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Medicine and Health

Revolution in medical imaging

   
 
Picture
Imaging of the cardiac cycle by the emission of radionuclides makes it possible to measure with precision the ejection fraction of the left ventricle.
The new particle detection technology developed by the French winner of the 1992 Nobel Prize for Physics, Georges Charpak, has caused an upheaval in nuclear medical imaging. With the support of the Standards, Measurements and Testing programme, and in cooperation with Italian and UK partners, the French SME, Biospace Instruments, has developed a light and simple instrument to monitor, in real time, the radioactive products used to display certain organs. From now on cardiologists in several European hospitals will find it easier to monitor the heartbeats of their patients "live".

 

For more than 30 years the technique of injecting radioactive products capable of fixing themselves selectively in certain organs has been used in nuclear medicine to display the liver, brain, thyroid and heart, and to look for tumour metastases throughout the body. "The same system, the Anger camera, has been used since the 1960s to display the distribution of radioactivity. At this level, progress has been minimal," notes Claude Hennion, Director of Biospace Instruments. However, the innovative results presented by this SME on completion of the European project in question could revolutionise this medical technique. In 1996 this project was able to draw on the additional combined expertise of Biospace (sensors), the Italian firm Caen (high-speed electronics), the UK firm Hamilton & Hamilton (nuclear medicine), the G. Galilei Department of Physics at Padua and the IDSET in Paris. In the enthusiastic words of Eddie Maier, the scientist responsible at the European Commission: "This is an exemplary project that has benefited from the CRAFT measures to promote research by SMEs. By embarking on the transfer of technology and high-energy physics to scientific and medical instrumentation, Biospace has developed a product which meets the expectations of the market and which therefore has every chance of becoming commercially viable."

All this began in the 1980s when Georges Charpak, a physicist specialising in particle detectors at the CERN laboratories in Geneva - and a future winner of the Nobel Prize (1992) for his discoveries in this area(1) - suggested to a biologist that they should construct a machine capable of displaying the radioactive markers relating to his own experiments. The image would be obtained in record time - several hours rather than several months. "Although the machine as initially developed was a physicist's prototype and extremely complicated to use," recalls Claude Hennion, "my enthusiasm as a biologist at the results obtained showed that the technology met a more general need, far exceeding previous expectations. Together with Georges Charpak, we then decided to set up Biospace Instruments. That was in 1989."

Picture
Rotary filming of the movement of the heart wall.

Performance
After two or three years of R&D, the first fully automatic autoradiography detector, displaying the distribution of radioactive markers on a section of organ, for example, was developed. The instrument, which now has the advantage of being simple to produce, consists of superimposed metal grills under high voltage, encompassed within a specific gaseous medium. When an ionising particle resulting from a radioactive disintegration penetrates the sensor, it draws off a cascade of electrons from the gas molecules, thereby creating a light-emitting cloud that is easily detectable by a camera or electronic means. Thus, in detecting the particles one by one, the system does not merely provide an image of the distribution of the radioactive product but also serves as sort of Geiger counter giving an absolute reading of the number of radioactive molecules present.

"We then sought to apply this capability to the vast nuclear medical-imaging market. In numerous diagnostic applications, such as pinpointing cancerous tumours or displaying cardiac pump efficiency by measuring the ejection fraction, the Anger camera has the disadvantage of being an expensive and heavy - 400 kg to 500 kg - instrument, of low efficiency and requiring lengthy integration periods. However, what the cardiologists need is an image of the moving heart in real time."

At the patient's bedside
During 1999, the first mobile devices, available to the cardiologist as and when required - i.e. at the patient's bedside - were installed in a number of prestigious European hospitals.

The efficiency of the detection technique, which requires only low doses and produces real-time images, opens up possibilities for numerous applications. "In cancer chemotherapy, our detectors will make it possible to adapt the treatment to each patient, ensuring the greatest possible therapeutic effect while at the same time avoiding cardiotoxic risks. In cardiac surgery, they will enable the results of an open-heart operation to be displayed before the thorax is closed up again, allowing for immediate further intervention if necessary. In brain surgery, the fact that an image of the tumour is available throughout the operation should permit a much more precise ablation." The possibilities offered by a sensitive, compact and relatively cheap machine will encourage the emergence of new working practices hitherto undreamed of.

Future prospects
Once launched on the market, however, this technology will still have to overcome a number of regulatory obstacles, since in many countries the authorising procedures governing the use of radioactive products are very strict as far as premises and personnel are concerned. Claude Hennion remains unperturbed: "Once the therapeutic benefits have been demonstrated, the pace of progress will be rapid."

Leaving aside the nuclear medicine sector, the Biospace detectors will also be able to adapt to conventional radiography with the added advantage of reducing by 20 to 30 times the levels of irradiation associated with each examination. The question of monitoring the levels of X-rays to which patients are exposed, particularly in the area of screening, is becoming more and more pressing in the context of international regulations.

A vast potential market therefore exists for the technology developed by Biospace, which holds more than 10 international patents. "As soon as we have entered the industrial marketing stage in nuclear medicine, we shall be embarking on a radiology-intensive R&D phase," concludes Claude Hennion. This, in turn, opens up the prospect of a new European project.

(1) The technology devised at CERN by Georges Charpak has been developed in order to provide of a means of identifying black matter in the universe - this missing mass the nature of which is still a mystery to the astrophysicists, who are nevertheless obliged to postulate its existence in order to explain the dynamics of the galaxies which they observe.

 

 

Project Title:  
Development of a detector for ultralow radioactivity measurements in biological and medical fields such as cardiac imaging

Programmes:
Standards, measurements and tests - CRAFT

Contract Reference: SMT4965502

CORDIS databaseFor more information on this project,
go to the Cordis database Record

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