THE STRONG ROOM
The right image
Professor Shonit Punwani finds harmony through diversity in the most unlikely of places.
Interview Lucy Jolin Photograph Alun Callender
Harmony within diversity: that was the ethos of the Three Wheels Japanese Buddhist Temple in Acton where I once lived, and it’s a principle that has informed my work with the game-changing Spinlab hyperpolariser.
It was back in the early 90s, as a student at UCL completing my PhD in Magnetic Resonance Imaging (MRI) and my clinical training as a doctor, when I first met my wife and ended up living at the temple. As my time at UCL continued, I often found myself reflecting on the harmony message, especially in 2017, when we carried out the first-ever hyperpolarised MRI scan. It’s a truly cross-institutional, interdisciplinary project involving doctors, pharmacists, imaging specialists, engineers and physicists.
At UCL, we have been working on using MRI to look at microstructure and blood flow to characterise cancers, including prostate cancer. But we wanted to develop the technique further to address a big problem for patients who are diagnosed with prostate cancer – only a small proportion of men (approximately 10 per cent) who are diagnosed actually die from their disease, so our challenge was to think about how we could identify the 10 per cent with aggressive tumours and avoid unnecessary treatment (which can have significant side effects and reduce quality of life) in the other 90 per cent.
That’s where the hyperpolariser comes in; it can create traceable compounds that can be injected into a patient and which get used in the metabolism of cancers, and therefore tell us information on how aggressive a cancer is. The hyperpolariser boosts the signal from the injected compounds by more than 10,000 times so that we can detect the signal using a slightly modified MRI scanner. If we didn’t have a hyperpolariser the amount of compound we would need to inject in order to produce enough signal would kill the patient! The whole process is quite amazing; it’s a cutting-edge piece of technology that has been installed at only a handful of centres across the world, and we are just starting to investigate its clincial potential.
That first scan we performed in a patient was a nerve-racking affair, but it was a success, and incredibly exciting to finally see our first, and Europe’s first, detailed image of a prostate cancer tumour metabolism.
We’re now starting a five-year project to scan almost 300 patients with prostate cancer using the hyperpolariser to develop the technique further and understand whether it can really tell us about the aggressive cancers.
It’s been hugely exciting to do something that’s never been done before. But to me, this machine symbolises that ethos of diversity and harmonious collaboration we have here – a principle that has been absolutely critical in bringing together such a diverse team of individual experts to work on one project. There are very few places in the world apart from UCL where this could have happened.
Shonit Punwani is Reader in Magnetic Resonance and Cancer Imaging.