SOMETIMES THE DEVICE a doctor needs to provide patients with the best treatment possible simply doesn't exist.
The clinician-scientists at Sunnybrook overcome these gaps by collaborating with the hospital's device-building teams. Even ideas scribbled onto napkins have been transformed into commercial devices that improve quality of care for patients at Sunnybrook and around the world.
Some tools offer diagnostic or treatment advantages to the patient, such as a new method to image tumours or a system that offers oncologists a way to precisely place radioisotopes into the tumour. Others allow technicians to ensure their machines are well calibrated so diagnostic images or interventions are accurately targeted. Still others help researchers study disease in animals.
The machine shop in the Odette Cancer Centre at Sunnybrook has been churning out life-changing devices for over a decade. Inventor Harry Easton and his medical physics team have turned ideas into devices that decrease the number of visits a breast cancer patient needs for treatment or deliver radiation doses to patients with inoperable brain tumours with sub-millimetre accuracy. Such innovations can make a dramatic difference in patients' lives.
In 2007, Sunnybrook was awarded close to $75-million from the federal government's Canada Foundation for Innovation to expand the hospital's research facilities, including opening the Device Development Lab, part of Sunnybrook Research Institute's Centre for Research in Image-Guided Therapeutics. Slated to open in mid-2012, the new facility will be a hub of activity for the design, fabrication, testing and validation of medical devices, bring team members together, and provide them with state-of-the-art equipment. It will have new, automated, powerful equipment to make parts and highly precise tools for miniature components. The new designs that spill out of the lab will offer more effective ways to diagnose disease, deliver therapy and guide interventions.
Here are a few innovative new devices from Sunnybrook's device labs.
1 Standing in for treatment
WHAT IT IS The Lucy Phantom helps treat inoperable brain tumours or arterial venous malformations that can be attacked with an intense, pencil-thin X-ray beam. The more focused the beam, the better the treatment.
WHAT IT DOES The Lucite sphere has roughly the same density as the brain (1.1 g/cm3). The oncologist can use the Lucy Phantom to track the x, y and z coordinates of the radiation beam so it will hit precisely the right spot in the brain during the patient's treatment.
WHO CREATED IT Easton's lab developed the Lucy Phantom, one of the best-known devices to come out of the machine shop at Odette.
THE PAYOFF Oncologists can better plan the treatment for each patient. "The tool provides quality control and quality assurance on the system and simulates the treatment," says Easton.
Building better MRIs
WHAT IT IS Specially designed coil-and-bed system to improve the detection and biopsy of breast cancer.
WHAT IT DOES MR images help doctors detect cancerous lesions in the body. Specially designed coils surround the body part of interest and receives the signals that are transformed into images. For years, breast MRIs were done using coils designed for something else.
WHO CREATED IT Twenty years ago, Dr. Don Plewes, a senior scientist at the Sunnybrook Research Institute, with then-graduate student Cameron Piron, began developing a system that would improve MRI results, particularly among women with a high risk of developing breast cancer. "The design optimizes the signal-to-noise ratio to improve the image quality and puts it into an elegant package that could be coupled to any commercial hardware," says Dr. Stuart Foster, head of the Centre for Medical Device Design.
THE PAYOFF The work was spun off into a company called Sentinelle, which was acquired by Hologic Inc. in 2010 for $85-million.
2 Sowing seeds of treatment
WHAT IT IS A stable platform (a flat, square block of ultra-lightweight plastic) punched with a grid of small holes, allowing needles tipped with radioactive pellets to be inserted into precise locations in or adjacent to cancerous tissues in the breast. An ultrasound machine visualizes the work.
WHAT IT DOES It makes it possible for breast cancer patients to receive what used to be a daily six-week treatment all in one afternoon.
WHO CREATED IT Inspired by a prostate cancer treatment, the device was conceived by Dr. Jean-Philippe Pignol and custom-designed and manufactured by engineering services.
THE PAYOFF The machine shop in the Odette Cancer Centre has manufactured three systems for Sunnybrook and additional systems for another Ontario hospital. Core Oncology now markets the device.
3 Lining up the lasers
WHAT IT IS A unique and expensive tool used to calibrate oncology treatment machines before treatment can begin.
WHAT IT DOES A transparent acrylic cube allows engineering staff to calibrate and align lasers used to position patients before treatment; if the lasers are off even slightly, the radiation beam won't hit its target precisely.
WHO CREATED IT The Odette lab engineering services team.
THE PAYOFF The device is now being used in locations in Canada and as far away as Florida.
WHAT IT IS The world's first high-frequency ultrasound tool.
WHAT IT DOES It uses high-frequency transducers, making it possible to see tiny features in real time. Clinical applications include neonatal imaging and the diagnosis of eye and skin diseases.
WHO CREATED IT When Dr. Stuart Foster couldn't find a device that would allow him and his team to look at the tiny blood vessels that feed blood into a mouse tumour, he decided to build it himself.
THE PAYOFF Universities and national health labs wanted them and hundreds were sold. The company, VisualSonics Inc., was bought by Sonosite Inc. in 2010 for $71-million.