Nuclear Medicine

Rome, Italy

Nuclear Medicine

Rome, Italy
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The report provides separate comprehensive analytics for the US, Canada, Japan, Europe, Asia-Pacific, Latin America, and Rest of World. Annual estimates and forecasts are provided for the period 2015 through 2022. Also, a six-year historic analysis is provided for these markets. Market data and analytics are derived from primary and secondary research. This report analyzes the worldwide markets for Nuclear Medicine Imaging Equipment in US$ Thousand by the following Product Segments: Further, the Global market for PET Systems is analyzed by the following: The report profiles 30 companies including many key and niche players such as For more information about this report visit http://www.researchandmarkets.com/research/r376t6/nuclear_medicine To view the original version on PR Newswire, visit:http://www.prnewswire.com/news-releases/research-and-markets---global-nuclear-medicine-imaging-equipment-market-2015-2022profiles-of-leading-players-including-digirad-ge-healthcare-mediso-medical-imaging-systems-philips-healthcare-positron-and-siemens-300444929.html


DUBLIN--(BUSINESS WIRE)--Research and Markets has announced the addition of the "Nuclear Medicine Imaging Equipment - Global Strategic Business Report" report to their offering. The report provides separate comprehensive analytics for the US, Canada, Japan, Europe, Asia-Pacific, Latin America, and Rest of World. Annual estimates and forecasts are provided for the period 2015 through 2022. Also, a six-year historic analysis is provided for these markets. Market data and analytics are derived from primary and secondary research. This report analyzes the worldwide markets for Nuclear Medicine Imaging Equipment in US$ Thousand by the following Product Segments: Further, the Global market for PET Systems is analyzed by the following: The report profiles 30 companies including many key and niche players such as For more information about this report visit http://www.researchandmarkets.com/research/572wmw/nuclear_medicine


Dublin, April 25, 2017 (GLOBE NEWSWIRE) -- Research and Markets has announced the addition of the "Nuclear Medicine Imaging Equipment - Global Strategic Business Report" report to their offering. The report provides separate comprehensive analytics for the US, Canada, Japan, Europe, Asia-Pacific, Latin America, and Rest of World. Annual estimates and forecasts are provided for the period 2015 through 2022. Also, a six-year historic analysis is provided for these markets. Market data and analytics are derived from primary and secondary research. This report analyzes the worldwide markets for Nuclear Medicine Imaging Equipment in US$ Thousand by the following Product Segments: Further, the Global market for PET Systems is analyzed by the following: The report profiles 30 companies including many key and niche players such as 8. GLOBAL MARKET PERSPECTIVE For more information about this report visit http://www.researchandmarkets.com/research/mk95p5/nuclear_medicine


— According to Stratistics MRC, the Global Nuclear Medicine Market is valued at $4.42 billion in 2015 and is expected to grow at a CAGR of 10.55 % to reach $8.92 billion by 2022. Rising demand from emerging nations and the growing incidence of cardiovascular ailments and cancers are some of the key factors driving the market growth. Conversely, strict government regulations and competition from conventional diagnostic methods are hampering the market. Furthermore, technological advancements in neurological applications are anticipated to create ample of opportunities for the market in the future. North America is the largest market in terms of revenue in 2015 due to several technological advancements within the region. However, Asia Pacific is poised to grow at a faster pace due to the increasing incidence of neurological and cardiovascular diseases and cancer. Various new products are being launched together with the several technological advancements. Thus, new product launch is the key strategy followed by the players to gain the traction in the market. Some of the key players in global Nuclear Medicine market are Advanced Accelerator Applications S.A., Ashby Gorman Baker Ltd, Bayer Healthcare, Bracco Imaging S.P.A, Cardinal Health, Digirad, Eczcibasi-Monrol Nuclear Products, GE Healthcare, IBA Molecular Imaging, Lantheus Medical Imaging, Mallinckrodt PLC, Mediso Ltd., Nordion, Inc., Philips Healthcare and Siemens Healthcare. Regions Covered: North America US Canada Mexico Europe Germany France Italy UK Spain Rest of Europe Asia Pacific Japan China India Australia New Zealand Rest of Asia Pacific Rest of the World Middle East Brazil Argentina South Africa Egypt What our report offers: - Market share assessments for the regional and country level segments - Market share analysis of the top industry players - Strategic recommendations for the new entrants - Market forecasts for a minimum of 7 years of all the mentioned segments, sub segments and the regional markets - Market Trends (Drivers, Constraints, Opportunities, Threats, Challenges, Investment Opportunities, and recommendations) - Strategic recommendations in key business segments based on the market estimations - Competitive landscaping mapping the key common trends - Company profiling with detailed strategies, financials, and recent developments - Supply chain trends mapping the latest technological advancements About Us: Orbis Research (orbisresearch.com) is a single point aid for all your market research requirements. We have vast database of reports from the leading publishers and authors across the globe. We specialize in delivering customized reports as per the requirements of our clients. We have complete information about our publishers and hence are sure about the accuracy of the industries and verticals of their specialization. This helps our clients to map their needs and we produce the perfect required market research study for our clients. For more information, please visit http://www.orbisresearch.com/reports/index/nuclear-medicine-global-market-outlook-2015-2022


News Article | May 25, 2017
Site: globenewswire.com

SAINT-GENIS-POUILLY, France, May 25, 2017 (GLOBE NEWSWIRE) -- Advanced Accelerator Applications S.A. (NASDAQ:AAAP) (AAA or the Company), an international specialist in Molecular Nuclear Medicine (MNM), today announced that Christine Mikail, J.D. has joined the Company’s board of directors as an independent non-executive director. “Ms. Mikail brings both a broad legal skillset and substantial business development experience in the pharmaceutical industry,” stated Stefano Buono, Chief Executive Officer of AAA. “Her expertise in these areas will augment the current board composition, as we continue to build a global enterprise and advance the development and commercialization of our theragnostic pipeline.” “I am delighted to join AAA’s board of directors at such an exciting time in the Company’s development," said Ms. Mikail. “With the potential approval of lutetium Lu 177 dotatate (Lutathera®) on the horizon, and additional significant oncology assets entering clinical development, I look forward to supporting the Company’s continued growth by applying the same hands-on approach I have utilized throughout my career.” Christine Mikail has over fifteen years of experience managing and advising a number of public and private biotech and pharmaceutical companies focusing in the legal and business development functions. Ms. Mikail is the founder of DCA Advisory where she is currently advising several start-up and private biotech companies. She is also an Adjunct Professor at the Rutgers Business School in New Jersey. From March 2015, to March 2017, she was Chief Administrative Officer, Head of External Business Development and Alliance Management, and General Counsel at Axovant Sciences, Inc., where she helped raise $362 million in one the largest biotech Initial Public Offerings. Prior to this, Ms. Mikail served as Senior Vice President of Legal Affairs, General Counsel and Secretary at NPS Pharmaceuticals, Inc., where she was an integral part of the deal team that sold NPS Pharma to Shire Pharmaceuticals for $5.2 billion. AAA thanks Dr. Yvonne Greenstreet, who has completed her term as a board director, for her service and contributions to the Company’s development. During Dr. Greenstreet’s tenure, AAA completed a successful IPO, delivered positive Phase 3 study results for lutetium Lu 177 dotatate (Lutathera®), and successfully launched its first drug in the Unites States. Advanced Accelerator Applications is an innovative radiopharmaceutical company that develops, produces and commercializes Molecular Nuclear Medicine products. AAA’s lead investigational therapeutic candidate, lutetium Lu 177 dotatate (Lutathera®), is a novel MNM compound that AAA is currently developing for the treatment of neuroendocrine tumors, a significant unmet medical need. Founded in 2002, AAA has its headquarters in Saint-Genis-Pouilly, France. AAA currently has 21 production and R&D facilities able to manufacture both diagnostics and therapeutic MNM products, and more than 500 employees in 13 countries (France, Italy, UK, Germany, Switzerland, Spain, Poland, Portugal, The Netherlands, Belgium, Israel, the U.S. and Canada). AAA reported sales of €109.3 million in 2016 (+23% vs. 2015). AAA is listed on the Nasdaq Global Select Market under the ticker “AAAP”. For more information, please visit: www.adacap.com. Molecular Nuclear Medicine is a medical specialty using trace amounts of active substances, called radiopharmaceuticals, to create images of organs and lesions, and to treat various diseases, like cancer. The technique works by injecting targeted radiopharmaceuticals into the patient’s body that accumulate in the organs or lesions and reveal specific biochemical processes. MNM can be divided in two branches: Molecular Nuclear Diagnostics and Molecular Nuclear Therapy. Molecular nuclear diagnostics employs a variety of imaging devices and radiopharmaceuticals. PET (Positron Emission Tomography) and SPECT (Single Photon Emission Computed Tomography) are highly sensitive imaging technologies that enable physicians to diagnose different types of cancer, cardiovascular diseases, neurological disorders and other diseases in their early stages. Molecular nuclear therapy uses radioactive sources (radionuclides) to treat a range of tumor types. Using short-range particles, this therapy can target tumors with little effect on normal tissues. This press release contains forward-looking statements. All statements, other than statements of historical facts, contained in this press release, including statements regarding the Company's strategy, future operations, future financial position, future revenues, projected costs, prospects, plans and objectives of management, are forward-looking statements. The words "anticipate," "believe," "estimate," "expect," "intend," "may," "plan," "predict," "project," "target," "potential," "will," "would," "could," "should," "continue," and similar expressions are intended to identify forward-looking statements, although not all forward-looking statements contain these identifying words. Forward-looking statements that appear in a number of places in this press release include the Company's current expectation regarding future events and various matters, including expected timing of filings with the FDA and EMA, approval dates, and expansion of NETSPOT®. These forward-looking statements involve risks and uncertainties that may cause actual results, events or developments to be materially different from any future results, events or developments expressed or implied by such forward-looking statements. Such factors include, but are not limited to, changing market conditions, the successful and timely completion of clinical studies, the timing of our submission of applications for regulatory approvals, EMA, FDA and other regulatory approvals for our product candidates, the occurrence of side effects or serious adverse events caused by or associated with our products and product candidates; our ability to procure adequate quantities of necessary supplies and raw materials for lutetium Lu 177 dotatate (Lutathera®) and other chemical compounds acceptable for use in our manufacturing processes from our suppliers; our ability to organize timely and safe delivery of our products or product candidates by third parties; any problems with the manufacture, quality or performance of our products or product candidates; the rate and degree of market acceptance and the clinical utility of lutetium Lu 177 dotatate (Lutathera®) and our other products or product candidates; our estimates regarding the market opportunity for lutetium Lu 177 dotatate (Lutathera®), our other product candidates and our existing products; our anticipation that we will generate higher sales as we diversify our products; our ability to implement our growth strategy including expansion in the U.S.; our ability to sustain and create additional sales, marketing and distribution capabilities; our intellectual property and licensing position; legislation or regulation in countries where we sell our products that affect product pricing, taxation, reimbursement, access or distribution channels; regulatory actions or litigation; and general economic, political, demographic and business conditions in Europe, the U.S. and elsewhere. Except as required by applicable securities laws, we undertake no obligation to publicly update or revise any forward-looking statements, whether as a result of new information, future events or otherwise.


News Article | May 25, 2017
Site: globenewswire.com

SAINT-GENIS-POUILLY, France, May 25, 2017 (GLOBE NEWSWIRE) -- Advanced Accelerator Applications S.A. (NASDAQ:AAAP) (AAA or the Company), an international specialist in Molecular Nuclear Medicine (MNM), today announced that Christine Mikail, J.D. has joined the Company’s board of directors as an independent non-executive director. “Ms. Mikail brings both a broad legal skillset and substantial business development experience in the pharmaceutical industry,” stated Stefano Buono, Chief Executive Officer of AAA. “Her expertise in these areas will augment the current board composition, as we continue to build a global enterprise and advance the development and commercialization of our theragnostic pipeline.” “I am delighted to join AAA’s board of directors at such an exciting time in the Company’s development," said Ms. Mikail. “With the potential approval of lutetium Lu 177 dotatate (Lutathera®) on the horizon, and additional significant oncology assets entering clinical development, I look forward to supporting the Company’s continued growth by applying the same hands-on approach I have utilized throughout my career.” Christine Mikail has over fifteen years of experience managing and advising a number of public and private biotech and pharmaceutical companies focusing in the legal and business development functions. Ms. Mikail is the founder of DCA Advisory where she is currently advising several start-up and private biotech companies. She is also an Adjunct Professor at the Rutgers Business School in New Jersey. From March 2015, to March 2017, she was Chief Administrative Officer, Head of External Business Development and Alliance Management, and General Counsel at Axovant Sciences, Inc., where she helped raise $362 million in one the largest biotech Initial Public Offerings. Prior to this, Ms. Mikail served as Senior Vice President of Legal Affairs, General Counsel and Secretary at NPS Pharmaceuticals, Inc., where she was an integral part of the deal team that sold NPS Pharma to Shire Pharmaceuticals for $5.2 billion. AAA thanks Dr. Yvonne Greenstreet, who has completed her term as a board director, for her service and contributions to the Company’s development. During Dr. Greenstreet’s tenure, AAA completed a successful IPO, delivered positive Phase 3 study results for lutetium Lu 177 dotatate (Lutathera®), and successfully launched its first drug in the Unites States. Advanced Accelerator Applications is an innovative radiopharmaceutical company that develops, produces and commercializes Molecular Nuclear Medicine products. AAA’s lead investigational therapeutic candidate, lutetium Lu 177 dotatate (Lutathera®), is a novel MNM compound that AAA is currently developing for the treatment of neuroendocrine tumors, a significant unmet medical need. Founded in 2002, AAA has its headquarters in Saint-Genis-Pouilly, France. AAA currently has 21 production and R&D facilities able to manufacture both diagnostics and therapeutic MNM products, and more than 500 employees in 13 countries (France, Italy, UK, Germany, Switzerland, Spain, Poland, Portugal, The Netherlands, Belgium, Israel, the U.S. and Canada). AAA reported sales of €109.3 million in 2016 (+23% vs. 2015). AAA is listed on the Nasdaq Global Select Market under the ticker “AAAP”. For more information, please visit: www.adacap.com. Molecular Nuclear Medicine is a medical specialty using trace amounts of active substances, called radiopharmaceuticals, to create images of organs and lesions, and to treat various diseases, like cancer. The technique works by injecting targeted radiopharmaceuticals into the patient’s body that accumulate in the organs or lesions and reveal specific biochemical processes. MNM can be divided in two branches: Molecular Nuclear Diagnostics and Molecular Nuclear Therapy. Molecular nuclear diagnostics employs a variety of imaging devices and radiopharmaceuticals. PET (Positron Emission Tomography) and SPECT (Single Photon Emission Computed Tomography) are highly sensitive imaging technologies that enable physicians to diagnose different types of cancer, cardiovascular diseases, neurological disorders and other diseases in their early stages. Molecular nuclear therapy uses radioactive sources (radionuclides) to treat a range of tumor types. Using short-range particles, this therapy can target tumors with little effect on normal tissues. This press release contains forward-looking statements. All statements, other than statements of historical facts, contained in this press release, including statements regarding the Company's strategy, future operations, future financial position, future revenues, projected costs, prospects, plans and objectives of management, are forward-looking statements. The words "anticipate," "believe," "estimate," "expect," "intend," "may," "plan," "predict," "project," "target," "potential," "will," "would," "could," "should," "continue," and similar expressions are intended to identify forward-looking statements, although not all forward-looking statements contain these identifying words. Forward-looking statements that appear in a number of places in this press release include the Company's current expectation regarding future events and various matters, including expected timing of filings with the FDA and EMA, approval dates, and expansion of NETSPOT®. These forward-looking statements involve risks and uncertainties that may cause actual results, events or developments to be materially different from any future results, events or developments expressed or implied by such forward-looking statements. Such factors include, but are not limited to, changing market conditions, the successful and timely completion of clinical studies, the timing of our submission of applications for regulatory approvals, EMA, FDA and other regulatory approvals for our product candidates, the occurrence of side effects or serious adverse events caused by or associated with our products and product candidates; our ability to procure adequate quantities of necessary supplies and raw materials for lutetium Lu 177 dotatate (Lutathera®) and other chemical compounds acceptable for use in our manufacturing processes from our suppliers; our ability to organize timely and safe delivery of our products or product candidates by third parties; any problems with the manufacture, quality or performance of our products or product candidates; the rate and degree of market acceptance and the clinical utility of lutetium Lu 177 dotatate (Lutathera®) and our other products or product candidates; our estimates regarding the market opportunity for lutetium Lu 177 dotatate (Lutathera®), our other product candidates and our existing products; our anticipation that we will generate higher sales as we diversify our products; our ability to implement our growth strategy including expansion in the U.S.; our ability to sustain and create additional sales, marketing and distribution capabilities; our intellectual property and licensing position; legislation or regulation in countries where we sell our products that affect product pricing, taxation, reimbursement, access or distribution channels; regulatory actions or litigation; and general economic, political, demographic and business conditions in Europe, the U.S. and elsewhere. Except as required by applicable securities laws, we undertake no obligation to publicly update or revise any forward-looking statements, whether as a result of new information, future events or otherwise.


News Article | May 24, 2017
Site: www.prweb.com

Last month, representatives from Rendina Healthcare Real Estate joined Clara Maass Medical Center CEO Mary Ellen, hospital employees, and town officials to celebrate the grand opening of the 87,000 square foot medical office/ICU addition in Belleville. The facility was developed by Rendina as part of its ongoing relationship with RWJBarnabas Health, New Jersey’s largest health system. Two years after breaking ground in early 2015, the new ICU addition opened to patients in April. As the new front entrance to the hospital, the facility houses 43,000 square feet of Class-A physician office space and a state-of-the-art, 32-bed ICU, among other amenities. Speaking at the ceremony, Hospital CEO Mary Ellen Clyne highlighted benefits the ambitious expansion will provide to the community. “Whether the patients would stay here or need service that would require going to one of our affiliate hospitals, such as a trauma center or burn unit, we can take care of anyone who would come through the doors,” said Ms. Clyne. Steve Barry, Executive Vice President of Business Development and Leasing for Rendina, praised the collaborative effort need to complete such a monumental task. “To see such an important project become a reality is incredibly rewarding for our team. We are proud to partner with RWJBarnabas Health on a new facility that will further enhance the high quality care that is provided at Clara Maass Medical Center.” Located in Belleville, N.J., Clara Maass Medical Center, an RWJBarnabas Health facility, provides a complete continuum of care to residents of northern New Jersey. Clara Maass’ centers and services include The Health and Wellness Center, Nuclear Medicine, The Cancer Center at Clara Maass, Adult Cardiac Services including Diagnostic Services, Cardiac Catheterization, Elective and Emergency Angioplasty and Rehabilitation, The Pain Management Center, The Joint & Spine Institute, a Vascular Center, Same Day Surgery, The Wound Center at Clara Maass, The Center for Sleep Disorders, The Bariatric Surgery Center, Rehabilitation Services, The Eye Surgery Center, Maternity Services and Parent Education, as well as Pediatrics. Clara Maass is an eight-time recipient of the A-rated Hospital Safety score from The Leap Frog Group, an independent national nonprofit group measuring hospital safety and quality. For more information about Clara Maass Medical Center, visit barnabashealth.org/claramaass. Rendina is a trusted national leader in healthcare real estate, providing a full-service platform that includes design, development, acquisition, leasing and management. Rendina has developed more than 7.5 million square feet of real estate throughout the country. Rendina has offices in Jupiter, Fla.; Dallas; Tucson, Ariz.; Solana Beach, Calif.; Cincinnati; Charlotte, N.C.; and Livingston, N.J. For information or questions, please contact Stephen Barry, Executive Vice President of Leasing, at 866-630-5055; or visit rendina.com.


News Article | May 11, 2017
Site: www.eurekalert.org

Tumors, inflammation and circulatory disorders locally disturb the body's acid-base balance. These changes in pH value could be used for example to verify the success of cancer treatments. Up to now, however, there has been no imaging method to render such changes visible in patients. Now a team from the Technical University of Munich (TUM) has developed a pH sensor that renders pH values visible through magnetic resonance imaging (MRI) - in a non-invasive, radiation-free manner. Four years ago, during a magnetic resonance experiment with tumor cells, TUM physicist Dr. Franz Schilling found signals from a molecule that was highly sensitive towards pH changes. The molecule, which was identified as zymonic acid in subsequent investigations, could play an important role in the future of medical imaging. As a biosensor for pH values, it could provide insights into the body which had been impossible in the past. "An appropriate pH imaging method would make it possible to visualize abnormal changes in tissue and specifically metabolic processes of tumors," explains Franz Schilling. Areas surrounding tumors and inflammations are usually slightly more acidic than areas surrounding healthy tissue, a phenomenon possibly linked to the aggressiveness of tumors. Schilling sees further potential uses in treatment prognoses: "pH values are also interesting when it comes to evaluating the efficacy of tumor treatments. Even before a successfully treated tumor starts to shrink, its metabolism and thus the pH value of the surrounding area could change. An appropriate pH imaging method would indicate at a much earlier stage whether or not the right approach has been selected." Schilling is now Director of the working group for Preclinical Imaging and Medical Physics at the Clinic and Polyclinic for Nuclear Medicine in the TUM Klinikum rechts der Isar. In past years, he has joined together with colleagues from the departments of Physics, Chemistry and Medicine to research zymonic acid as a biosensor. In the journal Nature Communications the team describes how it can be used to reliably represent pH values in the bodies of small animals. In order to make pH values visible using zymonic acid, the molecule is injected into the body and then a magnetic resonance imaging (MRI) investigation is made of the object tissue. In greatly simplified terms: In a strong magnetic field, radiowaves excite the nuclear spins of the zymonic acid to oscillation. The reactions of the nuclei are then recorded. This data is used to calculate frequency spectra that in turn provide information about the chemical properties of the molecular surroundings of the nuclei. Ultimately, the pH value at any examined location in the tissue can be represented based on pH-dependent molecular changes in the zymonic acid. Zymonic acid has to be marked with carbon 13 in order to be visible in MRI images. This means that the molecules contain carbon 13 atoms (13C) instead of "normal" carbon 12 atoms. But zymonic acid marked in this manner is still not measurable: its MRI signal is too weak. "We therefore use a relatively new method, hyperpolarization," explains Stephan Düwel, physicist and first author of the study. "We use a special device to transfer the polarization of electrons to the 13C atomic nuclei using microwaves at very low temperatures, which results in an MRI signal up to 100,000 times stronger." A hot liquid is then used to quickly return the zymonic acid to room temperature. After this, the scientists need to act quickly. The biosensor is injected intravenously into the organism, then the MRI scan has to be made immediately: It only takes 60 seconds for the signal-amplifying effect of the hyperpolarization to wear off again. "We're currently working on expanding this time window," says Düwel. "On the one hand, we're trying to improve the MRI properties of zymonic acid with appropriate modifications to the molecule; On the other hand, we're looking for other pH-sensitive molecules," explains biochemist Christian Hundshammer, second author of the study. Franz Schilling and his team have succeeded in showing that their method is sensitive enough to represent medically relevant pH value changes in the organism. Using zymonic acid it is furthermore possible to specifically investigate the pH value outside of the cell membrane: With other biosensors it is often not clear whether measured changes take place inside or outside of the cell (intracellular or extracellular). This is important because the intracellular value is usually stable, while changes in metabolism have a much greater impact on the extracellular value. In contrast to optical methods, which are limited to superficial penetration into the body because of the low transparency of tissue, there are no limitations to the depth of penetration for MRI. It has furthermore been demonstrated that zymonic acid is not toxic in the concentrations used with small animals and is also created in low concentrations as a by-product of the metabolite pyruvic acid which is present in the body. "We believe zymonic acid is a highly promising biosensor for patient applications," says Franz Schilling. For the time being, however, additional pre-clinical studies are planned in order to ascertain the advantages of this new imaging biomarker compared to conventional methods and to further improve the spatial resolution of pH imaging. The research project was funded by the Collaborative Research Centre 824 (SFB824) "Imaging for Selection, Monitoring and Individualization of Cancer Therapies" led by Prof. Markus Schwaiger. S. Düwel, C. Hundshammer, M. Gersch, B. Feuerecker, K. Steiger, A. Buck, A. Walch, A. Haase, S. J. Glaser, M. Schwaiger, F. Schilling, "Imaging of pH in vivo using hyperpolarized 13C-labeled zymonic acid". Nature Communications (2017). Doi: 10.1038/NCOMMS15126 F. Schilling, S. Düwel, U. Köllisch, M. Durst, R.F. Schulte, S.J. Glaser, A. Haase, A.M. Otto, M.I. menzel. "Diffusion of hyperpolarized 13C-metabolites in tumor cell spheroids using real-time NMR spectroscopy". NMR Biomed., 26:5 (2013) 557-568. doi:10.1002/nbm.2892


News Article | May 11, 2017
Site: phys.org

Four years ago, during a magnetic resonance experiment with tumor cells, TUM physicist Dr. Franz Schilling found signals from a molecule that was highly sensitive towards pH changes. The molecule, which was identified as zymonic acid in subsequent investigations, could play an important role in the future of medical imaging. As a biosensor for pH values, it could provide insights into the body which had been impossible in the past. "An appropriate pH imaging method would make it possible to visualize abnormal changes in tissue and specifically metabolic processes of tumors," explains Franz Schilling. Areas surrounding tumors and inflammations are usually slightly more acidic than areas surrounding healthy tissue, a phenomenon possibly linked to the aggressiveness of tumors. Schilling sees further potential uses in treatment prognoses: "pH values are also interesting when it comes to evaluating the efficacy of tumor treatments. Even before a successfully treated tumor starts to shrink, its metabolism and thus the pH value of the surrounding area could change. An appropriate pH imaging method would indicate at a much earlier stage whether or not the right approach has been selected." Schilling is now Director of the working group for Preclinical Imaging and Medical Physics at the Clinic and Polyclinic for Nuclear Medicine in the TUM Klinikum rechts der Isar. In past years, he has joined together with colleagues from the departments of Physics, Chemistry and Medicine to research zymonic acid as a biosensor. In the journal Nature Communications the team describes how it can be used to reliably represent pH values in the bodies of small animals. In order to make pH values visible using zymonic acid, the molecule is injected into the body and then a magnetic resonance imaging (MRI) investigation is made of the object tissue. In greatly simplified terms: In a strong magnetic field, radiowaves excite the nuclear spins of the zymonic acid to oscillation. The reactions of the nuclei are then recorded. This data is used to calculate frequency spectra that in turn provide information about the chemical properties of the molecular surroundings of the nuclei. Ultimately, the pH value at any examined location in the tissue can be represented based on pH-dependent molecular changes in the zymonic acid. Zymonic acid has to be marked with carbon 13 in order to be visible in MRI images. This means that the molecules contain carbon 13 atoms (13C) instead of "normal" carbon 12 atoms. But zymonic acid marked in this manner is still not measurable: its MRI signal is too weak. "We therefore use a relatively new method, hyperpolarization," explains Stephan Düwel, physicist and first author of the study. "We use a special device to transfer the polarization of electrons to the 13C atomic nuclei using microwaves at very low temperatures, which results in an MRI signal up to 100,000 times stronger." A hot liquid is then used to quickly return the zymonic acid to room temperature. After this, the scientists need to act quickly. The biosensor is injected intravenously into the organism, then the MRI scan has to be made immediately: It only takes 60 seconds for the signal-amplifying effect of the hyperpolarization to wear off again. "We're currently working on expanding this time window," says Düwel. "On the one hand, we're trying to improve the MRI properties of zymonic acid with appropriate modifications to the molecule; On the other hand, we're looking for other pH-sensitive molecules," explains biochemist Christian Hundshammer, second author of the study. Franz Schilling and his team have succeeded in showing that their method is sensitive enough to represent medically relevant pH value changes in the organism. Using zymonic acid it is furthermore possible to specifically investigate the pH value outside of the cell membrane: With other biosensors it is often not clear whether measured changes take place inside or outside of the cell (intracellular or extracellular). This is important because the intracellular value is usually stable, while changes in metabolism have a much greater impact on the extracellular value. In contrast to optical methods, which are limited to superficial penetration into the body because of the low transparency of tissue, there are no limitations to the depth of penetration for MRI. It has furthermore been demonstrated that zymonic acid is not toxic in the concentrations used with small animals and is also created in low concentrations as a by-product of the metabolite pyruvic acid which is present in the body. "We believe zymonic acid is a highly promising biosensor for patient applications," says Franz Schilling. For the time being, however, additional pre-clinical studies are planned in order to ascertain the advantages of this new imaging biomarker compared to conventional methods and to further improve the spatial resolution of pH imaging. More information: S. Düwel, C. Hundshammer, M. Gersch, B. Feuerecker, K. Steiger, A. Buck, A. Walch, A. Haase, S. J. Glaser, M. Schwaiger, F. Schilling, "Imaging of pH in vivo using hyperpolarized 13C-labeled zymonic acid". Nature Communications (2017). DOI: 10.1038/NCOMMS15126 F. Schilling, S. Düwel, U. Köllisch, M. Durst, R.F. Schulte, S.J. Glaser, A. Haase, A.M. Otto, M.I. menzel. "Diffusion of hyperpolarized 13C-metabolites in tumor cell spheroids using real-time NMR spectroscopy". NMR Biomed., 26:5 (2013) 557–568. DOI: 10.1002/nbm.2892


Feyer P.,Nuclear Medicine | Jordan K.,Martin Luther University of Halle Wittenberg
Annals of Oncology | Year: 2011

Chemotherapy-induced nausea and vomiting (CINV) continues to be one of the most feared side effects of chemotherapy. Inadequately controlled CINV can have a significant negative impact on quality of life and can in some cases compromise adherence to treatment. However, the repercussions of CINV for patients are often underestimated. Advances in our understanding of the physiology of CINV and the identification of risk factors have greatly contributed towards improvements in the control of CINV. A number of antiemetic agents are currently available for the prophylaxis and treatment of CINV, including 5-hydroxytryptamine 3 receptor antagonists corticosteroids, neurokinin 1 receptor antagonists, dopamine receptor antagonists, benzodiazepines, neuroleptics and cannabinoids. With the correct use of these agents, CINV can be prevented to a great extent; however, adherence to guidelines is disappointingly low. Furthermore, a significant number of patients still experience nausea and vomiting despite optimal treatment. More effective therapies are, therefore, greatly needed, with the ultimate goal of attaining complete control of CINV. This review focuses on the current understanding of CINV, problems associated with its management and the status of promising antiemetic therapies. © The Author 2010. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved.

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