-
RoFo : Fortschritte Auf Dem Gebiete Der... Jul 2022Therapeutics that specifically address biological processes often require a much finer selection of patients and subclassification of diseases. Thus, diagnostic... (Review)
Review
BACKGROUND
Therapeutics that specifically address biological processes often require a much finer selection of patients and subclassification of diseases. Thus, diagnostic procedures must describe the diseases in sufficient detail to allow selection of appropriate therapy and to sensitively track therapy response. Anatomical features are often not sufficient for this purpose and there is a need to image molecular and pathophysiological processes.
METHOD
Two imaging strategies can be pursued: molecular imaging attempts to image a few biomarkers that play key roles in pathological processes. Alternatively, patterns describing a biological process can be identified from the synopsis of multiple (non-specific) imaging markers, possibly in combination with omics and other clinical findings. Here, AI-based methods are increasingly being used.
RESULTS
Both strategies of evidence-based therapy management are explained in this review article and examples and clinical successes are presented. In this context, reviews of clinically approved molecular diagnostics and decision support systems are listed. Furthermore, since reliable, representative, and sufficiently large datasets are further important prerequisites for AI-assisted multiparametric analyses, concepts are presented to make data available in a structured way, e. g., using Generative Adversarial Networks to complement databases with virtual cases and to build completely anonymous reference databases.
CONCLUSION
Molecular imaging and computer-assisted cluster analysis of diagnostic data are complementary methods to describe pathophysiological processes. Both methods have the potential to improve (evidence-based) the future management of therapies, partly on their own but also in combined approaches.
KEY POINTS
· Molecular imaging and radiomics provide valuable complementary disease biomarkers.. · Data-driven, model-based, and hybrid model-based integrated diagnostics advance precision medicine.. · Synthetic data generation may become essential in the development process of future AI methods..
CITATION FORMAT
· Kiessling F, Schulz V, . Perspectives of Evidence-Based Therapy Management. Fortschr Röntgenstr 2022; 194: 728 - 736.
Topics: Biomarkers; Humans; Molecular Imaging; Precision Medicine
PubMed: 35545101
DOI: 10.1055/a-1752-0839 -
Journal of Nuclear Medicine : Official... Jul 2020Transthyretin and light-chain amyloidosis are the 2 main causes of cardiac amyloidosis. Recent developments in molecular imaging have transformed our ability to diagnose... (Review)
Review
Transthyretin and light-chain amyloidosis are the 2 main causes of cardiac amyloidosis. Recent developments in molecular imaging have transformed our ability to diagnose transthyretin cardiac amyloidosis noninvasively and unmasked a hitherto unrecognized prevalence of the disease. This review summarizes the current and evolving imaging approaches, their molecular structural basis, and the gaps in imaging capabilities that have arisen as a result of parallel developments in pharmacotherapy delivering the first effective treatment options for this condition.
Topics: Amyloidosis; Cardiomyopathies; Humans; Molecular Imaging
PubMed: 32482792
DOI: 10.2967/jnumed.120.245381 -
Drug Discovery Today Jun 2022In recent years, nanobodies have emerged as ideal imaging agents for molecular imaging. Molecular nanobody imaging combines the specificity of nanobodies with the... (Review)
Review
In recent years, nanobodies have emerged as ideal imaging agents for molecular imaging. Molecular nanobody imaging combines the specificity of nanobodies with the sensitivity of state-of-the-art molecular imaging modalities, such as positron emission tomography (PET). Given that modifications of nanobodies alter their pharmacokinetics (PK), the engineering strategies that combine nanobodies with radionuclides determine the effectiveness, reliability, and safety of the molecular imaging probes. In this review, we introduce conjugation strategies that have been applied to engineer nanobodies, including random conjugation, Tc tricarbonyl chemistry, sortase A-mediated site-specific conjugation, maleimide-cysteine chemistry, and click chemistries. We also summarize the latest advances in nanobody molecular imaging tracers, emphasizing their preclinical and clinical use. In addition, we elaborate on nanobody-based near-infrared fluorescence (NIRF) imaging and image-guided surgery.
Topics: Cell Line, Tumor; Molecular Imaging; Positron-Emission Tomography; Reproducibility of Results; Single-Domain Antibodies
PubMed: 35331925
DOI: 10.1016/j.drudis.2022.03.013 -
Radiology Mar 2021The increasing prevalence of dementia worldwide places a high demand on healthcare providers to perform a diagnostic work-up in relatively early stages of the disease,... (Review)
Review
The increasing prevalence of dementia worldwide places a high demand on healthcare providers to perform a diagnostic work-up in relatively early stages of the disease, given that the pathologic process usually begins decades before symptoms are evident. Structural imaging is recommended to rule out other disorders and can only provide diagnosis in a late stage with limited specificity. Where PET imaging previously focused on the spatial pattern of hypometabolism, the past decade has seen the development of novel tracers to demonstrate characteristic protein abnormalities. Molecular imaging using PET/SPECT is able to show amyloid and tau deposition in Alzheimer disease and dopamine depletion in parkinsonian disorders starting decades before symptom onset. Novel tracers for neuroinflammation and synaptic density are being developed to further unravel the molecular pathologic characteristics of dementia disorders. In this article, the authors review the current status of established and emerging PET tracers in a diagnostic setting and also their value as prognostic markers in research studies and outcome measures for clinical trials in Alzheimer disease.
Topics: Dementia; Disease Progression; Early Diagnosis; Humans; Molecular Imaging; Neuroimaging; Positron-Emission Tomography; Prognosis; Radiopharmaceuticals; Tomography, Emission-Computed, Single-Photon
PubMed: 33464184
DOI: 10.1148/radiol.2020200028 -
Ultrasound in Medicine & Biology Mar 2020Ultrasound molecular imaging has been developed in the past two decades with the goal of non-invasively imaging disease phenotypes on a cellular level not depicted on... (Review)
Review
Ultrasound molecular imaging has been developed in the past two decades with the goal of non-invasively imaging disease phenotypes on a cellular level not depicted on anatomic imaging. Such techniques already play a role in pre-clinical research for the assessment of disease mechanisms and drug effects, and are thought to in the future contribute to earlier diagnosis of disease, assessment of therapeutic effects and patient-tailored therapy in the clinical field. In this review, we first describe the chemical composition and structure as well as the in vivo behavior of the ultrasound contrast agents that have been developed for molecular imaging. We then discuss the strategies that are used for targeting of contrast agents to specific cellular targets and protocols used for imaging. Next we describe pre-clinical data on imaging of thrombosis, atherosclerosis and microvascular inflammation and in oncology, including the pathophysiological principles underlying the selection of targets in each area. Where applicable, we also discuss efforts that are currently underway for translation of this technique into the clinical arena.
Topics: Animals; Atherosclerosis; Contrast Media; Humans; Microvessels; Molecular Imaging; Neoplasms; Thrombosis; Ultrasonography; Vasculitis
PubMed: 31899040
DOI: 10.1016/j.ultrasmedbio.2019.11.007 -
Journal of Medicinal Chemistry Mar 2020Bacterial infections remain a major threat to humanity and are a leading cause of death and disability. Antimicrobial resistance has been declared as one of the top ten... (Review)
Review
Bacterial infections remain a major threat to humanity and are a leading cause of death and disability. Antimicrobial resistance has been declared as one of the top ten threats to human health by the World Health Organization, and new technologies are urgently needed for the early diagnosis and monitoring of deep-seated and complicated infections in hospitalized patients. This review summarizes the radiotracers as applied to imaging of bacterial infections. We summarize the recent progress in the development of pathogen-specific imaging and the application of radiotracers in understanding drug pharmacokinetics as well as the local biology at the infection sites. We also highlight the opportunities for medicinal chemists in radiotracer development for bacterial infections, with an emphasis on target selection and radiosynthetic approaches. Imaging of infections is an emerging field. Beyond clinical applications, these technologies could provide unique insights into disease pathogenesis and expedite bench-to-bedside translation of new therapeutics.
Topics: Animals; Bacteria; Bacterial Infections; Drug Development; Humans; Molecular Imaging; Radioactive Tracers; Radioisotopes
PubMed: 32048838
DOI: 10.1021/acs.jmedchem.9b01623 -
Thoracic Surgery Clinics Aug 2023Intraoperative molecular imaging innovations have been propelled by the development of fluorescent contrast agents that specifically target tumor tissues and advanced... (Review)
Review
Intraoperative molecular imaging innovations have been propelled by the development of fluorescent contrast agents that specifically target tumor tissues and advanced camera systems that can detect the specified fluorescence. The most promising agent to date is OTL38, a targeted and near-infrared agent that was recently approved by the Food and Drug Administration for intraoperative imaging for lung cancer.
Topics: Humans; Lung Neoplasms; Fluorescent Dyes; Molecular Imaging; Optical Imaging
PubMed: 37414478
DOI: 10.1016/j.thorsurg.2023.04.013 -
International Journal of Molecular... Apr 2022For years, nanomedical research has represented a challenge and an opportunity in terms of imaging techniques [...].
For years, nanomedical research has represented a challenge and an opportunity in terms of imaging techniques [...].
Topics: Molecular Imaging; Nanomedicine
PubMed: 35457025
DOI: 10.3390/ijms23084207 -
Journal of Nuclear Medicine : Official... Oct 2020The important insights yielded by molecular imaging (MI) into relevant biologic signatures at an organ-specific and systemic level are not achievable with conventional...
The important insights yielded by molecular imaging (MI) into relevant biologic signatures at an organ-specific and systemic level are not achievable with conventional imaging methods and thus provide an essential link between preclinical and clinical research. New diagnostic probes and imaging methods revealing comprehensive functional and molecular information are being provided by MI research, several of which have found their way into clinical application. However, there are also reservations about the impact of MI and its added value over conventional, often less expensive, diagnostic imaging methods. This perspective discusses seminal research directions for the MI field that have the potential to result in added value to the patient. Emphasis is placed on MI without probes, MI based on radiotracers and small molecules, MI nano- and microsystems, and MI in context with comprehensive diagnostics. Furthermore, besides technical innovations and probes, emerging clinical indications are highlighted.
Topics: Humans; Luminescent Measurements; Molecular Imaging; Multimodal Imaging
PubMed: 32859706
DOI: 10.2967/jnumed.120.241984 -
Inflammatory Bowel Diseases Sep 2020Inflammatory bowel disease (IBD) is defined by a chronic relapsing and remitting inflammation of the gastrointestinal tract, with intestinal fibrosis being a major... (Review)
Review
Inflammatory bowel disease (IBD) is defined by a chronic relapsing and remitting inflammation of the gastrointestinal tract, with intestinal fibrosis being a major complication. The etiology of IBD remains unknown, but it is thought to arise from a dysregulated and excessive immune response to gut luminal microbes triggered by genetic and environmental factors. To date, IBD has no cure, and treatments are currently directed at relieving symptoms and treating inflammation. The current diagnostic of IBD relies on endoscopy, which is invasive and does not provide information on the presence of extraluminal complications and molecular aspect of the disease. Cross-sectional imaging modalities such as computed tomography enterography (CTE), magnetic resonance enterography (MRE), positron emission tomography (PET), single photon emission computed tomography (SPECT), and hybrid modalities have demonstrated high accuracy for the diagnosis of IBD and can provide both functional and morphological information when combined with the use of molecular imaging probes. This review presents the state-of-the-art imaging techniques and molecular imaging approaches in the field of IBD and points out future directions that could help improve our understanding of IBD pathological processes, along with the development of efficient treatments.
Topics: Fibrosis; Gastrointestinal Tract; Humans; Inflammation; Inflammatory Bowel Diseases; Intestines; Molecular Imaging; Multimodal Imaging
PubMed: 32793946
DOI: 10.1093/ibd/izaa213