SNM: Exploring molecular imaging potential

'Shaping the Future' industry summit examines future basic research, instrumentation, drug development, clinical issues and educational needs

RESTON, Va. -- Experts in the molecular imaging field interacted and explored questions about basic research, instrumentation, drug development, clinical issues and educational needs during SNM's "Shaping the Future" industry summit. Panel presenters and attendees addressed the possibilities of molecular imaging, and their findings will be presented in December's Journal of Nuclear Medicine.

"While filled with optimism, the future of molecular imaging is far from defined," said SNM President Martin P. Sandler. "SNM--an international scientific and professional organization of more than 16,000 physician, technologist and scientist members--has traditionally represented all professionals involved in the practice of nuclear medicine--and as the society within which molecular imaging originated, SNM is uniquely responsible for supporting the new field of molecular imaging and the scientists, clinicians and technologists involved in it," he added. "SNM sees the merging of nuclear medicine techniques, new technologies, hybrid imaging and advances in molecular biology as a defining moment and is asking the necessary questions--and initiating the appropriate strategies--to identify and take advantage of the potential of molecular imaging for enhancing patient care and improving patient outcomes," noted the associate vice chancellor for hospital affairs for Vanderbilt University Medical Center in Nashville, Tenn.

"As summit organizer, SNM recognizes the critical role for molecular imaging in future patient care. We are working actively with the commercial sector to facilitate the movement of molecular discoveries from bench to bedside and with officials from the government and federal agencies to identify the needs and resources for advancing the nation's health care," explained SNM President-Elect Alexander J. McEwan. "The power of molecular imaging to integrate information about location, structure, function and biology will lead to a package of noninvasive, in vivo imaging tools that could have vast potential for improving both patient care and the utilization of health care resources," he said. "Molecular imaging will complement the diagnosis and staging of disease in the absence of anatomic findings, help determine biological response to specific therapeutic agents, lead to an understanding of the pharmacology of new drugs using labeled analogues and initiate exploration of the efficacy of new therapies," said the director of oncologic imaging at Cross Cancer Institute in Edmonton, Alberta, Canada.

SNM's first-of-its-kind forum allowed nearly 70 forward-thinking researchers, commercial sector representatives and officials from national government/regulatory agencies over three days to examine current and future applications of molecular imaging. Some of the group's discussion points are included here.

Basic research: Research leads clinical practice, and one of the challenges to the medical and regulatory communities is to facilitate the introduction of new imaging techniques into patient management. As technology advances, scientists will further their ability to use different probes with the whole spectrum of molecular imaging modalities to identify new targets within cells and associated with cell membranes and receptors and to quantify treatment effects on the expression of these markers. Traditional tracer-based nuclear medicine research will be expanded within the molecular imaging arena to include optical imaging and magnetic resonance spectroscopy. These new imaging technologies, particularly associated with new probe development, can provide new contrast to medical imaging. Optical imaging is currently limited by its spatial resolution and imaging depth, and thermoacoustic tomography or radio frequency–based photoacoustic tomography is being developed to meet this challenge.

Instrumentation: An evolution in imaging technology is occurring and will continue as imaging capabilities continue to expand from the anatomical to the functional and to the molecular. The expansion of imaging capabilities will allow the identification of imaging probes specific for molecular processes, and new multimodality imaging technologies will be developed to appropriately utilize these new probes, focusing on normal and abnormal biological processes. The future will bring nanoparticle delivery vehicles to deliver gene therapy to patients, smart contrast agents, target-specific optical agents and cell-based (stem cell) imaging therapy.

Drug development: The appropriate use of molecular imaging in drug discovery and development could significantly speed up the development process and save millions of health care dollars. Molecular imaging techniques are already being used in receptor occupancy studies and with transgenic animal models to validate drug development. In clinical trials, molecular imaging probes will also play an increasingly important role in developing new, smarter, and safer drugs for patients.

In clinical practice: Work will continue to examine and validate future clinical applications for FDG PET/CT for oncology (diagnosis and staging, treatment planning and response, detection of recurrent or residual disease, restaging), for myocardial perfusion (coronary artery disease, myocardial viability), and for neurology and neurosurgery (brain tumors, medically intractable epilepsy, stroke, movement disorders, Alzheimer's disease and other dementias). Bioluminescence imaging, which enables visualization of genetic expression and physiological processes at the molecular level in living tissues, can identify specific gene expression in cancer cells and may be used to identify metastatic potential.

Education and training: An evolution in the education of physicians to fully and effectively utilize changes in practice will occur as new probes and technologies become mainstream. The diversity of the field will make the design of a common curriculum difficult.

Summit participants: Nearly 70 molecular imaging experts participated in the summit. Attending were industry representatives from Biogen Idec, Bioperspectives, Bracco Diagnostics Inc., Bristol-Myers Squibb Medical Imaging, Capintec Inc., Cardinal Health, GE Healthcare, IBA Molecular, Mallinckrodt Inc., MDS Nordion, Merck & Company Inc., Philips, Siemens Medical Solutions USA, and Spectrum Dynamics. Also attending the end-of-July session in Key Biscayne, Fla., were representatives from the FDA's Office for In Vitro Diagnostic Device Evaluation and Safety, the Los Alamos National Laboratory, the National Cancer Institute and NIH's National Institute of Biomedical Imaging and Bioengineering.

Individuals attended from Kimmel, M.D. Anderson and Memorial Sloan Kettering cancer centers and George Mason, Texas A&M, Thomas Jefferson, Vanderbilt and Yale universities, as well as the University of Southern California and the University of Pennsylvania.

As the summit chair, Mathew Thakur, SNM past president and professor at Thomas Jefferson University in Philadelphia, Pa., assembled an exceptional molecular imaging think tank with assistance from Sandler, McEwan and Peter Conti, SNM immediate past president and USC professor. Individuals who participated and chaired the summit's panels included

  • Basic research: Malcolm Avison (Vanderbilt University Medical Center, Nashville, Tenn.), David Geho (George Mason University, Manassas, Va.), John Gore (Vanderbilt University, Nashville, Tenn.), Lihong Wang (Texas A&M University, College Station, Texas) and Michael Welch (Mallinckrodt Institute of Radiology, St. Louis, Mo., chair);
  • Instrumentation/animal model: Paul Acton (Thomas Jefferson University, Philadelphia, Pa.) and Cheryl Marks (National Cancer Institute, Bethesda, Md., chair);
  • Drug development: Eric D. Agdeppa (GE Healthcare, Piscataway, N.J.), Steven Bodovitz (BioPerspectives, San Francisco, Calif.), Chaitanya Divgi, (University of Pennsylvania Hospital, Philadelphia, Pa.; chair), Juri Gelovani, (M.D. Anderson Cancer Center, Houston, Texas) and Richard Pestell, Kimmel Cancer Center, Philadelphia, Pa.);
  • Clinical issues: Steve Larson, (Memorial Sloan-Kettering Cancer Center, New York, N.Y., chair), P. David Mozley (Merck Research Laboratories, West Point, Pa.), Adrian Nunn (Bracco Research USA, Princeton, N.J.) and Albert Sinusas (Yale University, New Haven, Conn.); and
  • Education: William Heetderks (National Institutes of Health, Bethesda, Md.) and Lalitha Shankar (National Cancer Institute, Bethesda, Md., chair).

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To learn more, visit SNM's Web site at http://www.snm.org.

About SNM--Advancing Molecular Imaging and Therapy
SNM is an international scientific and professional organization of more than 16,000 members dedicated to promoting the science, technology and practical applications of molecular and nuclear imaging to diagnose, manage and treat diseases in women, men and children. Founded more than 50 years ago, SNM continues to provide essential resources for health care practitioners and patients; publish the most prominent peer-reviewed journal in the field (the Journal of Nuclear Medicine); host the premier annual meeting for medical imaging; sponsor research grants, fellowships and awards; and train physicians, technologists, scientists, physicists, chemists and radiopharmacists in state-of-the-art imaging procedures and advances. SNM members have introduced--and continue to explore--biological and technological innovations in medicine that noninvasively investigate the molecular basis of diseases, benefiting countless generations of patients. SNM is based in Reston, Va.; additional information can be found online at http://www.snm.org.


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