New technologies for human cancer imaging
New technologies for human cancer imaging
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DOI：
10.1200/jco.2007.14.3065
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发表时间：
2008-08-20
影响因子：
45.3
通讯作者：
Frangioni, John V.
中科院分区：
文献类型：
--
作者：
Frangioni, John V.
尽管在诊断放射学的许多领域的技术进步，人类癌症的检测和成像仍然很差。在肿瘤与背景比率提高3 - 4个数量级（即10（3）-10（4）倍）之前，不太可能对癌症筛查、分期和治疗产生有意义的影响，这反过来又需要在灵敏度和造影剂靶向方面进行成比例的提高。这篇评论分析了癌症成像的物理和化学，并强调了在正常细胞背景下检测恶性细胞的基本原则。使用各种造影剂和放射性示踪剂的癌症成像进行审查，是目前的局限性超声，X射线成像，磁共振成像（MRI），单光子发射计算机断层扫描，正电子发射断层扫描（PET），光学成像。正在出现的创新技术为患者带来了巨大的希望，例如用于癌症筛查的正电子发射乳房X线摄影和光谱增强结肠镜检查，用于分期的超极化MRI和飞行时间PET，以及用于癌症治疗的离子束诱导PET扫描和近红外荧光引导手术。本综述探讨了这些新兴技术，并考虑其对临床护理的潜在影响。最后，讨论了目前难以成像和量化的癌症，如卵巢癌和急性白血病。
Despite technical advances in many areas of diagnostic radiology, the detection and imaging of human cancer remains poor. A meaningful impact on cancer screening, staging, and treatment is unlikely to occur until the tumor-to-background ratio improves by three to four orders of magnitude (ie, 10(3)- to 10(4)-fold), which in turn will require proportional improvements in sensitivity and contrast agent targeting. This review analyzes the physics and chemistry of cancer imaging and highlights the fundamental principles underlying the detection of malignant cells within a background of normal cells. The use of various contrast agents and radiotracers for cancer imaging is reviewed, as are the current limitations of ultrasound, x-ray imaging, magnetic resonance imaging (MRI), single-photon emission computed tomography, positron emission tomography ( PET), and optical imaging. Innovative technologies are emerging that hold great promise for patients, such as positron emission mammography of the breast and spectroscopy-enhanced colonoscopy for cancer screening, hyperpolarization MRI and time-of-flight PET for staging, and ion beam-induced PET scanning and near-infrared fluorescence-guided surgery for cancer treatment. This review explores these emerging technologies and considers their potential impact on clinical care. Finally, those cancers that are currently difficult to image and quantify, such as ovarian cancer and acute leukemia, are discussed.