- Email: [email protected]
Fifth National Forum on Biomedical Imaging in Oncology1
HEARD ON THE CAMPUS
PAUL E. WALLNER, DO
Fifth National Forum on Biomedical Imaging in Oncology As part of a continuing effort to focus attention on the importance of biomedical imaging in oncology, the National Institutes of Health and the Foundation for Advanced Education in the Sciences sponsored the Fifth National Forum on Biomedical Imaging in Oncology (NFBIO), in Bethesda, Maryland, from January 29 to 30, 2004. The program was jointly presented by the National Cancer Institute (NCI), the U.S. Food and Drug Administration (FDA), the Centers for Medicare and Medicaid Services (CMS), and the National Electrical Manufacturers Association (NEMA). The NFBIO was created “to facilitate partnerships with the imaging industry and government agencies to address new biomedical opportunities and challenges in oncology, and to focus on the regulatory, coverage, and reimbursement issues for more developed and established technologies.” In acknowledgment of advances and research efforts in molecular imaging, many speakers focused on the potential implications of these types of in vivo methodologies. Representatives from the Medical Division of NEMA outlined steps that the organization and its members have taken to inform the media, Congress, employers, and national organizations of the benefits of advancements in diagnostic imaging and to counter some of the concerns regarding the increasing
costs of emerging diagnostic imaging technologies. The FDA focused on its perspective regarding the introduction of new imaging technologies and its attempts to deal with the evolving transdisciplinary nature of these modalities. Representatives from the CMS also dealt with these highly complex and dynamic issues. A number of presentations highlighted the various screening, imaging, and interagency efforts of the NCI, and a number of biomedical imaging investigators discussed some of the clinical needs and future challenges, including the following: ●
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This column was written in a personal capacity and does not represent the opinions of the National Institutes of Health, the U.S. Department of Health and Human Services, or the federal government. © 2004 American College of Radiology 0091-2182/04/$30.00 ● DOI 10.1016/j.jacr.2004.03.006
Clinical needs and future challenges for molecular imaging: Cancer is now being viewed as a field defect, and the lethal potential of all cancer cells may enable researchers to develop new methods for early detection. The potential of proteomics: Emerging research is increasing our knowledge of the genetic pathways that cause cellular processes to change in cancer. Active investigations are under way to use protein fragments for early cancer detection. Ovarian cancer, an ideal model for molecular imaging technologies: Ovarian cancer is a treatable but seldom curable disease that has a potential for earlier detection using intraperitoneal molecular imaging. Optical spectroscopic technologies for in vivo imaging: Spectroscopic imaging can aid in biopsy techniques and provide real-time guidance for diagnosis and treatment. Modalities such as diffuse reflectance spectroscopy, light-
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scattering spectroscopy, and Raman spectroscopy may provide powerful tools for the in vivo analysis of tissue. Quantum dots for in vivo imaging: Quantum dots are nanometer-sized semiconductors that glow when stimulated with ultraviolet light. Latex beads filled with these crystals can be designed to bind to specific DNA sequences. These developments have implications for diagnostics, molecular imaging, molecular profiling, pharmacogenomics, and drug discovery. The basics of phage display for imaging agent development: Bacteria and bacterial viruses are used to display random DNA sequences encoding peptides and proteins. The use of genetically engineered bacteriophage libraries that encode peptides with intrinsic radiometal chelation or fluorescent sequences has the potential to expedite the direct selection of peptides for cancer imaging. Current patient management with molecular imaging: A trend toward more “personalized” therapy is driving the concepts of molecular imaging for the assessment of therapeutic targets and identification of resistance factors. Imaging can capture the heterogeneity of target expression and measure the in vivo effects of drug therapy on the target. The potential of nanotechnology in cancer diagnosis and treatment: Nanotechnology involves the manipulation of matter on a miniscule scale to create useful materials, devices, and systems. Tools developed through nano455
456 Heard on the Campus
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technology may be capable of detecting and monitoring disease at the cellular level. “The nanolab”: the potential for technology integration: Nanowires, microfluids, and molecular imaging are being used to investigate the cell and protein signature expression. The technology is being used to probe all genomic and proteomic expression and interactions.
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Contrast ultrasound imaging and local drug delivery: Ultrasound contrast agents are being developed and used to improve the specificity of ultrasonic imaging. New applications for the clinic are emerging, including visualization of tumor vascularity, measurement of flow characteristics, differential diagnosis, guided biopsy, and therapy monitoring and delivery.
These and other presentations highlighted some of the exciting areas of research and development that are almost certain to change the radiologic sciences in the coming decade and the public-private partnerships being created to expedite those changes. Although space constraints prevent a lengthy discussion of individual areas of development at this time, specific topics will be addressed in later columns.
Paul E. Wallner, DO, NCI/DCTD/RRP/CROB, EPN/6002, 6130 Executive Boulevard, MSC 7440, Rockville, MD 20892-7440; e-mail: [email protected].
PAUL E. WALLNER, DO
Fifth National Forum on Biomedical Imaging in Oncology As part of a continuing effort to focus attention on the importance of biomedical imaging in oncology, the National Institutes of Health and the Foundation for Advanced Education in the Sciences sponsored the Fifth National Forum on Biomedical Imaging in Oncology (NFBIO), in Bethesda, Maryland, from January 29 to 30, 2004. The program was jointly presented by the National Cancer Institute (NCI), the U.S. Food and Drug Administration (FDA), the Centers for Medicare and Medicaid Services (CMS), and the National Electrical Manufacturers Association (NEMA). The NFBIO was created “to facilitate partnerships with the imaging industry and government agencies to address new biomedical opportunities and challenges in oncology, and to focus on the regulatory, coverage, and reimbursement issues for more developed and established technologies.” In acknowledgment of advances and research efforts in molecular imaging, many speakers focused on the potential implications of these types of in vivo methodologies. Representatives from the Medical Division of NEMA outlined steps that the organization and its members have taken to inform the media, Congress, employers, and national organizations of the benefits of advancements in diagnostic imaging and to counter some of the concerns regarding the increasing
costs of emerging diagnostic imaging technologies. The FDA focused on its perspective regarding the introduction of new imaging technologies and its attempts to deal with the evolving transdisciplinary nature of these modalities. Representatives from the CMS also dealt with these highly complex and dynamic issues. A number of presentations highlighted the various screening, imaging, and interagency efforts of the NCI, and a number of biomedical imaging investigators discussed some of the clinical needs and future challenges, including the following: ●
●
●
●
This column was written in a personal capacity and does not represent the opinions of the National Institutes of Health, the U.S. Department of Health and Human Services, or the federal government. © 2004 American College of Radiology 0091-2182/04/$30.00 ● DOI 10.1016/j.jacr.2004.03.006
Clinical needs and future challenges for molecular imaging: Cancer is now being viewed as a field defect, and the lethal potential of all cancer cells may enable researchers to develop new methods for early detection. The potential of proteomics: Emerging research is increasing our knowledge of the genetic pathways that cause cellular processes to change in cancer. Active investigations are under way to use protein fragments for early cancer detection. Ovarian cancer, an ideal model for molecular imaging technologies: Ovarian cancer is a treatable but seldom curable disease that has a potential for earlier detection using intraperitoneal molecular imaging. Optical spectroscopic technologies for in vivo imaging: Spectroscopic imaging can aid in biopsy techniques and provide real-time guidance for diagnosis and treatment. Modalities such as diffuse reflectance spectroscopy, light-
●
●
●
●
scattering spectroscopy, and Raman spectroscopy may provide powerful tools for the in vivo analysis of tissue. Quantum dots for in vivo imaging: Quantum dots are nanometer-sized semiconductors that glow when stimulated with ultraviolet light. Latex beads filled with these crystals can be designed to bind to specific DNA sequences. These developments have implications for diagnostics, molecular imaging, molecular profiling, pharmacogenomics, and drug discovery. The basics of phage display for imaging agent development: Bacteria and bacterial viruses are used to display random DNA sequences encoding peptides and proteins. The use of genetically engineered bacteriophage libraries that encode peptides with intrinsic radiometal chelation or fluorescent sequences has the potential to expedite the direct selection of peptides for cancer imaging. Current patient management with molecular imaging: A trend toward more “personalized” therapy is driving the concepts of molecular imaging for the assessment of therapeutic targets and identification of resistance factors. Imaging can capture the heterogeneity of target expression and measure the in vivo effects of drug therapy on the target. The potential of nanotechnology in cancer diagnosis and treatment: Nanotechnology involves the manipulation of matter on a miniscule scale to create useful materials, devices, and systems. Tools developed through nano455
456 Heard on the Campus
●
technology may be capable of detecting and monitoring disease at the cellular level. “The nanolab”: the potential for technology integration: Nanowires, microfluids, and molecular imaging are being used to investigate the cell and protein signature expression. The technology is being used to probe all genomic and proteomic expression and interactions.
●
Contrast ultrasound imaging and local drug delivery: Ultrasound contrast agents are being developed and used to improve the specificity of ultrasonic imaging. New applications for the clinic are emerging, including visualization of tumor vascularity, measurement of flow characteristics, differential diagnosis, guided biopsy, and therapy monitoring and delivery.
These and other presentations highlighted some of the exciting areas of research and development that are almost certain to change the radiologic sciences in the coming decade and the public-private partnerships being created to expedite those changes. Although space constraints prevent a lengthy discussion of individual areas of development at this time, specific topics will be addressed in later columns.
Paul E. Wallner, DO, NCI/DCTD/RRP/CROB, EPN/6002, 6130 Executive Boulevard, MSC 7440, Rockville, MD 20892-7440; e-mail: [email protected].