UPMC Chief of Nuclear Medicine and Director of Theragnostic, Ashok Muthukrishnan, MD, MS talks about a new technology that is catching cancers quicker.
Interview conducted by Ivanhoe Broadcast News in 2022.
I wanted to ask you a little bit about the quadrant behind us. What kind of machine is this and what kind of imaging is it designed to do?
MUTHUKRISHNAN: Quadrants of revolutionary PET CT scanner, which conventionally we use PET CT technology to scan cancer patients, occasionally brain neurology indications, and some cardiology. Here at Hillman Cancer Center, we primarily use it for cancer imaging.
Can you walk me quickly through the procedure? What will a patient do and then how will this work for a patient?
MUTHUKRISHNAN: A typical patient would get a small amount of radioactive material injected through their body, through an IV. Once it goes, it goes and targets all the tumor sites. The scanner will be able to visualize those tumor sites from within the patient. The injection takes about less than a minute. The wait time for the uptake phase takes about an hour typically. After that the patient gets all the imaging table. Typical PET CT scan would be from eyes to thighs, which takes about 25 to 30 minutes.
Now, you said 25-30 minutes for a typical scan. Can you tell me about the quadrant by comparison, what is the difference?
MUTHUKRISHNAN: The quadrants as the name indicates are for PET CTs put together. It decreases the time by a factor of four. For a scan that takes 20 to 25 minutes, this takes only about four to five minutes. This directly translates into patient convenience and patient acceptability. Also, the image quality is unsurpassed because if you’re acquiring all the photons from the radioactivity that we injected, we’re not losing any data, so it directly translates into a very high-quality image.
How difficult is that if you ever have that before?
MUTHUKRISHNAN: Most of the patients, when they get on the scanner, are nervous. Even before they get on, they asked us for anxiety medications. We are anticipating we will not have this problem anymore because this one is much faster. The patient will also definitely like it a lot better than a conventional PET CT scanner.
Can you describe for me how much sharper the images are for you and what the benefit is for you and your team to be able to have the sharper images?
MUTHUKRISHNAN: I think the PET scan in general shows us the functional images from the body and in the cancer cells. Compared to a CT or EMR, which looks at the anatomy of the body and the cancer. This looks at the physiology or the function of the cancer. It is a whole different perspective from a PET standpoint. Images are usually a bit fuzzy. This scanner, because we’re not losing any of the data, has resolution through the roof. We have never seen this quality before. It’s almost like from a black and white TV to like a 4K television.
You had mentioned earlier that the patient has less radiation. Can you explain that for me?
MUTHUKRISHNAN: Traditionally we inject a small amount of radioactivity which ranges somewhere 15 to 20 millicurie of the dose. With this scanner, we can give four to five millicurie dose and get them scanned quicker. Overall, I think this reduces the amount of radiation exposure to the patients. The patients get multiple scans or a period of lifetime. Not only this scan, but they also get a CT scan or X-rays. All of this adds up to the radiation exposure, like a cumulative radiation exposure. By reducing the amount of the dose that they get for each of these scans. That will help them overall for the years to come.
How much less is the radiation?
MUTHUKRISHNAN: I would say about one third to one fourth of the radiation.
You mentioned doctor, there’s the additional benefit for research purposes. Can you tell me a little bit about that?
MUTHUKRISHNAN: This scanner can image real time right after the injection so we can actually follow the radioactivity. The quadrant can image the patient in real time from eyes to thighs. We can visualize what’s happening inside the body with the radio tracer kinetics. We can see things in a completely new different perspective, which we never saw before. This is going to open a lot more doors for research opportunities. We are going to see cancer biology in new ways that we’ve never seen before in real time.
Is there anything I didn’t ask you that you would want to make sure?
MUTHUKRISHNAN: We talked about the patient comfort, radiation dosage.
Why the improved visual. What does that mean for the physician? How is the improvement. They’re better picture quality. What does that mean?
MUTHUKRISHNAN: In addition to the unsurpassed image quality, we are able to see things which we never saw before because the typical resolution of a PET scan is around six to eight millimeters. This one goes up to like two millimeters. We are able to see microscopic, not anonymously microscopic disease, but tiny amounts of cancer that we were not able to see before.
How does this benefit the doctors?
MUTHUKRISHNAN: They are going to stage the patient more appropriately or more precisely than before. Say for example a patient with the traditional scanner may have a completely negative scan when they had some disease in them. This scanner is not going to miss it. That is a huge benefit for the oncologists and the radiologist. And the patients, they’re going to get staged more appropriately and more accurately.
END OF INTERVIEW
This information is intended for additional research purposes only. It is not to be used as a prescription or advice from Ivanhoe Broadcast News, Inc. or any medical professional interviewed. Ivanhoe Broadcast News, Inc. assumes no responsibility for the depth or accuracy of physician statements. Procedures or medicines apply to different people and medical factors; always consult your physician on medical matters.
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