Finding Innovative Ways to Use Radioactive Isotopes to Solve Common Problems

Dr. Michael Campbell, PhD

Vision for research

The goal of my research program is to find new and innovative ways to use radioactive isotopes to solve common problems.  My research lab applies chemistry techniques used for the synthesis of drugs, polymers or other common materials to find ways of working with these radioactive materials to answer specific questions.

Some of the questions we are looking at include:

  • Is there a better way to attach this radioactive atom to a radiopharmaceutical?
  • What precious metals are in this ore sample?
  • Are there better ways to produce and distribute medical isotopes?

First, a bit about what radioisotopes are.  Most of us will remember seeing the little cartoons of an atom where you have the electrons around the outside and the nucleus in the middle. If we zoom in to the nucleus you will find positively charged particles called protons.  The number of protons is what determines if the atom is hydrogen, carbon or some other element.  We will also see particle that don’t have any charge called neutron.  In most atoms if the number of protons and neutrons are balanced within a certain range the atom is stable and most likely has been around for billions of years and most likely will be around for another billion or so.  Where it gets interesting is when the number of neutrons gets out of balance, this makes the nucleus unstable and is radioactive.  To get to a stable state the atom releases some energy, this energy is what we detect when we use radioisotopes to diagnose or treat diseases.

Where do the radioisotopes come from? 

There are many sources of radioisotopes.  Many radioisotopes are naturally occurring, if you pick up a piece of granite chances are there are at least some radioactive atoms present.  Radioisotopes can also be created. In Thunder Bay, we are fortunate to have a cyclotron that can give us access to a variety of isotopes and facilities for working with these materials.

How do you use radioisotopes help detect diseases and what are the challenges?

The main isotope that the cyclotron produces for the detection of cancer is a radioactive version of fluoride called F-18.  If only F-18 was given to a patient it wouldn’t have any way of guiding it to the tumour, it needs to be attached to a drug that is able to seek out the tumour.  This is where we come in.  Chemists have developed many processes for connecting atoms to molecules but with Radiolabeling compounds one of the big (or very small in this case) problems is one of scale.  A very small amount of radioactive material goes a long way.  If we use the example of F-18 from our cyclotron as an example, the amount of F-18 that is in an actual dose is less than 1 nano gram.  To put that in perspective if you take a single grain of salt, that is 10,000 times larger than the amount of F-18 in a single dose used to detect cancer.

When working on this scale it is impossible to weigh out materials at that small a scale and as a result, the amount of other reagents the F-18 has to react with are in huge excess.  What this means is that after the reaction is done, there is a lot of other stuff that needs to be removed in order to get a pure product.  This is where the next problem comes up, the material is radioactive after all so that means that the normal methods of handling and purifying compounds become more difficult and can’t be handled directly.  The final challenge is time, as F-18 only has a half life of 110 minutes.  That means approximately every 2 hours you have half as much material remaining so we need to work fast.

The work we are doing hopes to address these problems. We are taking the molecules that the F-18 reacts with and attaching them to a tether and then attaching the other end of the tether to a small plastic bead.  We have set up the attachment of the molecule to the tether in such a way that when it reacts with F-18 the tether is cut and the radioactive molecule is now in solution.  What this lets us do is to remove any excess molecules by sampling filtering off the plastic beads.  This may not work for every molecule but it will hopefully allow us to prepare and purify molecules that we otherwise difficult to make.

Funding

The research in my lab would not be possible with out the generous support of the following group:

Thunder Bay Regional Health Research Institute

The National Science and Engineering Research Council

Acsion Industries in Pinawa, Manitoba

GoldCorp Musselwhite

Lakehead University

Health Research Institute Board Member Profile: Kathleen Lynch

Kathleen Lynch

My research vision is to encourage and support research to meet the unique needs of the people of Northwestern Ontario and to improve the health outcomes of our population. In alignment with the Health Research Institute’s vision of “bringing discovery to life,” I am interested in exploring opportunities to enhance patient care, while inspiring students through the integration of research and applied learning opportunities. By engaging learners in research and health care technology advances in the educational environment, we can instill a spirit of innovation in the future leaders of health care in our region and beyond.

It is my privilege to represent Confederation College on the Health Research Institute’s Board of Directors. We are grateful to have a permanent seat on the Board, supporting Confederation College’s valued and longstanding partnership with the Health Research Institute. Colleges have much to offer in applying the latest research through an applied, experiential learning environment. Confederation College is able to take advantage of our partnership with the Health Research Institute to apply the latest research developments to our curriculum and support the work of the Institute through our regional campuses as well.

The most important thing people should know about the Health Research Institute is how critical its work is in helping to support local research, which can help address the issues unique to northwestern Ontario.  Through the Health Research Institute’s efforts, our region is better able to anticipate the changing needs of patients and find solutions we can apply in the health care setting locally. The range of research projects in which we are engaged is considerable and we should be proud to have such a diverse group of scientists committed to working with the Institute.

I was appointed as the President of Confederation College in September of 2018 and have more than 30 years of progressive leadership experience in health care, human services and education. Prior to Confederation, I was the Vice President of Rehabilitative Care at St. Joseph’s Care Group (SJCG). There I witnessed first-hand the health care issues faced by people across this region and how advances in research are helping people on a practical level through prevention, treatment and care. I was born and raised in Thunder Bay. Prior to working at SJCG, I worked at Confederation College for 14 years, including serving as the Dean of the School of Health and Community Services. I hold an Honours Bachelor of Social Work degree from Lakehead University and a Master of Social Work degree from the University of Toronto, where I studied social policy and administration.

Preparing for a New Era in Health Care

Message from the Board Chair and CEO

Message from the CEO and Board Chair

Normally when we think of medical research advances, we think of scientists in white coats developing new treatments in test tubes. This is often still the case, but there is a new era in health care research on the horizon where test tubes are traded for something a little more digital.

Smart health isn’t a method of treatment as much as it’s a way to improve access to health care and patient flow, while supporting patients to receive the right care at the right time. The Digital Age has brought us instant communications, more advanced computer modelling and data management, and ultimately more ways for health care providers to connect with their patients.

The possibilities with smart health are almost limitless; smart health has the potential to affect every area of health care today – including, crucially, improving access to care for rural and remote communities and in particular our Indigenous peoples. This past January, we welcomed Dr. Zubair Fadlullah as the Thunder Bay Regional Health Research Institute’s newest scientist and the first Lakehead University-Health Research Institute Research Chair in Smart Health Technology. As you’ll read in this year’s Annual Report, he has a plan to implement smart health technology in three different ways: implementing sensors, improving connectivity, and using artificial intelligence (AI) for decision support. His work in distance and smart health in Japan will be a tremendous asset to our Health Research Institute and to health care in Northwestern Ontario.

We also welcomed Dr. Jinqiang Hou to our team of scientists this year. Dr. Hou’s research into Positron-emission tomography (PET) imaging using fluorine-18-labelled radio isotopes will further advance our radioisotope program, taking full advantage of the cyclotron technology. His research will lead to new ways of diagnosing and treating cancer as well as possibly other diseases. The Health Research Institute is lucky enough to be one of the few hospital-based research centres with access to an onsite cyclotron, making our research center so much more attractive.

These and other projects will enhance the Health Research Institute’s strengths and help our Hospital overcome barriers and challenges to care throughout our region including addressing our Indigenous population’s health disparities.

Twelve years ago, we made a commitment to provide patient-centred research to the region, finding solutions to our barriers to care. Smart health may be the newest direction, but it is not the only one. We continue to support the great progress of our scientists, advancing medical knowledge and bringing new ways of treating patients that are focused on the needs and challenges of Northwestern Ontario.

 

Jean Bartkowiak
CEO, Thunder Bay Regional Health Research Institute

Dr. Andrew Dean, PhD
Interim Chair, Thunder Bay Regional Health Research Institute Board of Directors

 

To read our full 2018/2019 Annual Report, please view it online at www.tbrhri.ca/2018-2019AnnualReport

Community Donations Go a Long Way to Supporting Regional Health Care

(L-R) Mike and Dawn Wrenshall.

Research is vital in Northwestern Ontario, helping us find solutions to our unique health care challenges. Despite our barriers to care, Thunder Bay Regional Health Sciences Centre programs consistently rank among the best in Ontario, and we are a Leading Practice in several areas including orthopaedics, Telemedicine, and Patient and Family Centred Care (PFCC). The Thunder Bay Regional Health Sciences Foundation continues to support health research thanks to the generosity of donors throughout the region.

Mike and Dawn Wrenshall are incredible examples of how local residents can make a big difference to research. Their contribution was a direct result of the care Mike received. He was diagnosed with bladder cancer in 2018 and referred to urologist Dr. Hazem Elmansy.

“When you find out you have cancer, your world shifts – majorly,” Mike said. “I had surgery in less than a week. It was such a relief to get it out of me… You feel violated that something like that would be in your body.”

Mike and Dawn credit Dr. Elmansy for helping Mike survive his cancer. “We’re extremely lucky to have him here in Thunder Bay,” Mike said. “I don’t actually think our community recognizes just how talented and caring he is.”

The story doesn’t end there. What you may not know is that research is of particular interest to Dr. Elmansy. Many clinicians choose to practice in Thunder Bay specifically because of the research opportunities available to them. It’s big enough to offer a wide range of possibilities, yet small enough that it’s easy to work with other clinicians and scientists at the Thunder Bay Regional Health Research Institute.

The couple decided to support Dr. Elmansy’s ongoing urological research, donating $10,000 to the Health Sciences Foundation. “I am proud to donate in honour of him,” Mike said. “I thought that if there was anything I could do to recognize his work and allow him to continue to offer incredible care, then I’d do it. It’s our way to show support for the work he’s doing now and the work we hope he will continue to do in the future.”

Many people in Northwestern Ontario like the Wrenshalls understand the importance of local research to find local solutions. Donations through the Foundation’s Health Discovery Fund help support scientists and clinician researchers meet those goals with funding that wouldn’t otherwise exist.

Designing Better Patient Care

(L-R) James McCormick, Lisa Ewen, Connor Little and Dr. Arnold Kim.

Standard patient records, whether they are paper or electronic, are large and often fragmented collections of information. But what if you could bring all that information into a design environment and create a “blueprint of care”? This would allow care providers to literally visualize the treatment plan and instantly see the big picture. That’s exactly what Dr. Arnold Kim, a Hospitalist at the Thunder Bay Regional Health Sciences Centre, set out to do 10 years ago.

When you go to see the doctor, he or she records your symptoms in your chart, analyzes what you’ve said, and then starts treatment planning. Your doctor may order tests, prescribe medications, and plan a follow-up visit. But these entries are disconnected bits of information that will need to be read again in the future, forcing the care provider to reconstruct the patient story or “narrative” from scratch every time.

“That’s a weak point in the medical system,” Dr. Kim said. “Narrative works well when you are giving simple directions, like to the store from your house. But when we rely upon narrative to describe very intricate relationships like those in health care, it breaks down. There are many more directions, perhaps several destinations, and even different steps happening at the same time.”

Now imagine that when doctors enter information into your electronic medical record (EMR), the system automatically suggests a blueprint of care. Instantly, any health care professional helping you can visualize your care plan, where you are, and what the next step is.

Aurora Constellations is that software. Dr. Kim calls it a patient care design tool – and there is nothing quite like it anywhere. The name comes from the fact that when we see constellations rather than a mass of disconnected stars, we are better able to navigate. Aurora Constellations represents the next generation of EMR technology, adding decision support for treatment planning, automating test ordering, direct prescription ordering, integration of the latest research, and more.

“It’s a powerful way to accurately implement evidence-based medicine, standardized care procedures, and hospital policies inside the patient’s blueprint of care,” Dr. Kim said.

Although patent pending, Aurora Constellations software is still in the development stage, he said. A number of collaborators came together including our Hospital, students from the Computer Science Department at Lakehead University including James McCormack and Lisa Ewen, and the Northern Ontario Medical School (NOSM). Clinical trials involving NOSM students are scheduled to begin at our Hospital in the fall of 2019.

“Students tend to be more tech savvy, so I believe that they will be more able to help undertake this huge shift towards design-based patient care.”

Health Research Institute Board Member Profile: James Peotto

James Peotto

Thunder Bay is unlike other cities in Ontario in that local health care providers are not only responsible for servicing the city and its immediate surroundings, but for servicing the entirety of Northwestern Ontario. For patients living in outlying communities, geographical remoteness can result in delayed diagnosis and restricted access to ongoing treatment of chronic diseases. I envision a health care system which is equally as accessible by patients living in both Thunder Bay’s surrounding areas and remote communities. Through continued innovation in health research, I believe the Thunder Bay Regional Health Research Institute can attract the scientists, scholars, clinicians, and funding support to effectively meet the health care needs of the entire Northwestern Ontario region.

As a lifelong resident of Thunder Bay, I am familiar with the unique demands of our local health care system and have a vested interest in improving the present and future health outcomes for the people of Northwestern Ontario. Becoming a member of the Health Research Institute Board of Directors will allow me an opportunity to further educate myself on the challenges faced by our health care professionals in achieving their goals and assist with improving the standard of clinical research in the region.

For those not familiar with the Health Research Institute, they may be surprised to learn that the Hospital, for which the Health Research Institute functions as a research arm, ranks among the leading health research institutions in the country. Research facilities of similar calibre are typically found in major metropolitan centres. This serves as a source of pride for the Thunder Bay community, and also provides patients of the Hospital with access to cutting-edge health care technology and treatment methods.

About James Peotto

James is the Senior Accountant, Reporting and Compliance for North American Palladium (NAP). He is responsible for the timely preparation of relevant and reliable financial reporting, as well as monitoring of internal controls and compliance with various regulatory bodies. Prior to his employment at NAP James worked as a Staff Accountant for BDO Canada’s Thunder Bay office, where he completed his Chartered Accountant (CPA, CA) designation. James graduated from Lakehead University in 2013 with an Honours Bachelor of Commerce (H.B. Com, Accounting) degree. He has also worked for the City of Thunder Bay Finance department and tutored accounting at Confederation College.

New Smart Health Research Chair Will Overcome Geographic and Other Barriers to Health Care in Northwestern Ontario

Dr. Zubair Fadlullah

“Smart health” is one of the most promising areas of health care advancement today. Smart health encompasses a wide range of technology that will help health care providers connect more easily with their patients, receive more information about their patients’ health faster, and ultimately improve patient care.

Dr. Zubair Fadlullah is the Thunder Bay Regional Health Research Institute’s newest scientist, joining in January 2019. He becomes the first Lakehead University-Health Research Institute Research Chair in Smart Health Technology. Dr. Fadlullah’s goal is to develop a smart health program that meets the needs of both institutions: a viable academic program focusing on smart health technology development at Lakehead, and clinical research initiatives at the Thunder Bay Regional Health Sciences Centre to help improve health care for patients across the region.

“Smart health is about health care access for patients, no matter where they live in Northwestern Ontario,” Dr. Fadlullah said. “Geographic barriers to care have always had a huge impact on health care here. Smart health can help us overcome these and other barriers to patient care.”

The lessons learned here could be applied to remote areas around the world that rely upon distance health programs. Dr. Fadlullah plans to focus on three specific areas: Sensors, Connectivity, and Analysis.

  • Sensors includes all data collection from remote monitoring of vital signs (for example, heart rhythms in a patient with cardiovascular disease) to simple questionnaires.
  • Connectivity is the ability to send that data from the patient to the health care provider – in this case, our Hospital – via existing and new infrastructure.
  • Analysis will involve some level of artificial intelligence (AI) to help quickly interpret the data and provide decision support for health care providers.

“Smart health has the potential to positively affect every area of health care at our Hospital,” Dr. Fadlullah said.

The first step is to decide what smart health technologies would be most effective in Northwestern Ontario. Over the next year, Dr. Fadlullah will conduct a patient needs assessment across the region, develop project plans to meet those needs, hire students and post-docs for research at Lakehead, and start building pathways to future clinical trials. “We need to find the areas we can start working on now, and create a plan for what we will do in the long term.”

Thunder Bay is a leader in the world in terms of working directly on smart health technology as a tool to overcome geographic barriers. It is a natural progression from our leadership in distance health research and program development.

Summer School of Medical Imaging gives future scientists an opportunity to sharpen their skills

Summer School of Medical Imaging Roster for 2019

The Summer School of Medical Imaging (SSMI), jointly hosted by the Thunder Bay Regional Health Research Institute and Lakehead University’s Faculty of Science and Environmental Studies, offers a unique research experience that showcases the graduate environment in Medical Imaging as a prospective career path for undergraduate students.

Within this program, Lakehead University and the Health Research Institute provide topical tutorials and a seminar series, and host an end-of-summer research project competition. The program runs from May to September.

“The Summer School of Medical Imaging is a great example of how the Health Research Institute partners with Lakehead University to train and retain our region’s youth,” said Dr. Alla Reznik, Canada Research Chair in Physics of Molecular Imaging, Senior Scientist at the Health Research Institute, and Summer School of Medical Imaging Co-Chair for 2019. “In the past, many students studying in Thunder Bay felt that they had to leave the city to pursue education and careers in science. Now, our youth are realizing they can have a top-quality education and career in the medical field — without leaving Northwestern Ontario.”

The roster for the 2019 edition of the SSMI includes 14 undergraduate students from Lakehead University, Ryerson University, and the University of Calgary. They’ll be working closely with scientists on research projects related to the medical imaging field, such as low-dose X-ray and Positron Emission Mammography imaging, novel tools in Magnetic Resonance Imaging and targeted cancer diagnostics.

The SSMI provides undergraduate students with a paid research position. Students work under the supervision of Lakehead University-Health Research Institute scientists to complete projects in their field of interest. These projects are related to the scientist’s research theme and often make real contributions to advancements in medical imaging technologies. Students who are successful in obtaining summer employment work in their supervisor’s lab and must attend the weekly Summer Student Seminar Series to gain exposure to a variety of research areas and topics in the field of Medical Imaging.

Social events such as barbeques, hiking and various sports activities are also organized as part of the summer schedule to encourage networking between students.

To learn more about the SSMI, visit http://bit.ly/SummerSchoolofMedicalImaging for more information.

Summer School of Medical Imaging: Class of 2019

Maxwell Yuan, Lakehead University
Craig Macsemchuk, Lakehead University
Tristen Thibault, Lakehead University
Anirudh Shahi, Lakehead University
Alejandro Ortigas, Lakehead University
Sarah Yeo, Lakehead University
Camryn Newman, Lakehead University
Malikah Haq, Lakehead University
Jonas Olsen, Lakehead University
Emily Hodgson, Lakehead University
Austin Hopkins, Lakehead University
Nicholas Randall, University of Calgary
Mihnea Constantin, Ryerson University
Yadunandan Sharma, Ryerson University

Save the Date for Research Day: October 4th, 2019

Dr. Patrick McGrath

After a successful debut in 2018, Research Day returns for another year.

The second annual Research Day will take place on Friday, October 4th at Thunder Bay Regional Health Sciences Centre (the Hospital) and will offer valuable information, skills-building and networking opportunities for anyone interested in health research. Research Day is proudly presented by the Thunder Bay Regional Health Research Institute, in collaboration with the Hospital.

The theme for this year’s event is ‘Moving Research to Patient Care: From Bench to Bedside’.

Highlights of this event will include a special keynote presentation from Dr. Patrick McGrath (‘Translating Research to Patient Care’), a panel discussion (‘Using seed funding to leverage research for patient care’), research presentations, interactive workshops, poster presentations, lunch and networking.

For more information, and to receive updates on this event as they develop, please contact Lisa Niccoli at niccolil@tbh.net

Health Research Institute Board Member Profile: Andrew Ross

Andrew Ross

Northwestern Ontario health care is unique in that we must collaborate with various institutions and agencies strewn over a vast area to effectively meet the health care needs of our region. Likewise, far-reaching partnerships in health care research are just as essential. They allow us to share diverse knowledge and resources which ensure a depth of study that better pinpoints region-specific solutions and develops greater capacity for discovery.

Research that is initiated, designed, and implemented by local investigators can best inform and advance optimal health care delivery for the people of our region and beyond. So it goes without saying that our many communities play a vital role in assisting scientists, scholars, and researchers in the development of locally relevant health care research. Such locally focused research can lead to new understandings or promote necessary changes that will increase regional capacity and innovate program development.

The Thunder Bay Regional Health Research Institute is distinct in its approach to health care research: from scientist initiated research, to educating and training in health care delivery, to developing the means to identify and investigate areas of health care concern, to collaborating with others to enhance health care on local, national, and international stages.

Becoming a member of the Health Research Institute Board of Directors will allow me to better assist in the research needs of our region by, in the continued spirit of collaboration, lending my own knowledge to research institute scientists and, in turn, utilizing the expertise of my fellow board members. 

About Andrew Ross

Andrew Ross is the Manager of the Anishnaabe Bimaadiziwin Research Program, a collaboration of the Sioux Lookout Meno Ya Win Health Centre (SLMHC) and Sioux Lookout First Nations Health Authority (SLFNHA).  He has experience with the design and implementation of educational and health care research programming in the Sioux Lookout region, including collaboration between First Nations communities, health care centres, and universities from across Ontario. Andrew oversees and assists researchers with navigating the research review and ethics process for both SLMHC and SLFNHA.

Prior to working in Northwestern Ontario, Andrew served as Assistant Dean at the Memphis College of Art (MCA) in Memphis, Tennessee where he oversaw institutional effectiveness, institutional research, academic advising, and served as a Master of Fine Arts (MFA) faculty member and advisor.

Andrew holds a BA and BEd from Lakehead University and a MFA from MCA.

Under Andrew’s leadership, the Anishnaabe Bimaadiziwin Research Program strives to create a culture of inquiry that will foster relevant research, both locally and regionally, to better inform health care providers and act as a catalyst in promoting excellence in optimal health care delivery.  The Research Program seeks input from numerous outside partners and agencies, including First Nations tribal councils and communities, and is continually developing opportunities and partnerships to expand research programming that includes community-based research models.

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