Archive for the ‘Imaging’ Category

Maximum Image Quality, Minimum Radiation Dose: Siemens Announces The International CT Image Contest 2011

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Posted 09 Mar 2011 — by James Street
Category Diagnostic, Imaging, Imaging

06 Mar 2011

Following on from the amazing success of the first computed tomography (CT) image contest in 2010, Siemens Healthcare has announced the “International CT Image Contest 2011″. Institutions and clinics around the globe will submit their best clinical images, taken with the lowest possible radiation dose on Siemens CTs, to a jury of internationally renowned professors. The contest starts on March 3rd, and the closing date for entries is September 18th, 2011. The winners will be announced at the next conference of the Radiological Society of North America (RSNA 2011) in Chicago.

“In our first contest the jury received around 300 clinical images from more than 30 countries”, says Andre Hartung, Head of Business Segment Computed Tomography at Siemens Healthcare. “We are pretty sure that as many of our customers as possible will take part again, as at Siemens radiation protection and dose reduction have always been a top priority in CT, right from the moment when the company launched the first computed tomography (CT) system in 1974.”

Excellent image quality is essential for computed tomography (CT). At the same time, the patient’s exposure to radiation should be as low as possible. Siemens Healthcare aims to help its customers make maximum use of the hardware and software to reduce dose on CTs and to share their experience with other users of Siemens CTs and interested audience. Which is why a 2nd International CT Image Contest will be held from March 3rd 2011 to September 18th, 2011. Customers who use a CT of the Somatom Definition family, a Somatom Emotion, Somatom Sensation or Somatom Spirit will be able to present clinical images – which have been reprocessed with Syngo CT Worksplace, Syngo MMWP or Syngo.via – in seven categories to an international jury of acknowledged experts: cardiology, angiography, dual energy, pediatrics, trauma, neurology and areas of their clinical routine, which includes thorax, abdomen and pelvis.

The Siemens “International CT Image Contest 2010″ was a huge success, with participants from over 30 countries, who submitted a total of around 300 images. There was even a fan community on Facebook with more than 1600 members, who discussed the images submitted. In addition to which, all internet users could vote for their favorite picture in a public vote. The internet page devoted to the contest received 17,000 hits within 6 months. The aim was to make the public aware of the responsibility that manufacturers and radiologists have as regards diagnostic radiation. The innovative concept of the contest received the accolade of two well-known communication awards: the Comprix 2010 Gold Award and the iF Communication Design Award.

For terms and conditions of entry for the “International CT Image Contest 2011″ go here.

Siemens Healthcare Sector

New prostate cancer imaging shows real-time tumor metabolism

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Posted 30 Nov 2010 — by James Street
Category Imaging, Prostate Cancer

Contact: Kristen Bole
University of California – San Francisco

A UCSF research collaboration with GE Healthcare has produced the first results in humans of a new technology that promises to rapidly assess the presence and aggressiveness of prostate tumors in real time, by imaging the tumor’s metabolism.

This is the first time researchers have used this technology to conduct real-time metabolic imaging in a human patient and represents a revolutionary approach to assessing the precise outlines of a tumor, its response to treatment and how quickly it is growing.

Data on the first four patients will be presented on Dec. 2 at the Radiology Society of North America’s weeklong annual conference.

The initial results validate extensive preclinical research that has linked the speed at which tumors metabolize nutrients to the aggressiveness of their growth. The new imaging technique also has been used to show early biochemical changes in animal tumors in real time as they respond to medication therapy, long before a physical change occurs.

So far, the technology has produced the same response in human patients’ tumors as it did in laboratory studies, even at the lowest dose, according to Sarah Nelson, PhD, a professor of Radiology and Biomedical Imaging and a member of the California Institute for Quantitative Biosciences (QB3) at UCSF.

“This is a key milestone that could dramatically change clinical treatment for prostate cancer and many other tumors,” Nelson said. “We had shown this worked in animal models and tissues samples. Now, in men, we are seeing exactly the type of results we had hoped for.”

For an oncologist, that means immediate feedback on whether a patient’s therapy is working, either during standard treatment or in a clinical trial.

“If we can see whether a therapy is effective in real time, we may be able to make early changes in that treatment that could have a very real impact on a patient’s outcome and quality of life,” said Andrea Harzstark, MD, an oncologist with the UCSF Helen Diller Family Comprehensive Cancer Center who is leading the clinical aspects of the current study.

More than 200,000 men are diagnosed with prostate cancer each year and 28,000 die from it, making it one of the most common cancer in men nationwide and also one of the leading causes of cancer death in men, according to the Centers for Disease Control.

Yet the disease ranges widely in its rate of growth and aggressiveness, according to John Kurhanewicz, PhD, a UCSF expert in prostate cancer imaging. As a result, there is great debate over the ideal strategy for treating the disease, he said, leaving patients with a difficult and potentially life-changing decision over how aggressively to respond to the disease.

“This test could give both physicians and patients the information they need to make that decision,” said Kurhanewicz, whose work with Dan Vigneron, PhD, and their colleagues from the UCSF Department of Radiology and Biomedical Imaging first linked a prostate tumor’s production of lactate to tumor aggressiveness. Other researchers also have linked that lactate production to tumor aggressiveness and response to therapy in other cancers.

The method uses compounds involved in normal tissue function – in this case, pyruvate, which is a naturally occurring by-product of glucose, and lactate, also known as lactic acid – and uses newly developed equipment to increase the visibility of those compounds by a factor of 50,000 in a magnetic resonance imaging (MRI) scanner.

That process requires pyruvate to be prepared in a strong magnetic field at a temperature of minus 272O C, then rapidly warmed to body temperature and transferred to the patient in an MRI scanner before the polarization decays back to its native state.

The result is a highly defined and clear image of the tumor’s outline, as well as a graph of the amount of pyruvate in the tumor and the rate at which the tumor converts the pyruvate into lactate.

The sterile production process requires a dedicated clinical pharmacist with the knowledge of both quality control and of clinical practice. As the birthplace of the field of clinical pharmacy and one of only a handful of schools nationwide with drug production expertise, the UCSF School of Pharmacy and contributions of Marcus Ferrone, PharmD, and his colleagues in the Drug Products Services Laboratory were integral to this process.

The procedure must take place within minutes, which meant integrating a clean room into the scanning facility. QB3 also worked with GE Healthcare in designing Byers Hall, in which the Surbeck Laboratory of Advanced Imaging is housed, to accommodate the extremely strong magnetic field of the MRI scanner and enable time-sensitive experiments.

“All of that insight is why we moved this technology to Northern California,” said Jonathan Murray, general manager, Metabolic Imaging at GE Healthcare. “This is a huge accomplishment UCSF and QB3 have achieved. They brought together the best engineering from UC Berkeley and the best bioscience and pharmacy knowledge from UCSF, and are now demonstrating the technology in a world-renowned academic medical center. We are delighted with the speed of progress of this collaboration. The science is very exciting.”

The first trial involves men with prostate cancer involved in the “watchful waiting” phase of treatment, Nelson said. Future studies will directly compare these data with the results from surgically removed tumors and will look at how specific therapies change tumor metabolism. UCSF also will be studying the process for use in brain tumor patients.

The project’s funding through the National Institute of Biomedical Imaging and Bioengineering, in the National Institutes of Health, was critical in adapting this technology for humans and developing new ways to obtain the MR metabolic imaging data. The project received further support from the American Recovery & Reinvestment Act and the UC Discovery Program.

Initial development of this instrumentation and its demonstration of proof of principle was conducted by Jan Henrik Ardenkjaer-Larsen, Klaes Golman and other colleagues from across GE. UCSF customized that principle and obtained the Investigational New Drug (IND) approval from the Food and Drug Administration to use the hyperpolarized pyruvate in humans.


These concepts are still investigational and not being offered for sale, nor have they been cleared or approved by the FDA for commercial availability.

About GE Healthcare

GE Healthcare provides transformational medical technologies and services that are shaping a new age of patient care. Our broad expertise in medical imaging and information technologies, medical diagnostics, patient monitoring systems, drug discovery, biopharmaceutical manufacturing technologies, performance improvement and performance solutions services help our customers to deliver better care to more people around the world at a lower cost. In addition, we partner with healthcare leaders, striving to leverage the global policy change necessary to implement a successful shift to sustainable healthcare systems.

Our “healthymagination” vision for the future invites the world to join us on our journey as we continuously develop innovations focused on reducing costs, increasing access and improving quality around the world. Headquartered in the United Kingdom, GE Healthcare is a unit of General Electric Company (NYSE: GE). Worldwide, GE Healthcare employees are committed to serving healthcare professionals and their patients in more than 100 countries. For more information about GE Healthcare, visit our website at

About QB3 and UCSF

QB3 is a cooperative effort among private industry and more than 200 scientists at UCSF, UC Berkeley and UC Santa Cruz. One of four California technology institutes, QB3 harnesses the quantitative sciences of information technology, imaging and engineering to integrate and enhance scientific understanding of biological systems, enabling scientists to tackle problems that have been previously unapproachable. Please visit

UCSF is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. For more information on UCSF, visit For specific information on UCSF imaging, visit:

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A World’s First In Imaging – Integrated Whole-body Molecular MR System Available For Clinical Use Testing

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Posted 25 Nov 2010 — by James Street
Category Diagnostic, Imaging

21 Nov 2010

Today, Siemens Healthcare unveils its new system, Biograph mMR, the world’s first integrated whole-body molecular MR with simultaneous data acquisition technology, currently undergoing clinical use testing. This revolutionary system comprises a magnetic resonance (MR) scanner and an integrated PET (Positron Emission Tomography) detection system with an architecture that performs as one. In the new 3-tesla hybrid system, Siemens developers have succeeded for the first time in simultaneously capturing MR and PET data with a whole-body system. The Biograph mMR system has been installed at the university hospital Klinikum rechts der Isar of the Munich Technical University, Germany.

“Together with our partner Siemens we are entering a new dimension in diagnostic imaging today”, said Prof. Dr. Markus Schwaiger, director of the clinic for nuclear medicine at the university hospital. “We’ve initiated clinical use testing of Biograph mMR in an effort to diagnose diseases at a very early stage; to see the progression of disease and to use that information to develop a therapy plan precisely focused on the respective patient. Furthermore, we plan to use the system for cancer follow-up in the long run, by reducing radiation exposure by the use of the system.”

With the simultaneous acquisition of MR and PET data, this system is designed to provide new opportunities for imaging. While MR provides exquisite morphological and functional details in human tissue, PET goes further to investigate the human body at the level of cellular activity and metabolism. The innovative system has the potential to be a particularly valuable tool for identifying neurological, oncological and cardiac conditions of disease and in supporting the planning of appropriate therapies. Since MRI does not emit ionizing radiation, Biograph mMR may provide an added benefit with lower-dose imaging. The Biograph mMR also opens new opportunities for research, such as the development of new biomarkers or new therapeutic approaches.

“Biograph mMR is the latest breakthrough innovation of Siemens in the field of diagnostic imaging. It will be a new instrument for driving personalized medicine forward”, said Walter Maerzendorfer, CEO of the Business Unit Magnetic Resonance at Siemens Healthcare. “Biograph mMR is designed to simultaneously acquire morphology, function, and metabolism for the entire body”, added Britta Fuenfstueck, CEO of the Business Unit Molecular Imaging at Siemens Healthcare.

MR and PET have become an established part of everyday healthcare routines and have proven themselves to be valuable clinical diagnostic tools. The integration of these two technologies into a single system capable of simultaneous acquisition brings the potential to revolutionize the diagnosis of many conditions. Initial research suggests that with this system, Molecular MR can scan the entire body in as little as 30 minutes for the combined exams, compared to one hour or more for sequential MR and PET examinations.

Siemens envisions a wide range of clinical applications for molecular MR including the early identification and staging of malignancies, therapy planning (including surgery planning) and therapy control.

A technical revolution

Until now, it was nearly impossible to integrate MR and PET technologies: the conventional PET detectors, which use photomultiplier tubes, could not be used in the strong magnetic field generated by an MR system. Integration was further limited by the lack of space inside the MR device. For this reason, MR-PET imaging was the result of two separate scans (MR and PET) with a significant time lag. With Biograph mMR, Siemens brings the first molecular MR system for clinical research that integrates MR with compact, specialized PET detectors.

The Biograph mMR – incorporating Tim, the “Total imaging matrix” technology from Siemens may make it even quicker and easier for clinicians to perform the MR examination.

*The Biograph mMR system requires 510(k) review by the FDA and is not commercially available. Due to regulatory reasons its future availability in any country cannot be guaranteed. Please contact your local Siemens organization for further details.

The outcomes achieved by the Siemens customers described herein were achieved in the customer’s unique setting. Since there is no “typical” hospital and many variables exist, e.g., hospital size, case mix, level of IT adoption, there can be no guarantee that others will achieve the same results.

Siemens Healthcare Sector

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Main News Category: MRI / PET / Ultrasound

Also Appears In:  Radiology / Nuclear Medicine,

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New imaging technique accurately finds cancer cells, fast

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Posted 24 Nov 2010 — by James Street
Category Diagnostic, Imaging
Nov 24th, 2010
New imaging technique accurately finds cancer cells, fast
(Nanowerk News) The long, anxious wait for biopsy results could soon be over, thanks to a tissue-imaging technique developed at the University of Illinois.
The research team demonstrated the novel microscopy technique, called nonlinear interferometric vibrational imaging (NIVI), on rat breast-cancer cells and tissues. It produced easy-to-read, color-coded images of tissue, outlining clear tumor boundaries, with more than 99 percent confidence – in less than five minutes.
Led by professor and physician Stephen A. Boppart, who holds appointments in electrical and computer engineering, bioengineering and medicine, the Illinois researchers will publish their findings on the cover of the Dec. 1 issue of the journal Cancer Research.
From left, Eric Chaney, a research specialist at the Beckman Institute; Stephen Boppart, a professor of electrical and computer engineering, of bioengineering and of medicine; Martin Gruebele, a professor of chemistry and of physics; and Wladamir Benalcazar, a graduate fellow at the Beckman Institute
From left, Eric Chaney, a research specialist at the Beckman Institute; Stephen Boppart, a professor of electrical and computer engineering, of bioengineering and of medicine; Martin Gruebele, a professor of chemistry and of physics; and Wladamir Benalcazar, a graduate fellow at the Beckman Institute.

In addition to taking a day or more for results, current diagnostic methods are subjective, based on visual interpretations of cell shape and structure. A small sample of suspect tissue is taken from a patient, and a stain is added to make certain features of the cells easier to see. A pathologist looks at the sample under a microscope to see if the cells look unusual, often consulting other pathologists to confirm a diagnosis.

“The diagnosis is made based on very subjective interpretation – how the cells are laid out, the structure, the morphology,” said Boppart, who is also affiliated with the university’s Beckman Institute for Advanced Science and Technology. “This is what we call the gold standard for diagnosis. We want to make the process of medical diagnostics more quantitative and more rapid.”
Rather than focus on cell and tissue structure, NIVI assesses and constructs images based on molecular composition. Normal cells have high concentrations of lipids, but cancerous cells produce more protein. By identifying cells with abnormally high protein concentrations, the researchers could accurately differentiate between tumors and healthy tissue – without waiting for stain to set in.
Each type of molecule has a unique vibrational state of energy in its bonds. When the resonance of that vibration is enhanced, it can produce a signal that can be used to identify cells with high concentrations of that molecule. NIVI uses two beams of light to excite molecules in a tissue sample.
“The analogy is like pushing someone on a swing. If you push at the right time point, the person on the swing will go higher and higher. If you don’t push at the right point in the swing, the person stops,” Boppart said. “If we use the right optical frequencies to excite these vibrational states, we can enhance the resonance and the signal.”
One of NIVI’s two beams of light acts as a reference, so that combining that beam with the signal produced by the excited sample cancels out background noise and isolates the molecular signal. Statistical analysis of the resulting spectrum produces a color-coded image at each point in the tissue: blue for normal cells, red for cancer.
Another advantage of the NIVI technique is more exact mapping of tumor boundaries, a murky area for many pathologists. The margin of uncertainty in visual diagnosis can be a wide area of tissue as pathologists struggle to discern where a tumor ends and normal tissue begins. The red-blue color coding shows an uncertain boundary zone of about 100 microns – merely a cell or two.
“Sometimes it’s very hard to tell visually whether a cell is normal or abnormal,” Boppart said. “But molecularly, there are fairly clear signatures.”
The researchers are working to improve and broaden the application of their technique. By tuning the frequency of the laser beams, they could test for other types of molecules. They are working to make it faster, for real-time imaging, and exploring new laser sources to make NIVI more compact or even portable. They also are developing new light delivery systems, such as catheters, probes or needles that can test tissue without removing samples.
“As we get better spectral resolution and broader spectral range, we can have more flexibility in identifying different molecules,” Boppart said. “Once you get to that point, we think it will have many different applications for cancer diagnostics, for optical biopsies and other types of diagnostics.”

Source: University of Illinois

BellBrook Labs Develops New High Content Assay to Explore Tumor Cell Invasion in 3D Matrix

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Posted 12 Nov 2010 — by James Street
Category Circulating Tumor Cells, Imaging, Metastases

BellBrook Labs has developed a high-content tumor cell invasion assay ( by expanding the capability of its proprietary iuvo™ Microconduit Array platform to assess three dimensional cell movement through extracellular matrix. The results of this research, recently published in the Journal of Biomolecular Screening (Vol 15, 2010, p. 1114-1151 (, showcase the ability of BellBrook’s 3D ECM Invasion Assay Service ( to advance the exploration of new targets for anti-cancer drug development.

Madison, WI (PRWEB) November 11, 2010

BellBrook Labs announced the publication of studies on an enabling new approach for studying tumor cell invasion entitled “An Automated High-Content Assay for Tumor Cell Migration through 3-Dimensional Matrices,” in the October volume of Journal of Biomolecular Screening (JBS). In the paper, Dr. Steven Hayes, Victoria Echeverria and their colleagues at BellBrook describe how the company’s iuvo™ Microconduit Array platform was used to overcome the limitations of current methods to enable development of an information-rich, 3D tumor cell invasion assay using automated high content analysis.

Metastasis is the predominant cause of death from cancer, and tumor cell migration is a key element in the metastatic process. Understanding how tumor cells invade other tissues and developing new drugs that block the process are fundamental challenges in cancer research. However, modeling tumor cell invasion the way it occurs in the body – three dimensional movement of cells through ECM (Extracellular Matrix) – has proven difficult, especially in an automated, high throughput format, largely because culturing and imaging cells in ECM in traditional mulitwell plates is problematic. As described in the JBS paper, the BellBrook team was able to circumvent these difficulties by performing invasion assays in submicroliter channels in their recently developed iuvo Microchannel 5250 plates. Metastatic prostate cells were added to the liquid media compartment and allowed to migrate into the collagen-filled microchannels and automated microscopy was used to image the ultrathin assay compartments, generating quantitative data on the number of cells invading the matrix and distance traveled as well as effects on cell proliferation. The study showed that that cell movement through ECM in the microchannels was truly 3-dimensional, and therefore, representative of the in vivo invasion process. In addition, quantitative potency measurements were obtained for known inhibitors of cell migration, as well as information on the effect of the inhibitors on cell health, demonstrating the utility of the assay for anti-cancer drug discovery. By using this newly-developed assay in their 3D ECM Invasion Assay Service, BellBrook can provide researchers with valuable information on how effectively and specifically their potential drug molecules target the invasion process.

About BellBrook Labs. BellBrook Labs, LLC develops detection reagents and microfluidic devices that accelerate the discovery of more effective therapies for cancer and other debilitating diseases. Transcreener® is a patented high throughput screening assay platform that was introduced in 2005 and is used to identify inhibitors for kinases and other types of protein drug targets. The iuvo™ Microconduit Array technology is a line of unique microscale devices for miniaturization and automation of advanced cell models that are more representative of human physiology. Visit BellBrook’s website for more information:

Contact us at 866.313.7881 or info(at)bellbrooklabs(dot)com for more information.


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High-Tech Lung Cancer Test Cuts Risk of Dying

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Posted 04 Nov 2010 — by James Street
Category Diagnostic, Imaging
NEW YORK, Nov. 4, 2010

Study Shows Older Smokers Who Puff a Pack a Day Less Likely to Die from Cancer if Screened with CT Scan

By Jonathan LaPook, M.D.
Video Lung Cancer Screening Breakthrough

  • Lung cancer is the No. 1 cancer killer, taking the lives of an estimated 157,000 Americans per year. For the first time, a high-tech way of screening has been shown to drastically cut the risk of dying from the disease. Dr. Jon LaPook reports.
  • The effectiveness of CT scanning for lung cancer has been debated for years. A key concern: the test picks up lung abnormalities that are not cancer. These are common in heavy smokers and can result in costly, anxiety-producing tests.The effectiveness of CT scanning for lung cancer has been debated for years. A key concern: the test picks up lung abnormalities that are not cancer. These are common in heavy smokers and can result in costly, anxiety-producing tests. (CBS)

(CBS) No cancer kills more Americans than lung cancer. Estimates are more than 220,000 will be diagnosed this year and 157,000 will die.

On Thursday, for the first time, a major government study showed a high-tech way of screening for lung cancer can drastically reduce the death toll, CBS Medical Correspondent Dr. Jon LaPook reports.

After 50 years of smoking, 67-year-old Steffani Torrighelli knew she was at high risk for lung cancer. Two years ago she enrolled in a study, and sure enough a CT scan picked up an early stage tumor before she had any symptoms.

“I said, ‘God gave me a second chance in life,’ and that’s how I looked at it,” Torrighelli said.

Now, for the first time, that screening test has been proven to save lives in heavy smokers like her.

The study looked at more than 53,000 men and women who smoked the equivalent of a pack a day for about 30 years. These older smokers, ages 55 to 74, were screened with either chest X-ray or a more sensitive CT scan that gives a three-dimensional view. After five years, those who got the scans had 20 percent fewer deaths from lung cancer.

“The 20 percent reduced mortality indicates that this approach is able to save lives,” said Dr. Douglas Lowy of the National Cancer Institute.

The effectiveness of CT scanning for lung cancer has been debated for years. A key concern: the test picks up lung abnormalities that are not cancer. These are common in heavy smokers and can result in costly, anxiety-producing tests.

Another concern is radiation. A CT scan, even in low dose, delivers about 15 times more radiation than a chest X-ray. But the new study suggests the benefit of finding lung cancer early trumps the risks.

“This is one of the most important cancer findings in the last 10 years,” said Dr. Harvey Pass of the department of cardiothoracic surgery at NYU Langone Medical Center. “It proves that you can save patients’ lives by detecting cancer early.”

Four years ago, Barton Lazarus had a CT scan that caught an early lung cancer missed by a chest X-ray. Doctors removed the tumor, and today he’s cancer free.

Since Torrighelli’s lung surgery two years ago, she’s also cancer free and vigilant about screening.

“I can walk,” said Torrighelli. “I can do everything that I did before. I’m feeling good. I feel perfect.”

Right now, 85 percent of patients diagnosed with lung cancer die because it’s not caught soon enough. However, not all of the 80 million smokers in the United States should get screened just yet, only high risk ones.

There are some drawbacks. For every 300 people who are screened, one life is saved, but 70 people were told they had an abnormality that turned out to be totally benign.

Another consideration is cost. The CT test costs between $300 and $400 and is not covered by Medicare or most plans. However, the government will be looking closely at this trial.

Luminous Jellyfish cells and early cancer diagnosis

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Posted 04 Nov 2010 — by James Street
Category Diagnostic, Imaging


It sounds like an idea plucked from the realms of science fiction writing. But in this case, there is nothing fictional about it. Scientists in Yorkshire have developed a process that uses the luminous cells from jellyfish to diagnose cancers deep within the human body.

article imageRed fluorescent cells inside an experimental tumour.

The method has been developed at the Yorkshire Cancer Research Laboratory at The University of York and the man who leads the York team, Professor Norman Maitland, believes it will revolutionise the way some cancers are diagnosed. “Cancers deep within the body are difficult to spot at an early stage, and early diagnosis is critical for the successful treatment of any form of cancer,” he said.

“What we have developed is a process which involves inserting proteins derived from luminous jellyfish cells into human cancer cells. Then, when we illuminate the tissue, a special camera detects these proteins as they light up, indicating where the tumours are.” The process is an extension of the work done by American chemist Dr Roger Y Tsien who won a Nobel Prize in 2008 for taking luminous cells from a common jellyfish called the crystal jelly and isolating the green fluorescent protein (GFP). The GFP is the substance that allows jellyfish to glow in the dark.

“When we heard about Dr Tsien’s work, we realised how that advance might be useful in the diagnosis of cancer,” said Prof Maitland. “X-Rays, for example, struggle to penetrate well deeply into tissues and bone, so diagnosing dangerous microscopic bone cancer is difficult. Our process should allow earlier diagnosis to take place.”

What the Yorkshire Cancer Research team has done is to use an altered form of the protein so that it shows up as red or blue, rather than its original green. Colour is important for these tests, as most colours in the spectrum are rapidly absorbed, and tumours deep within the body become invisible. You can try this for yourself by shining a torch light through your hand – the only colour which you can see is red.

In the procedure, viruses containing the proteins are targeted to home in on tiny bundles of cancer cells scattered throughout the body (metastases). Normally this would not be enough to see the minute tumours which are too small to be seen by conventional scanning techniques, but the viruses then start to grow, and while doing so make more of the red fluorescent proteins.

Thousands of copies are made in each cancer cell, a process, which is repeated in the surrounding cells, as the virus infection spreads and then stops. “When a specially developed camera is switched on, the proteins just flare up and you can see where the cancer cells are.” said Prof Maitland, “We call the process ‘Virimaging’ ”.

If the research continues to go according to plan, the method is expected to be ready for clinical trials within five years and could be ready for diagnostic use by clinicians a few years after this. It has to be tested thoroughly, as a failure to detect such small cancers has serious consequences for patients.

However, while the system works in the laboratory, one major hurdle is a shortage of specialised cameras. Only one company, based in the United States, has so far designed and built a camera system which allows the jellyfish proteins to be seen with the desired resolution deep in the body. The camera costs around half a million pounds and Prof Maitland is currently raising the funds to be able to buy one.

Should You Fear Radiation Exposure Associated with Medical Scans?

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Posted 23 Aug 2010 — by James Street
Category Imaging


Aug 21, 2010 – 8:56:00 AM

( – The short answer is…maybe. Critics of the health care industry postulate that our society’s quickness to test for disease may in fact be causing more of it, especially in the case of medical scans. To wit, the radiation dose from a typical CT scan (short for computed tomography and commonly known as a “cat scan”) is 600 times more powerful than the average chest x-ray.

A 2007 study by Dr. Amy Berrington de González of the National Cancer Institute projected that the 72 million CT scans conducted yearly in the U.S. (not including scans conducted after a cancer diagnosis or performed at the end of life) will likely cause some 29,000 cancers resulting in 15,000 deaths two to three decades later. Scans of the abdomen, pelvis, chest and head were deemed most likely to cause cancer, and patients aged 35 to 54 were more likely to develop cancer as a result of CT scans than other age group.

Another study found that, among Americans who received CT scans, upwards of 20 percent had a false positive after one scan and 33 percent after two, meaning that such patients were getting huge doses of radiation without cause. And about seven percent of those patients underwent unnecessary invasive medical procedures following their misleading scans. CT scans are much more common today than in earlier decades, exacerbating the potential damage from false positives and excessive radiation exposure.

“Physicians and their patients cannot be complacent about the hazards of radiation or we risk creating a public-health time bomb,” says Dr. Rita Redberg, a cardiologist at University of California-San Francisco. “To avoid unnecessarily increasing cancer incidence in future years, every clinician must carefully assess the expected benefits of each CT scan and fully inform his or her patients of the known risks of radiation.”

CT scans are not the only concern. Mammograms are now routine for women over 40 years old. But some studies suggest that these types of screenings may cause more cancers than they prevent. Because of this, the federally funded U.S. Preventive Services Task Force now recommends that women not otherwise considered high risk for breast cancer wait until age 50 to begin getting mammograms—and then to get them every two years instead of annually. However, the American Cancer Society argues that such restraint would result in women dying unnecessarily from delaying screenings.

Women with a family history of breast cancer may be at greatest risk. Researchers from the University Medical Center Groningen in the Netherlands found that five or more x-rays—or any exposure to radiation—before the age of 20 for “high risk” women increased the likelihood of developing breast cancer later by a factor of two and a half.

Individuals should ask tough questions of their physicians to determine if and how much screening is absolutely necessary to look for suspected abnormalities. Our knowledge of the risks of radiation-based screenings will only help us to make more informed decisions about our health.

CONTACTS: National Cancer Institute,; American Cancer Society,; University Medical Center Groningen,

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Longest disease-free interval before recurrence of osteosarcoma

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Posted 11 Aug 2010 — by James Street
Category Follow up Treatment, Imaging

To the best of our knowledge, this case report describes the longest disease-free interval between primary diagnosis and metastatic recurrence of an osteosarcoma.Case presentation.

A 35-year-old Caucasian American man presented with asymptomatic lung metastases 21 years after being diagnosed and treated for lower extremity osteosarcoma. He underwent curative lung resection, but 2 years thereafter developed metastatic disease in the scapula and tibia and, after resection and chemotherapy, is in remission 1 year later.


This case highlights the importance of long follow-up periods and continued surveillance of osteosarcoma patients after initial curative treatment.

Author: Ari HalldorssonSteven BrooksSam MontgomerySuzanne Graham
Credits/Source: Journal of Medical Case Reports 2009, 3:9298

Full Study

After Stroke Scans, Patients Face Serious Health Risks

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Posted 01 Aug 2010 — by James Street
Category Imaging
July 31, 2010By WALT BOGDANICH

When Alain Reyes’s hair suddenly fell out in a freakish band circling his head, he was not the only one worried about his health. His co-workers at a shipping company avoided him, and his boss sent him home, fearing he had a contagious disease.

Only later would Mr. Reyes learn what had caused him so much physical and emotional grief: he had received a radiation overdose during a test for a stroke at a hospital in Glendale, Calif.

Other patients getting the procedure, called a CT brain perfusion scan, were being overdosed, too — 37 of them just up the freeway at Providence Saint Joseph Medical Center in Burbank, 269 more at the renowned Cedars-Sinai Medical Center in Los Angeles and dozens more at a hospital in Huntsville, Ala.

The overdoses, which began to emerge late last summer, set off an investigation by the Food and Drug Administration into why patients tested with this complex yet lightly regulated technology were bombarded with excessive radiation. After 10 months, the agency has yet to provide a final report on what it found.

But an examination by The New York Times has found that radiation overdoses were larger and more widespread than previously known, that patients have reported symptoms considerably more serious than losing their hair, and that experts say they may face long-term risks of cancer and brain damage.

The review also offers insight into the way many of the overdoses occurred. While in some cases technicians did not know how to properly administer the test, interviews with hospital officials and a review of public records raise new questions about the role of manufacturers, including how well they design their software and equipment and train those who use them.

The Times found the biggest overdoses at Huntsville Hospital — up to 13 times the amount of radiation generally used in the test.

Officials there said they intentionally used high levels of radiation to get clearer images, according to an inquiry by the company that supplied the scanners, GE Healthcare.

Experts say that is unjustified and potentially dangerous.

“It is absolutely shocking and mind-boggling that this facility would say the doses are acceptable,” said Dr. Rebecca Smith-Bindman, a radiology professor who has testified before Congress about the need for more controls over CT scans. Yet because the hospital said no mistakes were made, regulatory agencies did not investigate.

The F.D.A. was unaware of the magnitude of those overdoses until The Times brought them to the agency’s attention. Now, the agency is considering extending its investigation, according to Dr. Alberto Gutierrez, an F.D.A. official who oversees diagnostic devices.

Patients who received overdoses in Huntsville say that in addition to hair loss, they experienced headaches, memory loss and confusion. But at such high doses, experts say, patients are also at higher risk of brain damage and cancer.

A spokesman for Huntsville Hospital, which now acknowledges that some patients received “elevated” radiation, said officials there would not comment.

Growing Number of Cases

So far, the number of patients nationwide who got higher-than-expected radiation doses exceeds 400 at eight hospitals, six in California alone, according to figures supplied by hospitals, regulators and lawyers representing overdosed patients. A health official in California who played a leading role in uncovering the cases predicts that many more will be found as states intensify their search.

“I cannot believe that this is not occurring in the rest of the country,” said Kathleen Kaufman, head of radiation management for the Los Angeles County Department of Public Health. “That’s why we are so keen on the rest of the states to go look at this.”

The Food and Drug Administration acknowledges, too, that the number does not capture all the overdoses.

The cases come at a time when Americans are receiving more medical radiation than ever before, a result of rapid technological advancements that improve diagnosis but can also do harm when safeguards and oversight fail to keep pace.

Even when done properly, CT brain perfusion scans deliver a large dose of radiation — the equivalent of about 200 X-rays of the skull. But there are no hard standards for how much radiation is too much. The overdoses highlight how little some in the medical profession understand about the operation of these scanning devices and the nature of radiation injuries, as well as the loose requirements for reporting accidents when they are detected.

For a year or more, doctors and hospitals failed to detect the overdoses even though patients continued to report distinctive patterns of hair loss that matched where they had been radiated. After the Food and Drug Administration issued a nationwide alert asking hospitals to check their radiation output on these tests, a few hospitals continued to overdose patients for weeks and in some cases months afterward, according to records and interviews.

Four of the hospitals involved were identified in recent months: the Los Angeles County and University of Southern California Medical Center, where one patient received seven and a half times the amount generally used; Bakersfield Memorial Hospital, where 16 people received up to five and a half times too much; South Lake Hospital in central Florida, where an unknown number of patients received 40 percent more than usual; and an unidentified hospital in San Francisco, government officials said.

None of the overdoses can be attributed to malfunctions of the CT scanners, government officials say.

At Glendale Adventist Medical Center, where Mr. Reyes and nine others were overdosed, employees told state investigators that they consulted with GE last year when instituting a new procedure to get quicker images of blood flow, state records show. But employees still made mistakes.

As a result, hospital officials said, a feature that technicians thought would lower radiation levels actually raised them. Cedars-Sinai gave a similar explanation.

“There was a lot of trust in the manufacturers and trust in the technology that this type of equipment in this day and age would not allow you to get more radiation than was absolutely necessary,” said Robert Marchuck, the Glendale hospital’s vice president of ancillary services.

A GE spokesman, Arvind Gopalratnam, said the way scanners were programmed was “determined by the user and not the manufacturer.” GE, he added, has no record of Glendale seeking its help setting up the new procedure in 2009.

Most of the known overdoses, including the biggest, occurred on scanners made by GE Healthcare. At two hospitals that use Toshiba scanners — Los Angeles County-U.S.C. and South Lake in Florida — officials said the manufacturer suggested machine settings that ultimately produced too much radiation. Representatives of Toshiba agreed to be interviewed in their California office but abruptly canceled.

A dozen overdose victims in California and Alabama said in interviews that the long delay in uncovering the flawed tests had left them struggling to understand what was happening to their health. One patient suspected that the Rogaine he used to stop hair loss was actually causing it. Another patient received steroid injections to stop the hair loss.

Patients said doctors speculated that their temporary hair loss might stem from a variety of causes — stress or a ponytail tied too tight — and that redness and rashes were caused by detergent used to wash bed sheets.

“What is amazing and seems painfully obvious is if someone walks in with a band of hair missing around the entire circumference of their head, you would ask the question: Have you had a CT scan?” said Richard A. Patterson, a Los Angeles lawyer who represents some of the patients. “Not ‘What did you eat for breakfast yesterday that would cause your hair to fall out today?’ ”

The overdoses did not discriminate. Among the victims: a member of Cedars-Sinai’s own board of governors, Ruthe Feldman. Mrs. Feldman says she left the board after learning about the mistake.

The Food and Drug Administration, in trying to assess the scope and cause of the overdoses, has had to rely on state radiation control officials for information. But if Alabama is any indication, the agency is not getting a full picture.

A Huntsville Hospital spokesman, Burr Ingram, said that about 65 possible stroke patients there had been overradiated. Lawyers representing patients say the number of overdoses is closer to 100.

Nonetheless, Alabama officials say the number is actually zero since the state does not define an acceptable dosing level. “No such thing as an overdose,” said James L. McNees, director of the Alabama Office of Radiation Control.

A Hospital’s Low Moment

One day last August, the radiation safety officer at Cedars-Sinai, Donna Early, decided she had to act.

It was a low moment for such an esteemed institution. Patients were being overradiated during CT brain perfusion scans, hospital officials concluded, and it was Ms. Early’s job to tell county health officials.

The genesis of Ms. Early’s alert was an event on the morning of July 4, when a 52-year-old executive producer of films, H. Michael Heuser, arrived in the emergency department with stroke symptoms.

A “code brain” was immediately called, signaling a life-or-death situation. A blood clot in the brain can be dissolved with medicine, but doctors must do it within several hours, before brain cells die from a lack of oxygen. So Mr. Heuser was rushed into a room with several CT scanners, where he underwent one brain perfusion study and at least one more later. A CT perfusion scan, which lasts about 45 seconds, can identify a stroke through a series of blood flow images.

Mr. Heuser did have a stroke, from which he would recover. But other parts of his body inexplicably began to break down.

“I had a full body rash — my whole body, legs, armpits, bottom, my back — with these red welts,” Mr. Heuser said.

It burned and itched. Then clumps of hair began to fall out. “I went completely bald in a perfectly symmetrical 4-inch-wide band that extended from ear to ear all the way around my head,” he recalled. The hospital, he said, responded by offering him a hairpiece.

Finally, a doctor was so struck by the unusual nature of Mr. Heuser’s hair loss that he took a picture. A second patient reported similar hair loss. Eventually, the hospital made the connection, and on Aug. 28, Ms. Early called county health officials, records show. From then on, as the accounting of overdoses at Cedars-Sinai reached 269 over a period of 18 months, Mr. Heuser would be known in government reports simply as “Patient 1.”

To this day, no one at Cedars-Sinai knows who programmed the scanners that delivered the overdoses, officials there say. But in written statements to The Times, hospital officials said they had figured out how they might have occurred.

Normally, the more radiation a CT scan uses, the better the image. But amid concerns that patients are getting more radiation than necessary, the medical community has embraced the idea of using only enough to obtain an image sufficient for diagnosis.

To do that, GE offers a feature on its CT scanner that can automatically adjust the dose according to a patient’s size and body part. It is, a GE manual says, “a technical innovation that significantly reduces radiation dose.”

At Cedars-Sinai and Glendale Adventist, technicians used the automatic feature — rather than a fixed, predetermined radiation level — for their brain perfusion scans.

But a surprise awaited them: when used with certain machine settings that govern image clarity, the automatic feature did not reduce the dose — it raised it.

As a result, patients at Cedars-Sinai received up to eight times as much radiation as necessary, while the 10 overradiated at Glendale received four times as much, state records show.

GE says the hospitals should have known how to safely use the automatic feature. Besides, GE said, the feature had “limited utility” for a perfusion scan because the test targets one specific area of the brain, rather than body parts of varying thickness. In addition, experts say high-clarity images are not needed to track blood flow in the brain.

GE further faulted hospital technologists for failing to notice dosing levels on their treatment screens.

But representatives of both hospitals said GE trainers never fully explained the automatic feature.

In a statement, Cedars-Sinai said that during multiple training visits, GE never mentioned the “counterintuitive” nature of a feature that promises to lower radiation but ends up raising it. The hospital also said user manuals never pointed out that the automatic feature was of limited value for perfusion scans.

A better-designed CT scanner, safety experts say, might have prevented the overdoses by alerting operators, or simply shutting down, when doses reached dangerous levels.

To Mr. Heuser, it is unconscionable that equipment able to deliver such high radiation doses lacks stronger safety features.

“When you are in a car and it backs up, it goes beep, beep, beep,” he said. “If you fill the washing machine up too much, it won’t work. There is no red light that says you are overradiating.”

Manufacturers say they will address some of these issues in newer models.

Form Letter, No Apology

Huntsville Hospital informed patients that they had been overdosed in a two-page form letter that included no apology. The word radiation was mentioned once — in the ninth sentence.

“We have identified a few patients, including you, who received a scan in which the dosage level was elevated,” stated the letter, dated Dec. 11, 2009.

The acknowledgment by hospital officials that 65 people were overradiated has come slowly.

After the California overdoses became public, Huntsville officials reviewed their testing and determined that their use of higher doses to get clearer images was not a mistake and was, in fact, appropriate, according to the GE inspection report. Therefore, they concluded, they had no overdoses.

State and federal officials said they did not investigate Huntsville, because there were no equipment malfunctions or because the dosing decisions were considered part of the practice of medicine. As a result, the only public accounting of the number of overdoses in Huntsville has come from the hospital, not government inspectors.

By contrast, California officials conducted investigations, released inspection reports and have cited at least four hospitals for failing to safely irradiate patients.

Because Huntsville Hospital officials declined to be interviewed, it is unclear how they determined who had been overradiated, when the overdoses started or why patients with sudden hair loss did not arouse more suspicion.

Melissa Faye Adams is one of a number of patients who have yet to be told they were overdosed, even though they have pictures of themselves with the distinctive band of hair loss. More than two years ago, just shy of her 40th birthday, she underwent a stroke test at Huntsville Hospital after developing a headache. Fifteen days later, her hair began falling out and her life began to lurch about in disquieting ways. She still keeps a plastic bag full of her hair marked with that date, 6/15/08. “I panicked,” she said.

It would take another year and a half of worry, of unsatisfying doctor visits, before her hairdresser called one day last December telling her to pick up a copy of the local paper. In the paper, the hairdresser said, was “a picture of a lady who looks just like you.” The woman said she had been overradiated at Huntsville Hospital.

Dr. Lon Raby, a Huntsville dermatologist, also noticed the picture. “I recognized the pattern with it,” Dr. Raby said. “I’ve seen six or eight all in the same time frame.”

Suzanne Sloan, a popular fifth-grade teacher, was one of his patients. She saw the picture, too. “We were screaming,” Ms. Sloan said. “She had the same identical thing.”

Ms. Sloan’s fruitless search for an explanation had taken her to the University of Alabama at Birmingham Hospital, Ochsner Health System in Louisiana and Vanderbilt University in Tennessee. “They had no clue,” she said. “I lost 15 pounds. I couldn’t sleep.”

Ms. Sloan had tried to cover her missing hair using bobby pins. But one day at school, a gust of wind blew and children saw her strip of missing hair. One got sick and vomited, she said. As word of her condition spread, former students flocked to her classroom, some crying. “We heard you were dying,” one said. “Is there something we can do?”

Another patient, an aerospace engineer who says she had a seizure after her scan, said her dermatologist wrote to Huntsville Hospital out of concern for her and another patient with similar symptoms.

“Even after the dermatologist put two and two together and asked Huntsville Hospital to contact me, they never did,” said the engineer, who provided a picture of her hair loss but asked that her name be withheld because of professional reasons.

She said she suffered from memory loss and confusion.

Huntsville Hospital officials said they did not routinely record radiation dose levels before 2009. Mr. Ingram, the spokesman, said the hospital did keep information needed to calculate the dose, but he declined to say whether officials had gone back to determine doses for all patients who had brain perfusion scans.

The form letter Huntsville sent to overdose patients appears to play down the damage that high doses can inflict. The hospital told patients that hair loss and skin redness might occur but would go away. “At this time, we have no recommendations for you to have any follow-up treatment,” the letter said.

Health experts elsewhere have warned of possible eye damage, in addition to the higher risk of cancer and brain damage.

For Dr. Smith-Bindman, a professor at the University of California, San Francisco, the larger question raised by her review of overdose cases, including one in Huntsville, is whether their symptoms actually required such a powerful test in the first place. She also noted that many of the patients were relatively young.

“These tests have really high doses,” she said. “And there’s no system for figuring out who is getting them and why they are getting them.”

Reducing mistakes is important, but the bigger challenge, she said, is to eliminate unnecessary testing.

“Utilization has increased dramatically, and as a society we have not had the time to respond.”

Kristina Rebelo contributed reporting.