NEW HYBRID IMAGING TECHNOLOGY MAY HAVE BIG POTENTIAL FOR IMPROVING DIAGNOSIS OF PROSTATE CANCER

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1 Media Release April 7, 2009 For Immediate Release NEW HYBRID IMAGING TECHNOLOGY MAY HAVE BIG POTENTIAL FOR IMPROVING DIAGNOSIS OF PROSTATE CANCER London, Ontario Improved hybrid imaging techniques developed at Lawson Health Research Institute (Lawson) may have big potential for effectively detecting prostate cancer, better guiding therapy selections and enabling minimally invasive treatments. Dr. Glenn Bauman, Associate Scientist with Lawson as well as Radiation Oncologist, London Regional Cancer Program, London Health Sciences Centre and Professor and Chair of Oncology at the Schulich School of Medicine & Dentistry at The University of Western Ontario, is leading a research team that aims to use multi-modality imaging to detect prostate cancer with a high degree of accuracy. The research will develop innovative techniques that will benefit cancer patients through improved abilities to detect, map and treat prostate cancer. Currently, PSA tests are performed to detect if prostate cancer is present. The tests work by measuring the amount of PSA (prostate-specific antigen) that is found in the blood stream. However, in men who are confirmed to have cancer, this diagnostic test is limited in its ability to predict the amount of cancer in the prostate and its exact location. According to Dr. Bauman, the lack of detailed information provided by PSA test limits the ability to tailor treatments like surgery and radiation to the individual patient for highest benefit and the lowest chance of side effects. Dr. Bauman and his research team of 23 investigators are researching a more precise and reliable technique for diagnosing and treating prostate cancer. The team is combining prostate cancer images using computed tomography, magnetic resonance imaging, three-dimensional ultrasound and nuclear medicine techniques to create hybrid imaging maps that can be used to non-invasively predict the location of cancer within the prostate. The researchers hypothesize that this unique imaging modality will be better able to characterize the biologic, functional and morphologic characteristics of prostate cancer and, as a result, will improve the ability to diagnose and cure prostate cancer with minimally invasive, low morbidity techniques. Essentially, the team hopes to use advanced imaging to form a GPS-like system of the prostate that will allow doctors to better target the cancer prior to treatment.

2 If we can create a more detailed picture of the prostate cancer prior to treatment, we can use this information to better target our treatments to the individual and maximize the chances of curing the cancer while reducing the chance of side effects, says Dr. Bauman. Not only will the scientists efforts translate into numerous benefits for patient care in prostate cancer diagnosis, the principles behind the research may have applications for many other cancers as well. The team and other research groups are exploring novel forms of imaging prostate cancer in laboratory-based, pre-clinical cancer models. The ability to create prostate maps that are established through the team s work can also be extended to incorporate these newer imaging techniques as they are developed for use in humans. The researchers are in the process of starting key clinical studies. The first stages of the research are focused on creating the ability to accurately combine the many imaging studies into one comprehensive map of the prostate cancer and to compare this map against the actual location of cancer found in the prostate following surgical removal of the prostate (prostatectomy). Once this first clinical study is completed, the hybrid imaging maps will be validated through a second study of patients undergoing prostatectomy. Through rigorous evaluations of the imaging-based maps through these clinical trials, we will have the opportunity to formally evaluate the benefits of this new diagnostic tool, minimize the learning curve and provide a mechanism to ensure appropriate use of the technology for the benefit of patients, says Dr. Bauman. Subsequent trials will explore the use of these maps in directing diagnostic tests such as prostate biopsy and guiding prostate directed treatments such as radiation and surgery. Prostate cancer remains a significant health care problem and is the second-leading cancer killer of men after lung cancer. Each year, 680,000 men worldwide are diagnosed with the disease and about 220,000 will die from it. The last decade has witnessed a 20% increase in the number of men diagnosed with prostate cancer and this trend is projected to continue in the coming decade. "Dr. Bauman and his team s research have the potential to transform the management of prostate cancer," says Dr. Morag Park, Scientific Director of the Canadian Institutes of Health Research s Institute of Cancer Research. "By harnessing the latest imaging technology, the team will improve the ability to identify, characterize and treat prostate cancer and help reduce the number of men who die from this disease each year in Canada."

3 Key leaders on the research team include, Dr. Ting Lee, Lawson Health Research Institute, Dr. Aaron Fenster and Dr. Terry Peters, Robarts Research Institute at The University of Western Ontario, Dr. Martin Yaffe, Toronto Sunnybrook Research Institute and Dr. Joseph Chin, London Health Sciences Centre. The work is being supported by a grant from the Canadian Institutes of Health Research. [Cutline for Photo: Pre-operative, multi-modality fusion images of biopsy-proven prostate cancer. (a) T1 and T2-weighted MRI. (b) dynamic CT and T2w MRI. (c) CT blood flow map. (d) dynamic CT and anatomical CT. Areas of increased blood flow indicated by red/orange colour on dynamic images (b, c)] About Dr. Glenn Bauman: -30- Dr. Bauman is a Radiation Oncologist specializing in Genitourinary and Central Nervous System Malignancies and is the Medical Director of the Genitourinary Disease Site Team. He is also Professor and Chair of the Department of Oncology at the Schulich School of Medicine & Dentistry at The University of Western Ontario in London, Ontario and is an Associate Scientist at Lawson Health Research Institute. About Dr. Joseph Chin: Dr. Chin is Chief of Urology at London Health Sciences Centre, Associate Scientist with Lawson Health Research Institute, and is a Professor of Urology & Oncology and Chair of the Division of Surgical Oncology at the Schulich School of Medicine & Dentistry at The University of Western Ontario in London Ontario.

4 About CIHR Team in Image Guidance for Prostate Cancer: The CIHR Team in Image Guidance for Prostate Cancer is a five-year funded grant that combines the expertise of scientists, imagers, medical physicists, and clinician researchers in London to develop innovative imaging techniques to accurately identify and characterize prostate cancer at the individual level, thus significantly improving the ability to diagnose and treat prostate cancer. About Lawson Health Research Institute: As the research institute of London Health Sciences Centre and St. Joseph's Health Care, London, and working in partnership with The University of Western Ontario, Lawson Health Research Institute is committed to furthering scientific knowledge to advance health care around the world. About the Canadian Institutes of Health Research: The Canadian Institutes of Health Research (CIHR) is the Government of Canada s agency for health research. CIHR s mission is to create new scientific knowledge and to enable its translation into improved health, more effective health services and products, and a strengthened Canadian health-care system. Composed of 13 Institutes, CIHR provides leadership and support to nearly 12,000 health researchers and trainees across Canada. Background about the study: The first study began enrolling patients in February 2009 and will recruit a total of 36 patients undergoing prostatectomy as their primary prostate cancer treatment. The study involves acquiring a series of pre-operative, multi-modality images of the prostate within six weeks of surgery. Patients are required to undergo two separate imaging sessions within a two week period: 1. magnetic resonance imaging and spectroscopy (MRI/MRS), and 3- dimensional ultrasound (3D US) conducted at Robarts Research Institute, and 2. dynamic computed tomography (CT), and positron emission tomography (PET) conducted at Lawson Health Research Institute (Lawson).

5 The first six patients enrolled in the study will have a dynamic CT examination whereas the second cohort of 30 patients will undergo 18-Fluorocholine PET/CT scanning at Lawson. Following surgical removal of the prostate, whole mount sectioning and digital imaging of tissue sections will provide 3-dimensional pathology. The team will work out the logistical issues with the image acquisition and tissue processing with the first six patients and will then start to enroll the second cohort of 30 patients (anticipated Fall 2009). Hybrid imaging maps will be generated using the combination of imaging traits that best correlates with the spatial distribution of cancer on the 3D pathology. Once this first clinical study is completed, the hybrid imaging maps will be validated through a second study of patients undergoing prostatectomy. For more information, please contact: Julie Barr Communications Consultant Lawson Health Research Institute ext

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