Research/Development

Research & Development

Nuclear Medicine

Conventional Nuclear Medicine : SPECT

SPECT imaging uses gamma emitting isotopes (such as Iodine-131 or Iodine-123), or molecules radiolabeled with gamma emitting radionuclides (such as Tc99m-labeled phosphonate for bone scintigraphy, or, Tc99m-labeled colloids for sentinel node scintigraphy). The most frequently performed examinations are bone scintigraphy (detection of bone metastasis), thyroid scintigraphy (thyroid cancer), sentinel node scintigraphy (see lower), lung scintigraphy (diagnosis of lung embolism), and cardiac scintigraphy (for monitoring the heart function during cardiotoxic chemotherapy).

The scintigraphic imaging is often performed in a tomographic (3D) mode which is called SPECT (Single Photon Emission Tomography). In the near future multimodal systems combining a SPECT with a CT module will probably become available.

The major areas of developpement and research in this specific area are highlighted hereunder.

 

Sentinel Node scintigraphy

The Nuclear Medicine department of the Bordet Institut played an important role in the clinical development of the sentinel node scintigraphy in breast cancer surgery. The sentinel node is the first lymph node draining the tumor bed. Its tumor status reflects the tumor status of the whole axilla. The diagnostic technique consists in the paratumoral injection of Tc99m-labeled colloids which, in the following hours, are transported to the first level lymph nodes. The accumulated radioactivity allows the intra-operative identification of the sentinel lymph node using a hand held detection probe.

Current research activities are focusing on the use of the same diagnostic principle for the lymph node staging of other cancer types, such as head and neck cancer, prostate cancer and gynaecological cancers. For this purpose, a specially designed probe for use during laparoscopic surgery has recently been acquired.

 

Multi Drug Resistance

Multi drug resistance (MDR) of tumors remains an important issue in cancer treatment. Preliminary reports have indicated that Tc99m-Sestamibi can be used as a surrogate substrate for a membrane protein (PgP) which is considered to play a major role in MDR.

The rationale of scintigraphic detection of MDR is the imaging of the wash out of the Tc99m-sestamibi, which can be assessed by performing early and late SPECT imaging of the tumor.

The principle is currently being investigated in the initial therapeutic management of newly diagnosed multiple myeloma patients receiving VAD polychemotherapy followed by a autologue bone marrow transplantation. The Bordet Institute has taken the lead in this research by organising a multicentric study covering all major oncology centres in Belgium. The study is a joint effort of the hematology and nuclear medicine department and funded by a grant of the Belgian Hematology Society.

 

Positron Emission Tomography (click here)

- Assesment of the efficacy of a treatment

- Somatostatin Receptor Imaging

- PET-CT based dosimetry for radio-imunotherapy

 

The therapeutic applications of radionuclides (click here)

- Yttrium-90 labelled microspheres

- Yttrium-90 labellled monoclonal antibodies against lymphoma