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May 2015 ECFA meeting 1
Spin-off technologies for cancer diagnosis
J. Varela, LIP Lisbon
ECFA meeting, Coimbra, 15 May, 2015
May 2015 ECFA meeting 2
Since ≈10 years there is an active program in Lisbon developing spin-off from HE physics in medical imaging, mainly PET.
Main activities are- ClearPEM- EndotofPET- Dedicated readout electronics for TOF-PET- New ClearPEM
May 2015 ECFA meeting 4
Why?
- breast cancer is 3rd most frequent cancer in humans
- one in 10 women eventually develops breast cancer
- good survival rate if detected at an early stage
May 2015 ECFA meeting 5
Hamamatsu APD arrayS8850How?
- take advantage of the (at that time) newAPD photodetectors
- Use our expertise in using APDs acquired in CMS
The ClearPEM scanners
6
ClearPEM-II in Monza (Italy)ClearPEM (prototype) in Coimbra
3.0 mm
2.5 mm 2.0 mm
1.5 mm
1.2 mm
Spatial resolution : 1.3 mmObtained with Derenzo phantom (Na22 rods)
Sensitivity: 2 to 5%, depending on the configuration
May 2015 ECFA meeting
Breast tumor with FDG activity is concentrated in the periphery
Clinical studies
Tumour heterogeneity is recognised as an important challenge in modern oncology.
Tumours consist of different populations of both benign and malignant cells with a specific impact on patient prognosis and outcome of neo-adjuvant treatments.
Tumor
Lymph Node
PET Whole Body
Clinical case: multifocal breast cancerClinical case: multifocal breast cancer
PET/CT exam Resolution is insufficient to identify multiple focus
PEM: Multifocal Lesions
ClearPEM
May 2015 ECFA meeting 9
In Monza, after one year of upgrade work on the image reconstruction software and user interface, the patient studies with ClearPEM have resumed very recently.
A clinical study (200 patients) will evaluate if FLT(3-deoxy-3-[18F]fluorothymidine) can be used to monitor the stage of the disease reducing the need to perform a biopsies. The performance of ClearPEM will be compared the one of the standard whole-body PET.
May 2015 ECFA meeting 10
In Coimbra, the team has mainly been using the ClearPEM as a small animal PET, and evaluating the possibility to use it as a brainPET.
May 2015 ECFA meeting 12
But we have been overtaken by technological progress
APD SiPMs allow for a dramatic improvement in time resolution
May 2015 ECFA meeting 15
Our role in the EndoTOFPET-US project is to develop the PET Detectors and the readout electronics based on SiPM readout of the scintillation light.
The challenge is to have a highly integrated electronics with low power consumption and the best possible time resolution (≈ 200 ps).
May 2015 ECFA meeting 16
Our new, SiPM based, front end PET detector based onthe TOF PET ASIC allows building the most compactPET detector ever.
May 2015 ECFA meeting 18
Should we revisit ClearPEM?
Make sure to keep the physician involved from the design phase
I didn’t know I had a problem
Hey, I’ve solved your clinical problem
Physicist Physician
Thesis• Design and Evaluation of a Positron Emission Tomograph for Breast Cancer Imaging, PhD
• Study and Development of the Clear–PEM Trigger and Data Acquisition System, PhD
• Development and Experimental Study of a Detector Module for Positron Emission Mammography, PhD
• The ClearPEM detector in breast cancer: correction methods for improved imaging, PhD
• Tecnologia de medicina molecular em oncologia. Avaliação da PET Mamografia , PhD
• Integrated Circuit Design for Time-of-Flight PET, PhD
• Controlo de Qualidade de matrizes de Fotodíodos de Avalanche, Master
• Development and Study of the Detector Control System and Calibration Software for the Clear-PEM Scanner, Master
• Development of an Intelligent Front End Board for a High Performance PET, Master
• Performance evaluation of new upgrades on ClearPEM detector modules, Master
• Evaluation of the Clear-PEM scanner in Clinical Environment, Master
• Development and Implementation of the ClearPEM-Sonic Detector Control System, Master
• Amplicador CMOS de baixo rudo para imagiologia medica, Master
• Investigação da detecção do cancro da mama com tomógrafo ClearPEM utilizando fantomas de gelatina, Master
• Development of an innovative LSO-SiPM detector module for high-performance Positron Emission Tomography, Master
• Development and Evaluation of Combined PET-MRI Imaging, PhD (on-going)
• Development of new high-performance Positron Emission Mammography based on silicon photomultipliers and optimized detector geometry, PhD (on-going)
May 2015 ECFA meeting 19
8 PhD, 9 Master
May 2015 ECFA meeting 23
Time Of Flight > TOFWhat if we could measure the time difference very accurately ∆t =1 ns >>> ∆x=15 cm => !
If ∆t ≈10 ps events would be space points !
Detector 1 Detector 2
May 2015 ECFA meeting 24
Simulation: object D=35 cm, TOF=600 ps, Sensitivity gain factor 3.9
Karp JS, Surti S, Daube-Witherspoon ME, Muehllehner G. Benefit of time-of-flight in PET, experimental and clinical results: . J Nucl Med 2008; 49(3):462-70.
May 2015 ECFA meeting 25
Colon cancer, left upper quadrant peritoneal node114 kg; BMI=32.2 ; 13.4 mCi; 2 hr post-inj
Images J. Karp, University of Pennsylvania