A Definition of Molecular Imaging

Jun 19, 04:38 AM

Current Headlines: By Mankoff, David A

MOLECULAR IMAGING UPDATE Over the past 4 months, the members of the Molecular Imaging Center of Excellence (MICoE) Standard Definitions Task Force have been developing standard definitions and terms that will serve as the foundation of all communications, advocacy, and education activities for MICoE and SNM. The members of this task force are: David A. Mankoff, MD, PhD (chair); Bennett Chin, MD; William Eckelman, PhD; Jerry Glickson, PhD; Craig Levin, PhD; Chet Malhis. PhD; Barry Shulkin, MD; Albert Sinusas, MD; Michael Stabin. PhD; Mathew Thakur, PhD; Benjamin Tsui. PhD; and Ronald Van Heertum. MD. The group was staffed by Sue Abreu, MD, and Marybeth Hewlett, director of MICoE.

The task force recommended, and the MICoE and SNM boards have approved, this definition of molecular imaging:

Molecular imaging is the visualization, characterization, and measurement of biological processes at the molecular and cellular levels in humans and other living systems. To elaborate; Molecular imaging typically includes 2- or 3-dimensional imaging as well as quantification over time. The techniques used include radiotracer imaging/nuclear medicine, MR imaging, MR spectroscopy, optical imaging, ultrasound, and others.

The group defined molecular imaging agents as "probes used to visualize, characterize, and measure biological processes in living systems. Both endogenous molecules and exogenous probes can be molecular imaging agents." Additional standard descriptions developed by the task force include:

Molecular imaging instrumentation comprises tools that enable visualization and quantification in space and over time of signals from molecular imaging agents. Molecular imaging quantification is the determination of regional concentrations of molecular imaging agents and biological parameters. Further, molecular imaging quantification provides measurements of processes at molecular and cellular levels. This quantification is a key element of molecular imaging data and image analysis, especially for inter- and intrasubject comparisons.

To assist with the understanding of molecular imaging in clinical care, statements were developed that can be used to help communicate the importance of molecular imaging:

* Molecular imaging has enormous relevance for patient care: it reveals the clinical biology of the disease process; it personalizes patient care by characterizing specific disease processes in different individuals; and it is useful in drug discovery and development, for example, for studying pharmacokinetics and pharmacodynamics.

* Molecular imaging offers unique insights that allow a more personalized approach to evaluation and management of cardiovascular disease conditions, such as: ischemie injury, heart failure, and left ventricular remodeling; thrombosis, atherosclerosis, and vulnerable plaque; and angiogenesis, transplant rejection, and arrhythmic substrates.

* By accurately characterizing tumor properties or biological processes, molecular imaging plays a pivotal role in guiding cancer patient management: diagnosing, staging (extent and location), assessing therapeutic targets, monitoring therapy, and evaluating prognoses.

* Molecular imaging is a very important diagnostic tool in the early assessment, risk stratification, evaluation, and follow-up of patients with neurological diseases. Molecular imaging is playing an increasingly significant role in neurological conditions such as: tumors, dementias (Alzheimer's and others), movement disorders, seizure disorders, and psychiatric disorders.

Because these definitions will be used in other communications from the MICoE, formulating these definitions was an important first step for the task force and was done on a relatively brief time scale. The effort and insights of task force members and SNM staff leading to these definitions are greatly appreciated.

David Mankoff, MD, PhD

David A. Mankoff, MD, PhD

University of Washington

Seattle, WA

Copyright Society of Nuclear Medicine Jun 2007

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