Monitoring tumor response

Pelvic malignancy: integrating form and function

Despite the essential role morphological imaging plays in the management of patients with malignancy, anatomical techniques are limited in their ability to report on tumour biology and behaviour. It has therefore been necessary to develop imaging techniques that integrate form and function to probe the micro and molecular environments of cancers. The role of clinical functional and molecular magnetic resonance imaging is discussed with an emphasis on pelvic malignancy. It is argued that the radiological sciences need to take a lead in translating molecular and functional imaging techniques into man. Imaging in support of drug development is suggested as a focus for that development.

Molecular imaging in oncology

Cancer is a genetic disease that manifests in loss of normal cellular homeostatic mechanisms. The biology and therapeutic modulation of neoplasia occurs at the molecular level. An understanding of these molecular processes is therefore required to develop novel prognostic and early biomarkers of response. In addition to clinical applications, increased impetus for the development of such technologies has been catalysed by pharmaceutical companies investing in the development of molecular therapies. The discipline of molecular imaging therefore aims to image these important molecular processes in vivo. Molecular processes, however, operate at short length scales and concentrations typically beyond the resolution of clinical imaging. Solving these issues will be a challenge to imaging research. The successful implementations of molecular imaging in man will only be realised by the close co-operation amongst molecular biologists, chemists and the imaging scientists.

The development and application of functional nuclear magnetic resonance toin vivotherapeutic anticancer research

A little over 30 years ago, Sir Godfrey Hounsfield and his colleagues revolutionized medical imaging by developing CT scanning. In recent years a combination of improved technology and a deeper understanding of tumour biology have led to the development of imaging based strategies aimed at interrogating tissue structure and function. The prospects of this new technology include the prediction of tumour response and the non-invasive study of conventionally inaccessible yet important pharmacological compartments. This article explores how functional nuclear MRI and spectroscopy have been used in predicting response to anticancer therapy in rectal cancers and to assess the biliary excretion of chemotherapeutics.