Personalized Medicine: Molecular Imaging, Radionuclide and Proton-Beam Therapy

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Nuclear medicine (NM) imaging modalities, such as single positron emission tomography (PET) and single photon emission tomography (SPECT), are already well recognized for their molecular characteristics. They both use biologically active molecules, labeled with radioactive atoms, to provide physicians with diagnostic information about the anatomy and/or physiology of patients. Recently, NM applications have been extended to include targeted radionuclide therapies (TRT), where same molecules labeled with therapeutic agents are used to deliver treatment to locations previously identified in diagnostic studies. ***Although the concepts presented here (named theranostics) seem extremely exciting, promising a new area in treatment of diseases, the effectiveness of such procedures is highly dependent on the proper selection of radioisotopes, the precise localization of radiolabeled molecules in the body and on the accurate quantification of radioactivity concentrations. Specifically, in order to optimize TRT outcomes and minimize potential damage to healthy tissues, accurate personalized dosimetry should be performed. Unfortunately, in contrast to the external beam radiotherapy, TRT dosimetry is considered difficult to perform therefore not routinely done in clinics. ***The main objective of the research program of my Medical Imaging Research Group (MIRG) is to use our basic science expertise in physics, engineering, mathematics and computer science to develop practical and robust methods that will improve the accuracy and effectiveness of NM procedures. We focus on methods which use quantitative imaging of radioisotope distributions in the ‘personalized medicine' paradigm, in order to optimize diagnosis and customize treatment to each individual patient needs. ***The projects discussed in this proposal range from the investigations of production of the new radioisotopes (for diagnosis and therapy), include extensive research aiming at optimization of the imaging methods (data acquisition and quantitative image reconstructions) to provide quantitative information about activity distributions in tumours and organs, and to track changes of these distributions over time, to accurate calculations of the absorbed radiation dose and this dose spatial distribution. In our search for new diagnostic and therapeutic isotopes we will strive to identify the best production conditions. In parallel, we will work on optimization of the practical image-based personalized dosimetry methods for TRT using existing and new ? and ? emitting radioisotopes. Additionally, we will use our nuclear and medical physics expertise to develop new imaging system (Cadmium Zinc Telluride (CZT)-based Compton camera) for in-vivo determination of proton ranges in proton-beam radiotherapy. The result of our research will be quantitatively accurate methods for diagnosis and personalized therapies.