The Wayne State University School of Medicine was well-represented during the Neutrons for Therapy symposium conducted at the 11th Neutron and Ion Dosimetry Symposium in Cape Town, South Africa, in October.

The symposium attracted representatives from all Fast Neutron Therapy facilities around the world. Seven centers in five countries are delivering FNT. Delegates from centers offering Boron Neutron Capture Therapy in six countries also attended.

Invited speaker Professor Wolfgang Sauerwein of the University Hospital in Essen, Germany, presented work by Jay Burmeister, Ph.D., D.A.B.R., associate professor of the Department of Radiation Oncology for the School of Medicine and chief of Physics for the Karmanos Cancer Center.

That presentation detailed the major technical advances made over the last five years at the Detroit FNT facility, where the possibility of intensity modulated fast neutron therapy (IMNRT) has been developed.

The potential of neutron therapy was demonstrated for prostate cancer treatment, the principal disease treated in Detroit. Dr. Burmeister, who also serves as director of Education in the Department of Radiation Oncology, said that to date almost 1,600 prostate cancer patients have been successfully treated using neutron therapy at WSU.

The work of Michael Snyder, Ph.D., a medical physics resident with the Department of Radiation Oncology at Wayne State University and the Karmanos Cancer Center, on Intensity Modulated Neutron Radiotherapy (IMNRT) vs. 3D Conformal Neutron Radiotherapy also was presented. The results of Dr. Snyder’s study open the possibility of dose escalation for prostate treatment with IMNRT and suggest this new technique might allow neutron therapy to be effective at sites previously restricted by normal tissue toxicities.

Professor Sauerwein also delivered a joint presentation on Boron Neutron Capture Enhancement of Fast Neutron Therapy conducted at Wayne State University and at the Cyclotron Isocentric Neutron Therapy Facility Radiological Centre Essen. The aim of this research is to attempt to capitalize on the potential advantages observed in the use of FNT for the treatment of Glioblastoma Multiforme, a highly malignant brain tumor. FNT has been shown to be capable of eradicating GBM, a disease that has proved resistant to all attempts using conventional radiotherapy. The capability of delivering a boron neutron capture boost to provide a 30 percent gain in dose to tumors was demonstrated using currently achievable boron concentrations in the WSU Fast Neutron Therapy beam.

“When you consider the small handful of centers around the world engaged in this type of medicine, it’s clear that the School of Medicine and Karmanos physicians are blazing new trails in cancer treatment,” said Andre A. Konski, M.D., M.B.A., M.A. F.A.C.R., professor and chair of the WSU Department of Radiation Oncology and chief of Radiation Therapy at the Barbara A. Karmanos Cancer Center. “Our facilities are not only a major hub of cancer research, but science that is readily translated into beside practice.”

The Wayne State University School of Medicine Continuing Medical Education Division and the Detroit Health Department will co-sponsor a public health grand rounds titled “Health Care Providers Town Hall: H1N1 Influenza and Vaccine Update” on Nov. 23.

The town hall will be presented by the Local Emergency Preparedness Committee, the Detroit Department of Health and Wellness Promotion and Detroit Homeland Security. The target audience includes community physicians and health professionals.

Organizers plan to update providers on the most recent Centers for Disease Control information on H1N1 influenza, inform providers on who and when to test for the influenza, increase the understanding of the indications for the use of Tami-flu and provide CDC recommendations for the vaccine and contraindications.

Panelists will include Scott Berkseth, vice chair of the LEPC; Melinda Dixon, director of Communicable Diseases for the DHWP; Walter Davis, Pan-Influenza coordinator for the DHWP; and Aloysius Hanson, director of Laboratory Services for the DHWP.

The town hall will take place from 6 to 8 p.m. at the Herman Kiefer Auditorium, located at 1151 Taylor in Detroit. Registration and dinner begin at 5:30 p.m.

Space is limited. Please contact Augustine Sharp at sharp@detroitmi.gov or (313) 876-4776 to attend. For more information, call Anita Moncrease, M.D., at (313) 876-4300.

A Wayne State University School of Medicine researcher is investigating the potential of a dietary agent in inhibiting the growth and spread of pancreatic cancer, often considered the mostly deadly form of cancer.

Fazlul H. Sarkar, Ph.D., a professor in the Department of Pathology at the School of Medicine and the Karmanos Cancer Center, received a $300,000 grant from the National Institutes of Health through the American Recovery and Reinvestment Act of 2009. The award is an expansion of two research grants totaling $3 million funding Dr. Sarkar’s investigation of the role of B-DIM, a small molecule found in leafy vegetables, in pancreatic cancer prevention and treatment.

Pancreatic cancer has one of the worst prognoses of any solid tumor type and is the fourth leading cause of all cancer deaths in the United States. The median survival time is six months after diagnosis, with only 3 percent of those diagnosed surviving five years. The low survival rate has been attributed to the ability of pancreatic cancer cells to grow and spread faster than most other cancers, a phenomenon that makes the disease difficult to treat.

Previous studies by Dr. Sarkar's lab found B-DIM to be a potent inhibitor of the expression of genes known to activate signaling pathways that lead to cancer cell growth, migration, invasion, and angiogenesis and inducing apoptosis. The current study focuses on determining the mechanism by which B-DIM inhibits these pathways and testing the molecule's effectiveness in pancreatic cancer prevention and treatment using two recently developed animal models. The results could aid in designing preventive or therapeutic approaches for saving the lives of pancreatic cancer patients.

"Our lab has shown that B-DIM can significantly inhibit the pathways that are instrumental in the progression of pancreatic cancer," Dr. Sarkar said. "Now we want to better understand the effect of this molecule on several genes essential to cancer progression and elucidate exactly how B-DIM works. The knowledge gained from this study could significantly increase our ability to prevent and treat this very aggressive form of cancer, for which there is no cure."

In addition to his research, Dr. Sarkar was recently selected to serve as an associate editor of Cancer Research, a journal of the American Association of Cancer Research. He was also recently chosen as one of 11 senior editors in the country for Molecular Cancer Therapeutics, another AACR journal.

A Wayne State University School of Medicine researcher has secured a Department of Defense grant for a study expected to lead to the discovery of biomarkers that will identify African-American men predisposed to especially aggressive forms of prostate cancer.

Izabela Podgorski, Ph.D., an assistant professor in the school’s Department of Pharmacology, won a $342,000 Early Career Investigator Health Disparity grant for her three-year project, “Biochemical and Genetic Markers in Aggressiveness and Recurrence of Prostate Cancer: Race-Specific Links to Inflammation and Insulin Resistance.”

Prostate cancer is a leading cause of death for men in the United States. Prostate cancer deaths are more than twice as high among African American men. Dr. Podgorski said that African-Americans are diagnosed with prostate cancer earlier in life and the disease is often in a more aggressive form at the time of diagnosis.

Oddly, there are no significant differences in prognosis between African-American and European-American men when the cancer is diagnosed before spreading to other organs. Yet, when diagnosed in advanced stages, the likelihood the cancer will return is much higher in African-Americans.

Dr. Podgorski noted that while it is likely genetic and environmental factors such as diet and chemical exposure contribute to prostate cancer risk and progression, researchers don’t yet know the reasons for the racial differences in the cancer’s aggressiveness. Recent clinical studies demonstrate that metabolic syndrome -- abdominal obesity, high blood pressure, high levels of triglycerides, low HDL cholesterol and high fasting glucose – plays a key role in the development of prostate cancer. Men with metabolic syndrome may have more aggressive tumors and be more likely to experience reccurrence after initial surgery.

High blood pressure and obesity are often associated with metabolic syndrome in African-Americans. Among this population, the risk of developing high blood pressure has recently been linked to low levels of a hormone called adiponectin, and high levels of proteins associated with inflammation. Research has also suggested that the distribution of specific forms of adiponectin in blood and not the levels of the total protein are associated with high blood pressure and insulin resistance, indicating biological factors related to metabolic syndrome may play a role in racial disparities in prostate cancer aggressiveness and prognosis.

Dr. Podgorski’s study will search for indicators of prostate cancer in the blood of prostate cancer patients. Those biomarkers may include proteins and genes associated with metabolic syndrome and related conditions such as inflammation, insulin resistance and oxidative stress and which may be responsible for racial differences in prostate cancer aggressiveness and prognosis.

“Overall, these studies will help us understand which factors are responsible for racial differences in prostate cancer risk, progression and responsiveness to treatment,” Dr. Podgorski said. “We expect that these studies will demonstrate that metabolic syndrome-related inflammation, insulin resistance and oxidative stress influence prostate cancer progression in African-American men differently than they do in European-American men.”

The findings, she said, should result in identification of novel biomarkers for the detection and prognosis of aggressive prostate cancer and of biological targets for improved therapy or prevention of aggressive forms of the disease. The study results will provide the basis for future validation of blood indicators as biological targets for improved therapy and prevention of aggressive cancer.

The study will collect blood samples from a large number of African-American and European-American prostate cancer patients recruited for a recently funded study on metabolic syndrome and prostate cancer. Dr. Podgorski will determine the levels of adiponectin in the samples and the levels of 15 proteins associated with inflammation, insulin resistance and oxidative stress in an effort to determine how different forms of adiponectin correlate with the biomarkers and how this relationship predicts cancer aggressiveness and racial differences. She will also, in collaboration with Cathryn Bock, Ph.D., M.P.H., and Jennifer Beebe-Dimmer, Ph.D., M.P.H., both assistant professors of the Department of Internal Medicine and the Karmanos Cancer Institute, study differences in DNA sequences of 34 genes related to inflammation, insulin resistance and oxidative stress to discover how differences predict the risk of aggressive prostate cancer and recurrence in the groups of men.

The project and grant, Dr. Podgorski said, resulted from collaboration with Isaac Powell, M.D., a professor of Urology at the Wayne State University School of Medicine and Karmanos Cancer Institute, on his study, “The Influence of Metabolic Syndrome on Prostate Cancer Progression and Risk of Recurrence in African-American and European-American Men,” which was funded last year.

Robert Lisak, M.D., chair of the Department of Neurology at the Wayne State University School of Medicine, is the senior editor of the newly published textbook, “International Neurology: A Clinical Approach.”

Published by Wiley-Blackwell, the book’s authors include Richard Lewis, M.D., professor and associate chair of the WSU Department of Neurology, and co-director of the Neuromuscular Program and director of the Hiller Amyotrophic Lateral Sclerosis Center; Alex Tselis, M.D., Ph.D., associate professor of the WSU Department of Neurology; and Kumar Rajamani, M.D., D.M., assistant professor of the WSU Department of Neurology.

Additional authors include Gregory P. Van Stavern, M.D., director of Neuro-Ophthalmology at Washington University in St. Louis. Mo., and formerly of the WSU Departments of Neurology and Ophthalmology; and Peter Lewitt of Henry Ford Health System and professor of the WSU Department of Neurology.

Daniel Truong, M.D., a former member of the WSU neurology faculty and now head of the Parkinson’s and Movement Disorders Institute, Orange Coast Memorial Medical Center, Fountain Valley, Calif., served as a co-editor of the textbook.

“The book differs from the usual textbooks of neurology in that it emphasizes how some diseases present differently in different populations, and therefore the authors are drawn from multiple countries and every continent,” Dr. Lisak said. “In the current practice of medicine neurologists in developing countries may be seeing patients from more advanced countries, and just as importantly, those of us in the U.S., Europe, Canada, etc. are seeing patients from developing countries or countries that while developed have very different ethnic/genetic populations, and their disease may present somewhat differently than in the developed Western countries.”

Two Wayne State University School of Medicine professors are the key co-inventors of a new breast cancer screening technology that the Barbara Ann Karmanos Cancer Institute will build and market through a new company.

Peter Littrup, M.D., professor of the Department of Radiology and the Karmanos Cancer Institute, and Neb Duric, Ph.D., professor of the Department of Radiation Oncology and the Karmanos Cancer Institute, developed the new technology, called Computerized Ultrasound Risk Evaluation. The technology will be marketed under the name SoftVue through a spinoff company called Delphinus Medical Technologies LCC.

Karmanos officials announced the launch of the new company Nov. 16.

“I’m proud to work with a dedicated team of physicians, scientific researchers and other medical experts who are committed to having a world free of cancer,” said Ann G. Schwartz, Ph.D., M.P.H., interim president and chief executive officer of Karmanos Cancer Institute. “Neb Duric and Peter J. Littrup, as well as their entire research team, never lost sight of the significance of achieving their goal. They continue to work tirelessly so this incredible imaging technology can go beyond the trial stage to benefit more people and help save lives.”

Dr. Littrup designed the ultrasound clinical studies and Dr. Duric is the project director of ultrasound tomography technology.

The SoftVue system is a tomographic ultrasound imaging and risk assessment device that examines women’s breasts for the presence of benign and malignant masses. The process does not involve radiation or compression. Instead, the breast is submerged in warm water and an ultrasound ring surrounds the breast and captures detailed three-dimensional images through the use of sound waves.

The system is also able to perform repeated imaging, a necessary tool for monitoring and treatment assessment. Through its three-dimensional capabilities, SoftVue can accurately measure breast density, a known risk factor for developing breast cancer. The system provides enhanced fusion imaging incorporating reflection, sound speed and sound attenuation information. The detailed images generated allow radiologists to make accurate breast cancer diagnoses. The results are similar to those provided by magnetic resonance imaging, but testing with the SoftVue system takes only minutes and costs much less.

What differentiates the SoftVue system from mammography, the current standard for breast cancer screening, is that this unique technology helps to accurately detect many early stages of breast cancer even in women with dense breast tissue, often not picked up by mammography.

"From a physics perspective, mammograms have the disadvantage of using X-rays, a form of radiation that can potentially damage tissue," Dr. Duric explained. "This is a major reason mammography usage is limited in the general population. It is also the main reason mammography cannot produce 3-D images. The radiation dosage would be too high to image the breast from many different angles. This is why mammography compresses the breast in order to make the breast as two-dimensional as possible, creating the discomfort that comes along with the exam. Our technique does not use X-rays but rather sound waves, which are completely safe at the levels of sound energy that we use. The technology is therefore unconstrained in the way mammography is and that is why we can do 3-D imaging and why we do not have to compress the breast. The exam is therefore both safe and comfortable."

More than 300 women were involved in the initial clinical studies that confirmed that SoftVue accurately and safely identifies breast cancer. SoftVue uses multi-parametric ultrasound and sophisticated computer algorithms rather than X-rays. The SoftVue exam takes about one minute, does not involve radiation or compression as the current mammography, and is a fraction of the cost of magnetic resonance imaging. It’s believed that it will help reduce the number of false positives that can occur with mammography and thereby reduce unnecessary biopsies.

“The work conducted by Dr. Littrup and Dr. Duric in developing this new technology is representative of the type of pioneering research that breaks new ground at the Wayne State University School of Medicine,” said Valerie Parisi, M.D., M.P.H., M.B.A., interim dean of the School of Medicine. “Our faculty members truly do change the face of medicine regularly. Millions of women around the world will benefit from the research of these doctors.”

Research carried out with the SoftVue product has been conducted under an investigational device exemption. The process to secure approval from the U.S. Food and Drug Administration is under way.

Delphinus -- Latin for dolphin -- symbolizes the use of underwater sound signals representative of SoftVue. The company’s leadership team includes Chief Executive Officer William C. Greenway, Chief Medical Officer Dr. Littrup and Chief Technical Officer Dr. Duric. The company has already secured sale commitments for the SoftVue system from several health institutions nationally and internationally.

Karmanos and Delphinus officials said the new company will create new jobs. Approximately 50 to 100 highly technical engineering system and software positions will be needed within the next three to five years, company officials said. Final assembly, testing and quality assurance of the product will be performed at the company’s facility, which will be located in southeast Michigan.

Delphinus plans to use dealer sales organizations in the United States, as well as imaging original equipment manufacturers outside the U.S., for product distribution. The company will follow up with the introduction of the product for screening women who are at high risk of breast cancer and eventually serve the entire spectrum of breast imaging needs.

Delphinus seeks to raise $5.5 million in venture capital to finance the company’s projected activities for the next 24 to 30 months. For more information on Delphinus visit www.delphinusmt.com or call (313) 576-8252.