Seeing the Future with Imaging Science Interdisciplinary Research Team Summaries (2011) / Chapter Skim
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IDR Team Summary 7: Find novel ways to use imaging methods to improve the treatment of diseases.
IDR Team Summary 7: Find novel ways to use imaging methods to improve the treatment of diseases.
Pages 79-100
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From page 79... ...
The challenge to imaging technology is to find ways with which this search could be improved. Concepts That Might Be Useful to Address the Challenge Improving Dose-finding Strategies with Positron Emission Tomography (PET)
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From page 80... ...
The application of imaging technology to monitoring treatment targets can be substantially enhanced if investigators develop new amino acid ligands (tyrosine, methionine, thymidine) that aim at more specific targets, such as hormones (e.g., receptors for estrogen, testosterone)
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From page 81... ...
Imaging offers a variety of opportunities to improve target identification. An obvious example of the potential utility of imaging tools is to apply the many methods available from standard imaging technologies such as structural magnetic resonance (sMR)
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From page 82... ...
Therefore, zebrafish offer an attractive option for high-throughput screening of drugs using imaging technologies because such studies can be conducted rapidly and on a large scale. Chemical libraries or potential therapeutic agents could be tested for efficacy or toxicology using zebrafish embryos or larvae and applying digital imaging methods to measure outcome.
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From page 83... ...
Further, an inoperable metastasis detected in the lung is treated by targeted drug administration and real-time image-guided evaluation of the efficiency and efficacy of drug delivery. After two days of lively brainstorming at the 2010 National Academies Keck Futures Initiative Conference on Imaging Science, an interdisciplinary team of nine researchers, with backgrounds ranging from electrical engineering to infectious disease, began their presentation of the solutions to
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From page 84... ...
IDR team 7A began tackling the challenge by drawing up the following list of novel imaging technologies and their applications in diagnostics and therapeutics. Novel Imaging Technology • Two-photon fluorescence microendoscopy: This minimally invasive imaging technology provides micron-scale resolution images of tissues in regions inaccessible by light microscopy.
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From page 85... ...
Medical applications of this technology include obtaining "freeze" organ motion images, for example, of breathing or of the heart beat; imaging tumors, the edges between organs, and internal structures of bones; and enhancing drug dosing and delivery. Currently, monochromatic X-rays are generated in a synchrotron, and it is the size and the cost of this machine that are the major barriers to the dissemination of monochromatic X-ray imaging technology.
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From page 86... ...
, the team discussed current problems in archiving and processing image data. Creating Image Databases Currently, there exists no single clinical image database that can be used to share, search, and retrieve medical imaging records.
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From page 87... ...
For example, information about the subject, machine-specific settings or parameters used to acquire the image, and how the image was processed is often unorganized and stored in files in different machines, making it difficult to reanalyze data, assess the quality or usefulness of the imaging data, or replicate experiments. Other issues discussed in the context of image database construction were difficulties in enforcing clinical image data disclosure; image annotation; image database encryption, privacy, and security; and the need to create databases that correlate image information with biological mechanisms and that enable cross-referencing of image information provided by different modalities (for example, radiological and histological data)
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From page 88... ...
For example, thermal imaging and T-rays (terahertz radiation) can be used to screen for infectious diseases at airports to understand mechanisms of disease transmission, and mobile phones can be used to image, share, and review global disease data.
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From page 89... ...
Instead, the process is complex and involves varying components that are each essential to the smooth operation of the imaging system and the subsequent health implications for the patient. Understanding each of these elements within the overall process of medical imaging was the challenge presented to a group of interdisciplinary scientists that convened at the National Academies Keck Futures Initiative Conference on Imaging Science.
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From page 90... ...
" Technology is still of the snapshot variety." The team approached the challenge by first discussing the current state of imaging technology and what will need to change to make significant improvement. Positron emission tomography (PET)
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From page 91... ...
However, after some debate over the importance of computer analysis in understanding medical images, the team arrived at the idea of large-scale data integration as beneficial to the disease treatment process. Although computers cannot perform all the functions a human observer can, humans have limitations that a computer does not.
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From page 92... ...
The most pressing issue when it comes to advancements in functional imaging is biological target identification. If the targeted object is not an appropriate biomarker, or indicator of the desired biological process, then the data generated from that image is useless for the purpose of designing a treatment plan.
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From page 93... ...
Without the compilation of this information, however, the decision-making process and subsequent treatment plans would remain time consuming and the interpretation of data divided. Although computer-aided analysis is an exciting concept for medical imaging, it is also one of the most difficult to put into action effectively.
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From page 94... ...
In considering how imaging could be used to improve disease treatment, IDR team 7C chose cancer as a disease model. The team's goals were three-pronged: streamlining diagnostic processes for patients by developing multimodal, multiplexed imaging; improving treatments by identifying imaging markers correlating with good or bad outcomes; and making these proposed technologies inexpensive, portable, and accessible to all patients.
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From page 95... ...
Then, a treatment plan is prepared, often limited to a standard protocol that generally cannot yet be tailored to the specific patient or to his or her specific tumor. Follow-ups happen every three to six months because technologies aren't sensitive enough to detect small numbers of regrowing tumor cells.
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From page 96... ...
Multifunctional imaging systems will improve the speed with which diseases are identified and diagnosed -- and also provide more specific information about what a patient is facing. For example, the reagents used in certain types of imaging -- positron emission tomography (PET)
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From page 97... ...
For example, if a subcutaneous fluorescent imager could "see" many different colors of injected fluorescent markers -- each attached to a different type of cell or tissue -- then it could weave together a more instructive image than one simply looking at, for example, green-tagged ovarian tumor cells. Two or three or five multiplexed probes could help researchers extract a lot of information from a single imaging procedure.
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From page 98... ...
New multimodal monitoring of blood vessels for metastatic tumor cells would offer a kind of constant vigilance that would be more reassuring and medically beneficial than the staggered, routine three- to six-month follow-ups made necessary by current limitations in finding tiny numbers of migrating cells.
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From page 99... ...
could be done by taking advantage of the eye's or skin's relative transparency. 3-D goggles could simultaneously scan retinal blood vessels and provide an exciting cinematic experience (Star Trek in 3-D?
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From page 100... ...
100 SEEING THE FUTURE WITH IMAGING SCIENCE thinking about disease diagnosis and treatment and blurring the lines generally separating levels of disease characterization. Alas, Andrew was accused of not knowing what a pyramid looks like, as the one the group developed was situated on its head.
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