ABSTRACT
Modern molecular imaging techniques are increasingly playing an
important role in individualized diagnosis and therapy in a wide
array of disorders. The impact is most evident in the field of
cancer, where patient-specific and tumor-specific information can
be obtained both at diagnosis and during the subsequent disease
course (viz., following initiation and completion of a particular
therapeutic intervention and in post-therapy disease surveillance).
The radionuclide-based PET-CT and SPEC) techniques have taken
the lead role in this arena. In recent years, there have been
varying degrees of success of novel methodologies being applied
to cross-sectional imaging as well. Examples include application of
(a) targeted microbubble techniques in the domain of ultrasound
(US), (b) hyperpolarized magnetic resonance imaging (MRI) (e.g.,
metabolic MRI employing hyperpolarized 13C-labeled pyruvate
molecules), (c) diffusion-weighted MRI, (d) and magnetic resonance
spectroscopy (MRS). Such endeavors are likely to help in molecular
characterization of tumors and may have potential implications for
personalized cancer medicine. For the purpose of discussion, the
available imaging modalities, thus, have been broadly classified into
two broad groups, (A) the radionuclide-basedmethods (e.g., PET-CT,
SPECT, and planar technologies) and (B) nonradioactive molecular
imaging modalities. The latter could be subclassified into (1) MRI,
(2) US, and (3) optical imaging (near-infrared fluorescence and
bioluminescence). In the recent literature on molecular imaging-
based personalized medicine, particular emphasis has been given
on radionuclide-based PET-CT and SPECT imaging, which could
provide tumor-specific information in an individual (e.g., tumor
metabolism, cell proliferation, hypoxia, receptor status, and other
pathway activities). It has a very high impact on revolutionizing
and materializing the concept of personalized medicine in the field
of oncology. The potential of nonradioactive molecular imaging
modalities is also being examined at present for defining their
precise clinical role in the future. In the present chapter, the current
status and future potentials of these promising medical imaging
modalities in advancing personalized cancer medicine have been
reviewed from a clinical perspective with an emphasis on how they
can influence clinical management decisions in cancer.
