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Mike Barber

The future of molecular imaging

By Mike Barber
From the June 2018 issue of DOTmed HealthCare Business News magazine

Imagine a world where the 12.7 million people who face a cancer diagnosis every year do not have to wait six months for a personalized treatment recommendation, and then another year to see if that treatment is effective.

Where a doctor – over the course of one day – can use AI to combine a patient’s in vitro molecular disease profile (data from DNA sequencing and molecular pathology) with in vivo insights (molecular imaging) to proactively address cancer before it spreads. A change like this would turn medical care on its head.
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This is the future of precision health. And it will be enabled by the next wave of molecular imaging.

Since its inception in the early 1990s, molecular imaging has been the driving force behind personalized medicine, providing doctors with a detailed look inside patients’ bodies at the cellular level, so they can better understand each patient’s unique disease processes. While remarkable advances in imaging technology, tracers, quantitation, and post processing have been made in the past three decades, molecular imaging is at an inflection point. In the years ahead, patients’ diagnostic and treatment experiences will be significantly more precise and personalized, thanks to integrated, quantified data analyzed by AI plus new tracers.

Take, for example, a patient with prostate cancer. Today, that patient would see his oncologist to have his tumor biopsied. That biopsy would be sent to a separate team that would perform a histopathological evaluation of the tumor and run targeted proteomic and gene panels to determine the tumor’s molecular composition and pinpoint its mutational profile. That data would then be sent back to the oncologist, who would integrate this information, compare it to similar cases and use that data to recommend a treatment strategy.

If this same patient goes in for treatment in the future, his experience could be significantly more efficient, as digital tools could combine in vivo and in vitro diagnostics in one setting and help prevent unnecessary biopsies. If disease is detected, a more reliable image-guided biopsy would be performed on the most relevant region of the tumor for precise evaluation. The oncologist would receive a complete, quantified look at the patient’s profile enabling her to select the most effective therapeutic strategy and predict the patient’s response.

Theranostics, the idea of using the same delivery agent for targeted diagnostics and therapy, could be used to not only pinpoint the stage of a patient’s disease and predict how it will progress, but also to deliver precise therapy to the molecular and cellular disease targets. When therapy is delivered, diseased cells will be destroyed while healthy cells will be mostly unharmed, minimizing side effects.
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