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Researcher/ Assoc Prof Renate Grüner Medical Physics and Technology, UiB From IEEE-NPSS Real Time Conference 2005 ○ new and better scintillator material (LYSO, LaBr3) ○ multipixel photon counters (MPPC, MAPD, SiPM) ○ high speed ADCs and analog memory In cohort with new developments of intelligent detectors to be used in future upgrades at CERN and other high energy physics experiments Helse Bergen HF 2011: ~11000 ansatte ~ 7700 årsverk ~ 7.8 milliarder kr (budsjett) Ansvar: Pasientbehandling, Forskning, Utdanning, Opplæring Haukeland University Hospital 1912 – 2012 Dept of Radiology Technical Devision Dept of Oncology and Medical Physics Dept of Clinical Eng. Medical Physics CT MRI NM/PET RT Radiologisk avdeling Ansatte ca 210 Ass. leger: 17 Overleger: 36 Radiografer: 100 Antall undersøkelser 2008: 180.000 Budsjett 2010: ca 230 mill Egne inntekter: ca 73 mill To spesialiteter: Radiologi og Nukleærmedisin PET-senter i 2009 Courtesy Aslak Aslaksen, MD. PhD, Head Dept of Radiology PET Cyclotron OH Radio chemistry HO HO 18 PET/CT O F OH NM CT Ultrasound NM CT Ultralyd MRI 06/08/06 - 1 9 What next? Towards multimodality? Towards super resolution? 11.74T, 10-100um, 10-100ms Combined PET/ MRI Data acquisition - Physical/ Mathematical/ Statistical Modeling – Assessment The image data acquisition Contrast resolution High Spatial resolution 8mm Low 1mm Available MRI parameters Signal/ Noise Temporal resolution Image quality week0 week3 week5 week8 Perfusion 50μm 100μm Harrison, 2002 DSC-MRI: Acquisition and analysis Acquisition: MR signals: s(t) baseline first pass recirculation Contrast concentrations: c(t) AIF (ACM) Gray matter White matter time Gd-DPTA iv bolus Cerebral blood volume Cerebral blood flow Susceptibility Contrast Physics Mean transit time Time to Peak Tracer Kinetic Principles Typical values: GM: 4-7 ml/100g WM: 2-3 [ml/100g] Gray Matter: 45-70 White Matter: 20-25 [ml/100g/min] CBV ________ Modified, JR Petrella et al. AJR 2000; 175:207-219 Time-to-peak, Time-of-arrival CBF [seconds] Delay and dispersion: Blood Flow using Arterial Spin Labeling (ASL) TR/TE = 36 ms/ 3.7 ms 300 ADC 250 DCE-MRI in endometrial ca. ID_012 ID_019 ID_022 200 ID_025 150 ID_026 ID_028 100 ID_030 ID_031 50 ID_032 AIF ID_033 1 7 13 19 25 31 37 43 49 55 61 67 73 79 85 91 97 103 109 115 121 127 133 139 145 151 157 0 ROI signal intensity 130 g b c d e f b c d e f g 125 PWI Myometrium 120 115 110 105 Pixel Intensity [a.u.] 100 95 90 85 Tumor tissue 80 75 70 65 60 55 50 45 0 50 100 150 200 250 300 350 400 Time [sec] Fig 5: ROI analysis in one random subject (FIGO IB) Bergen fMRI group (HUH/ UiB) http:// fmri.uib.no Belliveau et al. Science, 1991 Lundervold et al. (1995) Int. J. Neuroscience, 81, 151-168 YouTube Ongoing research activities 1/3 initiated within Dept of Radiology Pediatric imaging Neuroimaging (Head and neck) Male/ female pelvis 1/3 initiated from clinical departments or researchers at the university 1/3 clinical trials 60 50 Antall 40 2010 30 2011 (okt) 20 10 0 Antall Artikler Nivå1 tidsskr Nivå2 tidsskr 1.forfatter Antall Medforf Clinical Trials (GCP): Om radiologiske undersøkelser i studien: Hvilke undersøkelser: Hvilke visitter: Inngår i vanlig rutine: Ekstra på grunn av studien: Bone scan / sceletal servey CT/MR bryst, abdomen, bekken Evt. annet tilleggsarbeid (skal svarene leveres på CD og lignende): Bone scan/ CT/ MR sendes enten elektronisk eller på CD ROM Alle 1(screening/baseline), uke 9, og deretter hver 8. uke (bone scan ved skjelettmetastaser) Clinical Trials: Work Flow 1) 2) 3) 4) 5) 6) Certification of laboratories/ training of staff (Imaging Facility Qualification Procedure/ Training of staff) Establishment of imaging protocol. Piloting. Logistics: Allocate imaging equipment and staff Image acquisition – multimodal/ longitudinal Diagnotic reading (RECIST criteria) Image processing/ deidentification according to guidelines/ Image export and transfer Considerations Merge medical physicists? Emerging new technologies? (preclinical, OI, nano tech, US in therapy, bioechemistry/ molecular) Complexity of information (combining diagnotics, therapeutic outcome, disease progression/ reoccurence, serum/ blood samples, …) MedViz (HUH/ UiB) http:// medviz.uib.no Why research? Science, curiosity and creativity Less routine, more fun Implement new, improved health care (our best survival strategy?) Gateway to international web of knowledge (conferences, write paper to read paper) Requirements to us Be true to own knowledge (math, physics, C++..) Do basic scientific research to push frontiers Interdiciplinary teams (MD, chem, eng., bio.) High ethical standards and responsible decisions Develop good problemsolving skills Excellent communication skills High patient compliance 10000h (scan time during regular working hours!) FOCUS Thank you for your attention! http://fmri.uib.no & http://nordicneurolab.com Bergen,March 13th – 14th fMRI and DTI: From Research to Clinical Practice