Shimadzu_RADbook_2015:Layout 1 19.01.15 16:27 Seite 1 www.healthcare-in-europe.com 11EH @ ECR Yet, this presents a new challenge because the aperture for endoscop- ic cameras is small for the long and narrow instruments, exactly the opposite of the ideal setting for imaging Cerenkov luminescence emanating from a radiotracer. In addition to an on-going clini- cal trial at Memorial Sloan Kettering Cancer Center to explore Cerenkov light in patients, 30 patients are cur- rently being enrolled at the Guy’s and St Thomas’ NHS Trust in the United Kingdom for a pilot study to evaluate Cerenkov luminescence imaging using an analyser devel- oped by Lightpoint Medical Limited for the ex-vivo measurement of sur- gical margin status in breast cancer surgical specimens and the meta- static status of excised lymph nodes. Another 30 patients are being enrolled at University College Hospital London for a prospective, single-centre feasibility study test- ing the feasibility of 18F-choline Cerenkov luminescence imaging to measure margin status in radical prostatectomy specimens. Research at Memorial Sloan Kettering, supported by two the United States National Institute of Health and in collaboration with Lightpoint, aims to bring Cerenkov luminescence imaging over the next five years from testing in animals to patients, ‘…and then,’ Dr Grimm predicts, ‘all the way up to an open surgery procedure.’ in the future, the refined procedure will facilitate more precise diagnosis because the stronger signals can visualise structures not previously detectable in the MRI. ‘As a non- invasive procedure with excellent soft tissue contrast and no radiation exposure the only entity missing is the molecular specificity to turn MRI into the ideal procedure,’ the medical physicist believes. The method is also very impor- tant for the development of active ingredients. He hopes it will help to reduce the number of animal exper- iments required and to assess the effectiveness of new active ingredi- ents quickly. Although the team’s current research focuses on oncology diagnostics Xe MRI is not limited to any particular type of disease. ‘Everything that has an identifiable molecular marker can, in principle and at sufficient concentrations, be detected with biosensors. ‘Currently the detection limit is in the nanomolar range, making these markers around 1,000 times more sensitive than conventional MRI contrast media. ‘We have developed sensors for inflammatory processes and for cer- tain receptors on the surface of can- cer cells, but we can build on this in a very flexible way,’ the physicist points out. Whether or not Xenon-MRI will become established in clinical rou- tine is currently difficult to assess. The first trials on animal models are planned for this year, but Schröder cautions: ‘It’s likely to take several years before the procedure can be used in clinical routine. However, patients will also benefit indirectly from the use on animal models, which is expected to begin much sooner, through the improved devel- opment of new active ingredients and treatments.’ Physicist Leif Schröder preparing a rubidium sample under protection atmosphere for the laser setup to generate hyperpolarised xenon for novel MRI applications. Image: Monique Wüstenhagen, Berlin Partner GmbH The specific detection of cell surface proteins by xenon MRI. The image illustrates the use of hyperpolarised xenon gas (purple) combined with xenon cryptophane cages (pale blue), which are attached to cells via antibodies. During the MRI experiment a unique radio frequency pulse (red) is used to selectively image and ‘light up’ the surface of macrophage cells. Image: ©Barth-Jan van Rossum (Leibniz-Institut für Molekulare Pharmakologie, Berlin). Jan Grimm MD PhD, Assistant Professor at Memorial Sloan Kettering Cancer Center and Cornell University, New York Shimadzu_RADbook_2015:Layout 119.01.1516:27 Seite 1