An MRI combined with ultrasound was used to guide
the biopsy and find the occult prostate cancer of
Kim Stewart, shown here with Dr. Laurent Milot.
Dr. Cunningham’s new method uses a “hyper-polarizer” machine to add magnetic signals to pyruvate – a chemical compound produced when the body metabolizes glucose or sugar. When injected into a patient, this magnetized pyruvate can be captured visually using an MRI scanner.
“We make images of the pyruvates as well as other metabolic products such as carbon dioxide and glutamate produced within the heart muscle,” says Dr. Cunningham. “We know what the changes are for those products in early
Magnetic resonance imaging is already used today to visualize the pumping of a patient’s heart. Integrating the hyper polarizer would add a mere 10 minutes to the process and provide significantly more valuable information that may soon help doctors develop an optimal treatment plan for each patient.
Sunnybrook is now getting ready to embark on its first patient studies using this method for cardiovascular imaging. Dr. Cunningham says his team will also be working with drug companies on ways to target the different patterns in metabolic changes from heart disease, which affects about 1.4 million Canadians today and kills close to 50,000 a year.
“There are a lot of different drugs and they have varying degrees of efficacy for different stages of heart failure,” he says. “Our goal with these studies is to be able to identify which patients would be better candidates for certain types of therapy – that would be a huge improvement.”
THERANOSTIC: QUS (Quantitative Ultrasound)
Sunnybrook is making waves in breast cancer treatment with an innovative monitoring technique that can detect within one to four weeks whether or not a patient is responding to chemotherapy.
Known as QUS, the new technology applies specialized software to traditional ultrasound imaging to detect the absence or presence of cell death from chemotherapy.
For women with locally advanced breast cancer receiving pre-surgery chemotherapy, the use of QUS means they’ll no longer need to wait months to find out how the treatment worked.
“About 60 to 70 per cent of the time, chemotherapy could be more effective,” says QUS study lead, Dr. Gregory Czarnota, Sunnybrook’s head of radiation oncology at the Odette Cancer Program, and a senior scientist at Sunnybrook Research Institute. “But the problem with classic diagnostic imaging is that it measures tumour size and extent, and when you’re treating tumours, changes in size take many months to happen.”
With QUS, doctors will know sooner if they need to switch their patient to a different type of drug or treatment method – a move that potentially stands to change the outcome for women with locally advanced breast cancer.
More than 100 women have signed up to participate in a QUS study, and about 85 of these women have finished their tests.
“The results proved that the technology works – that within one and four weeks we can demonstrate whether the chemo was going to work or not,” says Dr. Czarnota. “We’re at the stage now where the technology is being expanded to other centres through the Ontario Institute for Cancer Research.”
THERAPEUTIC: MRI - RADIATION TECHNOLOGY
What if you could deliver cancer treatment with laser-sharp precision, killing only the cancer and leaving normal tissues untouched? That’s a goal Sunnybrook hopes to help accomplish soon.
Last year, Sunnybrook joined a research consortium to develop and test a new system that merges magnetic resonance imaging with radiation therapy. This breakthrough technology, which provides exceptional depictions of a patient’s soft tissues and tumour, could soon make it possible for doctors to track the treatment site in real-time and reduce side-effects from radiation therapy.
Created by Stockholm-based Elekta AB and Royal Philips Electronics in the Netherlands, the new technology represents one of the most exciting developments in radiation technology in the last decade.
QUANTITATIVE ULTRASOUND: AN EYE TO BREAST CANCER
The top row shows a large breast tumour before pre-surgery chemotherapy treatment and (bottom row) after four weeks of treatment, using four different techniques, starting with black-and-white ultrasound on the left.
This graph shows quantitative ultrasound of a case in which the breast cancer tumour is responding to pre-surgery chemotherapy treatment; the blue lines show the tumour before chemo, and the red lines are after treatment.
Each row shows a different tumour’s response to treatment. Red areas show low signal intensity – i.e. a low response to chemotherapy. Yellow shows high signal intensity, signalling a good response.
The top row is a nonresponding case; the two lower rows show tumours responding To treatment over a period that starts pre-treatment and progesses to the eighth week of treatment and (in the final square) just before surgery.
Follow us on Twitter: