This is the first time a flat panel X-ray detector will be used for CT imaging in nuclear medicine. This system, along with the new GEMINI TF Big Bore and new NM Application Portfolio on the Extended Brilliance Workspace, is currently on display at the Society of Nuclear Medicine (SNM) annual meeting.

The BrightView XCT features technological advances that can enable low patient dose levels, high-resolution localization and high-quality attenuation correction with the potential for fewer artifacts and shorter exam times. This offers clinical advantages particularly in cardiology studies, the top procedure in nuclear medicine. In addition, the co-planar SPECT and CT capabilities limit, and in some cases eliminate, the need to move the table between scans. Reduced movement can help improve patient comfort and allow for more confidence in image registration, the process of comparing, matching and superimposing the SPECT and CT images on one another for analysis. The BrightView XCT is also the only scalable SPECT and SPECT/CT system that fits into a 12'x15.5' room and does not require special certification for nuclear medicine technicians.

Press release: New Philips systems deliver first-of-their-kind integrated solutions for nuclear medicine and radiation oncology ...

Product page: BrightView SPECT ...

With a full 85 cm bore for PET and CT scans, the new system allows for positioning flexibility and has a rigid table design to meet the accuracy requirements for treatment planning. The GEMINI TF Big Bore allows clinicians to image patients in the same position they are treated, expanding PET/CT capabilities beyond diagnosis, staging and follow-up to include therapy planning. The system combines Philips' GEMINI TF time-of-flight PET imaging technologies with its Brilliance Big Bore CT localization to consolidate radiation oncology procedures, increase potential for greater accuracy and improve scheduling. It is the first system that offers tools and protocols to easily integrate PET functional images into radiation oncology, helping to consolidate procedures while maintaining premium image quality.

Press release: New GEMINI TF Big Bore provides the accuracy needed for radiation oncology ...

Flashback: GEMINI TF from Philips

Here is more from the press release:

The Intego System automatically extracts a patient dose from a multi-dose vial and delivers it directly to the patient, virtually eliminating manual dose preparation and handling, and the corresponding radiation exposure to the technologist. With the Intego System’s dose-on-demand capability, the prescribed dose can be delivered when the patient and technologist are ready, enabling technologists to easily and efficiently respond to schedule changes, patient delays, and add-on patients. Innovative features, including real-time dose availability information, an integrated ionization chamber, and an optional weight-based dose calculation, allow the healthcare provider to more precisely customize each patient’s dose. Safety features include a tungsten multi-dose vial shield, a fully lead-lined mobile cart, and an automated saline flush to remove residual FDG from the line after each infusion.

Product Page: Intego PET Infusion System...

Read the press release...

From the Society of Nuclear Imaging statement:

Semiconductor-based detectors could improve PET imaging capabilities because the smaller, thinner semiconductors are easier to adjust and arrange than conventional scanners. The new technology allows for even higher spatial resolution and less "noise," or irrelevant images. The prototype semiconductor brain scanner also employs a depth of interaction (DOI) detection system, which reduces errors at the periphery of the field of view.

Researchers evaluated the physical performance of the prototype scanner and studied the technology's clinical significance in patients suffering from partial epilepsy and nasopharyngeal cancer—a relatively rare form of cancer that develops at the top of the throat, behind the nose. The results indicate that the PET scanner is feasible for clinical use and has good potential for providing the higher spatial resolution and quantitative imaging required in nuclear medicine. This device, which has been installed in Hokkaido University Hospital, is a result of successful collaboration with staff from the Department of Nuclear Medicine at Hokkaido University in Sapporo, Japan.

Press release from the Society of Nuclear Imaging: First Semiconductor-Based PET Scanner Demonstrates Strong Potential to Aid in Early Diagnosis of Disease ...

From the product brochure:

SIR-Spheres microspheres consist of biocompatible microspheres containing yttrium-90 with a size between 20 and 60 microns in diameter. Yttrium-90 is a high-energy pure betaemitting isotope with no primary gamma emission. The maximum energy of the beta particles is 2.27MeV with a mean of 0.93MeV. The maximum range of emissions in tissue is 11mm with a mean of 2.5mm. The half-life is 64.1 hours. In therapeutic use, requiring the isotope to decay to infinity, 94% of the radiation is delivered in 11 days. The average number of particles implanted is 30 – 60 x 106. SIR-Spheres microspheres are a permanent implant.

SIR-Spheres microspheres are implanted into a hepatic tumor by injection into either the common hepatic artery or the right or left hepatic artery via the chemotherapy catheter port. The SIRSpheres microspheres distribute non-uniformly in the liver, primarily due to the unique physiological characteristics of the hepatic arterial flow, the tumor to normal liver ratio of the tissue vascularity, and the size of the tumor. The tumor usually gets higher density per unit distribution of SIR-Spheres microspheres than the normal liver. The density of SIR-Spheres microspheres in the tumor can be as high as 5 to 6 times of the normal liver tissue. Once SIR-Spheres microspheres are implanted into the liver, they are not metabolized or excreted and they stay permanently in the liver.

Each device is for single patient use.

SIRTeX USA website...

Press release: Sirtex receives US FDA approval for FAST clinical trial (.pdf)

Product page: Product Package Insert (PDF)

The drug, based on carbon nanotubes and two common food preservatives, has already shown huge promise in reducing the effects of radiation exposure:

The new study was commissioned after preliminary tests found the drug was greater than 5,000 times more effective at reducing the effects of acute radiation injury than the most effective drugs currently available...

NTH is made at Rice's Chemistry Department and Carbon Nanotechnology Laboratory in the Richard E. Smalley Institute for Nanoscale Science and Technology. The drug is based on single-walled carbon nanotubes, hollow cylinders of pure carbon that are about as wide as a strand of DNA. To form NTH, Rice scientists coat nanotubes with two common food preservatives -- the antioxidant compounds butylated hydroxyanisole (BHA) and butylated hydroxytoluene (BHT) -- and derivatives of those compounds.

"The same properties that make BHA and BHT good food preservatives, namely their ability to scavenge free radicals, also make them good candidates for mitigating the biological affects that are induced through the initial ionizing radiation event," Tour said.

In preliminary tests at M.D. Anderson in July 2007, mice showed enhanced protection when exposed to lethal doses of ionizing radiation when they were given first-generation NTH drugs prior to exposure.

"Our preliminary results are remarkable, and that's why DARPA awarded us this grant with a very compressed timeline for delivery: nine months, which is almost unheard of for an academic study of this type," Tour said. "They are very interested in finding out whether this will work in a post-exposure delivery, and they don't want to waste any time."

Feds fund study of drug that may prevent radiation injury ...

The new Symbia E is based on the success of Siemens' Symbia family of imagers. Based on state-of-the-art Symbia SPECT·CT technology and award-winning design, Symbia E leverages the strength of the industry's leading gamma camera, the e.cam. There are more than 4,000 e.cams installed in more than 120 countries, proving that the system is an industry icon. Siemens has redesigned the e.cam structure with an improved chassis and improved electronics. The Symbia E boasts features that will allow providers to work with increased confidence because of the system's improved image quality and increased reliability; these will lead to an accelerated workflow. The system is also versatile and it can be upgraded as a facility's workload grows.

Siemens has taken the best detector technology that the Symbia family of SPECT and SPECT·CT imagers has to offer and made it available on Symbia E. A new generation of HD detector first introduced with the Symbia TruePoint SPECT·CT imager, with best in class performance and reliability is also included in the new Symbia E scanner. Using these new detectors, where Siemens achieved an 85 per cent reduction in wiring and a 75 per cent reduction in components, and Siemens' own crystal material, the reliability of this new system is significantly increased. Symbia E also imports the clinically validated c.clear attenuation correction, which was developed on the Siemens c.cam dedicated cardiac scanner. So Symbia E users will take advantage of high-end cardiac scanning features.

To ensure the highest customer satisfaction and system uptime, the Symbia E is equipped with Siemens' Remote Services capabilities. The Siemens Remote Services program enables Siemens to check the system status through full remote access and remote diagnostics. This level of proactive monitoring and trending of key performance indicators will allow Siemens to service and update the system before small problems turn into big downtime. The end result is that Symbia E users will experience interruption-free imaging while having the support of a network of nearly 1,000 trained field engineers.

The Symbia E offers features to accelerate the clinical workflow in acquisition, processing and reviewing with syngo workflow solutions such as an integrated physician worklist and it provides imaging in half the time for cardiology and oncology patients, when using cardio·Flash and onco·Flash reconstruction software packages. Users will realize time savings from the system's integrated, simultaneous Quality Control component. With the Symbia E, facilities will be able to see a wide range of patients from pediatrics to bariatrics and can also be equipped with special positioning pallets for mammography. It also sports a tilting detector for optimized planar imaging.

Press release: Siemens Unveils New Technology for Nuclear Medicine's Hardest Working Gamma Camera ...

It looks like proton therapy will be developed into a compact device, after a technology transfer agreement between Lawrence Livermore National Laboratory and TomoTherapy Inc., a Madison, Wisconsin company, was announced just a few days ago.

From the Lawrence Livermore NL press office:

"This technology has grown out of work to develop compact, high-current accelerators as flash X-ray radiography sources for nuclear weapons stockpile stewardship," said George Caporaso, the lead scientist on the project at Lawrence Livermore. "We are excited about applying this new technology to the field of cancer treatment, to make proton therapy widely available as a treatment option."

"We have taken proton therapy and achieved major advances toward what we were told was impossible - to scale it down to a size and price that will bring it in reach of every major cancer center," said Ralph deVere White, director of UC Davis Cancer Center and associate dean for cancer programs. "Our research partnership with Lawrence Livermore National Laboratory has fulfilled the mission for which it was created: to deliver translational research in order to advance health care."

Conventional radiation therapy kills cancer cells using high-energy X-rays. These X-rays deliver energy to all the tissues they travel through, from the point they enter the body, until they leave it. Doctors therefore have to limit the dose delivered to the tumor to minimize damage to surrounding healthy tissue.

Unlike high-energy X-rays, proton beams deposit almost all of their energy on their target, with a low amount of radiation deposited in tissues from the surface of the skin to the front of tumor, and almost no "exit dose" beyond the tumor. This property enables doctors to hit tumors with higher, potentially more effective radiation doses than is possible with gamma radiation...

The compact system is expected to fit in standard radiation treatment suites and to cost less than $20 million. The compact system will be mounted on a gantry that rotates about the patient.

Caporaso's team overcame the size obstacle by using dielectric wall accelerator technology developed through defense research. The Livermore scientists have demonstrated in principle that this technology will enable proton particles to be accelerated to an energy of at least 200 million electron volts within a light-weight, novel, insulator-based structure about 6.5 feet long. It also won't use any bending magnets, and will be able to change the protons' energy and intensity between each burst that occurs many times per second.

Currently available proton therapy machines use cyclotrons or synchrotrons nearly 10 feet in diameter and weighing up to several hundred tons. This equipment includes the enormous gantry and bending magnets necessary to focus and direct the beams onto patients.

In addition to overcoming size and cost obstacles, the compact system will improve on existing full-scale systems by including the capability to vary the energy, intensity and "spot" size of the proton beam. Radiation will be produced in rapid pulses, creating small "spots" of dose throughout the tumor. Currently only one proton facility in the world, the Paul Scherrer Institute in Switzerland, is able to deliver this intensity-modulated proton therapy (IMPT). IMPT is generally considered the best way to destroy tumors while minimizing damage to surrounding healthy tissue.

Press release: First compact proton therapy machine for cancer treatment enters development ...

Press release: TomoTherapy Inc. and Lawrence Livermore National Laboratory to Develop Proton Therapy System ...

Flashbacks: Activate the Proton Beam ; The Physics of Proton Therapy; In the Works: Proton Treatment from MIT

Tovarisch Aleksey Bolotnikov (pictured), a physicist now working for Uncle Sam at the Brookhaven National Laboratory, developed a new radiation sensor that can function at normal temperatures, which is apparently a major improvement:

The improved sensors, for which the Laboratory has filed a U.S. provisional patent application, can be used at room temperature, which makes them more practical and cost-effective than existing detectors with similar performance, which must be operated at very cold temperatures using expensive liquid nitrogen. They can also more accurately detect the X-rays and gamma rays emitted by radiological sources such as dirty bombs and other illicit materials.

"Improving the performance of radiation detectors could improve the efficiency and accuracy of cargo screening at U.S. ports," said Brookhaven physicist Aleksey Bolotnikov, one of the inventors.

Radiation detectors work by detecting electrons and "holes" -- vacancies left by liberated electrons -- when ionizing radiation or high-energy particles strike the detector crystal. When the free electrons and holes flow toward electrodes (an anode and a cathode) at either end of the detector, they generate a signal that can be measured and recorded.

In an ideal detector, all of the electrons and holes created by the ionization process would arrive at the electrodes. But in reality, holes travel a very short distance before getting trapped by defects in the crystal. Also, because the electrostatic field inside the detector causes some of the electrons to drift, not all of them arrive at the anode. These losses lead to a subsequent inaccuracy in radiation measurements.

The Brookhaven-designed sensors improve on this situation by combining methods to shield the detector and focus the electrons toward the anode. In addition, the electrodes at each end of the detector give information about how many electrons/holes get trapped. This "correction factor" can then be used to reconstruct the number of electrons/holes originally created by incident gamma rays or high-energy particles.

"Together, these techniques enhance the energy resolution and efficiency of these detectors. In practical terms it means that the improved devices will be able to detect more minute quantities of radiation, detect radioactive materials more quickly or from greater distances, better identify the source of the radiation, and distinguish illicit sources of concern from common naturally occurring radioactive materials," Bolotnikov said.

Press release: New Method for Making Improved Radiation Detectors ...

Press release: NNSA Improves Technology for Radiation Detectors ...

The new scanner will make visible features not currently seen in conventional MRI. This improved sensitivity and specificity should lead to a better understanding of key diseases, result in more rapid and accurate diagnosis, and eventually pave the way for new treatments.

Professor Lurie, Chair in Biomedical Physics, University of Aberdeen, said: "We are tremendously excited about the potential for this scanner which uses new technology called Fast Field-Cycling MRI.

"We believe it has the potential to gain new insight into processes that give rise to disease, involving the complex interactions of atoms, molecules and cells in the body. Fast Field-Cycling MRI promises to be even more sensitive than conventional MRI at picking up these disease processes.

"This technology breaks the first rule of conventional MRI which is that the magnetic field is held constant while the image is being obtained.

"What we will do with our new scanner is to switch the magnetic field rapidly while the image is being obtained. In this way, we will be able to record information about how molecules behave at a whole range of magnetic fields.

"It is a bit like having at our disposal a hundred or more MRI scanners, each one operating at a different magnetic field - but all in the one scanner. The big advantage is that the new scanner will produce images of the body that will tell clinicians important information about disease processes at a much earlier stage.

"One area of research that will benefit in particular is the role of proteins in diseases. The malformation and malfunctioning of proteins is at the core of many diseases and disorders such as Alzheimer's, Parkinson's disease and Multiple Sclerosis. Aberdeen University's Institute of Medical Sciences has world-leading research teams in all of these areas, and the lead scientists are closely involved with the new MRI research.

"A clearer vision of the protein changes that occur in such disorders could lead not only to a better understanding of the disease process itself, but to more rapid and accurate diagnosis and eventually new treatments."

Press release: Pioneering Aberdeen again leads world with MRI...

Field-cycled MRI project page...