Molecular imaging technology has many implications for both the treatment and monitoring of cancer. Using in vivo imaging for cancer evaluation allows doctors to gather useful information about the disease, without performing invasive surgeries or unnecessary biopsies. By looking at cancer at the cellular and sub-cellular levels, doctors are able to understand and to counteract the molecular and genetic processes associated with cancer development.
One general use for PET scans is to determine patient prognosis. CD105 is a protein found on the surface of cells, and it is thought to be connected to angiogenesis (blood vessel development) within tumors. Large quantities of CD105 in a tumor tend to indicate poor prognosis, and this knowledge allows doctors to opt for more aggressive treatment, or for palliative care. CD105 is detected by injecting patients with a copper isotope, which bonds to TRC105, and antibody, which then attaches to CD105.
SPECT scans also help doctors to predict patient prognosis. SPECT scans have been used in patients with Hodgkin's lymphoma, to predict whether or not survival will be event-free. The predictions allow doctors to scale back treatment for less severe cases, and to ramp up treatment for more aggressive cases.
PET scans are used to monitor radiation therapy. Patients with lung cancer were given PET scans, and doctors discovered some places on tumors called "cold spots, " which are thought to contain dead cells. Using that information, doctors provided targeted radiation therapy, irradiating only active cancer cells within the lung tumors. In some cases, doctors were able to decrease the dose of radiation, which decreased associated side effects and healthy tissue damage.
Molecular imaging also helps to detect breast cancer. At times, mammography does not detect tumors in patients with implants or scar tissue, and sometimes, patients may feel lesions that mammography does not register. In these cases, doctors inject breast tissue with a radioactive tracer which is metabolized for cells, much like glucose. The majority of the tracer is absorbed by cancer cells, which then are shown as dark spots on the breast image.
Ovarian cancers are also detected with molecular imaging. Ovarian cancer cells, just like breast cancer cells, metabolize more of a radioactive tracer than healthy cells. Doctors, using PET/CT scans, were able to detect masses both in the Fallopian tubes and in the ovaries, and accurately predicted malignancy in the vast majority of cases.
Skin cancer may be detected by ultrasound with elastography. Cancerous lesions tend to be noticeably stiffer than benign growths, so doctors may scan for tissue elasticity using ultrasound with elastography. Additionally, doctors use ultrasound to see the depth and size of all types of skin cancers, which prevents unnecessary biopsies on suspicious but non-cancerous growths.
Molecular imaging technology means imaging in vivo for evaluation of cancer. The technology also has implications for a multitude of other diseases, including heart disease, stroke, and Alzheimer's disease. Seeing the disease as it happens, within its biological environment, provides doctors with information about cancer at both the cellular and sub-cellular levels, without the need for invasive exploratory surgeries.
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