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Breakthroughs

Canadian and World Firsts at Sunnybrook Research Institute

Sunnybrook Research Institute (SRI) scientists have made internationally relevant advances in medical science. These breakthroughs will transform, and in some cases already have transformed, countless lives. Download PDF version

Here are some of these.

2014

Launch a Phase 3 clinical trial to advance the use of magnetic resonance imaging (MRI)-guided focused ultrasound, or scalpel-free surgery, to treat patients with severe essential tremor. Sunnybrook is the only Canadian site for this international trial.

Discover that exercise alters blood flow to the region of the brain responsible for learning and memory, and feeds blood to the white matter in the brain. This is the first study using MRI to measure changes in the brain in healthy adults after 20 minutes of cycling on a stationary bicycle. Results provide the groundwork for further research in brain repair after stroke.

2013

Show that sound sleep can reduce the most common genetic risk factor for Alzheimer’s disease.

Demonstrate there are no additional health benefits for preterm babies whose mothers received multiple courses of corticosteroids before giving birth, even five years later.

Lead an international Phase 3 clinical trial for advanced HER2 (human epidermal growth factor receptor 2)-positive breast cancer. Results show patients on the antibody-drug conjugate trastuzumab emtansine had better survival with less toxicity compared to standard treatment. Health Canada approves this conjugate on Sept. 11, 2013.

Lead the first and largest multi-institutional study of spine stereotactic body radiotherapy (SBRT), a more targeted, image-guided radiation treatment for cancer that has spread to the spine. Researchers hope to help practitioners determine those patients most suitable for spine SBRT and patients who should first have surgery to make sure the spine is stable before radiation is delivered.

Launch the first national survey of the prevalence of hospital “superbugs,” or antibiotic-resistant organisms. Results aim to provide a basis for development of infection prevention and control guidelines in Canadian hospitals.

Show, in the largest randomized controlled trial for twin births ever done, that planned vaginal birth is as safe as a planned caesarean section for mothers and babies.

2012

Complete Canada’s first clinical trial evaluating the use of MRI-guided high-intensity focused ultrasound to treat essential tremor, with excellent results.

Discover a gene associated with the timing of one’s sleep-wake cycle and one’s circadian rhythm of death. This information could be helpful for the scheduling of work and even potentially the best times for an individual to receive medical care. 

Find a way to predict onset of Alzheimer’s disease or vascular dementia up to five years before diagnosis with neuropsychological tests that measure a patient’s learning ability and verbal skills.

Open the world’s first Centre for Research in Image-Guided Therapeutics on Nov. 2, 2012. Governor General David Johnston presides at the launch. This centre brings scientists and clinicians together to develop better ways to detect, diagnose and treat complex health conditions, including cancer, heart disease, musculoskeletal disorders, immune deficiencies, stroke and dementia.

Use ultrasound to cause microbubbles (tiny lipid-coated spheres of gas that pass safely through the body’s circulation) to resonate inside tumour blood vessels, thereby amplifying the sensitivity of tumours to radiation, and at a lower dose. Results show a 40% to 50% tumour volume cell death with just one dose of radiation, results typically achieved after 35 doses. 

Complete the world’s first clinical trial of a new treatment for patients with blocked coronary arteries, and show the enzyme is safe and has promise in terms of enabling angioplasty and restoring blood flow. The enzyme was developed and commercialized by an SRI scientist.

2011

Show that the ideal blood sugar range for burn patients is 130 to 140 milligrams per deciliter of blood. The finding guides clinicians in the treatment of severe burns, helping them to avoid adverse outcomes such as infection, organ failure and death.

Launch the first Canadian clinical trial assessing MRI-guided focused ultrasound as a therapy for brain tumours and essential tremor.

Pioneer a pain relief technique for patients undergoing orthopaedic surgery. The technique, now used clinically worldwide, uses ultrasound to guide the administration of a low volume of local anesthetic to reduce post-surgery pain and improve joint mobility.

Lead the first study comparing blood vessel functioning of teens with bipolar disorder and healthy teens. Researchers aim to understand better the link between bipolar disorder and heart disease to identify youth at risk and provide treatment strategies.

Develop, in collaboration with the University of Toronto, the first prostate cancer screening device that uses nanotechnology and prostate cancer-specific biomarkers to identify and distinguish between slow-growing and aggressive cancers.

2010

Show that the benefit of mammograms outweighs the risk of radiation exposure. An SRI scientist has shown that odds are almost 50 times greater of a life saved through earlier detection through screening, over a life lost due to radiation-induced breast cancer.

Launch the world’s first dual-site focused ultrasound surgery centre to test clinically the scalpel-less ablation of uterine fibroids using high-intensity focused ultrasound guided by MRI. On the back of early results from the centre’s first clinical trial, launch further trials of this technology, developed and commercialized by an SRI scientist, for other applications, including bone and breast cancer.

With Baycrest, invent an MRI-compatible tablet that pinpoints the origin of brain functions at their source, in the brain itself, while cognitive tasks are performed—thereby confirming or correcting results from writing-based tests of cognition.

Show that using focused ultrasound to deliver anti-amyloid antibodies into the brains of preclinical models can halt Alzheimer’s disease in these models. 

Invent a catheter-based technology that can be turned off and on, overcoming an obstacle to MRI-guided vascular procedures: the tendency of the imaging marker in the catheter tip to obscure the area that needs to be seen.

Show that diffuse optical spectroscopy can determine within four weeks which patients are responding well to neoadjuvant chemotherapy for locally advanced breast cancer. Enables oncologists to optimize treatments months earlier than was possible with conventional imaging.

Find that a commonly prescribed antidepressant—paroxetine—interferes with tamoxifen therapy in women with breast cancer, and that antidepressants of the same class do not produce this drug-drug interaction.

2009

Provide the first evidence to detail what the H1N1 virus looks like; find it hits younger and healthier people harder. Enables hospitals in Canada and around the world to prepare for and treat “high-risk” patients effectively.

Show that rushing acute stroke patients to Sunnybrook Regional Stroke Centre to receive tissue plasminogen activator (tPA) therapy—which if quickly administered reverses the signs and symptoms of stroke—works. Four times as many patients are treated with tPA after the protocol is implemented.

Invent and commercialize an ultrasound imaging catheter that can see inside heart chambers in 3-D in real time during heart procedures. It is the first such device that can look ahead of the tip of the catheter, not only to the side.

Engineer and commercialize a peptide that speeds wound-healing by 30% to 40% in mice with diabetes. It also dramatically improves the quality of wound closure. 

Discover that stimulating an area of the human brain responsible for P waves increases dreaming sleep. This finding will advance research using deep-brain recordings and stimulation to understand sleep, cognition and neurodegenerative disorders better.

Develop a unique model that monitors the functions of a single strand microRNA for longer-term studies of specific microRNAs, which are important in aging, self-renewal and tumour angiogenesis. This model may also serve as a new way of studying gene regulation by microRNAs in gene therapy.

Create human progenitor T cells from stem cells in the lab, and successfully instruct them to become fully functional immune T cells when implanted in mice. This advance opens a door to translational studies of treatments for immune-compromised patients.

Discover that enriching a class of blood stem cells inhibits the growth of a rare but aggressive form of leukemia in preclinical models. The finding offers further evidence that the cellular microenvironment around tumours influences gene expression and cancer cell growth.

2008

Build the world’s first breast cancer research “biomatrix.” The vast data repository advances research into breast cancer prevention, early detection and diagnosis, and enables new, individualized treatments for breast cancer to be developed and tested faster and more efficiently.

Invent and commercialize a device that pairs ultrasound and MRI to treat localized prostate cancer. The device destroys tumours with precision, thereby sparing surrounding healthy tissue and preserving urinary, bowel and genital function better than do current treatments.

Develop a therapy that uses an enzyme called collagenase to help restore blood flow in arteries of the heart that are chronically blocked. The treatment is a preferable alternative to bypass surgery and drugs (the current standards), and is in clinical testing at Sunnybrook.

Show that MRI of plaque hemorrhage, a 3-D technique, may be a useful screening tool to prevent stroke and heart attack by providing radiologists with a more detailed look into diseased arteries.

2007

Lead a practice-changing study showing that drug-eluting stents are as safe as bare metal stents: in patients who receive either of the two types of stents, the risk of postoperative heart attack was the same. In addition, the death rate was lower for patients given drug-coated stents.

Invent a device that combines low- and high-intensity ultrasound that, when guided by MRI, enables drugs to be delivered to previously impenetrable brain regions by temporarily disrupting the blood-brain barrier. The treatment is noninvasive and does away with the need for surgery.

Provide evidence of a unique molecular interaction in immunity to infection that suggests longer-term clinical implications for treatment of cytomegaloviruses, a family of herpes viruses causing chronic and sometimes fatal infections.

Are the first in the world to find and characterize the fundamental waveform of dreaming sleep in humans, facilitating the study of brain changes in sleep, learning and memory using deep-brain recordings and stimulation.

Lead an international study that shows MRI can improve the detection of hidden cancers in the opposite breast of women diagnosed with unilateral breast cancer. 

Find that expression of a prostate-specific hybrid gene predicts those prostate cancer patients at highest risk of disease progression, allowing doctors to identify patients most likely to benefit from treatment.

2006

Discover genetic similarities between the immune systems of the purple sea urchin and humans. Further study of these common genes in the sea urchin, a small and simple organism, will provide important clues to understanding the complex regulation of immunity in humans.

Find that bone-marrow-derived circulating endothelial progenitor cells are rapidly mobilized in tumour-bearing preclinical models after a vascular disrupting agent is given, contributing to blood vessel growth and subsequent tumour growth. Blocking this mobilization reduces tumour size and blood flow markedly.

Find that premenopausal women with HER2-positive breast cancer have better survival and lower recurrence rates when treated with anthracycline-based chemotherapy.

Show that bright artificial light therapy is as effective as, and works faster and produces less agitation than, antidepressant medication in the treatment of winter depression.

Lead a trial suggesting post-trauma administration of hypertonic saline can regulate the immune system’s inflammatory response, thereby limiting multiple organ failure and improving long-term survival.

2005

Participate as the only Canadian site in DMIST, an international study comparing digital mammography (DM) with film mammography. DMIST finds that DM detects more cancers than does film mammography in certain groups of women.

Show that early surgical removal of the spleen combined with antiangiogenic therapy, which arrests the growth of tumour-feeding blood vessels, may stop the progression of leukemia.

Validate a novel diagnostic imaging technology, an angiography device called the SPY system, that for the first time will provide cardiac surgeons with a clinical quality control tool for bypass grafts in the operating room.

Report that patients treated with high-dose radiation for head and neck cancer in the morning have a lower risk of developing mucositis, which damages the mouth and throat, than do patients who are treated in the afternoon. This is the first study to link circadian rhythms and mucositis due to radiotherapy.

Find that measuring peripheral blood cells that circulate in the blood and contribute to tumour growth may provide a way to measure and monitor the effectiveness of antiangiogenic therapies. 

Predict with neuropsychological testing, for the first time, which study participants will develop Alzheimer’s disease within five and 10 years.

2004

Show MRI detects more breast cancer tumours, earlier, compared with mammography, ultrasound or clinical examination in women with the BRCA1/BRCA2 genes.

Complete the first breast cancer treatment in the world that implants small beads of palladium, a low-dose radioactive material, in patients in a one-day outpatient technique.

Find evidence, in the first large multicentre clinical trial of its kind, to suggest that artery grafts from the forearm should be used in place of vein grafts from the leg for heart bypass surgery.

2003

Perform the first minimally invasive thoracoscopic modified Maze procedure in Canada to treat atrial fibrillation without stopping the heart.

Use the first worldwide application of a large database time-series analysis to examine causes of emergency department overcrowding in Canada.

Discover a molecular marker to diagnose hepatocellular carcinoma, the most common type of liver cancer. 

Co-lead the practice-changing letrozole trial of postmenopausal women with breast cancer, which finds that this drug reduces the risk of recurrence of breast cancer by over 40% for women who had taken the drug tamoxifen for five years.

Use intravenous contrast material in digital mammography (DM) research, the world’s first to do so. Results suggest that contrast-enhanced DM may be a new strategy to identify lesions in dense breasts. 

Find motor-vehicle fatalities in the U.S. jump 41% after a Super Bowl telecast, compared with the number of fatalities for a typical Sunday night.

Install a positron emission tomography (PET) and computed tomography (CT) simulator, a single device with an integrated control panel that allows for combined scanning of PET and CT images, the first hospital in Canada to do so.

2002

Create the world’s first system to generate T cells, a vital component of the immune system, in a Petri dish.

Perform the first spine surgery using a prosthetic disc nucleus as part of a multicentre Canadian trial.

Demonstrate that a cell population of unknown function, present in the gut of normal individuals, plays a key role in preventing the development of ulcerative colitis.

2001

Discover, with collaborators at the University Health Network and Osaka University in Japan, a protein in human breast milk that stimulates the immune system of newborns.

2000

Lead the first, international multicentre clinical trial to evaluate risks and benefits of caesarean and vaginal birth for breech pregnancies. The practice-changing results show C-sections for breech pregnancies offer benefits for mother and child. 

Show that much lower doses of chemotherapy combined with antiangiogenic drugs significantly delay tumour growth in animal models.

1999

Develop the world’s first method to image blood flowing in the microscopic vessels in the muscle of the heart in real time, a technique now used internationally.

1997

Provide the first proof that using a cell phone while driving increases the risk of a motor vehicle collision fourfold.

1994

Introduce new internal fixation techniques for C-spine fractures, the first hospital in Canada to do so.

1993

Form the first international digital mammography development group, led by Sunnybrook scientists. The group will later lead dramatic advances in developing new technology to detect breast cancer.

1991

Invent the world’s first high-frequency ultrasound microimaging scanner for preclinical imaging, which is now used worldwide for research and for clinical imaging of the eye to detect glaucoma and anterior segment tumours.