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Hospital
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June
2010
www.hos p ital ne ws .c om
Volume 23, Issue 6
PM# 40065412
Oncology • Medical Imaging • Paediatrics
Approaches to cancer treatment, diagnosis and prevention.
A look at medical imaging techniques for diagnosis, treatment and prevention of diseases.
Paediatric programs and developments in the treatment of
paediatric disorders including autism.
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Canada’s Health-Care Newspaper
Imaging advances in Parkinson’s disease
Inside
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More Features
• Early detection lung
study gives
participant a new
perspective
• New imaging
technology catches
cancer earlier
• Reducing Tunnel
Vision
• and more
Dr. Alexander Rauscher, a physicist and research associate at the UBC MRI Research Centre, developed a new technique
to gain better scans for Parkinson’s patients.
By Avril Roberts
Imaging in Parkinson’s disease diagnosis has been used
primarily to rule out conditions
that might mimic Parkinson’s.
The traditional thinking is that
the Parkinson’s brain appears
normal in MRI scans.
However, scientists at the
University of British Columbia
(UBC) MRI Research Centre in
Vancouver are challenging this
view. They are using MRI in a
novel way to reveal changes in
the Parkinson’s brain that are
not detected in conventional
scans. Research funded by
Parkinson Society Canada
is pointing to the possibility of
an imaging-based diagnostic
tool for Parkinson’s disease,
improved guidance for deep
brain stimulation surgery, and
new ways to measure the progression of Parkinson’s disease
in the brain.
Dr. Alexander Rauscher, a
physicist and research associate at the UBC MRI Research
Centre, has developed and validated a new imaging technique
that is extremely sensitive to
iron, more accurate at assessing
iron content, and yields better
and sharper images of the brain
and veins than can be obtained
with conventional MRI scans.
This new technique is called
susceptibility weighted imaging
(SWI) with multiple echoes.
Excessive iron in the brain
has been linked to the death of
dopamine-producing brain cells
in Parkinson’s disease. With
his multi echo SWI method,
Rauscher has already found
a good correlation between
overall iron content in the
substantia nigra, which is the
area of the brain affected in
Parkinson’s disease, and dis-
ease severity, as measured by
the Unified Parkinson’s Disease
Rating Scale (UPDRS).
“Using MRI to detect elevated iron content in the substantia
nigra, or other brain regions,
would provide a new measurement that could lead to earlier
diagnosis of Parkinson’s,” says
Rauscher. His novel MRI technique has potential for widespread use particularly in other
neurological diseases where
iron accumulation plays a role.
Rauscher’s research on
susceptibility weighted imaging with multiple echoes, was
published in the Journal of
Magnetic Resonance Imaging
in January 2010. The study was
Continues on page 15
Hospital News, June 2010
www.hospitalnews.com
15
Focus: Oncology • Medical Imaging • Paediatrics
Brighter future expected
with new advances
in kidney cancer
By Deb Maskens
F
ive years ago, kidney
cancer was in the shadows. A diagnosis of the
disease left few options for
patients and the average survival time was just 12 months. But
through exciting new developments in treating the disease,
there is now a brighter outlook
for people living with ki dney
cancer in Canada. This is critical for a disease that is on the
rise in Canada.
These developments can be
summed up in five words: survival, support, understanding,
research, and hope.
Survival
On average, patients with
kidney cancer are living
years longer today than ever
before. Kidney cancer has
few signs and symptoms and
is often diagnosed in the late
and much more serious stages.
Unfortunately, kidney cancer
does not respond to convention-
al therapies such as chemotherapy or radiation, which makes
the need for newer targeted
treatments critically important.
After 10 years of waiting, the
introduction of four new targeted therapies in Canada in the
past five years has significantly
changed the lives of people
with kidney cancer.
Support
Living with cancer is not just
about the medication. Disease
management often includes
support, education and an inclusive community. Kidney Cancer
Canada (KCC) was formed in
2007 to provide that level of
support to Canadian kidney
cancer patients. KCC (www.
kidneycancercanada.ca) is
now a registered charity with a
strong presence across Canada.
Understanding
In 2009, KCC established
a Medical Advisory Board,
comprised of cross-Canada
experts from specialties including urology, medical oncology,
Imaging advances
in Parkinson’s disease
radiation oncology and nursing. Their mission is to provide
KCC with a dedicated group of
medical practitioners focused
on kidney cancer research, collaboration, and best practices in
patient care, creating a strong
connection to build awareness
for the disease among healthcare professionals and patients
alike.
Research
Kidney cancer research has
come a long way in a short
period of time but there is still
a long way to go. Increased
research funding allows for
the development of superior
treatments, and more treatment
options allow physicians to tailor their care more effectively,
ultimately giving patients more
time with loved ones.
However, a recent report
from the Canadian Cancer
Research Alliance shows kidney cancer is proportionally
and significantly underfunded.
Kidney cancer receives less
than 1.2 per cent of the $402.4
million invested in cancer
research in Canada, even
though it accounts for up to
three per cent of new cancer
cases. To continue on the path
of achievement, more dedicated
research funding is urgently
needed.
Hope
Research advances have
already translated into longer
survival, deeper understanding and greater support.
Researchers and patients share
a greater sense of hope than
ever before. Hope that research
will continue to deliver breakthroughs in treatment and hope
that more Canadians with this
rare cancer will have access to
this new era of treatments and
the hope they bring.
To learn more about kidney
cancer or find out how you can
help make a difference, visit
www.kidneycancercanada.ca.
Deb Maskens is a writer for
Kidney Cancer Canada.
Are you a kidney cancer patient
or caregiver?
Do you need information or support?
We can help:
1-866-598-7166
[email protected]
www.kidneycancercanada.ca
patient information card (print).indd 1
18/08/2009 4:42:10 PM
Continued from cover
Research Centre, is working
with Rauscher to see if iron is
deposited in specific patterns in
Parkinson’s disease, making the
technique even more sensitive.
McKeown and colleagues
are also using conventional
MRI (collected at the same time
as the SWI) and novel analysis
methods to look for changes
in the shape of brain structures
in people with Parkinson’s
disease. They are then examining whether those shape
changes correlate with specific
Parkinson’s symptoms and disease severity.
“If we can tell, from the
change in shape of a part of
the brain, whether a person
will have more severe tremor,
be more rigid, have worsening memory and so on, this
may allow us to predict how
a person’s Parkinson’s disease
will progress,” says McKeown.
“One of the challenging things
about Parkinson’s disease is
that it varies tremendously from
person to person. If we could
target individuals who are at
risk for specific symptoms, we
could become more efficient
and effective at offering them
treatment.”
Avril Roberts is a Torontobased health writer.
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As a direct result of this
study, Rauscher and his colleagues have found that the
high resolution and high contrast of SWI enables clear
visualization of the subthalamic nucleus in MRI. “The
subthalamic nucleus is a small
structure in the brain and it is a
target for deep brain stimulation
which alleviates Parkinson’s
disease symptoms in some
people,” says Rauscher, “but
it is difficult to identify in
conventional MRI scans.”
Reliable, direct targeting of the
subthalamic nucleus with clear
identification of shape and location could eliminate one step in
DBS surgery and dramatically
shorten the procedure which
typically takes six to eight
hours. A research paper on this
was published in the Journal of
Neuroradiology in 2009.
Rauscher presented his
findings on iron and UPDRS
rating at the joint annual meeting of the International Society
for Magnetic Resonance
in Medicine in Stockholm,
Sweden, in May 2010.
In complementary research,
Dr. Martin McKeown, a
professor of medicine at
the University of British
Columbia and clinical director of the Pacific Parkinson’s