Fifty years of nuclear medicine has revolutionised management of the big impact diseases: cancer, heart disease, dementia. Now what we need is for all patients to have access to the cutting edge radiotracers, not just the lucky few – those who live near major cyclotron centres where the overly complex synthesis is possible. And we need to advance capability to serve new needs in the era of personalised medicine, which is underpinned by understanding of systems biology and disease heterogeneity. We will achieve these transformations using new chemistry in a multidisciplinary setting, by addressing three main challenges:
BACKGROUND
Fifty years of nuclear medicine has revolutionised management of the big impact diseases: cancer, heart disease, dementia. Now what we need is for all patients to have access to the cutting edge radiotracers, not just the lucky few – those who live near major cyclotron centres where the overly complex synthesis is possible. And we need to advance capability to serve new needs in the era of personalised medicine, which is underpinned by understanding of systems biology and disease heterogeneity. We will achieve these transformations using new chemistry in a multidisciplinary setting, by addressing three main challenges:
ACCESS
We propose chemical frugal innovation: simplifying tracer synthesis with smarter chemistry that can be performed in many more hospitals. It will be equally suited to the UK and low and middle income countries. In many cases we will make it as simple as adding radioactivity to a single vial, taking just five minutes instead of hours.
CAPABILITY
To transform nuclear medicine to characterise systems biology and heterogeneity, we need to image several disease phenotypes in the same patient where currently we can only image one – and it’s nearly always the same one. Faster, simpler, smarter chemistry will allow several tracers to be synthesised and used one after the other.
SUSTAINABILITY
To continue addressing exsisting and new challenges beyond the programme we need a national multidisciplinary resource for use by researchers nationwide, big enough to outlast the programme and any of the individuals in it. Our centre will be that resource.
The key to all these is our innovative chemistry, in a multidisciplinary and clinically embedded environment. Over the last 13 years we have assembled exactly this environment: King’s has a department of eleven academic molecular imaging chemists and biologists, alongside physicists and clinicians, plus key external experts at Imperial and Southampton feeding in additional novel chemistry. We have equipped them with unparalleled facilities, all embedded in a major hospital environment. Such a team on this scale is unique in the UK and our aims could not be achieved anywhere else. We don’t just do innovative chemistry, we apply it in the clinic. This clinical translation is our guiding principle. Recent examples are Cu-64 hypoxia imaging, the first F-18 tracer for thyroid cancer and cell tracking, and the first simple kit-based Ga-68 tracer, [BP1] for prostate cancer. Several more are at the stage ready for clinical translation and this programme will create yet more.