What new imaging techniques are being tested? How will imaging improve in the future?

[Music] what new imaging techniques are being used how imaging improve in the future so research just briefly what are we doing to learn more about the imaging techniques we can combine pet and MRI we cannot do it here yet but there are machines around the country where we can do that at the moment the benefit over a PET CT is not that much so this is just future we can use new functional techniques where we can actually measure how many cells you have in the bone marrow not only count them under the microscope but also can measure them in x-ray and this is again based on the water content as I mentioned if you have a lot of cells your water molecules cannot move that far if you have less cells in your bone marrow it they can move further and the Machine can measure that so cal TW eyelids fancy-looking here as you can see here those white spots where myeloma infatuations and this is a patient in CR you can see much fewer white spots but still some left so we get information this patient is in CR but we still have a few myeloma areas left so this is something where the imaging really gives us more information and we use computers and we're Jenny was talking about big data we try to teach our computers to learn to help us analyze images because I can tell you a whole-body low-dose CT your whole body pet and the whole body MRI each one has about 2,000 images and our radiologists have a new diagnosis they have the scrolling finger because on the computer they have to scroll through and this we try to teach our computers to help us to identify those four clinicians in the body besides advances in instrumentation in AI what other progress is being made that is I think one very valuable tool but there's also development of better tracers for the PET CT kind of the dye of the PET CT where this cd38 which is the the target of teratoma for example insta-tox enough and this cd38 specific for myeloma cells so some colleagues have started to attach the tracer towards this the thing that is lighting up in imaging attach this to the cd38 anybody and then you see much more with a much higher sensitivity and also much higher specificity where the myeloma cells are so this the the cd38 directed traces in PET CT and or the diffusion-weighted imaging are two areas where I think this future will go with imaging the myeloma what other ways is imaging being used to assess myeloma and guide treatment I think better tracers better techniques by itself and also the combination with other things what we do right now is we detect with imaging where the myeloma is taking place and then we do a guided biopsy we don't do the we also do the regular biopsy that we do at the crest at pelvis but we also do a biopsy often err in some patients of an area where we have a oscillating lesion for example and we found that there are genomic differences so it's not the same cells so that might be another area where imaging can can help us imaging is getting better every year and the primary engines of this improvement are improvement in the contrast agents especially in positron emission tomography so if we can have more specific contrast agents that target specific biomarkers on the myeloma tumor cells we'll get much better about diagnosing tumor cells the existing contrast agent which is FDG used for PET imaging it has done a huge service for myeloma patients however we as a scientific community we have an understanding that we need better more specific contrast agents for imaging myeloma cells within the bone marrow and so our institutions and like we are looking at imaging very late antigen for an myeloma cells which is very specific for for an activated confirmation of this receptor on the myeloma cells and there are other institutions across the world who are looking at different maluma specific contrast agents so in addition to the improvements in the instrumentation which is a big part of pet technology we are also making advances in developing more specific safe robust imaging agents contrast agents [Music]