Health and Medical News and Resources

General interest items edited by Janice Flahiff

[Reblog] One nanoparticle, six types of medical imaging – University at Buffalo

One nanoparticle, six types of medical imaging – University at Buffalo.

Tomorrow’s doctors could use this technology to obtain a super-clear picture of patients’ organs and tissues By Charlotte Hsu

Release Date: January 20, 2015

University at Buffalo researchers and colleagues have designed a nanoparticle detectable by six medical imaging techniques. This illustration depicts the particles as they are struck by beams of energy and emit signals that can be detected by the six methods: CT and PET scanning, along with photoacoustic, fluorescence, upconversion and Cerenkov luminescence imaging.

This transmission electron microscopy image shows the nanoparticles, which consist of a core that glows blue when struck by near-infrared light, and an outer fabric of porphyrin-phospholipids (PoP) that wraps around the core. Credit: Jonathan Lovell

“A patient could theoretically go in for one scan with one machine instead of multiple scans with multiple machines.”
Jonathan Lovell, assistant professor of biomedical engineering
University at Buffalo

BUFFALO, N.Y. — It’s technology so advanced that the machine capable of using it doesn’t yet exist.

Using two biocompatible parts, University at Buffalo researchers and their colleagues have designed a nanoparticle that can be detected by six medical imaging techniques:

  • computed tomography (CT) scanning;
  • positron emission tomography (PET) scanning;
  • photoacoustic imaging;
  • fluorescence imaging;
  • upconversion imaging; and
  • Cerenkov luminescence imaging.

In the future, patients could receive a single injection of the nanoparticles to have all six types of imaging done.

This kind of “hypermodal” imaging — if it came to fruition — would give doctors a much clearer picture of patients’ organs and tissues than a single method alone could provide. It could help medical professionals diagnose disease and identify the boundaries of tumors.

“This nanoparticle may open the door for new ‘hypermodal’ imaging systems that allow a lot of new information to be obtained using just one contrast agent,” says researcher Jonathan Lovell, PhD, UB assistant professor of biomedical engineering. “Once such systems are developed, a patient could theoretically go in for one scan with one machine instead of multiple scans with multiple machines.”

When Lovell and colleagues used the nanoparticles to examine the lymph nodes of mice, they found that CT and PET scans provided the deepest tissue penetration, while the photoacoustic imaging showed blood vessel details that the first two techniques missed.

Differences like these mean doctors can get a much clearer picture of what’s happening inside the body by merging the results of multiple modalities.

– See more at: http://www.buffalo.edu/news/releases/2015/01/015.html?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+Science360NewsServiceComplete+%28Science360+News+Service%3A+Complete%29&utm_content=Netvibes#sthash.uBpXDk8L.dpuf

January 22, 2015 Posted by | Medical and Health Research News | , , , , , , , , | Leave a comment

[Reblog] Imbalance in reporting on Alzheimer’s PET scan research

From the 4 October 2013 article by Gary Schwitzer at HealthNewsReview.org

Just two weeks ago, CBS reported on PET scans for Alzheimer’s disease, “New scan may diagnose Alzheimer’s as brain changes occur,” based on a study in the journal Neuron.  (Do they scour this journal all the time?)

Just four days ago, the Washington Post reported on “good news on Alzheimer’s: Better ways to diagnose it.“  Excerpt:

“Now, for example, we no longer have to rely on autopsies to confirm the existence of Alzheimer’s plaques. In a major advance last year, the Food and Drug Administration approved a method that uses a radioactive dye, known commercially as Amyvid, to light up amyloid plaques in a PET scan.”

University news releases promote even more Alzheimer’s PET scan research. For example, this UCLA news release: “Early imaging, diagnosis of Alzheimer’s leads to changes in patient care, better outcomes.”

Some journalists love such stories.  PET produces bright, colorful images.  It’s “good news” for Alzheimer’s, as the Washington Post headline stated, right?

Well, I didn’t see that either CBS or the Washington Post – or any other mainstream news organization, for that matter – reported on a paper published online this week by JAMA Internal Medicine – “Amyloid-β Positron Emission Tomography in the Diagnostic Evaluation of Alzheimer DiseaseSummary of Primary Findings and Conclusions.” The researchers reported that they analyzed data from 15 articles reporting on 15 studies focusing on Amyloid-β PET scan imaging. Their summary included this:

“At present, the medical literature provides extremely limited data with which to evaluate the clinical utility of Aβ (amyloid-β) PET. There are reasonable data showing that, when read by well-trained interpreters, Aβ PET is highly accurate in determining whether there is amyloid in the brain. However, the clinical utility of a positive scan result remains uncertain. If tested, approximately one-third of cognitively normal older adults would have a “positive” test result for brain amyloid. Thus a positive Aβ PET result is not diagnostic of AD, nor can the test be used to accurately predict the risk or the timing of progression of mild cognitive impairment.

The clinical utility of a negative Aβ PET result seems greater than the clinical utility of a positive result because the high sensitivity of a negative test result allows AD to be effectively ruled out as the cause of a patient’s cognitive impairment. It remains uncertain, however, if negative test results lead to important changes in subsequent clinical management or whether any such changes would produce net health benefits for patients and families. Even if negative test results would produce net benefits, rigorous evaluations of Aβ PET must consider the overall balance of benefits and harms of both positive and negative test results in broadly representative patient populations. The current literature on Aβ PET imaging for AD is insufficient to provide this level of evidence. Given the limited effectiveness of the targeted treatments for AD that are currently available, demonstrating that Aβ PET leads to changes in clinical impressions and intended management is insufficient. More persuasive evidence that Aβ PET improves patient outcomes is needed.”

An editor’s note in the journal stated:

“Clearly, more data are needed about the role of Aβ PET in the prevention, diagnosis, and treatment of patients with AD. At present, the evidence tells us that the role of the scans is uncertain in many situations. The test could aid diagnosis and management in some circumstances, but it could also be harmful in other circumstances; for example, if a positive scan result leads to labeling a person as having a dread and incurable disease and that potential diagnosis turns out to be wrong.”

Why wouldn’t this paper and this editorial receive the same kind of attention as the “good news” stories highlighted above?  Don’t journalists see the huge public policy issues at stake here?  It’s difficult to understand. If you’re that committed to reporting on imaging tests for Alzheimer’s that you are scouring the journal Neuron, for example, wouldn’t you consider these articles newsworthy as well?  If not, why not?

————————–

October 14, 2013 Posted by | health care | , , , , | Leave a comment

Huge Increase In Radiation Exposure From Diagnostic Imaging

From the 13 June 2012 Medical News Today article

As imaging technology advances and medical devices improve, healthcare professionals are more inclined to use these state-of-the art scanners to look inside patients’ bodies. Computed tomography usage, for example, more than tripled between 1996 and 2010. Over the same period, MRI (magnetic resonance imaging) usage increased fourfold. It is not surprising, therefore, that patient radiation exposure has also risen.

An article in JAMA, published today, asks the question to see if this technological dependance is going too far or even putting patients in danger with too many scans. Some people are worried about raditation from mobile phones, so stepping inside a multi-million dollar machine that blasts the body with one type of electromagnetic resonance or another, is going to draw warranted safety questions…

..One of the main points made in the article is that there has never been a comprehensive study of how much use healthcare providers are making of imaging technology. The studies that have been done are usually based around private practices and done for insurance purposes, and in these cases, imaging is usually encouraged. Looking at a wider range of patients and facilities enables the authors to provide us with a clear picture.

The authors summarize the use of various imaging techniques:

  • Radiography and angiography/fluoroscopy rates were relatively stable over time: radiography increased 1.2 percent per year, and angiography/fluoroscopy decreased 1.3 percent per year.
  • Computed tomography examinations tripled (52/1000 enrollees in 1996 to 149/1000 in 2010, 7.8 percent annual growth)
  • MRIs quadrupled (17/1000 to 65/1000,10 percent annual growth)…

…while healthcare has obviously improved with the use of technology, given the high costs of imaging, some $100 Billion annually, combined with the cancer risks and other possible side effects, the benefits of sending patients for scans, should be balanced by weighing the medical needs against both financial and heath risks of the technology itself.

Related Resource

   Choosing Wisely (US Agency for Healthcare Research and Quality)

Choosing Wisely™ aims to get physicians, patients and other health care stakeholders thinking and talking about the overuse or misuse of medical tests and procedures that provide little benefit, and in some instances harm.
Includes tips,scenarios, and information to get the most out of doctor visits.

 

English: Osteoarthritis Initiative (OAI) resea...

English: Osteoarthritis Initiative (OAI) researchers at Ohio State University look through the opening of an MRI machine, used to image the knees of patients. The OAI, a public-private partnership, led by NIAMS and the National Institute on Aging with additional support from five other Institutes and Centers, funds research and information sharing resources to aid in the identification of biological markers for osteoarthritis. (Photo credit: Wikipedia)

 

June 14, 2012 Posted by | Consumer Health, health care | , , , , | Leave a comment

   

%d bloggers like this: