title: Challenges in clinical studies with multiple imaging probes.
abstract: This article addresses two related issues: (a) When a new imaging agent is proposed, how does the imager integrate it with other biomarkers, either sampled or imaged? (b) When we have multiple imaging agents, is the information additive or duplicative and how is this objectively determined? Molecular biology is leading to new treatment options with reduced normal tissue toxicity, and imaging should have a role in objectively evaluating new treatments. There are two roles for molecular characterization of disease. Molecular imaging measurements before therapy help predict the aggressiveness of disease and identify therapeutic targets and, therefore, help choose the optimal therapy for an individual. Measurements of specific biochemical processes made during or after therapy should be sensitive measures of tumor response. The rules of evidence are not fully developed for the prognostic role of imaging biomarkers, but the potential of molecular imaging provides compelling motivation to push forward with convincing validation studies. New imaging procedures need to be characterized for their effectiveness under realistic clinical conditions to improve the management of patients and achieve a better outcome. The purpose of this article is to promote a critical discussion within the molecular imaging community because our future value to the overall biomedical community will be in supporting better treatment outcomes rather than in detection.
authors.affiliation: Radiology Department, Molecular Imaging Center, University of Washington, Seattle, WA 98195-6004, USA. kkrohn@u.washington.edu
authors.forename: Kenneth A
authors.initials: KA
authors.lastname: Krohn
authors.forename: Finbarr
authors.initials: F
authors.lastname: O'Sullivan
authors.forename: John
authors.initials: J
authors.lastname: Crowley
authors.forename: Janet F
authors.initials: JF
authors.lastname: Eary
authors.forename: Hannah M
authors.initials: HM
authors.lastname: Linden
authors.forename: Jeanne M
authors.initials: JM
authors.lastname: Link
authors.forename: David A
authors.initials: DA
authors.lastname: Mankoff
authors.forename: Mark
authors.initials: M
authors.lastname: Muzi
authors.forename: Joseph G
authors.initials: JG
authors.lastname: Rajendran
authors.forename: Alexander M
authors.initials: AM
authors.lastname: Spence
authors.forename: Kristin R
authors.initials: KR
authors.lastname: Swanson
mesh_terms: D035843:Biomedical Research / Q000639:trends*; D002986:Clinical Trials as Topic / Q000639:trends*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D015336:Molecular Probe Techniques; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals
chemical_list: D019275:Radiopharmaceuticals