Imaging in breast cancer – breast cancer imaging revisited

摘要: In 2000, Breast Cancer Research published a series of articles describing the state-of-the-art breast cancer imaging, edited by James Basilion [1-6]. This reviewed developments in magnetic resonance imaging (MRI), spectroscopy (MRS), radionuclide with single-photon emission computed tomography (SPECT) and positron tomogrophy (PET), optical including near infra-red fluorescence. The had an emphasis on technical development, pre-clinical research, early clinical studies. Five years later, we revisit same areas eye towards ongoing translational research new opportunities to detect direct effective, individualized therapy. Some these modalities have entered routine use clinic. MRI is frequently used management cancer, especially determine extent disease local therapy [7]. 18F-fluorodeoxyglucose (FDG) PET increasingly staging advanced or recurrent monitoring response has received approval for Medicare re-imbursement indications [8]. MRS are not yet use, but compelling data patients will likely lead more future. Lehman Schnall [7] from Universities Washington Pennsylvania provide broad overview current future uses contrast-enhanced MRI. They review approaches that emphasized either temporal spatial resolution. These been successfully merged optimal combination sensitivity specificity detection. New computer-based analysis methods may improve ability interpret large volumes generated dynamic authors describe highlight work using measure primary 'neo-adjuvant' systemic therapy. exciting recent screening high-risk women, showing lesions found mammography. As continue refine our estimate woman's individual risk it play role, perhaps complementary mammography, patients. development newer possibly targeted contrast agents expand capabilities MRI. Using much technology needed MRI, provides method characterizing chemical composition vivo. Bolan, Nelson, Yee Garwood [9] University Minnesota technological issues state MRS. Although some tumors, such as brain just emerging clinically practical tool. Bolan colleagues nicely physical principles underlying challenges applying human developments, higher fields, brought point being practical. very interesting diagnose characterize way highly addition, they promising monitor therapy, emphasizing biochemical changes associated progression precede anatomical (i.e., change tumor size). Benard Turcotte [8] Sherbrooke application both SPECT Radionuclide long management, primarily form bone scintigraphy ('bone scan') metastases. thorough applied detection, regional lymph node metastasis distant metastases staging, therapeutic assessment tumors results detection agents, although this only limited thus far. FDG now routinely care, indications. MRS, information provided radiotracer window identify quantitative endpoint practice trials. preliminary studies experimental radiotracers designed image aspects vivo biology beyond glucose metabolism blood flow. includes quantify estrogen receptor expression predictor hormonal Hormonal earliest 'targeted' treatment, therefore important paradigms assessing target. Tromberg, Carussi, Shah, Compton, Fedyk [10] California, Irvine, cancer. description methodology, near-infrared imaging. specific diffuse spectroscopy. how can be infer tissue properties relevance care. present prototype laser scanner index indicates likelihood particular lesion malignant. Serial measures indices also robust, portable, inexpensive devices holds great promise making truly 'bedside' diagnostic tool contribute significantly treat cancer. It emphasize existing modalities, mammography (CT), each other. Lehman overlapping, nonidentical, occult underscoring method, companion, replacement for, extensively tested older modality, It recognized functional well together; consideration led widespread CT capability (PET/CT) together without changing already tumors. suggest combined Preliminary show nature [11]. quite measuring biochemistry, since pool sizes flux between different pools. Tromberg repeatedly clinic operating suite detailed geometrically extensive images other modalities. examples together. A comparison 2000 2005 suggests made progress moving out laboratory into clinic; however, lot do. For applications like recently realm, need outcome cost-effectiveness decide best powerful, often expensive, tools. MRSand trials help practice. many cases, previously available clinic, example, assess target serially over course leading choosing treatments, gene capabilities, [2]. Advances animal instruments imaging's role facilitator translation. Imaging should serve quantifying animals humans accelerating transition I look forward next opportunity report further understanding lives