The Belgian historical expertise in medical applications of ionising radiation

Belgium is a world leader in medical applications of ionising radiation. This leadership has been achieved thanks to the creativity and the innovations by hundreds of scientists, clinicians and engineers who built on the very strong foundations provided by the pioneers in the field.

A world leader inmedical applications of ionising radiation

At the end of the 19th and beginning of the 20th century, Belgium being one of the richest countries per habitant in the world was very much oriented towards scientific discoveries and technological developments. As an example, in April 1896, only five months after the discovery of X-rays by Roentgen, the Belgian army had X-ray equipment installed to improve medical diagnosis.

In March 1896, Henri Becquerel discovered rays of unknown nature. Shortly afterwards, Marie and Pierre Curie would explain the origin of the rays and coin the term radioactivity.

Leg of Belgian soldier, 1896

Source: 100 years of radiology in Belgium, Belgian Museum of Radiology, ISBN 90-802575-1-6

Pierre and Marie Curie-Skłodowska, 1904

The discovery ofRadium

Marie and Pierre Curie discovered the existence of radium in 1898 and successfully isolated radium salts in 1902. On year later, they shared the Nobel prize in physics with Henri Becquerel. The potential of radium for therapeutic uses was realised soon afterwards when both Becquerel and Pierre Curie experienced skin lesions after having been exposed to radium.

Marie Curie became a frequent visitor to Belgium, both for scientific reasons, e.g. the Solvay Conferences, and also because Belgium had the largest uranium reserves in the world thanks to the Shinkolobwe mine in Congo. Marie Curie extracted radium out of the uranium ore to supply radiotherapy services worldwide.

Treatment of Lupus by X-rays

Already in 1900, Prof. Jules De Nobele, of (R)UGent, was using X-rays to treat Lupus by X-rays and in 1904, Prof Adrien Bayet of ULBruxelles, initiated treatment by radium.

Jules De Nobele and Adrien Bayet (source: Wikipedia)

Marie and Irène Curie, Hoogstade, 1915
(Source: Roseline Debaillie)

During World War I, Marie Curie and her daughter Irène would spend a several weeks in Belgium, training Belgian nurses and doctors in radiography.

A major producer of Radium fortherapeutic uses

From 1923 on, Belgium was the major producer of Radium for therapeutic uses in the world. That year, the Belgian Red Cross founded the Belgian Radium Institute and in 1931, the Sino-Belgian Radium Institute was created in Shanghai, now the Fudan University Shanghai Cancer Center, the major cancer specialty hospital in China.

Sino-Belgian Radium Institute, 1931 (source: wikipedia)

First therapy with Sr-89, 1940-1941

Pioneerin the use of Strontium-89 for bone metastasis

In 1939, a freshly graduated MD from ULB, Charles Pecher, moved to Berkeley to work with the inventor of the cyclotron, Ernest Lawrence, and his brother John Lawrence. MD. Pecher wanted to develop a cure for the pain caused by bone metastasis using one of the newly discovered radioisotopes. In 1940-41, he demonstrated that 89Sr (Strontium-89) is taken up by the bone, that the uptake dynamics were optimal for therapy and he performed the first successful therapies with 89Sr. If it hadn’t been for the fact that his work was classified as very secret – due to the link between Strontium and nuclear weapons research and therefore only rediscovered a few years ago – he would have been considered one of the great pioneers in nuclear medicine.

Belgium, a worldleader inmedical isoptope supply, cyclotron-based applications and installations for proton therapy

Nuclear medicine was introduced in most Belgian university hospitals in the late 40’s, early 50’s. This was also the period when the Belgian Nuclear Research Centre, SCK CEN, was created (1952). With its research reactors BR1 and BR2, SCK CEN performed uranium target irradiation to produce medical isotopes, and its spin-off, the Institute for Radioelements, IRE, took care of their separation and purification. Belgium then (and is still doing so today) started providing medical radioisotopes on a regular basis to nuclear medical centres in Europe and worldwide.

BR2 reactor (Source: SCK CEN)

By 1975-1980, the entire value chain, from production of isotopes up to clinical research and practice was operational. Already in the 80’s, more than 100 nuclear medicine departments were active in the country.

Up to then, only reactor produced isotopes were routinely available in Belgium. The first Belgian cyclotron was built in 1947 at the university of Leuven/Louvain. As researcher with extensive experience in cyclotron technology, Yves Jongen went to work at Berkeley and upon his return created IBA in 1986.

Soon, all Belgian universities would be equipped with cyclotrons which would open the door to the introduction of Positron Emission Tomography, PET, mainly with F-18 (Fluor-18). By the year 2000, Belgium hosted the highest density per capita of nuclear medicine departments, cyclotrons and SPECT or PET cameras in the world.

Today, Belgium is worldleader in medical isoptope supply, cyclotron-based applications and installations for proton therapy.

Yves Jongen at IBA (Source: 2020-01-18 IBA)