Radiation Could Be Less Damaging and More Effective with Trial Drug

An experimental drug has shown the ability to shield healthy tissue from radiation and enhance its ability to eradicate tumors. The study is published in Science Translational Medicine by UT Southwestern scientists. The pharmaceutical, named avasopasem manganese (AVA), has already been shown to prevent acute mucositis (a condition seen in head and neck cancer patients) in clinical trials. For the drug to become a routine part of clinical care, its ability to protect healthy – not only cancerous – cells from radiation needs to be tested.

Study leader Michael Story, Ph.D., professor of radiation oncology at UTSW and member of the Harold C. Simmons Comprehensive Cancer Center’s Experimental Therapeutics Research Program, worked with colleagues to treat cancerous cells with AVA prior to exposing them to radiation. After drug treatment, the cancerous cells were not protected from radiation and appeared to respond more to the adiation than those who did not receive AVA. This was especially true when high radiation doses were administered.

In mice, cancerous cells were allowed to grow into tumors. Before radiation treatment, AVA was administered, and the tumors shrank after being treated. Some of the tumors disappeared completely. Several different tumor types (lung, pancreatic, neck, head) also experienced positive results in animal trials.

Story noted that AVA is currently being tested in phase 1 and phase 2 clinical trials. “With this drug, the radiation doses we deliver could be profoundly more effective, while at the same time contribute to protecting adjacent normal tissues,” Story said.

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Low Doses of Radiation Might Help Severe Alzheimer’s Patients

A new study published in the Journal of Alzheimer’s Disease showed remarkable improvements in behavior and cognition in patients with severe Alzheimer’s following low-dose radiation treatment.

Morris Freedman, M.D., scientist at Baycrest’s Rotman Research Institute, and head of the neurology division, and senior author of the study said, “The primary goal of a therapy for Alzheimer’s disease should be to improve the patient’s quality of life. We want to optimize their well-being and restore communication with family and friends to avoid social isolation, loneliness, and under-stimulation. Although the study was a small pilot and should be interpreted with caution, our results suggest that low-dose radiation therapy may successfully achieve this.”

In 2015, a case report suggested a patient in hospice with Alzheimer’s disease showed signs of improvement after being treated several times with low-dose radiation to her brain. Her cognition, speech, movement, and appetite were all improved. The patient was eventually discharged from hospice and admitted to a long-term care facility for seniors.

While high doses of radiation are known to create harmful effects on our health, low-dose radiation used in CT scans, for example, can help the body protect and repair itself.

Jerry Cuttler, Ph.D., a retired scientist of Atomic Energy in Canada, has been studying the effects of radiation on health for over 25 years. “Numerous neurological disorders, including Alzheimer’s disease, are thought to be caused in part by oxidative stress that damages all cells, including those in the brain. We have natural protection systems to combat the damage, but they become less effective as we get older. Each dose of radiation stimulates our natural protection systems to work harder – to produce more antioxidants that prevent oxidative damage, to repair more DNA damage, and to destroy more mutated cells,” he said.

In the study, four individuals suffering from severe Alzheimer’s disease were treated with three low doses of radiation spaced two weeks apart. The researchers utilized standardized tests in addition to observation to record patient changes in communication and behavior following treatment. They also collected personal artifacts such as photos, videos, and descriptions from the patients’ family members.

Within one day of the first treatment, three out of four individuals showed improvements such as increased alertness and responsiveness, recognition of loved ones, mobility, social engagement, heightened mood, and more.

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Cancer Patients Can Be Protected from Radiation Using a 3D-Printed Shield

Cancer patients could soon be donning a personalized protection shield giving them an extra level of armor against radioactive toxicity while undergoing radiation therapy. More than 200,000 patients in the United States report injuries to healthy tissue from radiation exposure annually. A large portion of the damage occurs in the mouth and gastrointestinal tract leading to oral mucositis, esophagitis, and proctitis.

A team of researchers published a study in Advanced Science that outlines the personalized 3D-printed device that shields radiation from patients. The proof-of-concept was designed by the Brigham and Women’s Hospital, Dana-Farber Cancer Institute, Massachusetts General Hospital (MGH), and the Massachusetts Institute of Technology (MIT.)

James Byrne, M.D., Ph. D., a postdoctoral researcher at Brigham and Women’s and MIT; senior radiation oncology resident physician at Brigham and Women’s; MGH; and the Dana-Farber Cancer Institute, said their testing showed “Promising results. When we treat patients with radiation, we do our best to minimize the area of healthy tissue that receives radiation and break up treatment into small doses, but it’s a fine balance. We want to administer the most dose we can to shrink the tumor without causing damage to healthy tissue. Our goal through this project was to find an innovative solution that could offer personalized protection for patients.”

To develop the shield, several types of solid and liquid materials were used. Eventually, substances that block gamma and X-rays were chosen to reduce radiation backscatter. Custom-made designs from CT scans were produced from 3D printers. Rats and pigs were used to test the devices, focusing on whether they impacted the mouth and gastrointestinal tracts. Patients commonly experience side effects of radiation in the esophagus, small intestine, or gastrointestinal tract.

The encouraging results shows that the 3D shield successfully protects healthy tissue in the mouth and rectum of rats. In humans, the device could reduce mouth radiation by 30 percent for head and neck cancer patients. A 15-percent drop in radiation exposure could also be noted for prostate cancer patients without any dose reaction to the tumor.

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False Positive Cancer Diagnosis Can Result from COVID-19 Vaccine

Several peer-reviewed literature and radiology societies have been sounding alarms that COVID-19 vaccines can cause temporary inflammation and swelling of lymph nodes in some patients. While this is normal, according to experts, it can be a massive cause of concern for radiologists who assume it’s a sign of infection or cancer.

When lymph nodes are abnormal in size or consistency, lymphadenopathy (also called adenopathy) occurs. It commonly produces swollen or enlarged lymph nodes and is causing alarm on mammograms of recently vaccinated women. Patients who undergo CT scans can also exhibit these swollen lymph nodes.

The swollen lymph nodes that result from being vaccinated for COVID-19 are signs that the body’s immune system is gearing up in response to the vaccine. Experts say the inflammatory response will eventually go away. The same reactions have been seen in other vaccines such as human papillomavirus and influenza.

The Radiological Society of North America (RSNA) journal Radiology: Imaging Cancer published an editorial on April 9 that addresses the concerns and diagnostic dilemma. The authors point out that widespread patient education is necessary. Side-effects such as swelling should be emphasized and normalized as an immune response initiated by the vaccine.

“We write this editorial as a public service message at a time where other countries are starting mass vaccinations programs with the goal of preventing unnecessary nodal biopsies and alleviating patient concern. Imaging studies, clinicians, and news media outlets should spread awareness to educate the public regarding this side-effect to minimize patient anxiety,” the report states.

Recommendations are in place which suggest women should be asked if they have received a COVID-19 vaccine prior to imaging exams. The Society of Breast Imaging (SBI) swiftly issued recommendations for how long to wait before imaging women who receive the vaccine.

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GE Healthcare Releases Vscan Air, a New Wireless Handheld Ultrasound

A cutting-edge, wireless handheld ultrasound device called Vscan Air provides crystal clear image technology, whole-body scanning capability, and intuitive software.

In 2010, GE Healthcare announced the first color pocket-sized ultrasound called Vscan and has since continued to provide innovation in terms of clinician-patient relationships. Today, over 30,000 Vscan family systems are in use worldwide, impacting more than 50 million patients.

The Vscan Air is GE Healthcare’s latest product that facilitates and transforms the clinical exam by making it easier to acquire high-quality ultrasound images.

Kyle Leonard, M.D., family medicine clinician at Hudson Headwaters Health Network in Upstate New York, said, “The first time I fired up the Vscan Air it did feel a little bit like stepping into the future. Many of us are pressed to see patients, to give patients that access to care, so the more time something takes, the less patients I can provide access to in a day. With the portability and ease of use of the Vscan Air, I can bring it with me throughout the day in each exam room and spend more time with my patients.”

Handheld ultrasound has become an essential tool for clinicians worldwide, as they are treating many critically ill patients with limited staff, time, and resources. The Vscan Air will allow clinicians to rapidly collect images and triage patients while also providing the benefits of portability, cleanliness, and efficiency.

Yale Tung-Chen, M.D., Chief of the Division of Ultrasound in Internal Medicine at Hospital Universitario Puerta de Hierro, Majadahonda in Madrid Spain, said, “Time is one of the most valuable resources in this pandemic-challenged world, where so many patients need care. Now, I can carry Vscan Air in my coat pocket, take it out, and start to scan. With this powerful tool in my pocket, I can perform a complete examination on my patients and make decisions quickly right at the bedside. The images you can get of the heart on this handheld device are similar to what you’d get from a full-sized, high-end ultrasound. Vscan Air is a well-designed, powerful tool that’s easy to clean and easy to use.”

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Acceletronics is an industry leader in delivering the best equipment performance and service reliability from CT Scanners and Linear Accelerators across all major brands and models. Call 610-524-3300 or visit our website: https://www.acceletronics.com.


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Four Ways Radiology Can Reduce Its Climate Change Impact

Typically, climate change (a.k.a. global warming) is associated with planes, trains, and automobiles using fossil fuels, hazy skies, and radioactive plants pushing clouds into the atmosphere. However, the radiologic industry plays a more significant role than you might imagine, and industry leaders say the time to reduce that impact is now.

Published in the Journal of the American College of Radiology, a team of industry experts, including Geraldine McGinty, M.D., MBA, president of the American College of Radiology (ACR), issued a call-to-action statement.

“Radiology is well-positioned to spearhead climate change action in our practices and the healthcare system at large. Addressing climate change provides an opportunity to improve healthcare delivery and increase value of care using a different problem-solving approach,” said the team.

The Yale University School of Medicine released data that shows 10 percent of the nation’s carbon emissions (and nine percent of harmful non-greenhouse air pollutants) originate from the United States healthcare system.

Radiology is a significant contributor to each hospital’s energy use. In Switzerland, as the team pointed out, their three CT and four MRI scanners accounted for four percent of the hospital’s overall energy use. Being more environmentally conscious isn’t specific to the industry; it’s a patent priority as well. In the United Kingdom, a survey conducted showed that 92 percent of patients also consider sustainable healthcare operations vital.

Substantial energy use: Radiology utilizes an enormous amount of energy. In the span of a year, cumulative consumption from one CT scanner can equate to five four-person households. A single MRI uses nearly as much as 26 four-person residences. If at all possible, opt for ultrasound instead. Not only is it cheaper, but it also uses less radiation and has a lower environmental impact. Moreover, using Artificial Intelligence (AI) to shorten MRI protocols can lower energy use. To further reduce the carbon footprint, implementing life cycle analyses can quantify the environmental impact of various modalities.

Standby mode: To reduce the amount of energy used by the imaging machines, use standby mode. Even when idle, they are consuming significant amounts of energy, according to the team. Cooling machines take an equal amount of energy to operate. The team recommends a 24-hour operating cycle, as well as exploring energy-efficient HVAC systems and imaging technique improvements.

Power down: Though leaving the PACS on overnight might be more convenient and efficient for workload management, the team suggests turning the machine off overnight. A hospital in Iceland left its systems on overnight and accumulated 25,040 kilowatts of energy, producing 17.7 metric tons of carbon dioxide. These levels are equivalent to the emissions produced by four passenger cars annually. To decrease costs and improve energy efficiency, powering down can be an easy way to accomplish these goals. Additionally, the team suggested reducing excess packaging in your procedures to drive down the environmental costs in production and disposal.

Opt for clean energy: The team said now is the time to shift from fossil fuels and lean toward renewable energy. As prices are dropping, several facilities are already making progress. For example, Kaiser Permanente has achieved carbon-neutrality, and Gundersen Health System is already net carbon positive.

To make these changes a reality, radiologists need to become activists, according to the team. Lobby local ACR chapters to join national efforts or reach out to specialty societies to further push environmentally sustainable radiology. Publishing carbon footprints can help other medical departments understand the environmental dangers associated with over-utilization.

Radiologists are urged to join the Medical Society Consortium on Climate Health, which includes 29 national medical societies, as suggested by the team.

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FDA Authorizes New Device That Protects Athletes’ Brains During Impact

The United States Food and Drug Administration recently authorized a novel product that recent Magnetic Resonance Imaging (MRI) shows might protect athletes’ brains from traumatic injury.

A c-shaped, non-invasive device dubbed the “Q-Collar” goes around the neck and applies compression, which increases blood volume, therefore reducing brain movement.  

Several FDA studies proved the effectiveness and safety. One such study included a long-term analysis of 284 participants, age 13 and older. A total of 139 athletes wore the collars, and 145 did not; both underwent head MRI before and after the season.

To compare structural changes after a season of play, researchers also generated diffusion tensor imaging of the brain. Significant differences were noted in the deep tissue involved in transmitting electrical nerve signals in 73 percent of the collarless group. Those who were equipped with the Q-Collar showed no change in white matter throughout 77 percent of the group.

“These differences appear to indicate protection of the brain associated with the device use. No significant adverse events were associated with device use,” The FDA’s Center for Devices and Radiological Health reported.

An estimated 3.8 million sports-related traumatic brain injuries occur in the United States yearly, according to The National Institute of Neurological Disorders and Stroke.

Along with the Q-Collar manufacturer Q30 Sports Science, FDA officials hope the device will lower this number, reducing “slosh” by creating a tighter fit of the brain in the skull through increased blood volume.

The Q-Collar should not be used in place of helmets or other protective devices. Athletes with a history of seizure disorders, brain blood clots, or problems with blood clotting, in general, should not use the device.

For more information, read the full FDA report.

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Artificial Intelligence Learning Action Plan Released by FDA

The United States Food & Drug Administration (FDA) has released their first Artificial Intelligence (AI) and Machine Learning (ML)-Based Software as a Medical Device (SaMD) Action Plan. Detailed throughout the plan is a multi-pronged approach to “Advance the Agency’s oversight of AI/ML-based medical software,” according to the article.

Bakul Patel, director of the Digital Health Center of Excellence in the Center for Devices and Radiological Health (CDRH) said, “This action plan outlines the FDA’s next steps towards furthering oversight for AI/ML-based SaMD. The plan outlines a holistic approach based on total product lifecycle oversight to further the enormous potential that these technologies have to improve patient care while delivering safe and effective software functionality that improves the quality of care that patients receive. To stay current and address patient safety and improve access to these promising technologies, we anticipate that this action plan will continue to evolve over time.”

Five actions that the FDA intends to take based on the action plan include:

  • Further developing the proposed regulatory framework, including through the issuance of draft guidance on a predetermined change control plan (for software to learn in time)
  • Supporting the development of good machine learning practices to evaluate and improve machine learning algorithms
  • Fostering a patient-centered approach, including device transparency to users
  • Developing methods to assess and enhance machine learning algorithms
  • Advancing real-world performance monitoring pilots

This action plan was sparked by stakeholder feedback and is implemented as a response to the discussion. The FDA welcomes continual input and will continue to collaborate and build a coordinated approach in AI/ML areas.

The FDA is responsible for the safety and security of America’s food supply, cosmetics, dietary supplements, products that emit radiation, and regulating tobacco products. The agency also protects public health by assuring the safety, effectiveness, and security of human and veterinary drugs, vaccines, biological products for human use, and medical devices.

To read more about the FDA’s Action plan, see the full press release on their website.

Acceletronics is an industry leader in delivering the best equipment performance and service reliability from CT Scanners and Linear Accelerators across all major brands and models. Call 610-524-3300 or visit our website: https://www.acceletronics.com.

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Study Shows Drastic Decline in Cancer Screenings During COVID-19 Surge

According to a study published in JAMA Oncology by researchers at Dana-Farber/Bringham and Women’s Cancer Center, researchers documented a sharp drop in cancer and pre-cancer diagnoses at the Northeast’s most extensive health care system. Due to the first peak of the COVID-19 pandemic, a decrease in the number of screenings occurred.

Documented as one of the first studies to examine the impact of COVID-19 on cancer diagnoses, the findings confirm concerns that restrictions might have delayed the detection of many cancers. In the months following the initial peak, cancer screenings and diagnoses rebounded to pre-pandemic levels.

“It’s widely thought that fewer people were screened for cancer and pre-cancerous lesions during the first surge of the pandemic, because limitations on non-urgent medical procedures, restrictions on patient volume, patients’ concerns about the spread of the virus, and the need for social distancing,” said Ziad Bakouny, M.D. MSc, a co-author of the study. “For this study, we wanted to document the extent of this deadline, and its impact on cancer diagnoses, at a major U.S. healthcare system.”

Patient data from the Massachusetts General Bingham system of hospitals were used for the study. The number of mammograms, colonoscopies, Papinicolaou (“Pap”) tests for cervical cancer, prostate-specific antigen (PSA) tests, and low-dose Computed Tomography (CT) tests was all tracked for four three-month periods. March 2 to June 2, 2020, the previous three months, the subsequent three months, and the same three months in 2019 were all used in the study.

During the peak period, the statistics show a sharp decline in cancer screenings. In 2019, between March and June, 60,344 patients underwent screening exams. In 2020, a total of 15,453 patients had screening exams, compared to 64,269 in the previous three months. In the post-peak three-month period, screening levels mostly recovered to 51,944.

Unexpectedly, cancer diagnoses also declined during the COVID-19 peak. The researchers estimated that roughly 1,438 cancers and pre-cancerous growths were left undiagnosed during that period. Cancers are easier to treat when detected at early stages, so those that were overlooked could potentially be worse or life-threatening.

Bakouny remarked, “It’s reassuring, though, to see that in the three-month post-peak period, the number of screening tests and diagnoses resulting from those tests returned to near-normal level.”

Co-senior author Quoc-Dien Trinh, M.D., of Bingham and Women’s Hospital (BWH), said, “This investigation is especially timely given that we are currently dealing with a second, and potentially worse wave of the pandemic. We have learned to leverage a redesigned patient flow, increased use of telehealth, and made other accommodations to allow our patients to continue in receiving cancer screenings in the safest possible environment.”  

Acceletronics is an industry leader in delivering the best equipment performance and service reliability from CT Scanners and Linear Accelerators across all major brands and models. Call 610-524-3300 or visit our website: https://www.acceletronics.com.

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New Imaging Can Measure Cell Dysfunction in ALS Patients

More effective therapies could potentially be introduced thanks to a new magnetic resonance spectroscopy technique that can accurately measure how well the mitochondria are functioning in patients with Amyotrophic Lateral Sclerosis (ALS.) This non-invasive procedure may help measure the efficacy of treatments for ALS (also known as Motor Neuron Disease [MND]) patients.

Scientists from Sheffield Institute for Translational Neuroscience (SITraN) from the University of Sheffield in the United Kingdom tested how the 31-phosphorus magnetic resonance spectroscopy performed, publishing their findings in the January 13 issue of Brain.

Lead study author Dr. Matilde Sassani, a neurodegeneration researcher at Sheffield, said, “In this study, we found that phosphocreatine levels were depleted in the brain compared to healthy controls and, in this muscle, we found that inorganic phosphates were elevated in patients with MND. Both of these findings are consistent with mitochondrial dysfunction occurring in these people living with MND.”

People with ALS suffer from impaired mitochondrial function, so having a technique that can effectively and accurately measure mitochondrial activity could be critical to treatment.

In the study, the imaging technique was used to measure a chemical involved in the cell’s energy metabolism. ALS patients were compared to healthy age and gender-matched controls. The procedure resembles an MRI; the process allows investigators to capture a direct measurement of chemicals. This snapshot gives them the appropriate data needed to calculate a comprehensive view of a patient with MND.

Senior author Dr. Thomas Jenkins, a clinical senior lecturer at SITraN, said the newfound technique could pave the way for more effective MND treatments and potentially measure how effective medications are.

Jenkins said, “Treatments that aim to rescue mitochondrial function in MND are being investigated in labs around the world. This non-invasive tool can demonstrate whether medications in development are successfully targeting mitochondria, which is an important step in selecting treatments to take through clinical trials.”

Patients with other forms of neurodegenerative diseases might also benefit from this technique, though further research is needed.

To read additional information, refer to the article in the latest issue of Brain, a Journal of Neurology.

Acceletronics is an industry leader in delivering the best equipment performance and service reliability from CT Scanners and Linear Accelerators across all major brands and models. Call 610-524-3300 or visit our website: https://www.acceletronics.com.

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