Endomag’s new magnetic technology provides equivalent detection rates to current standards of cancer care

Alternative solution using advanced magnetic technology is seeing rapid increase in demand around the world

A global shortage of the most commonly used radioisotope in medical diagnostic procedures, Technetium-99 (^99mTc), will have a major impact on hospitals around the world within the next year.

More than 10,000 hospitals worldwide currently use radioisotopes, about 90% of which are for diagnosis. ^99mTc is the most commonly used radioisotope, involved in 40-45 million procedures every year and accounting for 80% of radioisotope procedures worldwide.

^99mTc is the decay product of Molybdenum-99 (⁹⁹Mo), which is currently produced by five nuclear reactors across the globe. In 2009, two of these reactors were shut down for maintenance and repair, causing widespread disruption with scans cancelled, operations postponed and patients receiving older diagnostic techniques that exposed them to higher levels of radiation. An even bigger issue for the industry today is that a reactor in Chalk River, Canada, which produces close to one third of the global supply, will stop production of isotopes at the end of 2016. To compound the problem, there are an additional three reactors nearing the end of their service life.

Stockpiling is not an option. ⁹⁹Mo continually decays so needs to be supplied to specialist hospitals on a weekly basis. These hospitals have the nuclear facilities and the highly trained staff in place to create ^99mTc. One of its common uses in oncology is sentinel lymph node identification in the management of breast cancer. In this procedure, ^99mTc-labelled material is injected into the patient’s breast and can be detected in lymph nodes of interest by a handheld scanner (gamma probe). As ^99mTc has a half-life of just six hours the injection would ideally take place in the morning, with the operation following that afternoon. However, this isn’t always possible and injections often take place the day before. The short half-life then causes a problem, making finding the exact spot on which to operate difficult and surgeons have to rely on blue dye that marks the majority of the lymph nodes.

There are some companies pioneering methods to produce medical isotopes in the next few years, but they are not yet ready for use so alternative solutions are needed, and fast. Fortunately, there are technologies available today that provide hospitals with benefits over the existing process. One of these solutions not only avoids exposing patients to increased levels of radiation, but is the only solution that avoids the use of radioisotopes altogether while maintaining standard working practice.

The solution, developed by cancer care specialist Endomag, uses magnetic technology to improve the standards of cancer care available to everyone, providing equivalent detection rates to current standards of care. Its magnetic tracer (Sienna+^®) replaces the use of radioactive tracers and blue dye and works with an ultrasensitive hand‐held magnetic probe (Sentimag^®) rather than a gamma probe.

With a shelf life of three years and no specialist storage facilities required, Endomag’s system is accessible to any hospital around the world. It also eradicates the need for scheduling between radiologists and surgeons and the patient no longer has to be wheeled between departments. The magnetic tracer can be injected in the operating room allowing ambulatory or same-day surgery, a benefit that is on the agenda for many countries. The French Ministry has a target of making 50% of surgeries ambulatory by 2016.

After half a dozen successful clinical trials across the EU, Endomag’s technology has now treated more than 10,000 people across Europe. Further trials of Sentimag® and Sienna+^® are currently underway in the US in anticipation of bringing the technology there.

Dr Mark Gittleman, of Coordinated Health Breast Care Specialists in Pennsylvania, a past president of the American Society of Breast Surgeons, said:

Endomag’s system means we can avoid all the logistic and regulatory concerns associated with radioisotopes, improving workflow and making scheduling more convenient. Sentimag^® and Sienna+^® remove the radiation from the operation, as well as the painful injection that occurs most often in the nuclear medicine department without anaesthesia. It’s making the procedure more convenient to patients.

Eric Mayes, CEO of Endomag, said:

The shortage of radioisotopes is going to be a very real problem for surgeons relying on them – and we’re now talking about months not years for it take effect. But the fact that our solution doesn’t rely on radioisotopes is not the only benefit. Using our innovative technology, we can improve the standard of cancer care available to everyone, everywhere. Our platform improves the process for patients and surgeons as well as reduces costs and we’re so excited to see surgeons around the world realising its benefits.