Molecular Imaging - Biograph Vision Quadra Meet and Greet welcomed nuclear medicine experts from five countries to share their insights and learn from one another.

Meet Biograph Vision Quadra 
PET/CT experts 


The power of a proven platform. The perspective of a large axial PET field of view. Meet nuclear medicine experts who take the potential of PET/CT further with Biograph Vision Quadra™.

Portrait of Prof. Marcus Hacker, MD, Professor of Nuclear Medicine and Director of the Division of Nuclear Medicine, Medical University of Vienna, Austria
Photo credit: Felicitas Matern

Medical University of Vienna, Vienna, Austria
After studying medicine at the University of Erlangen and the Technical University of Munich, Prof. Dr. Hacker trained in nuclear medicine at the University of Munich, Germany. Previously, he was vice chair of the Department of Nuclear Medicine and the head of the Preclinical Imaging Unit at the Department of Nuclear Medicine, University of Munich, Germany. Today he is working as a full professor of Nuclear Medicine and the director of the Division of Nuclear Medicine at the Medical University of Vienna, Austria. He also heads the Department of Biomedical Imaging and Image-Guided Therapy. Hacker’s main research focus is translational cardiovascular imaging, precision medicine (theranostics and companion use) in immuno- and oncological therapies, and network and prevention medicine. Hacker has won both the German Dagmar-Eißner-Award and the Wolfgang-Becker-Award for nuclear medicine. He was actively involved in the Austrian, German, and European Associations of Nuclear Medicine as president, board member, and working group leader. Hacker represents the Medical University of Vienna in the Network Medicine Alliance.


Network medicine is interested in the protein-protein and cellular interactions, as well as inter-organ communication and social networks and searches for new mechanistical insights to better guide therapy and organismal level and finally improve patients’ outcomes. We as nuclear medicine physicians have, in most of our examinations, a “whole person” view. In whole-body PET/CT, we are displaying molecular targets and physiology on a wholeperson level. So, we are predestined to be involved in whole-person research.

With total-body PET/CT, we are able to display the connectivity or at least the co-relation between organs and with it respective changes between healthy individuals, people with allostatic load, and people where the presence of disease was already diagnosed. This is unique and no other discipline or technology can provide this information non-invasively and serially on a wholeperson level.

First, we were inspired by the high sensitivity of those scanners and the question how we could make use of it. Providing whole-body molecular information ideally beyond 1mSv including CT, would be the basis for regular screening with PET/CT. There is already a huge amount of data on the performance of PET and PET/CT in a disease screening setting. But now we can achieve a much higher detection rate and—as described earlier—can add inter-organ relations to early detect not only disease but also allostasis.

There have been already published data on how emotional or post-traumatic stress affects outcome based on patient questionnaires. What is new is the understanding that we can use PET/CT signals from the amygdala to identify an emotional stress activation, and with total-body PET/CT, set these signals directly into relation to peripheral organ metabolism or diseases. In Vienna, we have built the whole translational pipeline from human total-body research back to animals and cells, so that we can understand metabolic signals of single organs better and, with it, understand the changes of signals. In cancer patients, you can even add the analysis of cancer genetics, tumor microenvironment, and inflammatory changes by adding molecular biology analyzing techniques. We could demonstrate how stress in lung cancer patients affects a systemic inflammatory response and, with it, the tumor microenvironment and how this changes survival rates.

The idea is to detect stress activation and downstream allostatic changes early, before disease occurs. After early detection, you can add primary prevention and observe the return of the organism in a balanced homeostatic setting. An image says more than thousand words, so that we hope that individuals can be better guided for prevention like weight loss, anti-stress training, and changes in behaviors. Of course, we are also thinking about medical strategies to resolve the metabolic dissociation driving disease development.

My hope is that our fantastic techniques will take an important place in routine clinical algorithms to better guide treatment (not only our own) and improve patients’ outcomes. PET in network and prevention medicine will help to detect allostatic load and disease earlier to conduct tailored primary prevention and improve outcomes. Furthermore, it will help to better understand disease mechanisms.
Portrait of Ashok MuthuKrishnan, MD, University of Pittsburgh Medical Center, Pennsylvania, USA

University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA

After beginning his medical education in India, Dr. MuthuKrishnan completed his residency in nuclear medicine at the University of Alabama—Birmingham, Alabama, USA, and his clinical fellowship in PET/CT at the University of Pittsburgh Medical Center. Since 2019, MuthuKrishnan has held the positions of chief of Nuclear Medicine, director of Nuclear Medicine Clinical Operations, and director of Theranostics at the University of Pittsburgh. He is also the founder and chief physician of the Florida Theranostics Cancer Center, Jupiter, Florida, USA. He is currently a member of RSNA, SNMMI, and the Indian Society of Nuclear Medicine, among other organizations.

The possibility of high-quality molecular imaging PET research, significantly improved image resolution, and speed were the three primary factors that helped us make the decision to invest in a Biograph Vision Quadra PET/CT.
One of the clinical research areas that was limited earlier in our institution with conventional PET/CT scanners was imaging pregnant women with cancer. With the use of Biograph Vision Quadra, imaging such patient groups with extremely small amounts of tracer doses with markedly decreased radiation exposure to the fetus while still maintaining a good quality PET exam has become a viable option now.
From the technologists’ perspective, they all love the quick turnover of the patients and the easy automated workflow they can choose for different patients and protocols. From the reading nuclear medicine physicians’ perspective, we truly appreciate the highest PET resolution yet and the ability to pick up tiny lesions that help us make important treatment decisions for cancer patients every day.

Yes. Our institution is a multi-campus, multi-PET/CT scanner environment where patients go back and forth between different PET/CT scanners for their staging and therapy assessment scans. Once patients have experienced the quick scanning times and their physicians saw the imaging quality from Biograph Vision Quadra, both the referring physicians and the patients never want to go back to a non-Biograph Vision Quadra PET/CT scanner.

Studying the pathophysiology of the tumor environment precisely and rapidly would open a lot of doors to more accurate staging and devising impactful treatment strategies. In a similar manner, understanding and quantifying non-tumor pathologies in ways like never before will pave a new paradigm shift in treating such disease processes. Total-body PET/CT is the tool we have in our hands now that would get us there in the near future.