The Big Picture
Molecular imaging is providing new insights into human physiology and disease. It provides more accurate diagnosis, cancer staging, restaging and treatment monitoring, and allows for highly accurate determinations of cardiac and brain function. Molecular imaging thus enables more appropriate and timely treatment decisions. Improved PET/CT and SPECT/CT systems and techniques that allow us to detect tumors measuring a few millimeters in diameter can help to initiate treatment when the tumor burden is still small, and cancers are potentially curable.

This month marks the premiere issue of Molecular Imaging Insight, a new digital magazine focused on bridging the science of molecular imaging and clinical practice. A new technology crossing that bridge is HD•PET, whose debut brings the promise of uniform resolution across the entire field of view to offer improvements in PET/CT imaging and thus visualization of structures as small as 2 millimeters. SPECT/CT, too, is gaining wider acceptance in differentiating benign from malignant lesions in a single examination, as Torsten Kuwert, MD, of the University of Erlangen details in “To the Bone: SPECT/CT Drives Diagnostic Clarity.”

Another very important clinical application is the longitudinal imaging follow-up of cancer patients. Innovative software allows the comparison of serial PET/CT and SPECT/CT images using a single, simple navigation tool to interpret images and report findings, according to the experience of Andreas Wahl, MD, of PET/CT-Zentrum Hamburg.

Technical innovation such as a wider axial imaging field in PET/CT translates into a 30 percent increase in sensitivity and 78 percent increase in count rates, according to Stig Larsson, PhD, professor at the Karolinska University Hospital/Institute in Stockholm. This also results in shortened imaging times and might further improve diagnostic accuracy.

SPECT imaging using CT-based attenuation correction improves image quality and diagnostic accuracy in myocardial perfusion imaging of patients up to and over 400 pounds, details James Corbett, MD, director of cardiovascular nuclear medicine at University of Michigan Health System.

Novel imaging technologies such as PET/CT and SPECT/CT have resulted in improved diagnostic accuracy in cancer diagnosis, staging and monitoring. Similar advances in diagnostic accuracy are becoming evident for patients with heart disease. Together with the development of new imaging probes, these technologies have made molecular imaging a clinical reality.

Johannes Czernin, MD

Professor, Molecular & Medical Pharmacology
Director, Nuclear Medicine Clinic, Positron Emission Tomography/Computed Tomography
David Geffen School of Medicine at UCLA, Los Angeles, Calif.