What scans we will read: imaging instrumentation trends in clinical oncology

Abstract

Oncological diseases account for a significant portion of the burden on public healthcare systems with associated costs driven primarily by complex and long-lasting therapies. Through the visualization of patient-specific morphology and functional-molecular pathways, cancerous tissue can be detected and characterized noninvasively, so as to provide referring oncologists with essential information to support therapy management decisions. Following the onset of stand-alone anatomical and functional imaging, we witness a push towards integrating molecular image information through various methods, including anato-metabolic imaging (e.g., PET/ CT), advanced MRI, optical or ultrasound imaging. This perspective paper highlights a number of key technological and methodological advances in imaging instrumentation related to anatomical, functional, molecular medicine and hybrid imaging, that is understood as the hardware-based combination of complementary anatomical and molecular imaging. These include novel detector technologies for ionizing radiation used in CT and nuclear medicine imaging, and novel system developments in MRI and optical as well as opto-acoustic imaging. We will also highlight new data processing methods for improved non-invasive tissue characterization. Following a general introduction to the role of imaging in oncology patient management we introduce imaging methods with well-defined clinical applications and potential for clinical translation. For each modality, we report first on the status quo and, then point to perceived technological and methodological advances in a subsequent status go section. Considering the breadth and dynamics of these developments, this perspective ends with a critical reflection on where the authors, with the majority of them being imaging experts with a background in physics and engineering, believe imaging methods will be in a few years from now. Overall, methodological and technological medical imaging advances are geared towards increased image contrast, the derivation of reproducible quantitative parameters, an increase in volume sensitivity and a reduction in overall examination time. To ensure full translation to the clinic, this progress in technologies and instrumentation is complemented by advances in relevant acquisition and image-processing protocols and improved data analysis. To this end, we should accept diagnostic images as "data", andthrough the wider adoption of advanced analysis, including machine learning approaches and a "big data" conceptmove to the next stage of non-invasive tumour phenotyping. The scans we will be reading in 10 years from now will likely be composed of highly diverse multidimensional data from multiple sources, which mandate the use of advanced and interactive visualization and

The Release of a Highly Cytotoxic Paullone Bearing a TEMPO Free Radical from the HSA Hydrogel: An EPR Spectroscopic Characterization

“…In oncology, imaging methods have become an indispensable part of the diagnostic approach [5]. The conventional imaging modalities, such as X-ray imaging, computed tomography (CT), and magnetic resonance imaging (MRI), established in cancer management, are usually followed by invasive biopsy extraction for a definite diagnosis [6]. Molecular imaging, which provides valuable insight into biological processes at cellular and sub-cellular levels, has exhibited the potential to suppress such an invasive procedure [7].…”

Medical Physics and Imaging–A Timely Perspective

“…cadmium-zinc-telluride) for SPECT with high performance diagnostic CT scanners. Statistical iterative image reconstruction algorithms have been implemented for SPECT and several vendors offer CT-based attenuation, scatter and even motion correction techniques for improved quantification [18]. Of note, one vendor provides a tri-modality SPECT-CT-PET system for maximum versatility [60].…”

“…Imaging is a means, provided through technological and methodological advances, to view the human body from outside and inside, to probe anatomical, functional and even molecular and signaling pathways non-invasively for new information of the state of the patient for rendering an accurate and personal diagnosis. Medical imaging, by means of radiology and molecular imaging, has become a foundation for diagnosis and therapy planning in numerous diseases that patients present with [18]. What is more, imaging is being used extensively in healthy subjects, or volunteers to better understand physiology and signaling, for example in the brain, so as to build reference models of normal physiology, biology and functional correlates that can be employed to better define abnormal variants during diagnostic and therapeutic work-up of patients.…”

Introduction to Special Issue of Radiology and Imaging of Cancer

“…The increase in knowledge in oncology and the possibility of creating personalized medicine by selecting a more appropriate therapy related to the different tumor subtypes, as well as the management of patients with cancer within a multidisciplinary team has improved the clinical outcomes [ 1 ].…”

“…The characteristics involved are a more appropriate surveillance for the patient at risk to obtain an early diagnosis of the disease, an improvement in the efficacy of therapies based on better patient selection [ 1 , 2 ] and, thanks to a more strategic approach, the possibility of identifying responders or non-responders to therapies as soon as possible, not least the possibility of selecting different treatments related to genomic data. In fact, it has been shown that genomic markers such as microRNA expression are associated with the response to treatment, metastatic spread and prognosis that could offer personalized and precision medicine.…”