Major advances in our understanding of the molecular mechanisms responsible for cancer, combined with new targeted clinical imaging technologies designed to detect the molecular correlates of disease progression and response to treatment, are set to revolutionize our approach to the detection and treatment of the disease.
Optical coherence tomography successfully revealed structural changes, including cartilage thinning, fissures and fibrillation, at substantially higher resolutions than those achieved with other currently used clinical imaging technologies.
This relationship between clinical medicine and imaging technology, nurtured and fostered over the past 75 years, has cultivated extraordinarily rich collaborative opportunities between basic scientists, engineers, and physicians.
From a clinical standpoint, optical imaging technology has been rapidly advancing in terms of molecular probes as well as imaging modalities such as endoscopic cameras(26) and clinical breast scanners, 33) and is expected to provide an informative navigation aid for surgical techniques.
53 As shown in the examples above, improvements in electronic health records, clinical imaging, and "omic" technologies (genotyping and phenotyping) are beginning to challenge current disease taxonomy, the focus of much healthcare policy on process (rather than clinical outcomes), and the clinical preoccupation with diagnosis (rather than risk).
However, only limited data are available on the clinical performance of the new hybrid imaging technology, and its clinical value remains to be evaluated in studies.
By tracing the dates of discovery, FDA clearance or approval, reimbursement, and adoption into clinical guidelines of each diagnostic imaging technology, we show that these milestones were often achieved without evidence of positive effects on long-term outcomes in breast cancer patients.
The implementation of the new ApoSense technology for clinical imaging of apoptosis would represent a major addition to this emerging field, allowing non-invasive imaging of cell death processes in vivo as a means to both the diagnosis of disease and the monitoring of treatment efficacy in a broad spectrum of disease states.
ACRIN has been and is continuing to conduct clinical trials of imaging technologies that promise to provide information that will lead to better, more appropriate cancer care.
