Großhadern Clinic in construction – with little-known new builds
In November last year, a survey of architects turned up ideas on how the University Clinic of Großhadern in Munich should best be modernised: the experts argued for a completely new construction with attendant demolition of the hospital building, built in the early ‘70s on the southern edge of Munich.
Although the architecture of the hospital building is in many parts clearly not at the leading edge of technology, a few infrastructure projects are already in place to take the hospital into the future and keep the site at the forefront of technological developments for decades to come.
In this manner, Europe’s largest and most state-of-the-art operating centre is currently under construction; a free-standing complex that can be linked up to any future new build. Also worthy of note are the building complex of the CSD (Centre for Stroke and Dementia Research), the Munich branch of the German Centre for Neurodegenerative Diseases (DZNE [Deutsches Zentrum für Neurodegenerative Erkrankungen]) and the new build housing the Hauner’schen Children’s Hospital after Großhadern (the New Hauner), the latter being still in the planning phase. At the same time, plans are progressing for a new mother-and-child centre.
The fact that the pre-clinic and some clinical research departments are moving as early as next year into the vast new Biomedical Centre (BMC), a stone’s throw away on the Martinsried campus next to the LMU’s Faculty of Biology and the new start-up centre IZB [Innovations- und Gründerzentrum Biotechnologie (Innovation and Start-Up Centre for Biotechnology)], doesn’t make the construction project and its state of progress (almost finished, started, planned, considered…) any clearer.
Construction complete: the new Centre for Radiopharmacy
From diagnostics to theranostics
The quiet introduction of another building complex remained unnoticed by many; however, its significance for a research location that counts as one of Europe’s top-ranking regions for therapy and diagnostics should not be underestimated: we are referring to the new Centre for Radiopharmacy on the outer western edge of the hospital area.
In July 2011, PET Net GmbH in Erlangen was given the task of setting up a radiopharmacy centre at the Großhadern Clinic in Munich, with an overall budget of €15 million funded by a public-private partnership (PPP). Alongside the construction of permanent premises, long-term cooperation is also planned for the production and development of both established and new radiopharmaceuticals and their approvals. PET Net München (PNM) GmbH was initiated to this end and, together with the consortium partner Perner Architekten GmbH Rosenheim, was not only able to obtain all the necessary permits but also to plan, build and deliver a validated building in a record time of barely 24 months.
The Medical Director of the University Clinic, Prof. Dr Karl-Walter Jauch, and the Director of the Medical Faculty at LMU Munich, Prof. Dr Maximilian Reiser, were impressed and delighted with the new opportunities for research and patient care. More than 600 m² of clean rooms and production space were created, and are split into two separate parts housing both PNM and the Nuclear Medicine department headed by Prof. Peter Bartenstein. A cyclotron with 16 MeV and dual beam, 20 synthetic cells and 3 filling systems are available for the production of specific radiopharmaceuticals. Most technical systems were implemented several times in excess to ensure a high level of failure safety. The cooperation between the Munich University Clinic and PNM is to be continued full-scale within the framework of the PPP. Images of the building as well as a short video can be found at http://nuk.klinikum.uni-muenchen.de/chemie/index.php.
the Video directly at: http://www.wcms-am-klinikum.de/videos/internet27394275.mp4
Why is this (small) centre nevertheless so significant? Munich University Clinic operates one of the largest nuclear medicine facilities throughout the whole of Germany, and its new centre will advance it into the top three of Europe’s largest radiopharmacy sites.
Around 6,500 PET and PET/CT scans are carried out every year at the LMU Clinic using short-lived radioactive tracers, predominantly in oncology. The most commonly used tracer is 18F fludeoxyglucose (FDG), which still makes up almost 70% of all radioactive tracers used in PET diagnostics. In addition to FDG, a range of other tracers have found their way into clinical treatment. Examples of these include various choline derivatives and, more recently, PSMA ligands (PSMA = prostate-specific membrane antigens) for diagnosing prostate cancer as well as a variety of peptide radiopharmaceuticals, e.g. so-called somatostatin analogues that attach to the somatostatin receptor on tumour cells. It was precisely this field that was able to demonstrate how a primary diagnostic imaging procedure can develop into a therapeutic treatment option: when you swap the radiation source in a radiopharmaceutical from a diagnostic positron emitter to a therapeutically effective beta emitter, you are able to use the beta-emitting peptide to fight the tumorous tissue in a targeted way, supported by imaging and with almost exactly the same target. These “theranostics”, a literal fusion of molecular diagnostics and therapy, are one of the priority areas for Prof. Bartenstein’s group. Neuroendocrine tumour indications are currently being intensively analysed and optimal tracer compounds are being explored. At the same time, an expansion of operations is not only taking place in the field of oncology, but is now also being initiated with new approaches to neurodegenerative diseases such as Alzheimer’s and Parkinson’s. In addition to this, however, there are exemplary biodistribution studies testing new, radioactively marked pharmaceutical candidates on people and animals; these are yielding a wealth of other questions for areas of operation to potentially expand into.
“With our very own production facility, we are now able to guarantee patient care as well as research and teaching in the field of nuclear medicine”, states Prof. Bartenstein modestly. For “personalised medicine” in particular, effective activities in the field of nuclear medicine in Munich create the ideal conditions to boost international appeal.