Molecular Imaging

Molecular imaging (also called nuclear medicine or nuclear imaging) can image the function of cells inside the body at the molecular level. This includes the imaging modalities of positron emission computed tomography (PET) and single photon emission computed tomography (SPECT) imaging. How does PET and SPECT imaging work? Small amounts of radioactive material (radiopharmaceuticals) injected into a patient. These can use sugars or chemical traits to bond to specific cells. The radioactive material is taken up by cells that consume the sugars. The radiation emitted from inside the body is detected by photon detectors outside the body. Computers take the data to assemble images of the radiation emissions. Nuclear images may appear fuzzy or ghostly rather than the sharper resolution from MRI and CT. But, it provides metabolic information at a cellular level, showing if there are defects in the function of the heart, areas of very high metabolic activity associated with cancer cells, or areas of inflammation, data not available from other modalities. These noninvasive imaging exams are used to diagnose cancer, heart disease, Alzheimer’s and Parkinson’s disease, bone disorders and other disorders.

FDA approves expanded use of radioembolization therapy for liver cancer
The added indications make the treatment the first Y-90 therapy approved for both unresectable hepatocellular carcinoma and metastatic colorectal cancer of the liver.
Post-ablation PET imaging may not be cost-effective in patients with liver metastases
Although most radiology organizations agree that [18F]FDG PET/CT can provide valuable information in these patients post-treatment, their recommendations differ on its use.
FDA approves expanded use of PET imaging agent
The product's updated indications include quantification and long-term monitoring of amyloid plaques on imaging.
'Powerful' new PET agent improves the diagnosis of triple-negative breast cancer
The agent “exhibits powerful tumor delineation” in challenging cases of determining cancer subtypes, and could potentially lead to more personalized, effective treatment strategies.
Industry partnership set to advance research on theranostics
The deal will create a Therapy Command Center to support the study and use of theranostics across Massachusetts General Hospital and its affiliated centers in bordering states.

Reducing Radiation Dose in Kids: How Low Can You Go

Radiation was brought to the fore within pediatric nuclear medicine following the release of a 2008 study which revealed a chaotic disarray of administered doses within North Americas premier pediatric institutions, including radiopharmaceutical doses varying by factors of as much as 10 in most children and by up to 20 in infants (J Nucl Med 2008; 49:10241027).

How will Comparative Effectiveness Research Impact Molecular Imaging?

Last year, the SNM received a $48,000 grant from the Agency for Healthcare Research and Quality to develop comparative-effectiveness research (CER) of PET and other molecular imaging techniques. The primary emphasis is on the diagnosis and management of cancer patients, but both cardiology and neurology questions are being addressed. Far beyond the dollars, too, is a significant increase in intellectual capital being expended across the globe on the role of CER in molecular imaging. 

Preclinical Imaging: The Rapidly Evolving Role of Nanotechnology

Researchers at Memorial Sloan-Kettering Cancer Center, along with collaborators at Cornell University and Hybrid Silica Technologies, have received approval for their first Investigational New Drug Application (IND) from the U.S. Food and Drug Administration (FDA) for an ultrasmall inorganic (silica) nanoparticle platform for tumor targeting and for the treatment of cancers in the future.

Improving Risk Stratification for Cardiovascular Disease

SPECT myocardial perfusion imaging (MPI) is a well-validated noninvasive test to determine if coronary artery disease (CAD) is the cause of a patients chest pain. While SPECT will continue to play a role in this patient population, other tests are helping to fill in the gaps in identifying those at risk of cardiac events.

Proving the Value of Registries

This issue provides updates on several important applications of molecular imaging. The cover story presents novel ideas to better identify patients who are at risk for or have coronary artery disease.

On the Verge: Inside Clinical Trials that Could Change Patient Care

PET imaging is effective in staging, restaging, detecting recurrence and treatment monitoring across a wide range of cancers.

Electrophysiology Procedure Planning: Using Nuclear Modalities to Help Guide Ablations & Patient Selection

Due to the commonality of these arrhythmias and the number of procedures necessary to treat them, there is a growing need for the field of electrophysiology (EP). And to better treat patients with dangerous arrhythmias, practitioners have begun using cardiac PET and SPECT to help in patient selection and to guide EP procedures including ablations, lead placements and CRT implantations.

Preclinical to Clinical 18F-FLT PET Imaging Moving from Mice to Men

One of the most promising radiopharmaceuticals is the proliferation marker 3'-deoxy-3'-[18F] fluorothymidine (18F-FLT). 

Molecular Imaging

FDA approves expanded use of radioembolization therapy for liver cancer

Post-ablation PET imaging may not be cost-effective in patients with liver metastases

FDA approves expanded use of PET imaging agent

'Powerful' new PET agent improves the diagnosis of triple-negative breast cancer

Industry partnership set to advance research on theranostics