The future of MPI: an interview with Dr Nikolaos Panagiotopoulos, University Hospital Schleswig Holsten

Thought leader series

Please could you introduce yourself and tell us a bit about your area of expertise?

I’m Dr Panagiotopoulos and I am a resident at the University Hospital of Schleswig-Holstein. I work in the Radiological and Nuclear Medicine Department, at the Lübeck campus. At the moment, we are working as what is called the MAPIT team, on a Magnetic Particle Technology project. We are the clinical part of the whole MAPIT project and we work with MPI.
We will present our vision of getting MPI into the clinic as an interventional device, as a new technology for visualizing and guiding interventions. We will also answer some questions about how to implement MPI.

So what are your particular areas of application within MPI?

We focus on the safety and visualization of the instruments and devices needed to carry out interventions under MPI guidance. We are testing how they behave during the scan.
For example, one safety concern is whether or not the instruments are heating up during a scan. We need to make sure that we can clearly visualize the instruments during the procedure, so that it can proceed in a safe way.

Can you explain a little bit about the MAPIT project?

The MAPIT project is a cooperation between different industries and areas in Germany. It is funded by the German Federal Department of Science on the one hand and the country states Schleswig-Holstein on the other. They are trying to get this technology into clinical use and into the industry.
Our vision is to provide a new technological modality that will somehow complement today’s gold standard. At the moment, that is Digital Subtraction Angiography, but it has some drawbacks because it relies on ionizing radiation, meaning both the patient and the interventionalist are exposed to ionizing radiation during all the procedures carried out at the hospital.
MPI offers an alternative technology, without this exposure being an issue and it also offers 3-dimensional quantitative analysis, so we can achieve real-time imaging.
However, I think we have to be realistic and keep in mind that it’s a very young technology. If we compare MPI with other technologies such as CT, which started in the 70s, and look at the first CT pictures, you would have never imagined this technology would be used as part of routine clinical practice. I think it’s the way we have to go, but we are at the beginning and we are on a good track as far as I am concerned.

Do you think MPI will replace current technologies?

I see MPI as complementing the arsenal of instruments we already have at the moment rather than being a replacement. MPI has much potential, but we will see if it really lives up to all our expectations.
We have good technologies already and we will complement them somehow, as we have always done with new technologies.
I think it’s important on the particle side, for example, to develop superparamagnetic iron oxide nanoparticles, specifically for MPI. That is being done at the moment. Work also needs to focus on coating purposes because we somehow need to visualize the instruments used for interventions and we need spheres that have a high MPI signal, even when immobilized.

What is your vision for the future?

My vision is to get MPI into routine clinical practice, as a new diagnostic and therapeutic technique that will complement the arsenal of modalities we have today, to treat patients with cardiovascular disease, for example.
For this we need to visualize the instruments on the one hand, and the cardiovascular system on the other, in a safe manner. My vision is to get the system onto this level and be sure to meet our expectations in the safety and visualization of instruments.