SRA: potential in Turku

Transcription

1 Working for health, added lifetime and social welfare Turku University Hospital SRA: potential in Turku Mika Teräs Chief Physicist, Turku University Hospital Professor, Medical Physics, University of Turku CORES Workshop

2 Content PART I Hospital/Medical Physics in Finland PART II Turku strategies PET related studies Other medical studies

3 80 years of Hospital physics in Finland 75 y history published in 2014 at Turku NACP Symposium The First PhD Paavo Tahvonen, Radiotherapy unit in Helsinki at Professor in Physics at UH at 1949 UH web-pages His successor, FM Kauno Salimäki Hospital physicist Chief of the Dep of radiation physics (later STUK) in

4 Medical physicists in Finland All together 120 Radiation Therapy 42 % Nuclear Medicine and clinical physiology 25 % Radiology 21 % Clinical neurofysiology 9 % In cardiology and others 3 % Number of MPEs in hospitals More RT units Clinical neurophysiology Radiology More RT units Nuclear Medicine also in central hospital 0

5 Level of education Professor or ass. Professor 20 PhD / PhTech 30 Licentiate or MSc/MTech 70 All MPEs have authorisation to act as Radiation Protection Officers (RPO) 2013/59/Euratom (BSS, Basic Safety Standard) MPEs will be trained to fulfil the criteria for RPE (Radiation Protection Expert)

6 EFOMP recognition since early 2000s

7 Kotisivut Ainakin Löytyvät KIITOS!

8 today Staff > 80 and researchers > 110 Centre of Excellence in Research status by Academy of Finland Internationally unique imaging infrastucture Clinical and preclinical imaging 4 PET/TT, PET/MRI, research PET, ultrasound Cyclotron and radiochemistry laboratories 4 cyclotrons, Ga-generators 19 hot cells (13 GMP) >70 different tracers produced Investments total nearly 45 Meur (not corrected for inflation) Running costs >10 Meur/y of which 73% outside funding Thesis In Finnish IF < 1 IF IF IF IF IF IF IF < 1 In Finnish Thesis

9 Research at TPC Instrumentation & modelling CoE Cardiovascular and Metabolic Imaging Cardiac Diabetes Exercise Radiochemistry projects Neurotransmission Research Neurology Psychiatry Anestesiology Preclinical Oncology Inflammation Clinical Drug discovery and development

10 Turku BioImaging Nanoscopic Cell In vitro tissue Ex vivo In vivo non-clinical Clinical

11 CORES.fi Collaboration National & International Finnish Consortium for Radiation Safety Research STUK + Nine Finnish universities EuroBioimaging.eu (EuBi, Headquarter in Finland) provides open physical user access to a broad range of state-of-the-art technologies in biological and biomedical imaging for life scientists

12 Identification of possible improvements Detector (up to 511 kev) Better detector properties Faster electronics Imaging Improved SNR Improved sensitivity Improved resolution Choice of modality availability Patient dose Choice of biomarker Imaging protocol Quality Control Image reconstruction Algorithms Corrections (psf, motion etc.) Modelling Quantification Signalling Uncertainty analysis Big Data National PACS Bio banks Reference databases Automated analysis Better patient throughput, lower patient dose levels

13 Dose Reference Levels (DRL) for Nuclear Medicine in Europe Radiation protection No 180 European Union, Part 2/2, 2014 DRL for 70 kg patients

14 Total Activity (MBq) Total Activity (MBq) Examples: WB FDG protocol Are house rule for administered activity respected? Discovery Patient weight (kg) kg : 280 MBq (DRL = 370 MBq) < 60 kg : 4MBq/kg > 80 kg: 4MBq/kg Maximum injection: 400 MBq Data collected between 12/2015 and 09/2016 Discovery STE Patient Weight (kg) TOTAL_ADMINISTERED_ACTIVITY EANM Barcelona Session EP-45 Presentation EP823

15 Case study: Dual EKG & Respiratory gating 39 year old man Risk factors of CAD: Smoking Family history + ECG: lateral T-inversion LCX subtotal occlusion stented TBR ratio 4.2 Lankinen EHJ 2011 (abstract), Finland

16 Aim - Dual gating in cardiac PET Motion correction with preserving maximal sensitivity? H4 H1 H2 M1 M2 L1 L2 M3 M4 H3 H4 H1 H2 M1 L2 M3 M4 H3 H4 H1 H2 M1 L2 M3 Mostly Z-axis motion Range 20 mm SYSTOLE DIASTOLE Z-axis motion correction and summing of images 50-70% sensitivity

17 Clinical motion trackers RPM: Based on tracking the patient s chest wall via an infrared tracking camera and a reflective marker Anzai: Is a surface tension monitoring device in the form of a belt

18 Physiological Heart Phantom Coronary vessels 2% contrast media A c = 1 kbq/ml LV cavity 2% contrast media A LV = 1 kbq/ml Ceramic hot plaques diam 3mm activity 1-6 kbq

19 Correction of respiratory motion in DG Lamare, Teräs et al. SNM 2008, poster presentation Respiratory average Single gated respiratory bin Use of all acquired events (corrected for respiratory motion) The registration was performed considering both an affine and an elastic (non-rigid) deformation approach. The affine registration process was based on maximizing the normalized mutual information using a least square error metric. The elastic registration approach is based on the use of B- spline basic functions

20 NEXT - Quiescent Phase Detection Mechanical states of the heart can be processed by MEMS sensors and quiescent phases used for motion correction A novel 6-axis sensor for cardiovascular motion processing is consisted of : 3-Axis MEMS Accelerometer sensor 3-Axis MEMS Gyroscope sensor Cardiac Quiecent Phase

21 (Cardiac) Perfusion Imaging (PET, CT, MR) EU EMPIR Health - Started July 2016 for 3 years (2 PhD students) Continuation to a 3-y Academy of Finland project (May April 2016) Research plan, August 31, 2016 Uncertainty analysis in quantisation of myocardial perfusion with PET(/CT/MR) Kick-off meeting Application of Medical ICT Devices - Novel system for multi-organ quantitative tissue perfusion, Academy of Finland

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24 Other research lines Dose optimisation Pediatric and adolescent organ doses and effective dose in computed tomography (PhD student) Radiation in cardiological procedures KARPO (PhD student) An extensive study on radiation doses to patients and staff in cardiological procedures in Finland (eight hospitals and STUK) Radiation Therapy Small-field dosimetry (three hospitals, several PhD students) MR-RT simulator (two PhD students) QC including geometrical accuracy Pseudo-CT

25 Thank You for your attention 60.51,