Atherosclerosis is not a disease that happens in isolation and can often lead to Small Vessel Disease and other serious end organ effects. Dr. Sandra Black discusses in detail many of the consequences of atherosclerosis on brain, including overt stroke, covert strokes and other small vessel pathologies. Through the CAIN program, Dr. Black is using various MR imaging sequences to fully understand these effects.
While imaging is recognized as a useful tool to characterize atherosclerosis and its complications, there is a critical need to undertake large population studies to truly understand the natural history of the disease as well as the links between imaging biomarkers and patient outcomes. This presentation outlines the objectives of CAIN3, which are to compare the extent of atherosclerosis, and rate of atherosclerosis progression in different vascular beds and to determine the correlation between imaging biomarkers and cardiovascular outcomes.
As the Director of the Evaluation of Radiopharmaceuticals and Biotherapeutic Products at Health Canada, Dr. Klein gives a brief background on the introduction of the Food and Drug Act in Canada, followed by a full explanation of the regulatory process for biomarkers in Canada. The regulatory body focuses on the quality, safety and efficacy of diagnostic, preventative and therapeutic agents, being constantly evaluated from first discovery through market use to further evolution and all steps between.
The Ottawa Heart Institute is active in the development of novel radiopharmaceutical agents for PET imaging of cardiac diseases. Dr. DaSilva describes several tracer development programs at the OHI, together with their targets and development status, particularly those to Angiotensin II. Enhanced visualization of disease targets can then be used to guide therapy in cardiac and renal events.
Using imaging to help unravel the complex relationships between vascular disease and cognitive impairment is the outline for this presentation. Imaging metrics can be quantified and used to identify disease markers, define risk factors and evaluate effectiveness of drug treatments. Vascular complications, correlated to age, are contributing to dementia onset. Research methods and important findings are outlined at each step, helping Dr. Black to give a full picture of the current state of knowledge.
Responding to the impending shut down of reactor facilities and a call for further research, deKemp et al. are exploring alternative agents for PET imaging of the heart that do not rely on Technetium-99m. In finding a suitable alternative, Rubidium-82 has been investigated for its accuracy and binding affinity, its ability to provide a prognosis of future events, and ability to guide effective therapy. Dr. deKemp provides an overview of the work completed to date, together with future directions of this research.
The ability to determine the functional significance of coronary stenosis and myocardium at risk in the clinical emergency setting is an important goal of myocardial perfusion studies. Here, Dr. Lee describes how perfusion is calculated from contrast CT imaging studies and describes the complications involved in these determinations and how they are corrected. The application of perfusion mapping for the clinical setting is also discussed.
The ability to calculate tissue perfusion accurately is clinically important challenge. Using magnetic resonance imaging, Dr. Frayne discusses two approaches to perfusion calculations; time-tested exogenous methods using tracer kinetic models and the newer arterial spin labelling endogenous method. The approaches are compared and contrasted and application to other organ systems are discussed.
Taking novel imaging probes from discovery in a lab setting, through full development and on to manufacturing and clinical trials is one of the goals of the MITNEC program and the Centre for Probe Development and Commercialization. Dr. Valliant, the leader of the CPDC and a collaborator in MITNEC outlines each stage in this process, describing all of the steps involved. In particular, new probes in development for imaging neurologic disease are discussed.