The use of hybrid imaging systems will clearly improve the accuracy of molecular imaging approaches—however, the imaging community will need to overcome several hurdles in translating the evolving targeted imaging probes, technologies and applications into clinical care.
A review published in January issue of Circulation: Cardiovascular Imaging on multimodality cardiovascular molecular imaging predicted how the concept of hybrid imaging can be extended even further by performing multimodal molecular imaging with several platforms. The authors said this could offer a global view of events, rather than focusing in isolation on a single molecule. The combination of fluorescence, MRI and PET or SPECT imaging, for instance, could allow more than four targets to be imaged at one time.
Potential applications of this strategy include inflammatory atherosclerosis, where the adhesion molecule VCAM-1 could be detected by PET imaging, the recruitment of monocyte/macrophages could be imaged with magneto-fluorescent nanoparticles and the assessment of their proteolytic activity could be detected with near infrared protease sensors.
Among the barriers faced, low sensitivity is the primary issue in MR-based molecular imaging. Current imaging systems have also not been optimized for cardiac applications, with inadequate correction for cardiac and respiratory motion and a lack of quantitative software for targeted agents, according to the authors.
The promise of hybrid multimodality molecular imaging can be fully realized in future—by developing collaboration between industry, basic science and imaging communities along with appropriate education and interdisciplinary training.
Turning to reimbursements, 2010 will see an 24 percent increase in reimbursements in the Hospital Outpatient Prospective Payment System for PET myocardial perfusion imaging by the Centers for Medicaid & Medicare Services (CMS).
In other news, if the potential and possibilities of molecular imaging make your pulse quicken, be sure to swing by our Molecular Imaging Insight Website. You can sign up for our weekly newsletter as well as subscribe to our quarterly magazine. In addition, if you or your group is interested in finding out more about technologies and systems for molecular imaging in your practice, head over to our Healthcare TechGuide and check out the variety of offerings available there.
Lastly, if you have a comment or report to share about the utilization of molecular imaging and nuclear medicine in your practice, please contact me at the address below. I look forward to hearing from you.
Manjula Puthenedam, Associate Editor