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While imaging professionals work to contend with the progression of disease, they strive to improve diagnostic accuracy that supports personalized treatment for each patient, all while maintaining operational efficiency.

Photos: Peter J. Reese & Alex Teuscher

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The challenge is clear: medical imaging must keep pace with progressive disease. Medical imaging noninvasively visualizes the physiology of disease and provides clinicians vital information that aids them in developing and monitoring a patient’s treatment strategy. Yet, the fact remains that progressive disease often outpaces medical imaging. “One of the problems with imaging is that you’re always running behind. The tumor has either grown or metastasized even in a very early stage of the disease, and it’s difficult to detect those very small locations of metastases,” emphasizes Dr. Walter Noordzij, PhD, MD, nuclear physician at the University Medical Center Groningen (UMCG) in the Netherlands.

Addressing a medical need of such magnitude proves daunting, especially when the pressure to support precision medicine and maximize operational efficiency compounds the challenge. For medical professionals, utilizing the latest innovations in imaging technology is a step towards overcoming this complex challenge. For Prof. Niklaus Schaefer, MD, nuclear physician at Centre Hospitalier Universitaire Vaudois (CHUV) in Lausanne, Switzerland, the approach is clear. “On one side we really want to propagate nuclear medicine as the best possible tool to visualize complex diseases, for example to better plan a treatment or assess response. For this we need the best possible scanner and for me, nuclear medicine is really facilitating precision medicine now.”

Technology that enables physicians to visualize disease in a way that facilitates better treatment is the fundamental cornerstone of nuclear medicine. For a field that was notoriously dubbed as “unclear medicine” in the past, the ability to deliver precise imaging changes how clinicians perceive disease. Schaefer elaborates, “over the years, nuclear medicine went from something that was seen as not very clear to really a precise form of medicine. Nuclear medicine is changing clinicians’ perceptions because we can now see nodules that are three millimeters, and it’s augmenting our perception of disease.”

As a physician, having access to PET/CT technology that acquires images which challenge previous perceptions of nuclear medicine—the possibilities as well as the limitations—incites excitement. Noordzij recounts his enthusiasm upon seeing the precise detail of Biograph Vision’s images. “When we got the image of the first patient, we were very excited. We could see lesions that were clearly outlined and also seemed fairly homogeneous, not patchy because of the different noise levels. It was a completely different kind of image.”

Physicians at CHUV also see the capacity for this new technology to aid in the determination of a patient’s therapy plan. Schaefer explains, “for those patients where localized treatment plays a huge role—in prostate cancer or lung cancer—it is certainly a factor because we need the fastest and highest form of resolution. In those situations, Biograph Vision will play a big part.”

However, for the team at UMCG, the realization that Biograph Vision allows them to couple precision and operational efficiency came quite unexpectedly. According to Borra, “one of the things we wanted to do was push the scanner to the limits and at some point, without meaning to, we entered seven seconds per bed. So, in total, we had around a 50-second scan for seven bed positions. We all expected the quality to be very poor, but the resulting images turned out to have spectacular quality for such a short scan time. One of my nuclear research colleagues said, ‘This thing is amazing. We can do so many scans.’ It was not something we intended, but it was a very early sign of how extremely good Biograph Vision is.”

Jreige stresses, “it is important for us to progress; not to remain where we are, and not just do a routine clinical workup. It‘s crucial for patients to receive their staging, monitoring, and therapy, but it’s also important for us to better understand cancer and other pathologies, as well as the continuum and difference between these entities so we can make diagnoses with more ease. It‘s important for us to understand the physiology of the disease, and having new technologies that help us do this is very promising and satisfying.”