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A Sharper Image with Combined PET/MR Technology

New instrument for cancer diagnostics provides precise images from inside the body

No. 23 | 15/04/2013 | by And

The German Cancer Research Center (Deutsches Krebsforschungszentrum, DKFZ) is sending a promising duo into the race against cancer: A new PET/MR system that can combine high-resolution images with functional information to improve cancer diagnosis. The instrument also supports clinicians in choosing the best options for treatments and monitoring their progress.

Combined imaging makes it possible: Images taken with the PET/MR scanner that recently started operating at DKFZ show not only highly resolved structures at a millimeter scale but also provide biological information. “This is particularly relevant in prostate cancer diagnosis,” says Prof. Heinz-Peter Schlemmer, head of the Radiology Division (right).
© DKFZ, Photo: Peggy Rudolph, Media Center, Heidelberg University Hospitals

Combining the methods of positron emission tomography (PET) and magnetic resonance imaging (MRI) makes it possible to simultaneously determine the location and size of a tumor while obtaining information about the metabolic activity of cancerous tissue. Radiologists obtain images with high spatial resolution and clear contrasts. The technology offers a key advantage over PET/CT, a method of combining PET with computer tomography (CT) that has been in use since 2000: MRI does not involve radiation exposure. In addition, PET/MR delivers better contrast in images of soft tissue. PET/MR is also superior when it comes to imaging organs in motion, such as the lungs. Professor Heinz-Peter Schlemmer, head of DKFZ’s Radiology Division and a pioneer of the new combined imaging technology, sees “an enormous potential” in this advance in imaging technology and points out the opportunities it opens for personalized oncology: “We can image tissue structures much more sensitively than before. This enables us to better differentiate the tumor from healthy tissue and to characterize tumor biology more precisely.” The additional information may help clinicians adjust therapies, such as radiation therapy, to the individual characteristics of a tumor. In the case of a tumor with a good prognosis, a patient may thus be spared the adverse side effects of aggressive therapy.

To date, only a few PET/MR instruments are in clinical use. Most of the 30-40 hybrid scanners that exist worldwide are used at research institutes and university hospitals in studies of their diagnostic potential. At DKFZ, radiologists and nuclear medicine specialists are using the combined imaging modality in clinical trials with, for example, prostate cancer patients. They are also studying the potential of PET/MR in patients suffering from multiple myeloma, lung cancer, brain cancer and malignant melanoma. Fundamental support for PET comes from the Clinical Cooperation Unit “Nuclear Medicine”, led by Professor Uwe Haberkorn, and the Division of Radiopharmaceutical Chemistry. This unit was led successfully for many years by Professor Michael Eisenhut, who was succeeded by Professor Klaus Kopka on April 1, 2013. The nuclear medicine specialists are developing radiotracers, i.e. radioactively labeled biologically active substances that visualize the modified metabolism of cancer cells.

Radiologist Heinz-Peter Schlemmer is optimistic about the potential of the benefits of the new hybrid method, while noting that developments are still necessary. While working at Tübingen University Hospitals, Schlemmer witnessed the early development of PET/MR very closely. In November 2006, he published the first ever PET/MR images of the human body in the specialist journal “Radiology”. Since the first prototypes of the hybrid instruments were used, there have been many advances in medical technology. “For many years now we have been working with Siemens Healthcare as a strong partner for further developing the technology,” the radiologist said, and notes that the future will surely see many more improvements.

Schlemmer cannot tell whether PET and MR will be the “dream couple” for cancer diagnostics over the long term, because of important aspects of the technology that go beyond their medical benefits. There are technical challenges still to be resolved, and medical staff must be trained in the use of the complex systems. “And then we simply don’t know yet whether the added value from the new technology will ultimately resist economic pressure in the healthcare system.”

A picture to accompany this press release is available at:
www.dkfz.de/de/presse/pressemitteilungen/2013/images/PET-MR-einweihung.jpg

Combined imaging makes it possible: Images taken with the PET/MR scanner that recently started operating at DKFZ show not only highly resolved structures at a millimeter scale but also provide biological information. “This is particularly relevant in prostate cancer diagnosis,” says Prof. Heinz-Peter Schlemmer, head of the Radiology Division (right).
Copyright: DKFZ, Photo: Peggy Rudolph, Media Center, Heidelberg University Hospitals

With more than 3,000 employees, the German Cancer Research Center (Deutsches Krebsforschungszentrum, DKFZ) is Germany’s largest biomedical research institute. DKFZ scientists identify cancer risk factors, investigate how cancer progresses and develop new cancer prevention strategies. They are also developing new methods to diagnose tumors more precisely and treat cancer patients more successfully. The DKFZ's Cancer Information Service (KID) provides patients, interested citizens and experts with individual answers to questions relating to cancer.

To transfer promising approaches from cancer research to the clinic and thus improve the prognosis of cancer patients, the DKFZ cooperates with excellent research institutions and university hospitals throughout Germany:

  • National Center for Tumor Diseases (NCT, 6 sites)
  • German Cancer Consortium (DKTK, 8 sites)
  • Hopp Children's Cancer Center (KiTZ) Heidelberg
  • Helmholtz Institute for Translational Oncology (HI-TRON Mainz) - A Helmholtz Institute of the DKFZ
  • DKFZ-Hector Cancer Institute at the University Medical Center Mannheim
  • National Cancer Prevention Center (jointly with German Cancer Aid)
The DKFZ is 90 percent financed by the Federal Ministry of Education and Research and 10 percent by the state of Baden-Württemberg. The DKFZ is a member of the Helmholtz Association of German Research Centers.

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