Molecular Imaging Program

Mission and Vision

To provide researchers, clinicians, and the people of Utah with the most advanced quantitative and molecular imaging technologies including radiopharmaceuticals and instrumentation to enable the highest quality research and assist clinicians in diagnosing disease and monitoring therapy.

The Vision

Patients participating in clinical trials and receiving state of the art cancer care at the Huntsman Cancer Institute (HCI) will be provided with quantitative imaging methods and techniques to accurately stage disease and measure response to therapy. With the increasing number of oncologic therapeutic strategies currently available in clinical trials this has generated a need to have available reliable and reproducible methods for prediction and /or assessment of therapeutic response. The Center for Quantitative Cancer Imaging at HCI is responsible for assuring that the imaging performed on our patients is state of the art and of the highest quality.

Importance of Quantitative Cancer Imaging and Molecular Imaging

Oncologists participating in clinical trials are often hampered by an absence of validated quantitative methods or imaging standards to predict and/or measure response to therapy. With the increasing number of oncologic therapeutic strategies currently available in clinical trials this has generated a need to have available reliable and reproducible methods for prediction and /or early assessment of therapeutic response. The need for validated quantitative imaging methods is particularly crucial in adaptive clinical trial where critical “go/no go decisions” are required. There is a critical requirement to have available validated new imaging techniques to meet these emerging requirements (1,2,3). The National Cancer Institute (NCI) has been instrumental in solving many of the problems associated with quantitative imaging in clinical trials. The Quantitative Imaging Network (QIN) is an example of a large NCI effort to solve many of the issues related to quantitative imaging in cancer clinical trials . Imaging societies such as the Radiologic Society of North America (RSNA) also have been instrumental in efforts to improve quantitative imaging. The RSNA effort known as the Quantitative Imaging Biomarkers Alliance (QIBA) has made many contributions in improving quantitative imaging in cancer  and other diseases. The Society for Nuclear Medicine and Molecular Imaging(SNMMI) also has developed a Clinical Trials Network with a mission of advancing the use of molecular imaging biomarkers in clinical trials through standardization of chemistry and imaging methodology . These society efforts are beginning to have a direct effect on improving the quality of imaging done in clinical trials.

Over the past decade, there has been a revolution in our basic understanding of most human disease. This has primarily been possible due to the rapid development of basic molecular biologic techniques and methods. We have witnessed the elucidation of the human genome (4); mouse genome (5); the description of the genetic abnormalities responsible for numerous diseases; and a better understanding of the basic molecular pathways, altered proteins, and signal transduction processes that are responsible for numerous human diseases. Associated with these developments in basic molecular biology, the imaging sciences have made remarkable advances in technologies and methodologies including MRI, PET and optical imaging.

Molecular imaging can be defined as the in vivo characterization and measurement of biologic processes at the cellular and molecular levels (6,7,8,9,10,11,12) and has already shown its potential importance for the practice of Radiology (13,14,15,16,17,18,19,20). Molecular imaging will assume an ever more important role in furthering our understanding of human disease and patient care in the future (6,7,9,15,16,17,18,19,20). Newly developed molecular imaging techniques allow for visualization and quantitation of relevant molecular and physiologic variables such as altered cellular metabolism, gene expression, protein-protein interactions, and enzymatic expression which contribute to human disease. Clinically relevant assays such as determination of protein-protein interactions, assessment of tissue hypoxia, non-invasive imaging assessment of gene expression, and assessment enzymatic function will be performed non-invasively using molecular imaging techniques.

As basic scientists gain a better understanding of the fundamental molecular nature of disease, molecular imaging techniques will be an important adjunct in translating this knowledge into clinical practice. This important information will allow for further elucidation of treatment effect, how patients will respond to certain drugs, treatments, and therapies.

Implicit in the development of molecular imaging techniques and methods are improved methods of detection and development of probes and ligands that will allow for the in vivo elucidation of the important and key molecular and metabolic alterations in disease. It is anticipated that in the future it will be possible to visualize and quantitate in vivo the critical changes in cells that transform from being normal to diseased and potentially allow for the evaluation of at-risk patients earlier in the pathogenesis of disease.

Current molecular imaging methods have primarily been laboratory-based techniques used in mouse models of human disease. However, these techniques and methodologies have the potential to revolutionize how the clinical imaging specialist approaches early detection and management of disease. There have been associated developments of targeted probes and enzyme-cleavable and activatable “smart” probes for both PET and optical imaging for example.

With the development of molecular imaging there has been substantial efforts to improve imaging by making the assessments more quantitative and reproducible.

References

  1. Jaffe TA, Wickersham NW, Sullivan DC. Quantitative imaging in oncology patients: Part 1, radiology practice patterns at major U.S. cancer centers. AJR Am J Roentgenol. 2010 ;195(1):101-106

  2. Jaffe TA, Wickersham NW, Sullivan DC. Quantitative imaging in oncology patients: Part 2, oncologists' opinions and expectations at major U.S. cancer centers. AJR Am J Roentgenol. 2010 ;195(1):W19-30

  3. Muzi M, O'Sullivan F, Mankoff DA, Doot RK, Pierce LA, Kurland BF, Linden HM, Kinahan PE. Quantitative assessment of dynamic PET imaging data in cancer imaging. Magn Reson Imaging. 2012;30(9):1203-15

  4. International Human Genome Sequencing Consortium. Initial Sequencing and Analysis of the Human Genome. Nature 2001; 409: 860-921. [http://www.genome.gov/11006929]

  5. Mouse Genome Sequencing Consortium, Initial Sequencing and Comparative Analysis of the Mouse Genome. Nature 2002; 420: 520-562.

  6. Pomper MG. Translational molecular imaging for cancer. Cancer Imaging; 23;5 Suppl:S16-26, 2005’

  7. Kelloff GJ, Krohn KA, Larson SM, Weissleder R, Mankoff DA, Hoffman JM, Link JM, Guyton KZ, Eckelman WC, Scher HL, O’Shaughnessy J, Cheson BD, Sigman CC, Tatum JL, Mills GQ, Sullivan DC, Woodcock J. The progress and promise of molecular imaging probes in oncologic drug development. Clin Cancer Res. 2005;11(22):7967-7985

  8. Gambhir SS. Molecular imaging of cancer with positron emission tomography

    Nat Rev Cancer. 2(9):683-93, 2002.

  9. Hoffman JM. Imaging in cancer: a National Cancer Institute "extraordinary opportunity”. Neoplasia. 2(1-2) 5-8, 2000

  10. Hoffman JM, Menkens A. Molecular Imaging in Cancer: Future Directions and Goals of the National Cancer Institute. Acad Radiol 7(10): 905-907, 2000

  11. Hoffman JM, Croft B. Future Directions in Small Animal Imaging. Lab Animal 30(3): 32-35, 2001

  12. Wagenaar DJ, Weissleder R, Arne Hengerer A, Glossary of Molecular Imaging

    Terminology. Acad Radiol 2001;8: 409-420

  13. Hillman BJ, Neiman HI. Translating molecular imaging research into radiologic practice: summary of the proceedings of the American College of Radiology Colloquium, April 22-24, 2001. Radiology 2002; 222: 19-24.

  14. Jaffer FA, Weissleder R. Molecular Imaging in the Clinical Arena. JAMA, 2005; 297: 855-862.

  15. Hoffman JM, Gambhir SS. Molecular Imaging: the Current State of the Science and the Future in the Clinical Practice of Radiology. Radiology 244: 39-47, 2007

  16. Wu JC, Bengel FM, Gambhir SS. Cardiovascular molecular imaging. Radiology. 244(2):337-55. 2007

  17. Biswal S, Resnick D, Hoffman JM. Gambhir SS. Molecular Imaging: Integration of Molecular Imaging into the Musculoskeletal Imaging Practice. Radiology 244(3):651-671, 2007

  18. Hammoud D. Hoffman JM, Pomper MG. Molecular neuroimaging: from conventional to emerging techniques. Radiology. 245(1):21-42. 2007

  19. Margolis D, Hoffman JM, Jeffrey RB, Herfkens RJ, Quon A, Gambhir SS. Molecular Imaging Techniques in Body Imaging Radiology. 245(2):333-356. 2007

  20. Hoffman JM, Gambhir SS, Kelloff GJ. Regulatory and Reimbursement Challenges for Molecular Imaging. Radiology 245(3):645-660, 2007