Time : 17:25-17:55
Biography:
Alexander van Oepen completed his studies at the age of 25 years and graduated with a Master of Science from the University of Luebeck, Germany. He is a research associate of Prof. Dr. Michael Friebe at the Chair for Catheter Technologies and Image guided Interventions of the Otto-von-Guericke University in Magdeburg. His research topics are focused on the field of nuclear medicine and biomedical optics for cancer treatment.
Abstract:
The possibility to use ionizing radiation in form of x-rays for therapeutic purposes was recognized early after their discovery by Wilhelm Conrad Roentgen. Therapeutic irradiation can be applied mainly in three different ways: external beam radiation, sealed source radiation and unsealed source radiation. The most significant medical applications of irradiation therapies are in the field of cancer treatment. The cell-killing biological effects of the irradiation are utilized to minimize the risk of cancer recurrence after surgical tumor removal or to directly irradiate the tumorous tissue. In the case of breast surgery, external beam radiation therapy is often performed post-operatively in multiple fractions. This leads inevitably to damage of healthy tissue along the beam path and is also stressful for the patient due to repeated attendance in the hospital. To overcome these problems, new approaches to deliver the irradiation doses to the tumor side were devised. Based on radionuclides, which emit ionizing radiation in a finite range around the source, therapeutic radiation can be delivered directly to the tumor within or immediately after surgery via special applicators. Tumor removal and irradiation could be completed in one session. These intraoperative approaches can lead to less trauma and bed time for the patient with the same therapeutic outcome. Concepts for intraoperative radionuclide based irradiation approaches are presented in this work. Different applicators and operation room settings are discussed as well as current developments for the systems of the future.