The ability to anticipate future ischemic events in the brain is the goal of CAIN1. This presentation given by Josephine Pressacco for Alan Moody, covers the hypothesis, rationale, methods, goals and status of the CAIN1 project as of April 2011. Building on work already accomplished, it is anticipated that high resolution MRI will be proven useful in predicting end organ ischemic events through detailed characterization of atherosclerotic plaques.
In keeping with the goals of the MITNEC program, Dr. Mercer discusses the roles of radiopharmaceuticals in PET and SPECT imaging. Flourine-based FDG is by far the most common of the imaging probes and is suitable for most cases, but it is not appropriate for all types of cancer. Other imaging probes have been developed for specific purposes and new probes are being investigated for enhanced pathology differentiation. The process of novel radiopharmaceutical development is discussed, together with case studies of Edmonton-based developments and current trends in research.
Working within the goal of CAIN2, Dr. Spence outlines the importance and methods towards outlining atherosclerosis patients would would benefit from intervention. It has been determined that those with microemboli and with greater than 3 ulcers benefit and that characteristics of individual plaque predicts outcome. CAIN2 strives to validate imaging methods for detection of vulnerable plaque.
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.
This presentation focuses on how MRI techniques can be used to examine carotid artery diseases. Dr. Moody aims to convey how characterisation of vessel walls can be achieved by overlaying various weighted MR sequences to give a full picture of vessel wall disease. Imaging of the end organ effects can also be used to determine biomarkers through local cause, distal effect analysis, local disease disruption and distal end organ effects.
Understanding the markers of atherosclerosis is pivitol to providing effective care and perhaps prevention of the disease in others. Currently, upwards of 50% of patients with atherosclerosis first present to clinical medicine after a critical event. Dr. Larsose describes what is currently known and what steps are being taken to understand important disease targets including effective characterization of plaque morphology. It is our goal to prove imaging as an invaluable tool in improving patient outcomes.
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.
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.
Positron Emission Tomography is an invaluable and perhaps most important tool for assessing cancer in vivo. Dr. Burrell provides a quick overview of the types of imaging used in oncology, specifically describing the role of PET in each stage of the therapy cycle. A brief history of PET is given, together with the basic physics and a glance at radiopharmaceutical use in oncology. The potential role of PET from diagnosis through staging, therapy planning, post-therapy evaluation and followup is discussed and many case studies presented.