James Park, M.D.
Dr. James Park is a surgeon-scientist with extensive training and experience treating complex hepato-pancreato-biliary cancers. He is a core member of the University of Washington Liver Tumor Clinic, the largest and longest-running multidisciplinary clinic of its kind in the Pacific Northwest. As such, he sees many patients weekly who have had inadequate scans to define their liver tumor or its extent, requiring unnecessary repeat imaging or biopsy. This experience has triggered a deep personal desire to improve the sensitivity and accuracy of diagnostic imaging for patients with liver cancer.
Satoshi Minoshima, M.D., Ph.D.
Dr. Satoshi Minoshima, the Wil B. Nelp Endowed Professor in Nuclear Medicine, is the vice chair of research at UW Medical Center’s radiology group and director of the Neuroimaging and Biotechnology Laboratory. His expertise is in functional brain imaging, Alzheimer’s disease and other dementias, as well as neuroimaging technology. He runs a heavily funded laboratory effort investigating brain disorders and aging using innovative PET and MR imaging technology and biotechnology. The laboratory, initiated in collaboration with the Department of Radiology, the Department of Bioengineering and the Washington National Primate Center, includes a dedicated primate PET scanner, near-infrared ICG optical instrument, a basic cell processing/chemistry facility and small-animal surgical capability.
Liver cancer is the second most lethal malignancy worldwide, and its incidence is only rising due to the obesity epidemic. Current imaging cannot diagnose liver cancer until it has reached the size of a nickel and consists of over a billion cancer cells. This results in missed treatment opportunities and poor patient outcomes.
The Illuminator, an advanced imaging technology that you can help develop through this crowdfunding project, will increase diagnostic accuracy and speed, potentially saving millions of lives around the world.
Liver cancer diagnosis: what we’re missing
In the U.S., the recent epidemic rise in liver cancer is attributed to non-alcoholic fatty liver disease (NAFLD), a condition that develops because of obesity and diabetes. Two-thirds of Americans are either overweight or obese, and with obesity rates skyrocketing across the world, liver cancer is a true global health crisis.
Early and accurate diagnosis of liver cancer is challenging. The standard computed tomography (CT) scan or magnetic resonance imaging (MRI) cannot diagnose liver tumors smaller than a nickel — and by the time a liver tumor is that size, it already contains more than a billion cancer cells.
Consequently, up to half of liver cancers are missed in the early stage, and inaccurate scans harm the patient. Repeat imaging is costly, time-consuming, and exposes the patient to additional CT radiation, while invasive biopsies carry risks such as hemorrhage or tumor seeding. Delays in diagnosis result in missed treatment opportunities, which worsen the patient’s prognosis.
Liver resection and transplantation are the two potentially curative therapies for liver cancer, and planning for both are based on CT and MRI findings. Small cancers missed by these scans prior to treatment result in early cancer recurrences and suboptimal transplant organ allocation — both poor outcomes for the patient.
Creating better imaging for liver cancer
As a surgical oncologist who specializes in treating liver cancer, I knew there had to be a better way. Dr. Minoshima and I set out to create an imaging tool that could detect liver cancers earlier and before they spread. We developed a novel imaging contrast agent using an antibody that can seek out and precisely pinpoint miniscule liver cancers and illuminate them on positron emission tomography (PET) scan with a special radioisotope. We’ve named this breakthrough technology the “Illuminator.”
Our lab’s Illuminator is able to detect liver cancers several times smaller than what is possible by CT or MRI. The first-ever PET study of liver cancer in mice using the Illuminator was recently published in the Journal of Nuclear Medicine. We are now ready to perform the first human clinical PET scan using this contrast agent. We believe that the Illuminator could be a revolutionary diagnostic tool for liver cancer, as the antigen the Illuminator recognizes is found in up to 80 percent of liver cancers.
With your support, our lab can take the first step towards bringing the Illuminator to the American public. We need $10,000 for filing an investigator-initiated Radioactive Drug Research Committee application with the FDA and begin development of a clinical-grade Illuminator that meets good manufacturing practice standards.
Please join us in bringing the Illuminator to our patients. Liver cancer is the world’s second most deadly form of cancer, a statistic that unfortunately will only worsen due to increasing obesity rates. It is essential that we develop this diagnostic tool as quickly as possible so that liver cancer can be detected in its earliest stage. The Illuminator will significantly expedite accurate diagnosis and staging, resulting in more treatment options and the potential of saving millions of lives.
Why is this important?
The Illuminator allows for a more confident diagnosis and accurate staging of liver cancer, which, in turn, decreases the number of costly repeat scans and potentially harmful biopsies. The Illuminator also will allow for more accurate selection of patients for procedures such as liver resection or transplantation. This will improve patient outcomes and reduce the suffering caused by this devastating disease, reduce the cost of healthcare delivery and lessen the financial burden to the society at large.
PET imaging using the Illuminator provides several significant improvements over the existing “gold standard” of CT and MR scans for liver cancer patients.
First, the Illuminator specifically targets the imaged liver cancer. CT/MR does not.
Second, the Illuminator is exquisitely sensitive, permitting detection of tiny liver cancers in a mouse. This is major improvement in the spatial resolution compared to CT/MR.
Third, the Illuminator PET is a whole-body scan that can also diagnose disease outside of the liver.
Fourth, iodine or gadolinium contrast agents can induce kidney damage and/or nephrogenic systemic fibrosis. For this reason, patients with poor kidney function can’t receive CT/MRI. The Illuminator PET will not harm the kidney.
Who will benefit?
All liver cancer patients — potentially millions of people — stand to benefit from this novel imaging technology.
Antibodies are the fastest growing category of cancer therapy, with more than 200 antibodies in development by biotech and pharmaceutical companies. Antibodies are expensive, however, costing up to $100,000 annually. Since there’s no way to determine ahead of time which patients are most likely to benefit from antibody therapy, many patients undergo several months of expensive trials to see if it will work.
By creating a PET scan to show whether the tumor possesses the target for the antibody would be invaluable in selecting the patients most likely to benefit from antibody therapy, saving patients money, time, and — potentially — their lives.