Prof. Brian W. Pogue

Professor of Engineering Science, Director of MS and PhD Programs
Thayer School of Engineering, Department of Physics and Astronomy, Dartmouth College
Department of Surgery, Geisel School of Medicine at Dartmouth

Molecular guidance of intervention could provide more specificity and higher likelihood of success in therapeutic outcome.  In this talk, methods and unique imaging systems being developed to advance molecular guidance towards metabolic and immunologic targeting are discussed.  The imaging is compared to the contrast possible with conventional structural x-ray and MRI based approaches.

One of the largest areas of R&D is for molecular probes that target cancer cell immune expression, however these often suffer of non-specific uptake issues from tumor enhanced permeability & retention. The use of ratiometric approaches to imaging receptor binding are demonstrated in lymph nodes and resected breast cancer tissue.  Structured light imaging can also help advance surgical guidance by providing a signal which is more specific to the sub-cellular organelle and stromal changes present in cancer.

In radiation oncology, radiation dose imaging has been shown to be possible from gamma-ray and electron interactions emitting Cherenkov light, and this is a unique way to verify dosimetry in radiation therapy.  The major potential benefit of Cerenkov imaging is that it is a way to image beams in real time.  As such, it is feasible to image treatment beams in water tanks dynamically, and create composite visualizations of the treatment plans.  This imaging can be used to verify new treatment plans prior to application to patients, or to quickly verify new machines, or testing in situations where access is limited. In human imaging studies, two clinical trials have been completed to image surface emissions in real time during therapy.  In the first case, whole breast irradiation was followed for fractionated therapy in 12 patients.

Finally, molecular imaging using the radiotherapy-induced Cerenkov as an internal tissue excitation system is shown, allowing high–resolution sensing of metabolites.  This is demonstrated in tissue phantoms as well as mouse studies, sensing molecular oxygen in lymph nodes in vivo. The extension of this to molecular guidance of radiation therapy seems feasible, or for using Cerenkov sensing as a diagnostic tool for cancer.

Brian Pogue is Professor of Engineering, Physics and Surgery at Dartmouth College in Hanover NH USA. He has a PhD from McMaster University, in Hamilton ON Canada, and did post doctoral research at the Harvard Medical School in the Wellman Center for Photomedicine. At Dartmouth for the past 20 years, he works on creation and testing of new imaging systems for surgery and radiation therapy guidance. He has published over 300 peer-reviewed and 400 conference papers, on work funded by NCI, NIBIB and DoD. He is on editorial boards for Physics in Medicine & Biology, Medical Physics, Journal of Biomedical Optics, and Breast Cancer Research and is an elected Fellow of the Optical Society of America (OSA) and the American Institute for Medical and Biological Engineers (AIMBE).