Advances in Molecular Imaging

Hybrid Imaging and Precision Medicine Offer New Ways to Diagnose and Treat Breast Cancer

Amy Fowler, MD, PhD is researching new ways to use imaging in the staging and treatment of breast cancer. In current clinical practice, MR and PET imaging are used separately to gain information about a tumor. An MRI scan reveals the structure and anatomy of a tumor, and PET imaging – with a tracer for glucose – quantifies the tumor’s metabolic activity. The “hybrid” PET-MRI provides both functional PET data and anatomical MRI information, a combination that may improve diagnostic accuracy and better inform surgical and medical treatment decisions.

Dr. Fowler is also pioneering novel tracers – specific to estrogen and progesterone – for PET imaging.

“While conventional PET imaging gives you information about the tumor’s glucose metabolic activity, it doesn’t tell you about the receptors that will be targeted during treatment,” explains Dr. Fowler. These new tracers may allow her to pinpoint the kind of therapy that will be most effective for treating each patient’s breast cancer. By advancing precision medicine and improving diagnostic accuracy, Dr. Fowler and her colleagues hope to reduce the morbidity and mortality of breast cancer.

Thanks to Campus-Wide Cooperation and Unique Resources, UW–Madison Is Poised to Lead in Theranostics

The efforts of Steve Cho, MD to coordinate collaboration and expand critical infrastructure have positioned UW–Madison to become a leader in the emerging field of theranostics. As the popularity of theranostics grows, so has the demand for clinical trials.

“We’ve been inundated with industry trials,” says Dr. Cho. “The goal is to have the logistical capability to handle that demand.”

The first necessity is an expert and interdisciplinary team. The theranostics disease-oriented team (DOT) at the UW Carbone Cancer Center includes radiation oncologists, medical physicists, and radiologists. This group will perform research, run clinical trials, and serve as a resource to other disease teams.

UW has the right people on campus, and it also has the right facilities and infrastructure. In addition to on-site groups capable of producing radiotracers, the soon-to-be completed East Park Medical will increase UW’s capacity for clinical studies and theranostics treatment.

“We can be at the forefront of the field as an institution and we can provide these new agents as options for patients,” says Dr. Cho.

The Cyclotron Research Group joins national effort to expand radionuclide accessibility

By joining the Department of Energy’s (DOE) University Isotope Network (UIN), UW-Madison’s Cyclotron Research Group is one of the leaders in a new effort to improve the accessibility of radionuclides for researchers across the country.

For over four decades, the Cyclotron Research Group has produced the radionuclides and radiotracers that are the foundation for research, at UW–Madison and beyond.

At many institutions, a lack of access to these materials restricts technology development and advancement in nuclear medicine. The UIN hopes to address this problem, with the National Isotope Development Center (NIDC) coordinating production and transportation of the materials between UIN members and users.

“The University Isotope Network provides new ways for the Department of Energy to support our labs,” explains Jonathan Engle, PhD, who leads the Cyclotron Research Group. “It should increase access to these unique materials for researchers across the country.”

The group produces numerous radionuclides and radiotracers. Among the available production lines are bromine-76 (Br-76), bromine-77 (Br-77), manganese-52g (Mn-52g), and yttrium-86 (Y-86). Br-76, Mn-52g, and Y-86 are useful for positron emission tomography. In addition, Br-77 is a Meitner-Auger emitter with promise as a therapeutic radionuclide. Already, at UW-Madison, access to Y-86 has helped to stimulate research. Notably, it is essential for an NIH-funded P01 on immunomodulatory targeted radionuclide therapy led by Jamey Weichert, PhD and Zach Morris, MD, PhD, into emerging cancer therapies, and Mn-52g is the radiotracer used in a recently approved clinical trial led by Department of Radiology investigators Sandip Biswal, MD, Ali Pirasteh, MD and Dr. Engle.

“The UIN can democratize access to radionuclides that have half-lives long enough to ship,” says Dr. Engle. “We’re hoping that this catalyzes research that comes back to the people of Wisconsin in the form of better technologies but that also generally benefits the population served by healthcare, specifically nuclear medicine.”