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Nuclear Technology Brings Hope to Patients

MEDICALISOTOPESSaskatchewan cancer patients have been given a new reason to be hopeful thanks to nuclear technology.

The Royal University Hospital in Saskatoon is now receiving on-site medical isotopes thanks to the Fedoruk Centre, a cyclotron and a funding partnership between the province and the feds.

A cyclotron is a particle accelerator and it uses power to make particles radioactive. When these particles collide isotopes are created.

Medical isotopes are safe radioactive particles used to diagnose health conditions.

In total, the nuclear medicine community relies on a wide suite of medical isotopes. There are approximately 200 isotopes available for use. Each isotope has its own characteristics and the ability to provide doctors with a window into what is happening inside the body.

The isotope used to help detect medical issues such as cancer and Parkinson’s through a positron emission tomography (PET)/computerized tomography (CT) scan (PET-CT).

An isotope known as fluorine-18 is attached to a tracer to make a radiopharmaceutical. It is then injected into the patient where it moves throughout the body depending on the tracer.  In Canada, PET/CT scans use the radiopharmaceutical flurodeoxyglucose (FDG).  Approximately 60 minutes after injection, the scanning part of the procedure begins.

“FDG is a sugar and the sugar is burned up by different parts of the body at different rates,” according to Dr. Neil Alexander, executive director of the Fedoruk Centre. “In nuclear medicine, particularly in diagnostics, if you have a sugar it goes around the body and anything burning up the sugar at a great rate lights up on the scan.  As one example, cancer cells burn up sugar at a greater rate than healthy cells, allowing physicians to detect cancers and see how the disease responds to treatment.”

PET/CT scans provide doctors with vital information on the location and extent of cancer within the body. The test also allows doctors to assess the success of treatments; providing patients with a better chance at survival.

Parkinson’s disease diagnosis and research is one of the newest areas for medical isotopes and PET/CT. Early diagnosis in the case of Parkinson’s is an important step to increasing knowledge on how the disease progresses and responds to therapy.  In the case of Parkinson’s patients the scan is looking for a decrease in proteins used in the synapses, or the junctions between nerve cells, in the brain.

Until the cyclotron started producing isotopes, patients requiring a scan in Saskatchewan needed isotopes flown in from Ontario and because the radioactivity is short-lived, meaning FDG cannot be stored, daily shipments were required. The challenges of early morning production added to air transportation often led to delayed starts and cancellations, providing unreliability for patients in need of medical diagnoses.

“Up until now, all of it was coming in from Hamilton and a lot of the material had decayed so they couldn’t process as many patients,” says Alexander.

Producing locally means more reliable health care for patients, cutting wait times and diagnosing more patients sooner. It also means that Saskatchewan medical researchers have a supply readily available to expand their research programs.

CNA2016

Nuclear Medicine and Your Pet

For 153 years, since 1862, the Ontario Veterinary College, has led the way ini Canada for animal medicine, improving the lives of four legged friends and their humans.

OVC ranks fourth in the world for veterinary medicine and includes a nuclear medicine division.

Dr. Alex Zur Linden is an assistant professor in the Diagnostic Imaging department at OVC where he assesses patients using tools such as Computed Tomography (CT) scans, a nuclear technology tool. The scan allows physicians to get a 360-degree snapshot of what is happening inside the animal.  But as Dr. Zur Linden points out, the work poses some unique challenges.

“Prior to a scan taking place the animals are sedated. We do this so that they won’t move off the table and to minimize their respiratory motion because unlike humans you can’t ask them to hold their breath,” says Dr. Zur Linden.

catdogAnother area of veterinary nuclear medicine is in the treatment for cats with hyperthyroid. A condition in which the thyroid overproduces a hormone known as thyroxine, this can cause the body processes to speed up.

Signs of hyperthyroidism in cats include faster heart rate, vomiting and diarrhea. If left untreated it can lead to blindness.

Once diagnosed, usually following a blood test, treatment can begin. A common method of treatment is something known as radioiodine therapy. A non-invasive procedure, patients do not have to undergo the stress of sedation or an operation.

Instead, radioactive iodine is injected into the cat where it is absorbed by the thyroid. The radioactive iodine is able to destroy the infected cells and patients usually see a return to normal hormonal levels with a week or two of treatment.

The cross over applications between research amongst humans and animals has meant the ability to better diagnose and treat patients. One such application is a procedure known as microwave ablation (MWA). Primarily used in humans, due to its expensive cost, MWA involves using microwave energy to heat and destroy tumors.

“One promising area is with cancer in the lungs. Right now there is not much we can do, however, with microwave ablation, you can kill the tumor. It’s been done in people,” Zur Linden goes onto say, “it’s likely palliative therapy but has the potential to be curative as well.”

As outlined in The National Research Council’s Committee on the National Needs for Research in Veterinary Science it was through work with chickens that the cancer causing virus, sarcoma was discovered. An immune suppressing virus in cattle was discovered years before HIV or AIDS would be diagnosed in humans. Advances in one stream have had numerous benefits in another. However, according to Zur Linden,while in the past advances were often made in the animal world first, that is changing.

“Nowadays veterinary medicine is catching up to the technology which is tested in people first and then applied to animals.”