Multiplexed imaging in cancer diagnosis: applications and future advances

Abstract

The development of imaging technologies that have sufficient specificity and sensitivity to enable early, accurate detection of cancer and response to therapy has long been a goal in oncology. Various radiological techniques have been used for diagnosis and surveillance of disease recurrence and imaging has revolutionised oncology. However, despite the widespread use of technologies, the ability of currently available imaging methods to facilitate early detection, precise characterisation, and accurate localisation of maligant disease could be improved. The simultaneous use of two or more techniques, contrast reagents, signalling methods, or the coupling of agent and tissue properties to achieve so-called multiplexed imaging is a promising approach. In this review, we provide a broad overview of current and emerging multiplexed, imaging technologies.

Multiplexed imaging for diagnosis and therapy

“…The selection of complementary information using distinct imaging channels of transmission can lend incredible value in delineating and characterising the multiple features of tumours by yielding a more comprehensive pathological view of tumour structure and function [32][33][34][35][36][37][38][39][40] . Traditionally, in the case of PET-MR, MR provides the anatomic correlation for the quantitative functional information supplied by PET, leveraging the advantages of both the PET and MR components to provide a sensitive and detailed spatial map of a lesion.…”

“…In the advancing era of precision and personalised medicine, the role of multiplexing is not only essential; it is evolving. Echoing several themes 32,33,41 , this section surveys applications, challenges and advances in several of the most clinically relevant examples of multiplexed-imaging strategies, and includes clinically ubiquitous approaches in modern biomedical imaging as well as strategies at the forefront of the field, but not yet in widespread clinical use.…”

“…Compared with PET-CT, PET-MR affords a significant reduction in patient exposure to ionising radiation in addition to generally better intrinsic soft-tissue contrast [57][58][59] . PET-MR delivers additional opportunities for multiplexing through the use of dual-modality radioisotope/MR active molecular or nanoparticle-based probes, and the option of simultaneous T1-/T2-/diffusion-weighted data acquisition 33,60 .…”

Approaches to Multireceptor Targeting: Hybrid Radioligands, Radioligand Cocktails, and Sequential Radioligand Applications

“…Their potential advantages are an increased sensitivity and simultaneous localization of disease with only 1 injection. There are only a few examples of the use of the cocktail approach in the clinic, such as using SPECT agents for the localization of parathyroid adenomas and medullary thyroid cancer as well as some cardiac nuclear imaging studies (52). In addition the Stanford group advocated for the combined administration of 18 F-NaF and 18 F-FDG in a single PET scan and initiated a prospective international multicenter trial (53).…”

“…Otherwise the modality is underused and almost excluded in PET for obvious reasons. Optical imaging has a big potential within the cocktail approach as simultaneous multicolor imaging can be performed and used for localization and characterization of expression profiles (52).…”