Medical imaging is one of the fastest growing fields in medicine. In addition to routine X-rays, the most common imaging techniques in current clinical practice are: computed tomography (CT), magnetic resonance imaging (MRI), ultrasound (US), and single photon emission computed tomography (SPECT). CT and MRI scanners, ultrasound units and gamma cameras are now an essential part of clinical practice. Positron emission tomography (PET) and magnetic resonance spectroscopy (MRS) are also increasingly used in the management of patients with cancer. With the development of innovative new imaging modalities, contrast agents, molecular probes and radiopharmaceuticals, our ability to study biological structures and functions in health and disease has vastly improved, and continues to contribute to the evolution of medical care.
Alternative Radiopharmaceuticals for Medical Imaging (2009)
Imaging technologies that require the use of radiopharmaceuticals fall within the field of nuclear medicine. About 1.5 million nuclear medicine procedures are performed annually in Canada. Over 80% of all nuclear medicine investigations involve radiopharmaceuticals labeled with Technetium-99m (99mTc). In 2009, a critical shortage of Technetium-99m (Tc99m) threatened to seriously disrupt clinical practice. ICR responded to this crisis by leading a research response. Six CIHR Institutes (ICR, ICRH, III, IMHA, INMHA, INMD) in partnership with NSERC, launched the ‘Alternative Radiopharmaceuticals for Medical Imaging’ funding opportunity. Through this initiative, CIHR and NSERC jointly awarded $5.4 million towards 7 innovative research projects. The title and a summary for each of the 7 funded projects can be found in the "Alternative Radiopharmaceuticals for Medical Imaging" funding decisions data report.
The seven projects funded through this initiative were tasked with developing viable alternatives to the nuclear reactor production of the medical isotopes, such as Tc99M, used in routine clinical practice. Within two years this group of researchers succeeded in finding new technologies, such as cyclotrons, to produce clinically viable Tc99m as well as alternate isotopes to replace Tc99m in some routine medical procedures. Viable alternatives to 99mTc are now available for the diagnosis of coronary artery disease and ventricular heart function, the evaluation of myocardial function, the diagnosis of lung disease, and the monitoring of renal structure and function. In addition, an improved method for preparing a 99mTc labeled radiotracer for assessing lymph node involvement in breast cancer has been developed. This new method will make optimum use of the available 99mTc, especially in times of isotope shortage.
Medical Imaging Clinical Trials Network (2010)
CIHR was awarded $10M over two years in the Budget 2010 as part of the federal "Isotope Supply Initiative", to establish the Medical Imaging Trials Network of Canada (MITNEC). This initiative represents a further component of the federal Government's response to the isotope shortage of 2009. MITNEC encompasses imaging expertise in oncology, cardiology and neurology and has engaged internationally-respected leaders from 13 universities across five provinces in Canada. This national medical imaging clinical trials network established a clinical platform for imaging research in Canada, to facilitate the evaluation of existing and new imaging technologies and enable their uptake into routine patient care.
Quantitative Imaging for Responses to Cancer Therapies (2013)
In 2011, an international need for physical standardization in the cancer-imaging field – from image acquisition, processing, segmentation and feature extraction, to clinical nomenclature and methods of recording follow-up – was identified at the Canada/UK/US workshop entitled “Linking ’omics to Patient Care through Imaging: Exploring a Global/International Program in Cancer” (for more infornation on this workshop please see below). To address this gap, ICR partnered with the National Cancer Institute (NCI) of the National Institutes of Health (NIH) and Genome British Columbia (BC) to launch the “Quantitative Imaging for Evaluation of Responses to Cancer Therapies Initiative” funding opportunity, in 2013. This opportunity has led to the creation and integration of two Canadian nodes in the NCI Quantitative Imaging Network (QIN) that is currently comprised of 21 US-based nodes.
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