Question ID: Feb 2-4
Submitted by: February 2, 2011 Clinical and Translational Sciences Provocative Questions Workshop - Submitted to the website
March 3, 2011
Can tumors be detected when they are two to three orders of magnitude smaller than those currently detected with in vivo imaging modalities?
Background: Current imaging modalities allow detection of growths composed of 107-109 cells (in the range of 1 to several hundred cubic millimeters). But there is room for enhanced sensitivity, since PET scanners collect less than 1% of the radioactivity that comes from the PET agent. Since early detection of primary or metastatic lesions is likely to provide a greater opportunity for effective treatment and since clinical decisions on patient management are often based on microscopic lesions, more sensitive imaging could change clinical practice and cancer outcomes.
Feasibility: Although there is a trade-off between sensitivity and resolution of imaging methods, it should be possible to detect smaller tumors, if imaging probes can be more precisely matched to biologic targets on tumor cells (which might be achieved through partnerships between the pharmaceutical industry and academia in which agents disqualified as drugs might be “repurposed” as imaging agents), if new and more sensitive imaging probes can be developed, and if the sensitivity of cameras can be improved.
Implications of success: Being able to detect very small clusters of cells in patients and in experimental cancer models is important from therapeutic and investigative perspectives—to understand how and when tumors spread, to study how dissemination correlates with malignant progression, to improve strategies for treatment with precisely targeted radiation or drugs, and to monitor therapeutic responses.
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