Into the Clinic
This issue of Molecular Imaging Insight addresses various important areas of molecular imaging. The need for reducing radiation dose in molecular imaging is paramount, and is a topic that has gained considerable public attention. Obviously, the ALARA (As Low As Reasonably Achievable) principle applies to PET/CT imaging.
However, achieving the best diagnostic quality remains the most important goal in the population that needs imaging to optimize their care. These are mostly patients with cancer at various stages, those with advanced heart disease and others with cognitive dysfunction. There are no data to suggest that PET/CT imaging of these patients has any harmful effects. Clearly, dose reductions should be attempted in children as well as in women of child-bearing age (although, except for some model-based data, there is no evidence to suggest an increased risk for cancer in these populations). A scientific, rather than an emotional discussion of this topic would be helpful and desirable.
Another important challenge arises from the new FDA regulation for the production of PET radiopharmaceuticals. The insights provided in this issue should help readers understand the impact of these regulations on the practice of PET/CT imaging.
Applications of PET/CT imaging are expanding. Several molecular imaging probes including 18F-NaF for bone imaging, 18F-FDOPA for imaging movement disorders and tumor imaging and 18F-flurothymidine (FLT) for imaging cellular proliferation are showing their value in clinical practice worldwide. There are others still, such as probes targeting fatty acid synthesis such as labeled choline or acetate and labeled peptides for receptor imaging. Various approaches to image gene expression in vivo also could enter the clinical arena to support new approaches such as stem cell and other cell based therapies.
Imaging of cell-based therapies is discussed in the context of cardiac applications. While in its early development, these therapies could become standard in the future and imaging tools to monitor cell movement towards and into their target will become increasingly important.
It is important to move these probes into the clinical mainstream—the relatively low hanging fruits—while at the same time continue to develop novel, meaningful probes that address important clinical needs and targets.
Professional organizations, together with industry, should focus on advancing these probes into the clinic which requires creativity as well as investment of time and financial resources. Molecular imaging research has made remarkable progress in instrumentation and probe development. Now we need to translate these discoveries into the clinic.
To this end, we need to understand and hopefully change and facilitate regulatory processes that frequently represent the “bottleneck” for successful translation.
However, achieving the best diagnostic quality remains the most important goal in the population that needs imaging to optimize their care. These are mostly patients with cancer at various stages, those with advanced heart disease and others with cognitive dysfunction. There are no data to suggest that PET/CT imaging of these patients has any harmful effects. Clearly, dose reductions should be attempted in children as well as in women of child-bearing age (although, except for some model-based data, there is no evidence to suggest an increased risk for cancer in these populations). A scientific, rather than an emotional discussion of this topic would be helpful and desirable.
Another important challenge arises from the new FDA regulation for the production of PET radiopharmaceuticals. The insights provided in this issue should help readers understand the impact of these regulations on the practice of PET/CT imaging.
Applications of PET/CT imaging are expanding. Several molecular imaging probes including 18F-NaF for bone imaging, 18F-FDOPA for imaging movement disorders and tumor imaging and 18F-flurothymidine (FLT) for imaging cellular proliferation are showing their value in clinical practice worldwide. There are others still, such as probes targeting fatty acid synthesis such as labeled choline or acetate and labeled peptides for receptor imaging. Various approaches to image gene expression in vivo also could enter the clinical arena to support new approaches such as stem cell and other cell based therapies.
Imaging of cell-based therapies is discussed in the context of cardiac applications. While in its early development, these therapies could become standard in the future and imaging tools to monitor cell movement towards and into their target will become increasingly important.
It is important to move these probes into the clinical mainstream—the relatively low hanging fruits—while at the same time continue to develop novel, meaningful probes that address important clinical needs and targets.
Professional organizations, together with industry, should focus on advancing these probes into the clinic which requires creativity as well as investment of time and financial resources. Molecular imaging research has made remarkable progress in instrumentation and probe development. Now we need to translate these discoveries into the clinic.
To this end, we need to understand and hopefully change and facilitate regulatory processes that frequently represent the “bottleneck” for successful translation.