Focusing on helping clinicians improve experiences for their patients, GE Healthcare is highlighting an innovative portfolio of molecular imaging technologies and agents at the 57th annual meeting of the Society of Nuclear Medicine (SNM), June 5-9, in Salt Lake City.
“Our vision for the Molecular Imaging business is to apply innovation to improve the patient experience,” said Terri Bresenham, vice president of the GE Healthcare Molecular Imaging business. “We have shortened traditional exam times and reduced dose without compromising a clinician or researcher’s ability to understand disease from the beginning.”
GE Healthcare innovations advance dose management
One example of how GE Healthcare is improving experience for patients is through dose management. At SNM, GE Healthcare is showcasing the groundbreaking technique of Adaptive Statistical Iterative Reconstruction (ASiR)* resulting in a reduction of CT dose by up to 40%. With this breakthrough innovation across the Discovery PET/CT 600 series platform and Discovery NM/CT 570c, clinicians don’t compromise image quality while reducing dose to their patients. Further, GE Healthcare is introducing new PET pediatric protocols available on the Discovery Dimension Console, that allow the lowest dose possible for the youngest patients.
Another example of GE Healthcare’s commitment to responsible dose management is the ability to reduce injected dose by up to 50 percent compared with standard cardiac and bone protocols. Enabled by GE’s exclusive Evolution family of products and first available on the Discovery NM/CT 670, this technology is now available on the Infinia and Hawkeye 4 products. GE further extends patient dose and imaging time management with solid-state Alcyone acquisition technology, which allows up to a four fold decrease in either imaging time or injected patient dose.
New technologies address exam times
PET/CT technology has also evolved with the patient in mind. With specialized detector configuration designed for sensitivity, event throughput and efficiency, researchers and clinicians have the necessary speed in workflow, protocol flexibility to help forge new frontiers in clinical techniques, drug discovery and motion management. The scan itself is also more efficient with a 2-meter scan option that allows clinicians to complete an entire head to toe examination in one scan. In addition, image reconstruction can make or break clinical workflow schedules. The patient scan can be reviewed while the patient is still on the table.
In conventional nuclear cardiac imaging, a patient must hold their arms above their head for two scans that take between 15-20 minutes each. With GE Healthcare’s next-generation Alycone technology available on GE’s revolutionary cardiac imaging scanners, Discovery NM 530c and Discovery NM 570c, clinicians are able to gather image data much more quickly. Unlike conventional nuclear imaging, all views are acquired simultaneously during a fully stationary SPECT acquisition, eliminating equipment movement during the scan. Focused multi-pinhole collimation has been strategically positioned to view cardiac anatomy and pathology with greater clarity and speed, resulting in scan times as short as three minutes.
Furthermore, the most commonly performed Nuclear Medicine procedure—whole body bone imaging—which includes a whole body planar and at least one position SPECT/CT, and traditionally required over 35 minutes to complete, has been shortened to 16 minutes imaging time with the state-of-the-art Discovery NM/ 670.
Adventure Series™ transforms anxiety into adventure
Demonstrating its commitment to patient centered innovation focused on safety, clinical solutions and an optimized environment for even the smallest patients, GE Healthcare will be showcasing Molecular Imaging products featuring the Adventure Series, a bold and innovative concept that makes diagnostic imaging a better experience for kids*. The result is GE Healthcare is helping to evolve pediatric imaging from ‘exams’ to ‘procedural theater,’ all with the primary goal of minimizing the anxiety journey for the patient and their family.
“Through all of these revolutionary technologies, patients spend less time in the exam and doctors get the information they need to determine course of treatment more quickly,” said Bresenham.
Imaging Advancements at SNM
In addition to the focus on the patient experience at SNM this year, GE Healthcare is featuring the latest SPECT/CT, PET/CT, radiopharmacy, and pre-clinical technologies addressing inaccuracies caused by motion in PET/CT imaging, the need for better visualization of disease and efficient workflow, faster throughput, and more consistent, accessible and compliant imaging agent production in radiopharmaceuticals.
GE Healthcare continues to demonstrate its commitment to both clinicians and researchers by introducing six features that enhance predictability, efficiency, and confidence across the Discovery PET/CT 600 series portfolio. GE Healthcare is the only vendor offering the choice of detectors within the same cutting-edge product series, allowing users to tailor systems to their needs and providing flexibility to excel both in clinical implementation and imaging exploration. “We have a unique advantage in that we can combine advanced molecular imaging tools with the latest CT technology,” said Jim Mitchell, general manager of GE Healthcare’s PET/CT business. “The result is a suite of applications and innovations for our customers to understand disease from the beginning.”
First to introduce MotionFree imaging technology nine years ago, GE Healthcare continues to drive advancements and enhancements to applications reconstruction. All of the Discovery PET/CT 600 series products incorporate industry leading, MotionFree imaging technologies into the clinical workflow. This capability allows clinicians and researchers to align PET and CT gated images to compensate for movement in all regions of the body, most importantly those regions subject to respiratory motion. Combined with VUE Point HD or VUE Point FX reconstruction, these technologies have the potential to improve small lesion detection, treatment planning, and better therapy response monitoring.
In Nuclear Medicine, the Discovery NM/CT 670 advanced hybrid imaging platform is designed to improve workflow, dose management and overall image quality. The system combines a newly designed SPECT gantry for greater positional flexibility, the latest in Nuclear Medicine detectors and GE Healthcare’s state of the art BrightSpeed Elite 16 slice CT. The Discovery NM/CT 670 incorporates flexible and proven workflow technology advancements from 11 years of Infinia Hawkeye innovations and installations with a modular gantry, designed to embrace tomorrow’s technology today. And now the Infinia Hawkeye 4 is benefitting from advanced applications first introduced on the Discovery NM/CT 670, including Cardiac Morphing, Volumetrix™ MI and the Evolution Toolkit further expanding the capabilities of this hybrid solution.
Debuting at SNM is the Xeleris™ 3, the latest version of the Xeleris MI platform granting a portal to all that is possible in molecular imaging quantification and review. The Xeleris 3 workstation provides remote access and PACS integration via XFL, advanced application tools integrated within Cardiac Myovation and SPECT Volumetrix packages. Complicated SPECT, PET, CT and MRI workflows are simplified and accessible anywhere.
PET Tracer Production
GE Healthcare simplifies the complexity of radiopharmacy infrastructure into a single touch-point solution that provides end-to-end capabilities. TRACERcenter –GMP™ combines equipment, information and services that allow customers to establish and operate their research or clinical PET tracer production center with confidence. Through its industry-leading PETtrace family, including the new PETtrace 880™, the most powerful production system to date, GE brings customers a consistent, reliable source combined with flexible production. TRACERcenter-710S™, the new entry-level production center brings customers world-class PET imaging anywhere with its upgradeable platform.
In addition to industry leading multimodality small animal imaging scanners such as the Triumph™ (PET/SPECT/CT). GE Healthcare now brings a panel of imaging biomarkers, including oncology specific tracers that are available exclusively for pre-clinical imaging. Probe mechanisms of action for drug candidates for their impact on fundamental mechanisms such as angiogenesis (VEGF), cytotoxic chemotherapeutic resistance (EGF), apoptosis and necrosis (Annexin V), as well as cell metabolism (FDG). This solution offers kits for SPECT, PET and Optical imaging to help users probe tumor biology, in live subjects tracked over long periods of time - delivering in vivo results you can be confident in, quickly.
GE Healthcare’s Innovation Center will feature a look at next-generation molecular imaging concepts, developments and innovations. Attendees will have the opportunity to see how GE Healthcare is helping clinicians and researchers alike understand disease, from the beginning.
Radiotracers and Molecular Imaging Agents
Featured at SNM are our key products, AdreView™ (Iobenguane I-123 Injection) and Myoview™ (99mTc-Tetrofosmin for Injection). AdreView, which was FDA-approved for use in the US in September 2008, is used in the detection of primary or metastatic pheochromocytoma or neuroblastoma as an adjunct to other diagnostic tests. AdreView is backed by a rigorous prospective clinical trial, and enables the use of both planar and SPECT imaging.
Myoview is a myocardial perfusion imaging agent approved for scintigraphic imaging of the myocardium. It is useful in the delineation of reversible ischemia, identifying changes in perfusion induced by pharmacologic stress, and the assessment of left ventricular function. Myoview combines excellent myocardial uptake and retention with high sensitivity and specificity for detecting angiographically significant coronary artery disease.
MYOVIEW (myoview.com) is indicated for scintigraphic imaging of the myocardium following separate administrations under exercise and/or resting conditions. It is useful in the delineation of regions of reversible myocardial ischemia in the presence or absence of infarcted myocardium. MYOVIEW is also indicated for scintigraphic imaging of the myocardium to identify changes in perfusion induced by pharmacologic stress in patients with known or suspected coronary artery disease. MYOVIEW is also indicated for the assessment of left ventricular function (left ventricular ejection fraction and wall motion) in patients being evaluated for heart disease. In studying patients with known or suspected coronary artery disease, care should be taken to ensure continuous cardiac monitoring and the availability of emergency cardiac treatment. Pharmacologic induction of cardiovascular stress may be associated with serious adverse events such as myocardial infarction, arrhythmia, hypotension, bronchoconstriction, and cerebrovascular events. Caution should be used when pharmacologic stress is selected as an alternative to exercise; it should be used when indicated and in accordance with the pharmacologic stress agent’s labeling. To minimize radiation dose to the bladder, the patient should be encouraged to void when the examination is completed and as often thereafter as possible. Adequate hydration should be encouraged to permit frequent voiding. Safety and effectiveness in pediatric patients have not been established. The contents of the MYOVIEW vial are intended only for use in the preparation of MYOVIEW Injection and are NOT to be administered directly to the patient. As with all injectable drug products, allergic reactions and anaphylaxis may occur. Sometimes Tc99m labeled myocardial imaging agents may produce planar and SPECT images with different imaging information. In patients who have a MYOVIEW GSPECT LVEF value or wall motion assessment that is not consistent with the clinical status, additional evaluations with other modalities should be considered as appropriate. Drug interactions were not noted and were not studied in clinical studies in which MYOVIEW was administered to subjects receiving concomitant medication. Drugs such as beta blockers, calcium blockers and nitrates may influence myocardial function and blood flow. The effects of such drugs on imaging results are not known. The following are spontaneously reported adverse reactions from post-marketing experience. Because the reports cite reactions reported spontaneously from worldwide post-marketing experience, frequency of reactions and the role of MYOVIEW in their causation cannot be reliably determined. The most common adverse reactions reported included the following: rash, urticaria, abnormal vision, allergic reactions, and fever. Deaths did not occur during the clinical study period of 2 days. Six cardiac deaths occurred 3 days to 6 months after injection and were thought to be related to the underlying disease or cardiac surgery. After MYOVIEW injection, serious episodes of angina occurred in 4 subjects, ventricular tachycardia in 1 subject, and respiratory arrest in 1 subject. The respiratory arrest occurred within minutes of MYOVIEW and pharmacologic stress dosing in a subject with underlying pulmonary disease. The patient was treated and fully recovered. Whether this event was caused by underlying disease or concurrent use of MYOVIEW injection and a pharmacologic stress agent cannot be determined. Prior to Myoview administration, please read the full prescribing information available online.
AdreView is a radiopharmaceutical indicated for use in the detection of primary or metastatic pheochromocytoma or neuroblastoma as an adjunct to other diagnostic tests. AdreView is contraindicated to known hypersensitivity to iobenguane or iobenguane sulfate. Hypersensitivity reactions have been reported following AdreView administration. Prior to administration, question the patient for a history of prior reactions to iodine, an iodine-containing contrast agent or other products containing iodine. If the patient is known or strongly suspected to have hypersensitivity to iodine, an iodine-containing contrast agent or other products containing iodine, the decision to administer AdreView should be based upon an assessment of the expected benefits compared to the potential hypersensitivity risks. Have anaphylactic and hypersensitivity treatment measures available prior to AdreView administration [see Adverse Reactions (6.2)]. Benzyl alcohol has been associated with a fatal “Gasping Syndrome” in premature infants and infants of low birth weight. Exposure to excessive amounts of benzyl alcohol has been associated with toxicity (hypotension, metabolic acidosis), particularly in neonates, and an increased incidence of kernicterus, particularly in small preterm infants. There have been rare reports of deaths, primarily in preterm infants, associated with exposure to excessive amounts of benzyl alcohol [see Description (11)]. Observe infants for signs or symptoms of benzyl alcohol toxicity following AdreView administration. AdreView safety and effectiveness have not been established in neonates (pediatric patients below the age of 1 month). AdreView is cleared by glomerular filtration and is not dialyzable. The radiation dose to patients with severe renal impairment may be increased due to the delayed elimination of the drug. Delayed AdreView clearance may also reduce the target to background ratios and decrease the quality of scintigraphic images. These risks importantly may limit the role of AdreView in the diagnostic evaluation of patients with severe renal impairment. AdreView safety and efficacy have not been established in these patients [see Clinical Pharmacology (12.2)]. Failure to block thyroid uptake of iodine 123 may result in an increased long term risk for thyroid neoplasia. Administer thyroid blocking medications before AdreView administration [see Dosage and Administration (2.2)]. Drugs which interfere with norepinephrine uptake or retention may decrease the uptake of AdreView in neuroendocrine tumors and lead to false negative imaging results. When medically feasible, stop these drugs before AdreView administration and monitor patients for the occurrence of clinically significant withdrawal symptoms, especially patients with elevated levels of circulating catecholamines and their metabolites [see Drug Interactions (7)]. Assess the patient's pulse and blood pressure before and intermittently for 30 minutes after AdreView administration. AdreView may increase release of norepinephrine from chromaffin granules and produce a transient episode of hypertension, although this was not observed in the clinical study. Prior to AdreView administration, ensure emergency cardiac and anti-hypertensive treatments are readily available. Hypersensitivity reactions have uncommonly been reported during the postmarketing use of AdreView [see Warnings and Precautions (5.1)]. The following drugs have the potential to decrease the uptake of norepinephrine and cause false negative imaging results: antihypertensives that deplete norepinephrine stores or inhibit reuptake (e.g., reserpine, labetalol), antidepressants that inhibit norepinephrine transporter function (e.g., amitriptyline and derivatives, imipramine and derivatives, selective serotonin reuptake inhibitors), sympathomimetic amines (e.g., phenylephrine, phenylpropanolamine, pseudoephedrine and ephedrine), and cocaine. Clinical studies have not determined which specific drugs may cause false negative imaging results nor whether all drugs in any specific pharmacologic class have the same potential to produce the negative imaging results. Prior to AdreView administration, please read the full prescribing information available at tinyurl.com/adreview-oncology/.
*Not available in the U.S. on PET/CT systems using BrightSpeed CT.
**Not yet commercially available.
About GE Healthcare
GE Healthcare (gehealthcare.com) provides transformational medical technologies and services that are shaping a new age of patient care. Our broad expertise in medical imaging and information technologies, medical diagnostics, patient monitoring systems, drug discovery, biopharmaceutical manufacturing technologies, performance improvement and performance solutions services help our customers to deliver better care to more people around the world at a lower cost. In addition, we partner with healthcare leaders, striving to leverage the global policy change necessary to implement a successful shift to sustainable healthcare systems.
Our "healthymagination" vision for the future invites the world to join us on our journey as we continuously develop innovations focused on reducing costs, increasing access and improving quality and efficiency around the world. Headquartered in the United Kingdom, GE Healthcare is a $16 billion unit of General Electric Company. Worldwide, GE Healthcare employs more than 46,000 people committed to serving healthcare professionals and their patients in more than 100 countries.
Molecular Imaging Agents
E: Conor.mckechnie[.]ge.com; P: +44 1494 498 276