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Letter to the presenters and organizers of the Total Body PET Conference in Edinburgh Sept. 22nd-24th, 2021
Dear Colleagues, Sept. 16th, 2021
Over the past few months, I have witnessed the pain and suffering of a person very dear to me due to the fact that there were no affordable examinations, procedures, or techniques capable of detecting the primary 2.5 cm tumor (with more than two billion cancerous cells) on her appendix that had been present between four and ten years. What happened to her could happen to any of us. This tumor was discovered only after it broke its structure and metastasized in the peritoneum, affecting other organs, and generating three secondary tumors, the largest – 7.5 cm – on the ovaries. This became symptomatic on January 28th, 2021, when she felt a mass touching her abdomen. On February 8th, 2021, a CT exam detected only the large secondary tumors, not the 2.5 cm primary tumor. This patient has never smoked, does not drink, is not overweight, goes to the gym, follows a healthy diet, walks every day, and has regularly undergone all possible screening tests available (several MRI and CT exams during the past four years, mammography, colonoscopy, ultrasound, etc.) and the most important screening test among the 27 offered by www.lifelinescreening.com.
This just goes to prove that an effective affordable screening test that could avoid unnecessary pain and suffering does not exist. On March 8th, 2021, the surgeon faced a disastrous situation when he opened the patient’s abdomen. Having suctioned out one liter of mucoid fluid and tissue to gain access to the pelvis, he found two enormous 10 cm complex adnexal structures. He removed these, together with the ovaries, uterus, Fallopian tubes and appendix. The pathology exam helped to diagnose Pseudomyxoma peritonei (PMP) Low-grade appendiceal and ovarian mucinous neoplasm LAMN, well differentiated, which led to a second 11 hours and 46 minutes surgery in May 2021, that was much riskier, and more painful and debilitating. This was labeled as MOS surgery (Mother of All Surgery) consisting of a CRS (Cytoreductive Surgery) removing the spleen, which was totally compromised, two small tumors in the liver, tumors at fatty tissues in the peritoneum, scraping the colon and the pancreas attacked by cancer cells. The CRS was followed by the HIPHEC (Hyperthermic Intraperitoneal Chemotherapy) procedure which involves 14 liters of chemotherapy fluid at 106 F circulating for 90 minutes in the abdomen to kill cancer cells at 104 F in metastasis in the peritoneum. She spent 13 days in the ICU, also being affected by pneumonia that required removing fluid from her lung. She was intubated with a ventilator for 5 days, it was removed for 3 days and placed back for another 3 days, receiving to date (09/17/2021) wound care every other day, physiotherapy and occupational therapy, which were not enough to prevent several blood clots in her right leg. Visiting her every day at the hospital for more than two months, I witnessed her pain and suffering, vomiting, nausea, and three and a half months of tube feeding as with great courage and a strong will she struggled to regain energy and strength by eating and exercising, etc., now also facing blood clots.
Her tumor, like the tumors of millions of other people, could have been removed with a simple surgical procedure, before it broke down its structure and metastasized in the peritoneum affecting many other organs, if only my 3D-CBS invention, which has the capability of detecting fewer than 100 cancerous cells at a cost of $200/test, and requiring 1% the radiation dose of commercial PET, had been funded 21 years ago.
If anyone has any doubt that it is preferable to detect clusters (tumors) with fewer than 100 cancerous cells, rather than waiting for them to grow to billions of cells and metastasize to other organs, I invite them to express their doubts or disagreement in public and to analyze and discuss with me the calculations and scientific evidence that I reported in my book of the year 2000 “400+ times improved PET efficiency for lower-dose radiation, lower-cost cancer screening” ISBN 0-9702897-0-7, in subsequent articles and on the website www.crosettofoundation.org.
We should work together as summarized in the title “The €20 billion annually spent on cancer in Italy must not create a competition between researchers but a union in publicly discussing strategic plans that can defeat the common enemy that is cancer” of the article published on August 2021 by the Italian Magazine “Il Previdente”. Instead of worrying about how a paper and presentation is helping to advance a career, we should discuss what impact it will have in reducing cancer deaths and costs, serving others and being honest and fair toward taxpayers by evaluating each presentation and paper that maximizes those results for them.
It is a responsibility toward humanity not to silence and suppress the work and research of colleagues proving advancements in science, in alleviating suffering, saving lives and costs, as was done in my case, only to discover 21 years later that I was right in my calculations, and the scientific evidence reported in my book that would detect clusters (tumors) with fewer than 100 cancerous cells.
Now if the combination of my three inventions 3D-Flow, 3D-CBS and TB-CAD, which can save over 260 lives per year per machine, reducing 80 times the cost per life saved and with the potential to save over 100 million lives and over $27 trillion in 30 years, is silenced and suppressed as it has been for 21 years, who will be responsible for preventing and/or delaying these benefits to humanity?
I therefore respectfully propose the following to all colleagues who are presenting their work at this 2021 Total Body PET Conference:
- Please read carefully the 280-word abstract and the three references. Express any disagreement that will substantially invalidate my claims that the component cost of the 3D-CBS is less than $2 million per device, with a two-minute screening test at $200 per test and the results in benefits in lives and money saved listed above. (Costs for services, salaries of 20 doctors at $400k/year each have been discussed with professionals working in the field and were found adequate. A disagreement in some calculated rates might increase the price to $250 per test, however, this would not invalidate the essence of the lives and money saved per year).
- To facilitate understanding the essence of these three references I suggest reading the summary of my inventions 3D-Flow, 3D-CBS and TB-CAD and also the original 22 letters of testimonials from Nobel Laureate, from the Director of Fermilab and SSC, from the inventor of the pocket calculator, and the inventor of the first 300MHz Microprocessor and others, who endorsed the scientific merit of my inventions. Let me know if you disagree with their statements and how you counter them with scientific arguments.
- Because my abstract “Multi-3D-CBS whole-body screening tests: a revolutionary invention making diagnosis based on CAD trends calculated on anomalies in biological processes, rather than on a single examination, for saving millions of lives and trillions of dollars” was approved on July 22nd, 2021, by the TBPET Scientific Committee but it was not included in the program, zero time was allocated for presentation and its title was not even mentioned in the program, no one will know of its existence and could not express agreements or disagreements (On 9/15/2021 this was the final agenda available on TBPET website since 7/22/2021). If you believe my 280-word abstract is reporting a work which provides less benefit than yours or any work in any other abstract, please substantiate the essence of yours and your colleague’s greater benefits in advancing science in the field for saving lives and money.
- If you cannot show your work/paper having a higher impact in reducing cancer deaths and costs, out of respect to cancer patients, I respectfully ask you to sacrifice 10 percent of your allotted time slot and I hope that you would consider it to be fair to taxpayers and cancer patients that my abstract/paper/inventions more beneficial to them should have at least the same number of minutes allocated as the longest presentation of 45-50 minutes.
- Consider that, without relinquishing any impact in visibility of your presentation/work to the world, as endorsed by the superb venue, with the striking features of the University of Edinburgh, you will be helping cancer patients and humanity to receive the best possible solution to beat cancer, emerging from the scientific truth in a transparent, open, collaborative environment of scientists at the TBPET Conference. Your name, title, abstract and presentation will still appear, only 10 percent of your time will be donated for the benefit of taxpayers to receive maximum results.
- Specifically, I respectfully ask Axel Rominger, Suleman Surti and Adam Alessio to sacrifice 5 minutes of their 50 minutes allotted time slot; Guabao Wang, Oliver Langer and Antony Gee to sacrifice 4 minutes of their 40 minutes allotted time slot; Adriana Tavares to sacrifice 3 minutes of her 30 minutes allotted time slot; Stefaan Vandenberghe to sacrifice 2 minutes of his 20 minutes allotted time slot; Marta Freire and Hasan Sari to sacrifice 2 minutes of their double presentations for an allotted time slot of 10 minutes each; Stephan Naunheim, Julien Bordes, Maya Abi Aki, Tim Jasper, Irene Hernandez-Lozano, Janko Lambertus, Terry Jones, Hui Liu, Francois Villinger, Austin Pantel, Jason Laval, Lalith Kumar Shiyam Sunder, Elizabeth Li, Yingying Li, Ruiyao Ma, Venkata Kandarpa, Song Xue, Aleksander Gajos, Antonio Gonzales, to sacrifice 1 minute of their 10 minutes allotted time slot.
- On behalf of cancer patients, I thank you for your generosity. This is a serious issue with millions of lives and trillions of dollars at stake that rely on our responsibility to understand the laws of nature and make the scientific truth emerge, therefore I hope you would answer to info@crosettofoundation.org by either claiming your work/presentation has a higher impact in reducing cancer deaths and cost or to allow me to serve cancer patient in presenting mine. Because the scientific committee already approved my abstract, there should be no problem for them to shift some allocated time from your presentation to my presentation.
We should help each other to observe and interpret the laws of nature for beating cancer. We should help each other in revising the calculations and claims which should reflect the expected results when the actual results from an experiment will be the final judge. For no reason should we silence, delay or suppress ideas and innovations from being presented, published and funded without having calculations and solid scientific arguments showing irrefutably that they will not provide benefits.
I will listen attentively to the presentation by the Keynote speaker, Axel Rominger, who has access at Bern University Hospital to the “world’s first ultra-large axial field-of-view PET scanner from Siemens”, which is the 106cm FOV Biograph Vision Quadra, the assembly of four 26 cm FOV Biograph Vision. The measurements performed by Rominger could have been made by him and by many other hospitals in the world 19 years ago when I wrote the book in 2000 and met the leaders of Siemens Nuclear Medicine in November 2002.
After I solved the inefficiency problem on Siemens’s PET devices during our 2002 meeting (that was recorded with the consent of the participants), they were forced to retract publicly on their website their incorrect statements that it was not possible to increase the efficiency of their PET devices by improving the electronics. After solving their inefficiency problem in 2002, they could have assembled side-by-side four Siemens 23.4 cm FOV PET966 EXACT3D using BGO crystal detectors, as described on page 47 of my book, to verify that the number of counts increases approximately by the square of the length increase of the detector. Then by implementing my 3D-CBS device, they could have provided the advantage of a more efficient $200 per screening test cost using the BGO crystals instead of the LSO crystals used in the Vision Quadra.
So, in 2019, Siemens just assembled side-by-side four devices they could have assembled 19 years earlier. When would they agree to build a 3D-CBS providing a more efficient $200 per screening test requiring a very low radiation dose to the patient? Rominger’s developments on artificial intelligence would be much more accurate and effective if it were based on millions of data that could only be acquired when a screening test costs $200 rather than thousands of dollars. This would be an interesting discussion that I could contribute to with my 3D-CBS device and with the strategic plan for an effective mass screening test.
I will listen one more time to the 50-minute presentation by Suleman Surti “Total-Body PET system design” with many ideas taken from my book and documents as was also admitted in slides presentations by his co-developer stating that they were not presenting a new idea with the EXPLORER. However, it would be fairer to taxpayers and cancer patients if he and his colleagues would let me present my idea and strategy targeted to maximize reduction in cancer deaths and costs, while their implementation of the EXPLORER cannot do that.
The real advancement in science comes from helping each other to understand the laws of nature to achieve specific publicly declared objectives and not by undermining and suppressing the presentation of colleagues with different objectives. My goal is to design instrumentation to reduce cancer deaths and costs. At this conference I hope that there will be an opportunity for me to present my combined inventions to maximize benefits and that colleagues will express their disagreements on technical issues without denying transparency and suppressing advancement in science.
Sincerely, Dario Crosetto