Review of functional/anatomical imaging in oncology.
Review of functional/anatomical imaging in oncology.
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DOI：
10.1097/mnm.0b013e32834ec8a5
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发表时间：
2012-04
影响因子：
1.5
通讯作者：
Kurdziel KA
中科院分区：
文献类型：
--
作者：
Histed SN;Lindenberg ML;Mena E;Turkbey B;Choyke PL;Kurdziel KA
肿瘤学中的患者管理越来越依赖于用于诊断、反应评估和随访的成像。结合功能解剖成像模式的临床可用性，将可视化肿瘤生物学的益处与高分辨率结构成像的益处相结合，彻底改变了肿瘤患者的临床管理。传统的高分辨率解剖成像方式，如计算机断层扫描（CT）和磁共振成像（MRI）擅长提供有关病变位置，大小，形态和邻近组织的结构变化的细节;然而，这些方式提供的肿瘤生理学的洞察力很少。随着对分子靶向治疗的日益关注，使用正电子发射断层扫描（PET）和单光子发射断层扫描（SPECT）对放射性标记的化合物进行成像通常用于深入了解肿瘤的生物学功能及其周围微环境。尽管它们具有高灵敏度和特异性，但单独的PET和SPECT基本上受到低空间分辨率和不能提供解剖细节的限制。将SPECT或PET与能够提供这些（即CT或MR）的模态相结合，最大化了它们各自的优势，并提供了生理过程的解剖定位以及肿瘤结构的详细可视化。PET/CT、SPECT/CT和PET/MR的多模态（混合）成像的可用性提高了我们表征病变并影响治疗决策和患者管理的能力。我们才刚刚开始利用多模态成像的真正协同能力。仪器和显像剂开发的持续进步将提高我们非侵入性表征疾病过程的能力。本文将讨论混合成像技术的发展，并提供其当前和潜在的未来临床应用的例子。
Patient management in oncology increasingly relies upon imaging for diagnosis, response assessment, and follow-up. The clinical availability of combined functional-anatomic imaging modalities, which integrate the benefits of visualizing tumor biology with those of high-resolution structural imaging, revolutionized clinical management of oncologic patients. Conventional high resolution anatomic imaging modalities such as computed tomography (CT) and magnetic resonance imaging (MRI) excel at providing details regarding lesion location, size, morphology, and structural changes to adjacent tissues; however, these modalities provide little insight into tumor physiology. With the increasing focus on molecularly targeted therapies, imaging radiolabeled compounds with positron emission tomography (PET) and single photon emission tomography (SPECT) are often used to provide insight into a tumor's biologic functions and its surrounding microenvironment. Despite their high sensitivity and specificity, PET and SPECT alone are substantially limited by low spatial resolution and inability to provide anatomic detail. Integrating SPECT or PET with a modality capable of providing these (i.e. CT or MR) maximizes their separate strengths and provides anatomic localization of physiologic processes with detailed visualization of a tumor's structure. The availability of multi-modality (hybrid) imaging with PET/CT, SPECT/CT and PET/MR improves our ability to characterize lesions and to affect treatment decisions and patient management. We have just begun to exploit the truly synergistic capabilities of multi-modality imaging. Continued advances in instrumentation and imaging agent development will improve our ability to noninvasively characterize disease processes. This review will discuss the evolution of hybrid imaging technology and provide examples of its current and potential future clinical uses.