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Good afternoon, this is David Mankoff,
and I'll be talking to you today about
clinical applications
of molecular imaging.
And in specific, we'll look at
imaging to guide cancer therapy,
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today we'll start by looking
at some of the questions that
arise in trying to treat cancer patients
that imaging can be helpful for.
And we evaluate some of the methods
that we can use to address them, and
then we'll go on to show some examples
of recent work using cancer imaging and
then specific molecular imaging
to guide cancer therapy.
Number one by choosing the right patients,
number two by choosing the right drug
that we know will get to the target, and
number three, getting the right result,
and number four,
using imaging to try to predict outcome.
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To start, we need to distinguish
anatomic versus functional imaging,
anatomic imaging is what most of us
are used to in clinical medicine and
in radiology, and are exemplified
by things like CT and mammography.
And here we rely on the tumor size,
shape and
density to be able to identify it, we
also look for changes in that same size,
shape and density to be able to
infer response to treatment.
And that's really been the gold
standard for many, many years and
is really what much of the current
practices is based upon.
Now, functional molecular imaging
are a bit different in that they rely on
in vivo tumor biology looking at processes
such as perfusion metabolism, and
more recently at the molecular features of
the tumors, to be able to generate images
and to be able to identify properties of
tumors in particular for cancer imaging.
Examples of this include MRI and PET, and
I'll be focusing mostly
on PET in this talk.
And one of the reasons that this kind of
approach would work better, we think, for
evaluating changes in response to therapy,
is that we would expect to
see these functional molecular changes
significantly precede changes in size,
shape and
density over the course of treatment.
In addition, these type of features might
be particularly helpful for trying to
choose the right kind of patients and help
choose the right drugs for those patients.
So if we think about what are the
different functional molecular imaging
