Molecular Imaging at RSNA: Moving from Bench to Bedside

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Lisa Fratt, Editor

Molecular imaging is celebrating its fifth year as an RSNA track, as the science has grown from preclinical to translational. The blend of clinical studies and preclinical research demonstrates the shift, Umar Mahmood,MD, PhD, co-director of nuclear medicine and molecular imaging in the department of radiology at Massachusetts General Hospital in Boston and chair of the RSNA molecular imaging abstract review subcommittee, told Health Imaging News. “Molecular imaging is the future of radiology," he added.

“Molecular Imaging is just starting to realize the breadth of its potential with bench research increasingly making it into human studies,” said Mahmood.

This year, RSNA leaders reinforced the importance of molecular imaging by selecting personalized medicine as the theme for the show. The marriage of molecular imaging and powerful IT tools will allow physicians to subdivide patients into thousands of patient subgroups based on molecular characteristics of disease.

Molecular imaging sessions run the full gamut at RSNA 2010. Basic sessions examine the impact of molecular imaging by modality. RSNA attendees more up to speed in molecular imaging can learn about new tracers such as 18F-fluorothymidine ( 18F-FLT ), 60/62/64Cu-labeled diacetyl-bis (N4-methylthiosemicarbazone) (60/62/64Cu-ATSM) and 18F-fluoromisonidazole ( 18F-FMISO) as well as new applications for FDG.

While researchers explore new tracers on the lab bench, academic medical centers and pioneering oncology practices are pushing PET/CT further into clinical use, by employing the hybrid systems for treatment planning and therapeutic monitoring. Over the last year, numerous studies demonstrated the value of FDG PET/CT for both indications.

1. A study presented at the European Association of Nuclear Medicine Congress this fall indicated that PET/CT could be valuable for the prognostic evaluation of patients with breast cancer. The Italian study adds to previous data in the August issue of the Journal of Nuclear Medicine indicating that the combination of PET/CT and circulating tumor cell counts could provide a useful tool in monitoring therapeutic response for breast cancer.
2. PET/CT can confirm suspected colorectal cancer at an early stage, according to British research presented at the American Roentgen Ray Society meeting in San Diego in May. The data could aid treatment planning and target patient care.
3. In the November issue of the Journal of Clinical Oncology, researchers at Wake Forest University Baptist Medical Center in Winston-Salem, N.C., reported that FDG-PET complete response accurately predicted outcomes in esophageal cancer patients treated with chemoradiotherapy, which ultimately could help physicians better target candidates for surgical resection.

      The economic front also saw a bit of positive news in 2010. An analysis published in the March issue of the Journal of Nuclear Medicine suggested that PET and PET/CT are cost effective for staging of non-small cell lung cancer, differential diagnosis of solitary pulmonary nodules, restaging of Hodgkin's disease and non-Hodgkin's lymphoma and the restaging of colorectal carcinoma.

      As RSNA 2010 embraces personalized medicine, the molecular imaging subcommittee is ready to shine with a wide spectrum of education offerings.

      Lisa Fratt
      Editor of Health Imaging & IT