New technologies and directed agents for applications of cancer imaging

Assessment of tumor response in malignant pleural mesothelioma

Most patients with malignant pleural mesothelioma (MPM) are candidates for chemotherapy during the course of their disease. Assessment of the response with conventional criteria based on computed tomography (CT) measurements is challenging, due to the circumferential and axial pattern of growth of MPM. Such difficulties hinder an accurate evaluation of clinical study results and make the clinical management of patients critical. Several radiological response systems have been proposed, but neither WHO criteria nor the more recent RECIST unidimensional criteria nor hybrid uni- and bidimensional criteria seem to apply to tumor measurement in this disease. Recently, modified RECIST criteria for MPM have been published. Although they are already being used in current clinical trials, they have been criticized based on the high grade of inter-observer variability and on theoretical studies of mesothelioma growth according to non-spherical models. Computer-assisted techniques for CT measurement are being developed. The use of FDG-PET for prediction of response and, more importantly, of survival outcomes of MPM patients is promising and warrants validation in large prospective series. New serum markers such as osteopontin and mesothelin-related proteins are under evaluation and in the future might play a role in assessing the response of MPM to treatment.

A paramagnetic nanoprobe to detect tumor cell death using magnetic resonance imaging

A 110 kDa (ca. 5 nm in diameter) bivalent paramagnetic nanoprobe for detecting cell death using magnetic resonance imaging (MRI) is described, in which two biotinylated C2A domains of the protein synaptotagmin-I were complexed with a single avidin molecule, which had been labeled with gadolinium chelates. This nanoprobe bound with high affinity and specificity to the phosphatidylserine exposed by dying cells and was demonstrated to allow MRI detection of apoptotic tumor cells in vitro.

Dynamic Contrast Enhanced Magnetic Resonance Imaging in Oncology: Theory, Data Acquisition, Analysis, and Examples

Dynamic contrast enhanced MRI (DCE-MRI) enables the quantitative assessment of tumor status and has found application in both pre-clinical tumor models as well as clinical oncology. DCE-MRI requires the serial acquisition of images before and after the injection of a paramagnetic contrast agent so that the variation of MR signal intensity with time can be recorded for each image voxel. As the agent enters into a tissue, it changes the MR signal intensity from the tissue to a degree that depends on the local concentration. After the agent is transported out of the tissue, the MR signal intensity returns to its' baseline value. By analyzing the associated signal intensity time course using an appropriate mathematical model, physiological parameters related to blood flow, vessel permeability, and tissue volume fractions can be extracted for each voxel or region of interest.In this review we first discuss the basic physics of this methodology, and then present technical aspects of how DCE-MRI data are acquired and analyzed. We also discuss appropriate models of contrast agent kinetics and how these can be used to elucidate tissue characteristics of importance in cancer biology. We conclude by briefly summarizing some future goals and demands of DCE-MRI.

Digital quantification of mutant DNA in cancer patients

PURPOSE OF REVIEW

The accumulation of somatic mutations is the major driving force for tumorigenesis. These mutations uniquely differentiate tumor cells from their normal counterparts. Mutations within tumor cells and mutant DNA released by tumor cells into blood, lymph, stool, tissues and other bodily compartments can thereby be used for cancer detection. Here we discuss technologies available for the detection and quantification of mutant DNA in clinical samples and the value of such measurements for patient management.

RECENT FINDINGS

Conventional mutation detection technologies are either qualitative or only roughly estimate the abundance of mutant DNA molecules. Recently-developed approaches, however, use single molecule counting to determine the genotype of each individual member of a DNA population, providing a more accurate and precise digital output.

SUMMARY

In this review, we discuss the clinical utility of mutant DNA quantification in cancer patients in the context of recent technical advances made in digital mutation detection.

The future of proteomic analysis in biological systems and molecular medicine

Proteomics is the study of proteins and their interactions within complex biological systems. While this field is often associated with mass spectrometry, it is more useful to consider proteomics in the context of an objective: to identify and understand the molecular basis of health and disease at the protein level in vivo. Achieving this objective will require (1) technological developments to resolve current instrument limitations and (2) multidisciplinary integration of biological and protein analysis technologies to answer important questions in both the biological sciences and molecular medicine.