Technical improvements in the staging of cancer: the role of imaging and contrast agents.
Despite advances in cancer diagnosis, there has been little impact upon outcome. This may be a consequence of the exceptional heterogeneity in cancers, especially their cell types, perfusion, oxygenation, and metabolic circumstances. Better therapeutic plans could require better characterization of individual tumors in individual patients. For some tumors, tissue characterization by sophisticated histologic analysis of biopsy samples may improve staging. However, noninvasive staging is more acceptable to patients and may be more comfortably repeated in the course of monitoring therapeutic regimens. Several imaging applications may serve these goals. First, new contrast agents may allow accurate cancer detection in regional lymph nodes. High resolution CT with perfluorocarbon lymphography is in the clinical trial stage. This could presage minimally invasive ablation of cancer in lymph nodes, as well. Second, new agents will better define local and metastatic cancers, also impacting standard and minimally invasive treatments. Finally, imaging methods may be able to measure perfusion and metabolism in small volumes in vivo, as well as estimate important local pharmacokinetics of therapeutics.
Wolf
G L
GL
Center for Imaging and Pharmaceutical Research, Massachusetts General Hospital, Charlestown 02129.
D000818:Animals; D003287:Contrast Media; D003952:Diagnostic Imaging; D006801:Humans; D009367:Neoplasm Staging; D009369:Neoplasms / Q000473:pathology*; D009374:Neoplasms, Experimental / Q000473:pathology; D009389:Neovascularization, Pathologic / Q000473:pathology
D003287:Contrast Media