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LONDON, ON – A new system that turns ultrasounds into a 3D image could make treatment of liver cancer using thermal ablation more accurate, a new simulated study from Lawson Health Research Institute and Western University has found.

Liver cancer is the fourth leading cause of cancer death globally. While surgery is one treatment option, thermal ablation, using heat to destroy the cancerous tumour, can have fewer complications and a shorter recovery time. It can also be used for patients who are not surgical candidates.

Thermal ablation requires precise needle placement to treat the cancer without damaging the vital organs and blood vessels around it.

“It's very important that we get the needle right in the centre of the tumour,” says Dr. Derek Cool, Associate Scientist at Lawson, Assistant Professor at Western University’s Schulich School of Medicine & Dentistry and Interventional Radiologist at London Health Sciences Centre (LHSC). “If the treatment area doesn't fully cover the tumour, patients are left with a small amount of residual cancer, risking recurrence and the need for additional treatment.”

Ultrasound or CT (computerized tomography) imaging is normally used to guide needle placement, but both are limited. Ultrasound is widely available and can be done in real-time, but only delivers a 2D image. While a CT scan provides a 3D image, it isn’t in real-time and can be a lengthy process.

“We developed a new 3D ultrasound method that shows promise in analyzing whether the complete liver tumour will be ablated by the procedure,” explains Dr. Aaron Fenster, a Professor at Schulich and Scientist at Robarts Research Institute. “And we're now using the same system to guide the needle directly into the centre of the tumor.”

To create the 3D ultrasound images, a robotic cradle moves a standard ultrasound probe, collecting images and stacking them like puzzle pieces.

The simulated study, published in IEEE Transactions on Medical Imaging, used data from 14 patient cases at LHSC to analyze accuracy of the technology. It found that while 64.3 per cent of cases showed complete tumour coverage with standard imaging methods, the new system could result in complete coverage for 92.9 per cent of cases (13 of 14 cases). The researchers found that the remaining case could benefit from increasing the ablation time or intensity.

“Our next step is to move from simulation studies to a clinical trial,” says Dr. Cool.

If proven effective, the robotic ultrasound system’s portability could potentially allow for more widespread use of 3D ultrasound imaging, including in smaller health care centres. By eliminating the need for CT scans, it could also help to reduce imaging wait times.

“If a clinical trial shows the approach is more accurate and more precise than conventional techniques, there would be a direct impact on patient care,” says Dr. Fenster. “We hope to explore commercialization to license the technology and distribute it worldwide.” 

Advanced imaging will help better guide radiation treatments

MEDIA RELEASE
For Immediate Release
January 12th, 2022

 

London, Ontario- Prostate cancer is the most common cancer among Canadian men, and it is estimated that one in eight men will be diagnosed with prostate cancer within their lifetime. Researchers at both Lawson Health Research Institute and Sunnybrook Research Institute, are teaming up on a study which is pairing advanced imaging technology with high precision short course radiotherapy, that could lead to better outcomes for patients.

“We have started to look at ways to integrate advanced imaging to help better understand the amount of cancer in the prostate and the location of cancer in the prostate to help guide radiation treatments,” says Lawson Scientist, and Radiation Oncologist at London Health Sciences Centre’s (LHSC) London Regional Cancer Program (LRCP), Dr. Glenn Bauman.

Currently when radiation is done, a computer tomography scan (CT)  gives radiologists the location and boundary of the prostate, but it doesn’t give details about the location of the cancer within the prostate.

“What we are doing in the study is integrating two other forms of imaging; magnetic resonance imaging (MRI) and prostate specific membrane antigen (PSMA) PET scans, both of which can give information on the exact location of the cancer,” explains Dr. Bauman. “This will allow us to refine the radiation treatment and to target the cancer with more intensified radiation.”

Scientist at Sunnybrook Research Institute, Dr. Andrew Loblaw says using advanced imaging will also pinpoint if the cancer has moved into other areas of the pelvic region, which helps target all possibilities and lessens the chance of the cancer coming back. The type of radiation being used for this study is called stereotactic body radiotherapy (SBRT) which is more accurate, and reduces both radiation side effects to adjacent organs, while also reducing treatment visits.

“The combination of PSMA and SBRT gives us the ability to save some normal tissue and dramatically reduce treatment times,” explains Dr. Loblaw. “If we know the cancer is in one place and not another, we can spare radiation from areas not needing it which spares side effects.”

The team plans to recruit 50 men for the study that have advanced prostate cancer and need more intense treatments.  Participants will undergo the advanced PSMA PET imaging at St. Joseph’s Health Care London.  The same imaging techniques will be used to determine and track if the cancer is responding well to treatments.

“This is a smarter tool that will help us more accurately know what patients have,” says Dr. Loblaw. “We will know if they have more of a metastatic disease and who has localized disease. Cure rates are better when you know exactly what you are trying to cure.”

Study participants will be closely monitored for five years, to determine the success of the more targeted and intense radiation treatments.  Dr. Bauman says this will also help quickly identify the potential need for more advanced therapies.

“Our treatments are good, but If there is a man we haven’t cured we want to know as soon as possible.”

The study has received funding by the Ontario Institute for Cancer Research (OICR) as part of the Institute’s new initiative that supports pre-clinical research and new clinical trials that focus on early stage, and recurrent cancers.
 

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About Lawson Health Research Institute: Lawson Health Research Institute is one of Canada’s top hospital-based research institutes, tackling the most pressing challenges in health care. As the research institute of London Health Sciences Centre and St. Joseph’s Health Care London, our innovation happens where care is delivered. Lawson research teams are at the leading-edge of science with the goal of improving health and the delivery of care for patients. Working in partnership with Western University, our researchers are encouraged to pursue their curiosity, collaborate often and share their discoveries widely. Research conducted through Lawson makes a difference in the lives of patients, families and communities around the world. To learn more, visit www.lawsonresearch.ca.

About Sunnybrook Research Institute: Sunnybrook Research Institute (SRI) is the research arm of Sunnybrook Health Sciences Centre, an internationally recognized academic health sciences centre fully affiliated with the University of Toronto. SRI is one of the fastest growing hospital-based research enterprises in Canada with well-established programs in basic and applied sciences which span across three scientific platforms and ten clinical programs, developing innovations in care for the more than 1.3 million patients the hospital cares for annually. Recognized as a Centre of Excellence in focused ultrasound, SRI has one of the most comprehensive and successful focused ultrasound research programs in the world, with technical, scientific and clinical experts accelerating progress in the field.

FOR MORE INFORMATION, PLEASE CONTACT:
Celine Zadorsky
Communications Consultant & External Relations
Lawson Health Research Institute
T: 519-685-8500 ext. 75664
C. 519-619-3872
@email
www.lawsonresearch.ca/news-events

LONDON - In a study published in MDPI Journal, a team of researchers at Lawson Health Research Institute have shown that the use of technology may assist in better outcomes for those living with both mental health and physical disorders.

Dr. Cheryl Forchuk, Assistant Scientific Director at Lawson, and her team embarked on a pilot study that used smart home monitoring solutions to assist those living with both a mental health disorder and other health challenges. The purpose of this pilot study was to see if technology could improve overall lifestyle and wellbeing.
 
“We began our research by using hospital prototype apartments – apartment style care spaces within hospital settings – that were equipped with smart home technology solutions such as a screen device, activity trackers, weigh scales and medication dispensers,” says Dr. Forchuk who is also the Beryl and Richard Ivey Research Chair in Aging, Mental Health, Rehabilitation and Recovery at St. Joseph’s Health care London. “Once we tested it in a hospital setting, we wanted to find a way to take this idea out into the community in different kinds of housing and living situations to see if it would be beneficial.”

The research team partnered with the Canadian Mental Health Association (CMHA) and the London and Middlesex Community Housing (LMCH) to work together to retrofit the homes of the 13 study participants.

“We worked together with the participants and their care providers to choose what combination of  technology they felt would be best for them,” says Dr. Forchuk. “No matter their health condition each participant wanted to be more active and independent, with the goal of staying out of hospital.”

All smart devices were connected to the Lawson Integrated Database, which is a database that can securely collect data from multiple sources such as health devices. This allowed care providers to send reminders to participants, while also tracking usage and results.

“The key benefits we noted was that study participants started to live healthier lives,” says Jonathan Serrato, Lawson Research Associate. “Participants logged going for walks and exercising more often, as well as making healthier food choices. Those who used the medication dispensers did not miss a single dose. The touch screen devices also allowed participants to easily communicate with care providers and support networks, and access more resources.”

Following the pilot study, the research team also published a subsequent paper, as a ‘how-to guide’ for utilizing smart home technology interventions as a health care tool.

“This paper is a helpful resource that outlines implications and considerations when it comes to smart home technologies,” adds Serrato. “There are many areas we touch upon such as security, privacy and feasibility as well as hardware and software information for those who would like to take on their own similar type of smart home technology project.”

LONDON, ON- A recently published preclinical study by researchers at Lawson Health Research Institute and Western University’s Schulich School of Medicine & Dentistry show that vaping may negatively affect pulmonary surfactant in the lungs.

Surfactant, which is made of lipids and proteins, is a critical layer in the lungs that allows people to breathe with minimal effort by reducing surface tension. Without surfactant, it would take more effort to breathe and a person would need mechanical help to do so.

“Vaping continues to be popular but not much is known about what happens with the aerosol when it enters the lungs,” says Dr. Ruud Veldhuizen, Lawson Scientist and Professor at Schulich Medicine & Dentistry. “We realized that the first thing the vapor aerosol comes in contact with in the lungs is pulmonary surfactant, which is an area our team specializes in.”

The research team was able to study the effects by placing a film of surfactant inside a syringe and, then using a vaping device to push aerosol into the syringe. This allowed the vapor to directly interact with the surfactant. The researchers then mimicked inhaling and exhaling vapor into the syringe 30 times to resemble a standard vaping session.

“In particular we were looking at the surface tension in the surfactant,” explains Emma Graham, Master’s student at Schulich Medicine & Dentistry. “After vaping, we saw high surface tension which suggests the surfactant would not be as effective at supporting proper lung functioning.”

The team also examined different vaping devices, flavours, additives and nicotine to see if there were any difference in effects.

“Nicotine didn’t have any worse effects on surface tension of surfactant compared to other e-liquids, but some flavourings like menthol e-liquid did,” says Graham.

While his team intends to study this further, Veldhuizen says these findings could provide an indication as to why people that vape have a susceptibility to develop lung injury, including those with respiratory viruses such as COVID-19.

“We would like to get this information out there so that people know vaping may be damaging to the lungs,” says Veldhuizen. “As a next step, we hope to further investigate the effects of vaping on the lungs and how we can treat resulting injury.”

The study has been published in the PLOS ONE Journal.  These findings build on a body of research about the impacts of vaping through Lawson and Schulich Medicine & Dentistry. Our researchers were the first in the world to report on a potential new type of vaping-related injury in 2019.

London - In a national multicentre study, scientists at Lawson Health Research Institute and Western University are working to create rare isotopes that will be used as an important tool to help treat cancer.

Currently, radiation therapy is a staple in cancer treatment, with approximately 50 per cent of cancer patients receiving radiation at some point in their cancer journey. Although a very effective tool, traditional radiation therapies rely on intense beams of energy. These beams can kill cancer cells, but their use is limited to select locations, making them less suited for difficult-to-treat metastatic cancers that have spread to multiple sites.

“Cancer treatment has evolved over the years with targeted drugs that go straight to the cancer and advanced radiation therapy. However, radiation comes from an external source that can damage other areas in the body,” says Dr. Len Luyt, Lawson Scientist and Professor at Western. “We are now working to advance treatment further by combining radiation and targeted drug therapy.”

The therapies work like a homing device — using specially designed molecules to seek out and deliver radioactive isotopes directly to cancer cells, wherever they might be in the body.

The multidisciplinary research team involves researchers at Lawson, Western University, University of British Columbia, BC Cancer, TRIUMF, Simon Fraser University, Université Laval, Université de Sherbrooke, University of Toronto and University of Alberta.

“This is the holy grail of cancer treatment. These disease-targeting molecules circulate throughout the body, binding tightly to cancer cells in order to eliminate them with a highly localized blast of energy,” explains principal investigator Dr. François Bénard, Professor of Radiology and Associate Dean at UBC’s Faculty of Medicine, and Senior Executive Director of the BC Cancer Research Institute.

The London, Ontario team will focus on developing the radio pharmaceuticals at labs in the London Regional Cancer Program at LHSC, the Cyclotron located at St. Joseph’s Health Care London, and at Western. 

“The radio pharmaceuticals we are designing will be very specific to certain receptor proteins that are on cancer cells and not elsewhere on the body. This allows us to bring the isotopes to the cancer cells and clear it from the body so you have less side effects in other areas,” says Dr. Luyt. “This approach is showing promise in prostate cancer and now this team-based approach is looking at targeting any metastatic cancer.”

This collaborative research project has received $23.7 million in federal funding through the New Frontiers Research Fund (NFRF) over six years.

“We will establish Canada as a world leader in the field of nuclear medicine and ensure Canadian patients are the ones who benefit,” adds Dr. Bénard. “By developing these medicines in Canada and bringing them into local clinical trials, we will ensure Canadians have access to innovative cancer treatments sooner.”

The team hopes to bring multiple drug candidates into clinical trials in the coming years with the ultimate goal of developing an effective treatment for metastatic cancer patients. 

LONDON, ON – Transitional aged youth in Middlesex County now have access to a free transportation resource to access mental health services. Called the County Transport initiative, it will help youth ages 16 to 25 in Lucan, Parkhill, Exeter and Strathroy-Caradoc get the mental health care they need, when they need it.  

County Transport is being coordinated by MINDS of London-Middlesex, a program of Lawson Health Research Institute, in partnership with the Canadian Mental Health Association (CMHA) of Elgin-Middlesex, Star Taxi and Middlesex County through the Lucan and Parkhill Libraries.  

“Through our collaborative work, we’ve heard from many youth that transportation is a barrier for them when trying to access mental health services when in crisis. Youth in rural areas find this very challenging since most services are not close to their location,” says Romaisa Pervez, Research Assistant at MINDS of London-Middlesex.  

MINDS, a Mental Health INcubator for Disruptive Solution, is a social innovation lab with a mission to address the complexity of the mental health care system. Youth with lived experience, community members and researchers work together to understand and help those living with mental health challenges in London-Middlesex by designing, piloting and testing innovative solutions developed locally.  

“We do not have the exact numbers of Transitional Aged Youth (TAY) living in rural Middlesex who would benefit from access to the County Transport Initiative, but we know that mental health services in rural communities are limited and that access to the services available in larger city centres is challenging due to transportation difficulties,” explains Cathy Burghardt-Jesson, Warden for Middlesex County. “Transportation from Middlesex to London, where the majority of mental health resources are located, is underdeveloped as there are limited bus routes and schedules. This leaves little in the way of affordable transit options for TAY in crisis.”  

Youth in crisis who connect with CMHA’s Reach Out 24/7 line at www.reachout247.ca or by phone at 519-433-2023 will be supported and assessed by the Crisis Line staff. If it is determined that a visit to the London Crisis Centre is needed, the CMHA Crisis worker will ensure a smooth transition from the Crisis Line to the Star Taxi Service. The youth will be provided with free transportation to and from CMHA’s Mental Health and Addictions Crisis Centre located at 648 Huron Street.  

To ensure the safety and wellbeing of the youth accessing this service, Star Taxi drivers have received training developed by CMHA regarding mental health and crisis de-escalation, as well as suicide prevention training by Living Works. 

Funding for the initiative has been provided by St. Joseph’s Health Care Foundation and the generous support of individual donors in the community. 

“With additional funding, the initiative could be scaled up to reach as many youth as possible in Middlesex County and beyond. We want to see all youth in rural areas who want to access mental health services able to do so, by removing the barriers of location and transportation,” adds Pervez. They will be collecting information regarding use of the transportation service and youth experience to refine and improve the initiative.  

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