Professor Andrew Peet BA, PhD, MBBS, MRCP, FRCPCH

• Fellow of Royal College of Paediatrics and Child Health 2005 
• Member of Royal College of Physicians (UK) Paediatrics, February 1998
• MBBS in Medicine, St Georges Hospital Medical School, University of London, 1994
• PhD Chemistry, University of Cambridge 1987 
• BA Natural Sciences, University of Cambridge 1984

Andrew Peet studied initially at the University of Cambridge gaining first class honours in Natural Sciences (Chemistry) in 1984 and a PhD in Theoretical Chemistry in 1987. Doctoral research, under the supervision of David Clary, focussed on quantum dynamics and electrodynamics of molecular systems in particular spectroscopy and led to the publication of 7 papers and two invited presentations, one at the Max Planck Institute in Goettingen, Germany. In the final year of his PhD, he was awarded a Bye Fellowship at Magdalene College, Cambridge. He was then awarded an SERC/NATO fellowship which he undertook in the Chemistry Department at the University of California, Berkeley, USA from 1987 to 1989. At UC Berkley, he was attached to William Miller and published a further 7 papers on the quantum theory of molecular interactions and their use in the interpretation of spectroscopy.

On returning to the UK, he enrolled at St George’s Hospital Medical School, London to undertake medical training, qualifying in 1994. In the final exams, he won the Brackenbury Prize in Medicine and was awarded University of London distinctions in Pharmacology, Pathology and Medicine. During medical school, he worked with John Griffiths on the use of magnetic resonance spectroscopy (MRS) to diagnose cancer being involved in the first studies using computerised pattern recognition of MRS/NMR as a diagnostic tool for cancer.

After house officer jobs, he specialised in paediatrics, training in the West Midlands. He passed MRCP in 1998 and subspecialised in paediatric oncology. In 2002, he received a Department of Health Clinician Scientist Award undertaken at the University of Birmingham and Birmingham Children’s Hospital, becoming a consultant a year later. Research focussed on medical imaging, MRI and MRS of childhood brain tumours. He aims to make techniques widely available and has had leadership roles in several multi-centre collaborations, including the EU framework 6 projects eTumour and HealthAgents. He was a founder member of the Children’s Cancer and Leukaemia Group’s Functional Imaging Group, led the CRUK/EPSRC Children’s Cancer Imaging Programme and was the first co-chair of the SIOPE Brain Imaging Group. This work has led to seminal reviews and consensus papers in Nature Reviews Clinical Oncology and Radiology. In a global initiative, Andrew Peet and Franklyn Howe set up a Pediatric Study Group of the ISMRM with its inaugural meeting in Singapore 2016. This aims to put children at the forefront of MRI developments.

On a local level, Professor Peet led a successful £3.7M bid to the NIHR for the establishment of a 3T MRI Research Centre at Birmingham Children’s Hospital and is the Research Director of this Centre. In recognition of the excellence of his translational research, he was awarded an NIHR Research Professorship in 2013. He leads the Children’s Brain Tumour Research Team in Birmingham which has around 20 members and works between the clinic and the laboratory. Strong local collaborations exist with other research groups in brain cancer and particularly cancer metabolism as well as those involved in imaging research.

There is a strong connection to patients and the public and there are particular links to brain tumour charities within the region. As a member of the CCLG executive and the chair of its research advisory group, Professor Peet can ensure strong national and international leadership in the treatment of children with cancer and the research which will lead to improvements in their outcome.

• Lecturer on Paediatric Oncology MSc Module
• Academic Module Lead for undergraduate Paediatrics 2012/3
• Senior Clinical Examiner
• Medical student teaching ward and problem based learning

PhD students main supervisor - 10 completed

PhD students co-supervisor -  9 completed

Professor Peet has combined a background in physical sciences with the skills of a practicing clinician to make important advances in the diagnosis and management of childhood brain tumours through improvements in imaging. He has played an important role in key consensus statements defining the field for adults and children (1,2).

The focus of his research is in functional imaging, a group of techniques which are designed to probe tissue properties rather than structure and thereby answer many key clinical questions including diagnosis and prognosis (3). The techniques his team use are based on magnetic resonance imaging (MRI) which allows them to be rapidly incorporated into clinical management protocols since MRI is a standard investigation in these children. The main functional imaging method they have employed to date is magnetic resonance spectroscopy (MRS), which provides a metabolite profile of tissue. They have shown that these metabolite profiles are highly characteristic for tumour type and have used this to develop a non invasive diagnostic aid which gives high diagnostic accuracy for the most common brain tumours seen in children on a conventional 1.5T MRI scanner (4).

Multi-centre implementation of these techniques is challenging, particularly in children, but a multi-national study led by Professor Peet has confirmed that they can yield high diagnostic accuracies in this setting (5). This method can also be used at relapse where biopsies are usually avoided but it can be challenging to distinguish recurrent tumour from treatment related damage (6).

Importantly, tumours which have chemical profiles which are not consistent with their tumour type on histology were found to respond to treatment in unexpected ways showing that the MRS profile gives information beyond that available from histology and allowing clinical management to be tailored to the individual. Studies of specific tumour types have reinforced this important finding. The most common high grade brain tumour in children, medulloblastoma has a different metabolite profile if it has already seeded to other parts of the brain implying that the potential to do this is an underlying property of certain tumours rather than delays in diagnosis (7).

The most common brain tumour in children, pilocytic astrocytoma has a different MRS profile depending on where it is in the brain (8), mirroring clinical behaviour and again emphasising the importance of underlying tumour makeup in determining response to treatment. MRS clearly gives new information about tumours not available from conventional methods. More detailed metabolite profiles can be obtained by MRS of tissue samples in the laboratory, a very quick method which could provide a rapid intraoperative diagnostic tool (9).

In addition to diagnosis and improved characterisation of tumours, Professor Peet's group have discovered and started to evaluate a number of non-invasive biomarkers of prognosis and found key metabolites that are markers for overall survival (10). Certain metabolites are biomarkers of prognosis for specific tumour types. Glutamate is a marker of poor prognosis in medulloblastoma (11) whilst myo-inositol was found to be a marker of indolent pilocytic astrocytomas which may not need any active treatment (8).

Myo-inositol was also found to be a useful early predictor of tumour response to treatment in these tumours (5), an important finding since it can take 6 months for a change in size of the tumour to be seen. Professor Peet has also collaborated with the researchers in inherited metabolic diseases to investigate children with neuro-cognitive decline. They have found important chemical differences in the brain depending on the disease type and discovered novel biomarkers for cognitive function (12). Evaluation of these biomarkers is now being undertaken. Measuring metabolite levels accurately can be very challenging and in a collaborative effort, Professor Peet's group have developed a robust automated analysis method for achieving this (13) and made it widely available.

References: [1] O’Connor JPB et al, Nature Reviews Clinical Oncology, accepted April 2016. [2] The MRS Consensus Group, Radiology. 2014;270(3):658-79. [3] Peet AC et al, Nature Reviews Clinical Oncology, 2012; 9: 706-711. [2] Davies NP et al, NMR Biomed, 21(8), 908-18, (2008). [4] Javier Vicente et al, European Journal of Cancer, 2013;49(3):658-67.  [5] Gill SK et al, Neuro Oncol. 2014;16(1):156-64. [6] Peet AC et al Eur J Cancer, 43, 1037-44, April (2007). [7] Harris LM et al Eur J Cancer, 2008; 44: 2640-7. [8] Wilson M et al. Molecular Cancer, 2009; 8:6. [9] Wilson M, European Journal of Cancer, 2013;49(2):457-64. [10] Wilson M et al, Clin Cancer Res, 2014;20(17):4532-9. [11] Davison, JE et al Orphanet Journal of Rare Diseases, 2011; 6:19. [12] Wilson, M et al Magnetic Resonance in Medicine, 2011; 65(1):  1-12.

• NIHR Clinician Scientist Award Panel Member
• Scientific Advisor to Help Harry Help Others Charity
• Award Panel member for Foulkes Foundation Fellowships
• Birmingham Children’s Hospital Research Foundation panel member
• NCRI Brain Imaging and Technology Group member
• NCRI CCLG Brain Tumour Group Member
• NCRI CCLG New Agents Group Member