Canada’s First Digital PET/CT Scanner Turns One: Cheers to a Hopeful Future and the Provision of World-Class Health-Care Delivery in Newfoundland and Labrador!


Celebrating an anniversary signifies the beginning of something wonderful – and remembering the birth of Eastern Health’s “PET project” is no exception.

Today, October 24, 2018, marks the one-year anniversary of launching Canada’s first digital positron emission tomography /computerized tomography (PET/CT) scanner, as well as the official opening of Eastern Health’s world-class Nuclear and Molecular Medicine facility!

The PET/CT scanner is an incredible piece of medical equipment and it’s housed inside a modern medical facility, located in St. John’s, Newfoundland and Labrador. During the initial year of service, over 1,300 patients received a fluorodeoxyglucose (FDG) PET/CT scan for the first time in their home province – a diagnostic test that patients did not have prior access to.

Members of Eastern Health’s PET Steering Committee. Eastern Health’s Board of Trustees and officials from Memorial University of Newfoundland pose for a photo to mark the official opening of the state-of-the-art Nuclear and Molecular Medicine facility and launch Canada’s first digital PET/CT scanner in St. John’s, NL (Oct. 24, 2017)
 
Front: Dr. Conor Maguire, nuclear medicine specialist at Eastern Health and associate professor and clinical chair of radiology at Memorial University of Newfoundland (MUN)
  
Middle row (l-r): Dr. Margaret Steele, Dean of Medicine, MUN; chair of Eastern Health’s Board of Trustees, Lesley O’Reilly and his wife Mrs. Joan O’Reilly; Lynn Wade, member of Eastern Health’s Board of Trustees; Paul Snow, president and CEO of the Health Care Foundation; Clayton Kennedy, former manager of nuclear medicine at Eastern Health; Julio Panama, cyclotron engineer at Eastern Health; Dr. Doug Abrams, manager of radiopharmaceutical sciences at Eastern Health
 
Back row: Dr. Bassem Elshahat, medical physicist and radiation safety officer at Eastern Health; Daniel Parsons, regional manager of planning and engineering at Eastern Health; Tammy Hudson, regional manager of nuclear and molecular medicine at Eastern Health; Zelda Burt, communications manager at Eastern Health; Scott Gow, project engineer at Eastern Health; Dr. Jeffrey Flemming, clinical chief of nuclear and molecular medicine; Kenneth Baird, vice-president of clinical services at Eastern Health; Dr. Peter Hollett, nuclear medicine specialist at Eastern Health; and Dr. Edward Kendall, medical physicist at Eastern Health.

Before the launch of our Eastern Health’s Nuclear and Molecular Medicine program, approximately 300 patients had to travel to other hospitals across Canada to complete a PET scan every year, many during the most difficult and emotional times of their lives.

“Now that we have our own digital PET scanner in-house, combined with a CT scan capability, patients and their families no longer have to face that burden and stress of traveling for diagnostic procedures,” says Tammy Hudson, regional manager of nuclear and molecular medicine at Eastern Health. “We have successfully met the target for our first year of service, and we couldn’t have done it without the dedication of our highly skilled, multi-disciplinary team at this one-of-a-kind, state-of-the-art medical facility.”

Tammy Hudson, regional manager of nuclear and molecular medicine at Eastern Health.

Tammy is an expert in nuclear medicine technology and completed a conjoint program with the Nova Scotia Institute of Technology and the Victoria General Hospital in 1994. In 2012, she obtained a certificate in modern management from the Canadian Healthcare Association, which has equipped her to understand health-care technology and laws; lead positive change in health care; develop people, as well as successfully manage complex departments and human and financial resources.

The purpose of Tammy’s role is multi-faceted – it comes with hefty responsibilities to ensure the well-being of both patients and employees of Eastern Health’s Nuclear and Molecular Medicine program. Not only does she help ensure that patients of Newfoundland and Labrador receive timely access to nuclear medicine services, but she is also responsible for ensuring that all aspects of nuclear and molecular medicine operations strictly follow the Canadian Nuclear Safety Commission and Health Canada regulations and recommendations.

What Tammy loves most about her role is leading a diverse team and collaborating with experts to help make a difference in the lives of patients and their families. Most importantly, her passion is driven by the privilege of being involved in leading-edge health care and research. As part of her portfolio, she works closely with a range of highly specialized staff, including St. John’s native Dr. Peter Hollett, who graduated from Medical School at Memorial University of Newfoundland (MUN) in 1982.

Jolly good fellows

Dr. Hollett wears many different hats. Some may recognize him as the former clinical chief of nuclear and molecular medicine program of Eastern Health; the head of the organization’s PET Steering Committee; clinical professor of radiology at MUN; a Fellow of the Royal College of Physicians and Surgeons of Canada (FRCPC); or the president of the Canadian Association of Nuclear Medicine. Others know him as a long-standing employee of Eastern Health; in fact, he has been a nuclear medicine specialist with the organization since 1987!

Outside the area of medicine, Dr. Hollett is an active member of the Royal St. John’s Regatta and he enjoys curling and fly fishing as his favourite pastimes. However, one of Dr. Hollett’s biggest passions is speaking about his involvement in Eastern Health’s “PET project.” In fact, he has been involved in the project from the very beginning. Dr. Hollett is quick to credit many other talented individuals who have been instrumental in getting the project off the ground.

(l-r): Dr. Peter Hollett, FRCPC, clinical chief for nuclear and molecular medicine at Eastern Health (1987-2018) and clinical professor of radiology (nuclear medicine) at MUN; Dr. Conor Maguire, FRCPC, nuclear medicine specialist at Eastern Health and associate professor and clinical chair of radiology at MUN

Behind the scenes, Dr. Hollett, along with some of his colleagues who have since retired, spearheaded discussions with the Provincial Government of Newfoundland and Labrador to propose a case for introducing a digital PET/CT scanner to enhance access to quality care to the people of Newfoundland and Labrador. Dr. Hollett says that planning the “PET project” was a high point of his career. The project was complex and exciting as Dr. Hollett recalls several significant milestones that have been achieved over the years, ranging from:

  • seeking funding for specialized equipment and the recruitment of highly qualified personnel in 2008;
  • to facilitating public consultations about the project’s concept in 2013;
  • to visiting foreign countries to shop for ground-breaking technology in 2015;
  • to lifting Newfoundland and Labrador’s first cyclotron into a vault in 2016; and
  • to finally opening the doors of the beautifully designed, bright and spacious Nuclear and Molecular Medicine facility to patients from across the province in 2017.

Eastern Health’s newly purchased cyclotron in the manufacturer’s warehouse in Belgium, 2015

One of Dr. Hollett’s peers from medical school, Dr. Conor Maguire, has also been influential in the successful start-up of the “PET project.” Dr. Maguire hails from Grand Falls, NL and was recruited in 2012 to the develop and implement the clinical service component of the PET/CT imaging program. He was also heavily involved in the recruitment of a high-quality team of scientists which includes some of the most sought-after experts in Canada. Prior to 2012, Dr. Maguire practised at the University of Alberta Hospital in Edmonton, Alberta for 21 years, where he was chief of nuclear medicine and head of the PET/CT imaging program.

Dr. Maguire and Dr. Hollett go back a long way – even before the diving accident in Germany (1977) which left Dr. Maguire with a spinal cord injury just after completing his first year of medical school.

With the support of his wife and family, MUN Medical School, and his medical student peers, Dr. Maguire was successful in achieving his Doctor of Medicine degree in 1981. He then went on to complete residency training in two separate specialties, including radiology at MUN and nuclear medicine at the Western University in London, Ontario.

“When I graduated from medical school, I felt blessed and very grateful,” says Dr. Maguire. “To my knowledge, I was the first person in the country to go through medical school with a spinal cord injury of my kind. I believe this could only happen in the close-knit special community we have here.”

Today, Dr. Maguire is a combined radiology/nuclear medicine specialist at Eastern Health and is the academic chair of radiology at MUN.

“When I was offered the position in St. John’s, I relished the opportunity to contribute to the community and medical school that made it possible for me to pursue my medical vocation,” adds Dr. Maguire. “Returning home to help develop the PET program was my way of saying ‘thank you.’ It’s nice to come full circle and give back to our province.”

“Eastern Health’s ‘PET project’ has been a team effort from the beginning,” says Dr. Maguire. “It is nice to be part of the history of the project, and a privilege to work with a team of like-minded, talented people to establish a world-class essential clinical service for the people of our province.”

Both Dr. Maguire and Dr. Hollett agree that the “PET project” has been one of the most fulfilling experiences of their careers. In addition to supporting state-of-the-art clinical care for our patients the world-class new Nuclear and Molecular Medicine facility and program has also opened the door to many exciting future opportunities in the areas of research; the provision of personalized medicine; and the potential to manufacture new diagnostic and therapeutic agents – for patients of Newfoundland and Labrador, or possibly across Canada and internationally!

Canada’s first digital PET/CT scanner in operation, Eastern Health (2017)

Seeing is believing

“Eastern Health’s digital PET/CT scanner is leading-edge, life-saving medical equipment that offers many benefits to patients and their respective health-care teams, adds Dr. Hollett. “What makes this digital PET/CT scanner so exceptional is that it combines two diagnostic tests into one, offering nothing short of a brilliant image and an astounding amount of information for clinicians that would enable them to provide enhanced patient care and treatment.”

A PET/CT image offers a unique representation of what is happening inside a patient’s body. The CT part of the scanner provides structural information about human anatomy, while the PET diagnostic test provides functional information about how the patient’s organ systems work. Eastern Health’s digital PET/CT scanner uses a small amount of radioactive sugar called fluorodeoxyglucose (FDG) to help detect certain diseases earlier. Patients are injected with FDG in their arm or hand with a small needle before the exam takes place. Other types of radioactive materials can be used to evaluate other illnesses.

Best kind

Some of the key benefits of the digital PET/CT scanner include:

  • enabling physicians to detect certain diseases much earlier than other diagnostic tests can, such as X-rays, MRI- or CT scans;
  • enabling physicians to significantly improve and customize treatment plans for patients to fight against cancer, neurological diseases or cardiac illnesses; and
  • early detection of treatment response;
  • offering patients more positive health outcomes.

But that’s not all, the PET/CT scanner will expand life-changing discoveries thanks to Eastern Health’s primary platform for research – the cyclotron! To many, this contraption looks like a small white spaceship, and once operational, it will one day generate an array of “homemade” radioisotopes that would help advance more personalized therapy for patients and offer them a fighting chance for better health outcomes.

This video shows Newfoundland and Labrador’s first cyclotron being lifted into a vault inside Eastern Health’s Nuclear and Molecular Medicine facility, St. John’s, NL. A cyclotron produces medical isotopes that are used in molecular or nuclear diagnostic procedures such as a PET/CT scan. Medical isotopes are very small quantities of radioactive material used to diagnose and determine treatment for disease. Disappearing in a matter of minutes or hours after they are made, medical isotopes can be used safely in a patient’s body. The home of the cyclotron, a.k.a. the vault, includes built-in safety features such as extra thick concrete walls and lead shielding, safety monitoring systems and other security features. Watch the video to learn more!

The ability to one day create a range of radioisotopes for both biological and physical investigations means that Eastern Health can collaborate with MUN to pursue fundamental research. Innovative research may lead to the discovery of new types of drugs; generating clinical trials for patients; and it will also enable experts to design a variety of novel radiopharmaceuticals – the potential “magic bullet” to locating, treating and hopefully curing specific kinds of cancers.

68Ga Dotatate is a radioactive diagnostic agent for PET imaging in neuroendocrine tumours and prostate-specific membrane antigen (68Ga-PSMA) for prostate cancer,” says Dr. Hollett. “With our cyclotron in operation, we could begin manufacturing this tool in-house, enabling us to locate a patient’s primary cancer first. We would then be able to find ways of providing highly targeted and more effective therapy that would not negatively impact any healthy cell walls. This makes our work so exciting, hopeful and incredibly rewarding.”

Talent magnet

What makes Eastern Health’s Nuclear and Molecular Medicine Program so special is that it has everything clinical and research teams would possibly require – the latest technology; a modern, spacious and patient-centred facility that is conveniently located right next to Dr. H. Bliss Murphy Cancer Care Centre and close to MUN; as well as local experts and highly-specialized individuals who have “come from away” – across Canada and from around the globe – choosing to further their careers and provide service here right here at Eastern Health!

Dr. Jeffery Flemming (FRCPC) is the current chief of Eastern Health’s Nuclear and Molecular Medicine program and the residency research director with MUN’s Faculty of Medicine. He grew up in St John’s and returned to Newfoundland and Labrador in November 2015 from Alberta. His vast knowledge in cancer imaging and research has been instrumental in the planning and start-up of Eastern Health’s “PET project.”

The medical facility also has adequate room to operate nuclear and molecular medicine services. The facility has built-in space to house future specialized equipment, such as a PET/MR scanner – a rare imaging commodity in Canada that Eastern Health hopes to acquire one day. The top floor of the building is currently undeveloped and reserved for any future expansion of the Provincial Cancer Care Program of Newfoundland and Labrador.

Eastern Health officially opens the doors of its state-of-the-art Nuclear and Molecular Medicine facility, October 24, 2017

Attracting only the best talent with modern facilities and the latest equipment is especially beneficial for patients of Newfoundland and Labrador since this will mean the provision of world-class care, treatment and results. It also means that scientists, psychists, radiopharmacists, radiochemists, specialists, engineers and other health-care professionals have the privilege of advancing medicine and being involved in groundbreaking research in the field of nuclear and molecular medicine that originated in Newfoundland and Labrador – the possibilities to enhancing patient care and health outcomes seem endless!

Dr. Vincent Bouvet (Ph.D.), radiochemist at Eastern Health and clinical assistant professor at MUN stands proudly in the radiochemistry lab of the Nuclear and Molecular Medicine facility in St. John’s, NL. Dr. Bouvet’s primary responsibility is to produce radiopharmaceuticals; train and manage the production team; and develop a collaborative research program between Eastern Health and MUN.

Between the jigs and the reels

It is estimated that over the next two years, Eastern Health could begin producing its own radioisotopes once all licensing requirements have been obtained – a process that seems like a moving target since it is thorough, complex and very lengthy. Eastern Health is involved with the Canadian Nuclear Safety Commission and Health Canada in all its licensing requirements for acquiring and housing the cyclotron to date since patient-, public- and employee safety is always a top priority for the organization.

Julio Panama, cyclotron engineer at Eastern Health and professional associate at MUN, standing next to the cyclotron which is housed inside the vault at the Nuclear and Molecular Medicine facility in St. John’s, NL. As his primary duty, Julio is responsible for the production of radionuclides and the optimization of the cyclotron system; training the technical staff and supporting the research program.

More specifically, the next approaching milestone for the cyclotron involves commissioning – a process that validates the safe and proper operation of the cyclotron and facility. After it has been commissioned, the step thereafter will include obtaining a license to operate the cyclotron – or ‘turning it on.” Although this will be an incredibly exciting time for many, in the grand scheme of things, this is only a stepping stone to bringing state-of-the-art diagnostic imaging and radionuclide therapy to the patients of Newfoundland and Labrador. Obtaining a license to operate the cyclotron will enable the production radionuclides that can be used to prepare an array of radiopharmaceuticals for the digital PET/CT scanner – something that otherwise would never have been possible here in Newfoundland and Labrador!

Dr. Doug Abrams, manager of the radiopharmaceutical sciences at Eastern Health and clinical assistant professor at MUN

“While bringing FDG to Newfoundland and Labrador is our initial goal within its own right, our ultimate goal is to move closer to being able to provide personalized medicine by determining the most appropriate therapy for each patient,” says Dr. Doug Abrams, manager of the radiopharmaceutical sciences at Eastern Health. “To do this, we will need to prepare many different diagnostic radiopharmaceuticals that will enable us to determine the most appropriate therapy. Eastern Health’s Nuclear and Molecular Medicine facility is designed specifically to prepare radioactive therapeutics – an integral part of the personalized medicine paradigm!”

With his Ph.D. in bionucleonics and radiopharmacy from the University of Alberta, in addition to his role as manager of the radiopharmaceutical sciences at Eastern Health, Dr. Abrams is a clinical assistant professor at MUN.

He has many great memories of completing his fellowship at the German Cancer Research Centre in Heidelberg and a post-doctoral fellowship at the Cross Cancer Institute with Alberta Health Services in Edmonton. But like many in his department, Dr. Abrams wears a few other hats too!

Dr. Abrams is known for being actively involved in several national and international professional organizations in the field of nuclear medicine. He was the former president of the Canadian Association of Radiopharmaceutical Scientists for the Prairie Provinces Chapter and the Canadian Society of Nuclear Medicine – and he was the founding president of the Canadian College of Radiopharmaceutical Scientists. Dr. Abrams was also instrumental in finding a regulatory consultative group to liaise with the Federal Government on regulatory matters of interest to the nuclear medicine community. If there is any free time left outside of his professional schedule and family life, Dr. Abrams likes to watch a game of hockey or football; play squash; and custom frame beautiful pieces of artwork.

But as the saying goes, “we live in a small world.” Dr. Abrams has previously crossed paths with Dr. Hollett and Dr. Maguire even before joining Eastern Health. In fact, he worked closely with them in Winnipeg and Edmonton several years ago. For Dr. Abrams, to have the opportunity to work with these experts again, along with the privilege of being involved in developing a radiopharmaceutical chemistry facility from the ground up became the primary reasons for attracting him to Newfoundland and Labrador.

(l-r) Dr. Doug Abrams, manager of the radiopharmaceutical sciences at Eastern Health and clinical assistant professor at MUN signing the cyclotron upon purchase with Daniel Parsons, regional manager of planning and engineering at Eastern Health, Belgium, 2015

“The design of a radiopharmaceutical chemistry building like Eastern Health’s Nuclear and Molecular Medicine facility is a very complex process,” adds Dr. Abrams. “Reflecting back, it involved the teamwork of many incredible experts. I have been fortunate to provide various levels of input into the ‘PET project’ ranging from the type of radionuclides that would be produced here in Newfoundland and Labrador; the layout of the facility during the design phase; the equipment required to produce and test the radiopharmaceuticals; as well as how the facility functions today and how it may be used in the future.”

Being involved in Eastern Health’s “PET project” will remain to be a topic Dr. Abrams will speak passionately about. Dr. Abrams adds that “Eastern Health’s state-of-the-art ‘PET project’ will contribute to advance science and patient care well beyond our initial goal of bringing FDG to Newfoundland and Labrador. All the physicians, scientists and many others who have been involved in this project are visionary and second to none.”

Dr. Abrams says that in a class of its own, Eastern Health’s Nuclear and Molecular Medicine facility has the potential of being known as the centre of excellence for molecular and nuclear medicine and radiopharmacy – offering only the best possible care delivery and treatment plans for patients.

Eastern Health’s PET/CT service is currently available to oncology patients – the largest patient group that can benefit from this technology. As the organization’s nuclear and molecular medicine experts experience continues to grow, the goal is to expand access to this service to also include other patient groups who live with neurology, cardiology and inflammatory conditions.

To many more

Celebrating a birthday offers a perfect opportunity to give thanks and travel down memory lane to reflect on some challenging, exciting and heartwarming moments from the past.

As noted in Eastern Health’s Annual Performance Report 2017-18, as part of our Strategic Plan 2017-20, Lighting the Way: Navigating Together, officially opening the doors of the Nuclear and Molecular Medicine facility and launching Canada’s first digital PET/CT scanner come as a result of valuable partnerships that we have formed with the Provincial Government, MUN and the Health Care Foundation, a philanthropic partner to Eastern Health that supports adult hospitals and facilities within the St. John’s region.

“Launching Eastern Health’s world-class Nuclear and Molecular Medicine program has been an incredible and collective undertaking,” concludes Tammy. “Celebrating the first anniversary of our ‘PET project’ is a dream come true for many, and a reminder of the teamwork that has been done to give the people of Newfoundland and Labrador access to first-class clinical services.”

To all of those who have been involved in our “PET project,” including patients who have received this specialized care or will in future, cheers to successful and hopeful future ahead!

This article was written by Zelda Burt (MA Comm), communications manager and member of the PET Steering Committee at Eastern Health. Zelda was an employee of the health authority from 2011 to 2018 and recently relocated to Ontario with her family.

 

 

 

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