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Inaugural Lecture - Professor Barrington and Professor Mikhaeel

01/03/2017 (17:30-18:30)

Location: Lecture Theatre 1, New Hunt's House, Guy's Campus

My PET subject: personalising treatment for patients with lymphoma


PETs, butterflies and deep breath for lymphoma: reducing the pain while maintaining the gain

Speakers: Professor Sally Barrington, Division of Imaging Sciences and Biomedical Engineering, and Professor George Mikhaeel, Division of Cancer Studies

More info: To attend this lecture, please register online.

Abstract 1: Positron Emission Tomography (PET) is a whole-body imaging technique which involves injection of trace amounts of substances into patients, such as glucose (sugar), to image metabolism. 18-Fluorine-fluorodeoxyglucose (FDG), a type of glucose has increased uptake in cancer, such that FDG uptake on a PET scan can be used to monitor cancer treatment.  PET scans often show changes before other imaging techniques like CT or MRI, enabling earlier evaluation of treatment success or failure.  Professor Barrington will discuss how standardised methods for performing and reporting PET have been important for the success of national and international clinical trials in lymphoma run by the UK PET Core Lab at the PET Centre at St Thomas.  She will discuss how an early ‘read-out’ on PET scans in the RAPID and RATHL trials has enabled treatment to be modified in patients with Hodgkin lymphoma, giving less treatment for patients with good response and more intensive treatment with poor response on PET.  This work and her future planned programme of research is aimed at using PET to guide more effective treatment with fewer side-effects for patients with cancer.

barrington140x180About Professor Barrington: Sally Barrington is Professor of PET Imaging at the KCL and Guy’s & St Thomas’ PET Centre, with experience in oncological and non-oncological imaging.  She is internationally known for her work in lymphoma. 
Sally is first author of international imaging guidelines for staging and response assessment in lymphoma (2014).  She is senior author of two New England Journal of Medicine practice-changing publications reporting clinical trials using PET for response-adapted treatment in Hodgkin lymphoma, to improve outcomes for patients while reducing side-effects. 
She is lecturer for the European School of Oncology (2012 -), on the Scientific Board for international workshops on PET in lymphoma (2010 - ), member of the European Association of Nuclear Medicine Oncology Committee (2013 - )  and the Editorial Board for the Journal of Clinical Oncology (2013 -). 
Nationally, she is co-lead of the UK PET Research Network, with the Core Imaging Lab at St Thomas’.  She is author of UK Evidence-based indications for PET/CT used for commissioning of NHS Scans.  She is member of the Administration of Radioactive Substances Advisory Committee (ARSAC), an advisory body to Government.  She has authored a well-known Atlas on Clinical PET, 4 book chapters and ~ 150 publications.


Abstract 2: Lymphoma is a success story in cancer treatment, having become one of the most curable human malignancies. However, cure can be costly, with serious complications later in life e.g. increased incidence of second malignancy and heart disease. 
Significant efforts have been made over the last 2 decades to reduce late effects of treatment. The introduction of PET scanning provided better assessment of treatment response early during chemotherapy and enabled treatment modification. This approach was first introduced at Guy’s & St Thomas’ Hospitals and has now become a standard of care in some situations.
While radiotherapy is the most curative single treatment for lymphoma, it has been associated with late complications, particularly when given to the chest (mediastinum) in young individuals which is commonly required in lymphoma. Treating patients while they have a deep breath moves normal structures away from the lymph nodes in the middle of the chest, reducing the radiation dose and risk of complications. In addition, an innovative arc technique (called Butterfly-VMAT) has been introduced in Guy’s Cancer Centre and combined with treatment whilst holding a deep-breath can further reduce dose to normal structures, making radiotherapy to the mediastinum much safer and highly accurate.

mikhaeel140x180About Professor Mikhaeel: George Mikhaeel is Professor of Radiation Oncology at KCL and Consultant Clinical Oncologist at Guy’s & St Thomas’ Cancer Centre, where he specialises in the treatment of lymphomas. His two main academic interests are imaging and modern radiotherapy treatment for lymphoma.
George is a founding member of the International Lymphoma Radiation Oncology Group (ILROG)and a member of its steering committee.  Nationally, he chairs the UK Lymphoma Radiotherapy Group (UK-LRG). He is co-author of two influential international guidelines in lymphoma; the international imaging guidelines and guidelines for modern radiotherapy in Hodgkin Lymphoma. He recently introduced new radiotherapy techniques for treating lymphoma in Guy’s & St Thomas’ Hospitals to reduce the risk of late side-effects. George published the first UK study on interim PET in lymphoma and developed a scoring system for PET response assessment with colleagues at the St Thomas’ PET centre, which was adopted internationally.
George has a passion for teaching and has organised national and international meetings under the auspices of the National Cancer Research Institute, Royal College of Radiologists, UK-LRG, and the European Society of Radiation Oncology (ESTRO).  He is vice-chair of the haematology track for the American Society of Radiation Oncology (ASTRO) annual meeting scientific committee.


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