21^st World Congress on Radiology & Cancer Research Aug 27-28, 2018 Toronto, Ontario, Canada

Radiology therapy is the use of high energetic radiation to kill cancer cells DNA also their ability of grow. Linear accelerator (a machine that accelerates electrons to produce x-rays or gamma rays) also known as LINAC is used for radiology. Radiation therapy also damages the normal cells leading to side effects. Scientists studying radio sensitizers & radioprotectors, chemicals that modify the cancer cells response towards the radiation.

Radiology is a branch of treatment that uses imaging technology to diagnose and treat disease. This technique is used to detect and monitor diseases or injuries via the generation of images representing internal anatomic structures and organs of the patient's body so that patient’s treatment and therapy can be specifically planned and implemented. Most common types of diagnostic radiology tests are

An imaging test is just a way to check what is going inside the body. Imaging test is done for early detection of cancer.This may be called Cancer Screening Test. Imaging is done to check whether tumor (rapid growth of abnormal tissues) is happened due to cancer or other diseases. Few Imaging Tests are given

Computed tomography (CT) scan: It is a diagnostic imaging test used to create detailed images of internal bones, soft tissues, blood vessels, organs. CT Scan is often the best method for detecting many different types of cancers and confirm its presence of a tumor & determine its size & location.

Magnetic resonance imaging (MRI) scan: MRI is a type of Scanning technique where strong magnetic fields and radio waves are used to produce detailed images of the inside of the body. It can be used to examine almost any part of the body.

Ultrasound: Ultrasound is a type of Scanning technique where sound waves are used to produce images inside of the body. It is also used for biopsies, heart diseases, examine a baby in pregnant women. It is safe, does not use ionizing radiation.

X-rays and other radiographic tests: X ray tests helps doctors to detect cancer in different parts of body including stomach, kidneys as well as bones. It is rapid, painless.

Clinical trials are the research studies that explore whether a medical treatment or device is safe and effective for humans or not.These studies also show which medical approaches work best for certain illnesses or groups of people.The purpose of clinical trials is research of new drugs/drug molecules or devices, so the studies should follow strict scientific standards. These standards protect patients and help produce reliable study results.

Researchers have designed the cancer clinical trials in such a new way to test thoroughly.For that Nowadays, people are living longer lives from successful cancer treatments that are the results of past clinical trials result.

Before announcing new drugs, there are series of steps are present in clinical trials called Phases. During Phase 1 & 2 researchers study the drug’s safety. In the last Phase (Phase 3) researchers study whether the drugs are more effective than the standard one or not.

Most cases of cancer are detected and diagnosed after a tumor can be felt or when other symptoms develop. In a few cases, cancer is diagnosed incidentally as a result of evaluating or treating other medical conditions. People having cancer mostly have a combination of treatments such as Chemotherapy, Radiation therapy or nuclear medicine. The treatment of cancer has undergone evolutionary changes as understanding of the underlying biological processes has increased.

Oncology is a subspecialty of medicine that specializes in the diagnosis and treatment of cancer or suspected cancer. It also deals with the diagnosis and treatment of tumor cells. Cancer begins when cell division starts to grow out of control. The field of oncology has three major areas: medical, surgical, and radiation.

(a) Robot-assisted surgery offers cancer patients various unique advantages. The robot helps replicate the surgeon’s hand movements while removing the tumors.It consists of several advantages like less damage to healthy tissue, less pain during surgery, minimal blood loss on surgery, faster recovery, reduced risk of infection, better cancer control. The machine is designed to console viewing a 3-D image of the operative site. As the surgeon moves his hands, wrists, and fingers, the instruments are performing the same movements inside the patient’s body.

(b) Surgery is the oldest way to treat cancer. Before the surgery, the surgeon determines whether the cancer is respectable or not.In surgical oncology, the cancer cells are removed by the surgical way. The type of surgeries actually depends on the stage & location of the tumor.

Screening can help doctors find & treat cancer at early stages. At the early stages, cancer cells are easier to treat but by the time, cancer cells began to spread and harder to treat. Some cancer screening tests are Colonoscopy, sigmoidoscopy, and high-sensitivity fecal occult blood tests (FOBTs), Low-dose helical computed tomography, Mammography, Pap test and human papillomavirus (HPV) testing. Others Screening tests are Alpha-fetoprotein blood test, Breast MRI, CA-125 test, PSA test, Virtual colonoscopy.

Cancer is a kind of disease in which cells divided abnormally, without any control. It can spreads all over the body also in the lymph as well as blood systems. It is estimated that more than 72% worldwide populations are having Cancer. Nowadays 30-50% cancers can be prevented. On avoiding some unhealthy factors Like Tobacco, Alcohol, carcinogenic products, overweight, obesity, ionizing radiation, infectious infection actually can prevent cancer. Sufficient healthy diet & Proper exercise is also needed.

Researchers have brought one new concept like Chemoprevention, medicines which use to treat precancerous conditions or to keep cancer from ever developing.

Chemotherapy or chemo drugs are used to treat cancer, either alone or recombining with another medicine. Also called as ‘cytotoxic drugs.Chemotherapy drugs actually targeted the newly forming cells at different phases. Different chemo drugs are there like Alkylating agents, antimetabolites agents, antitumor antibiotics, Topoisomerase inhibitors, mitotic inhibitors, corticosteroids help to destroy, shrink or control the abnormal cells.

Antibody agents are also used for cancer. Proteins, that target specific molecules on the surface of cancer cells. An antibody which is going to used are specifically engineered to target certain types of cancer cells.

Pharmacology, the study of drugs. It consists of two main areas: pharmacokinetics(how body reacts to drug) & pharmacodynamics (what drug does to body). Pharmacology Consists of molecular carcinogenesis, biochemical pharmacology, radiation biology, and clinical pharmacology. Cancer Pharmacology helps to understand the biology of cancer drug targets, the mode of action, and mechanisms of response and resistance to anticancer agents, also develop novel concepts and strategies for more effective cancer treatment.

Resistance towards the cancer drugs is a  challenge is a big issue today. Researchers are making progress on that.no cancer treatment is 100% effective against cancers. But the resistance of cancer drugs results from a variety of factors like somatic cell differences in tumors. most common reason for resistance of anticancer drugs is an expression of one or more energy-dependent transporters that detect and eject anticancer drugs from cells, but other mechanisms of resistance including insensitivity to drug-induced apoptosis and induction of drug-detoxifying mechanisms probably play an important role in acquired anticancer drug resistance.

Vaccines or vaccinations are medicines that help the immune system to recognize and destroy the cancer cells. Most of the cancer vaccine work in a same way to treat the cancer. Cancer treatment vaccines are different from vaccines that work against the viruses. Different types of cancer vaccines are Antigen vaccine, Whole-cell vaccine, dendritic cell vaccines, DNA Vaccines, anti-idiotype vaccine.There are other types of cancer vaccines that are under clinical trials not yet approved in the US to treat cancer.

Nuclear Medicine is a branch of medical Imaging techniques that use radiation (radioisotopes) to treat some medical conditions especially cancer. Initially, it was used for thyroid diseases diagnosing. The special camera and imaging techniques used in nuclear medicine include the gamma camera and single-photon emission-computed tomography (SPECT). Nuclear medicine has benefits as well as risk factors. Patients having Non-Hodgkin’s lymphoma patients who do not respond to chemotherapy may undergo radioimmunotherapy (RIT).In future, it may be possible to embed chemotherapy into medication imaging agents that will attach only to cancer cells, In this way, the chemotherapy would kill only the target cells and not the nearby healthy tissue. This would reduce some of the adverse effects of chemotherapy.

Paediatric Cancer is rare but unfortunately nowadays many child deaths main cause is cancer. Cancers that are exclusive to children are Neuroblastoma, Wilms tumor, Rhabdomyosarcoma, retinoblastoma. Currently, it is estimated that there are 350,000 adult survivors of childhood cancer in the United States. Children who survive cancer have more years than adults to develop long-term consequences of chemotherapy and radiation therapy, which include Infertility, Poor growth, Cardiac damage, Development of second cancers.

Treatment for Children’s cancers is not always like adult cancers. Paediatric  Oncology is a subspecialty which only focused on the child cancer patients. Treatment for child cancer depends on the type of cancer and common types of treatment are surgery, chemotherapy, immunotherapy, radiation therapy, stem cell transplant.

The field of Radiology imaging has rapidly enhanced with few many features: 

(a) The use of lead aprons certain drugs, improved patient positioning can reduce the radiation exposure during scanning.

(b) Ultrasound, this latest remote viewing systems not only monitor pregnancy but also used for echocardiograms, bone sonometry, and abdominal imaging. This latest systems can detect breast cancer as well as prostate cancer, liver, kidney, pancreatic & bladder.

(c) PET Scans, combined with CT to detect cancer much earlier with a broad clearer image which provides more information regarding patient rather than traditional scan.

(d) In the latest CT Angiography, the process is much faster, safer & less expensive. In new CT angiogram, the process take 10-25 minutes without all the risk. It can be used for arteries in the lungs, kidneys, arms and legs.

(e) Digital  Mammography has proven most effective in case of breast cancer diagnosis. A study has proven that digital mammogram are more accurate in detecting breast cancer in women aging under 50, premenopausal women.

Breast Cancer is the leading cause of death in women in the United States. Early detection of breast cancer through mammographic screening has decreases 30% breast cancer mortality since 1989.Mammography is considered the ‘gold standard’ in the evaluation of the breast lesions from an imaging perspective. Improvements over the last decade in the quality of performance and the reporting of mammography studies are the most important advances in breast imaging.

Breast ultrasound uses sound waves to create images of the breast. It is often used as a follow-up test after an abnormal finding on a mammogram or clinical breast exam. Breast ultrasound can tell the difference between a liquid-filled cyst and a solid mass (which may or may not be cancer).

Breast MRI uses magnetic fields to create an image of the breast, sometimes it can find cancers in dense breasts that are not seen on mammograms. It is more invasive than a mammogram.

This technique allows direct imaging of the living tissues by exposure to X rays. The absorption of x-rays by the patient’s body is measured by detectors and calculated in a slice-wise manner resulting in black-and-white images of the different x-ray densities of the tissues. A computed tomogram usually consists of a number of slices but 3D images can be calculated as well. In contrast to the conventional x-ray, bones and soft tissue organs can be presented without any superposition. The usually small differences in radiodensity between different tissues can be enhanced by injection of contrast medium.

Elastography is a new field of medical imaging where it maps the elastic properties and stiffness of tissue, to determine the presence or status of cancer. Sometimes Cancerous tumors will be harder than the surrounding tissues. Ultrasound or MRI technique is used for detecting the Stiffness.

Now a days global cancer drugs is primarily driven by increasing of cancers among peoples. Annual global growth in the cancer drug market is expected to be 7.5% – 10.5 % through 2020, reaching $150 billion. Immunotherapy dominates the global market for cancer drugs due to its high efficacy and fewer side effects. Moreover, the disposable income and reimbursement of life-threatening diseases are very high in this region which promotes the growth of cancer drugs market.

North America represents developed regional markets for cancer drugs and is expected to see the rapid growth in the years to come. The U.S. is by far the leading cancer drugs market by country in North America. Moreover, the disposable income and reimbursement of life-threatening diseases are very high in this region which promotes the growth of cancer drugs market.

Europe was the second largest regional market and is expected to show significant growth in the years to come. This growth is mainly due to an increase of patients diagnosed with cancer.

Asia-Pacific is expected to witness noticeable growth in the near future. In Asia, China, India, and Japan will continue to be the fastest growing markets in cancer drugs market. Growth in Asia-Pacific market is expected to be driven by increasing tobacco consumption, growing population, and increasing disposable income.

Diagnostic imaging software includes:

•Integrated RIS/PACS and Clinical Data Archive that combine images and patient information for processing, diagnosis, sharing and storage.

•Advanced clinical applications that build on our PACS solution including Orthopaedic Digital Imaging, Virtual Colonoscopy, Cardiology PACS and Advanced Visualization Tools.

•Computed Assisted Diagnosis (CAD) tools that enhance diagnostic confidence, boost productivity and improve the chances for early detection across clinical specialties with a computerized second read.

•CARESTREAM Professional Services designed to help you get higher performance from your medical imaging software and staff who use it. Our offerings include CARESTREAM Integration Services, Network Services, Project Management Services, Software Refresh Program and DICOM Interoperability Services.

Radiopharmaceuticals or medical radio compounds are groups of pharmaceutical drugs which have radioactivity, intended for diagnosis, therapeutically purposes. Radioisotopes emitting penetrating gamma rays are used for imaging where the radiation has to escape the body before being detected by a specific device (PET cameras/SPECT).Common isotopes for imaging are 99mTc,I 131,TI201,ln 111 etc.

A case report is a detailed report of the symptoms, signs, diagnosis, treatment, and follow-up of an individual patient. Case reports may contain a demographic profile of the patient, but usually describe an unusual or novel occurrence.

Neuro interventional Radiology (also known as Neuro interventional Surgery or Endovascular Neurosurgery) is a medical specialty that uses minimally invasive procedures to diagnose and treat diseases of the brain, head, neck, and spine. Neuro interventional procedures use state-of-the-art devices and image-guided techniques to deliver treatments through a small puncture in the skin of the groin or the arm.

Ultrasound uses sound waves to create images. This section includes breast ultrasound, echocardiography (echo), transthoracic echo (TTE), transesophageal echo (TEE), echo contrast, transducers, ultrasound software and point of care (POC) ultrasound

PET-CT combines positron emission tomography (PET) detectors and computed tomography (CT) into one imaging system.
The  main Application of PET/MRI Scanners: Many PET/MRI scanners are used for research purposes. For example, Stanford University is using GE Healthcare’s system for research only, with efforts put into identifying diseases and patients who are ideal candidates for PET/MRI.

A biological molecule found in blood, other body fluids, or tissues that is a sign of a normal or abnormal process, or of a condition or disease. A biomarker may be used to see how well the body responds to a treatment for a disease or condition.Cancer biomarkers can be DNA, mRNA, proteins, metabolites, or processes such as apoptosis, angiogenesis or proliferation. The markers are produced either by the tumor itself or by other tissues, in response to the presence of cancer or other associated conditions, such as inflammation. Such biomarkers can be found in a variety of fluids, tissues and cell lines.
A number of different types and forms of cancer biomarkers (tumor markers) exist

The term phenotype can be used in clinical medicine for speaking about the presentation of a disease.The 
study and practice of medicine based on direct observation of patients. Clinical medicine is a field of medicine that deals primarily with the practice and study of medicine based on the direct examination of the patient. In clinical medicine, medical practitioners assess patients in order to diagnose, treat, and prevent disease.

Radiation detector

Radiation Detector or particle detector is a device that measures this ionization of beta radiation, gamma radiations and alpha radiation with matter which creates electrons and positively charged ions. Or Radiation Detector is an instrument used to detect or identify high-energy particles, such as those produced by nuclear decay, cosmic radiation, or reactions in a particle accelerator.

Musculoskeletal imaging is a subspecialty of diagnostic radiology which involves ordering and interpreting medical images of bones, joints and associated soft tissues and diagnosing injuries and disease.

Musculoskeletal imaging radiologists use:

● X-rays/plain radiography;

● Fluoroscopy (a continuous X-ray that creates moving images of the functioning of joints and soft tissue);

● CT (computed tomography) scans;

● Ultrasound which is used to image the anatomy and function of soft tissue around bones and joints;

● MRI (magnetic resonance imaging) scans;

● Imaging-guided pain management.

There are two main reasons that bones receive radiotherapy: 1) an intentional delivery to bones to treat painful metastatic bone lesions or 2) their unavoidable inclusion into a radiation field which intends to treat an adjacent soft tissue neoplasm. In either case, the effects on the bone are varied and depend upon:

1. Dosage.
2. Quality of the x-ray beam.
3. Age of the patient.
4. Method of fractionation (fractionating treatment enables the physician to give the patient the necessary treatment dose while separating its delivery by a time interval in order to reduce toxic side effects to normal tissue).
5. Length of time of therapy.
6. Specific bone or bones involved.
7. Existence of trauma or infection at the site.

Virtual colonoscopy is a medical imaging procedure which uses x-rays and computers to produce two- and three-dimensional images of the colon (large intestine) from the lowest part, the rectum, all the way to the lower end of the small intestine and display them on a screen.

[1] The procedure is used to diagnose colon and bowel disease, including polyps, diverticulosis and cancer. VC is performed via computed tomography (CT), sometimes called a CAT scan, or with magnetic resonance imaging (MRI).

[2] A virtual colonoscopy can provide 3D reconstructed endoluminal views of the bowel.