title: Making Molecular Imaging a Clinical Tool for Precision Oncology: A Review.
abstract: OBJECTIVE
  Individualized cancer treatment, tailored to a particular patient and the tumor's biological features (precision oncology), requires a detailed knowledge of tumor biology. Biological characterization is typically performed on biopsy material, but this approach can present challenges for widespread and/or heterogeneous disease and for performing serial assays to infer changes in response to therapy. Molecular imaging is a complementary approach that provides noninvasive and quantitative measures of the in vivo biology of the full disease burden and is well suited to serial assay.
  
  
  METHODS
  Molecular imaging can provide unique information to guide precision oncology that includes measuring the regional expression of therapeutic targets, measuring drug pharmacokinetics, measuring therapy pharmacodynamics, and providing a marker of therapeutic efficacy that is highly indicative of outcome. Thus far, most trials of novel molecular imaging in oncology have been small, single-center trials. Only a few methods have progressed to multicenter trials and even fewer have become part of clinical practice.
  
  
  CONCLUSIONS
  Molecular imaging holds great promise for precision oncology, complementing tissue-based markers to guide more effective, less toxic, and more cost-effective cancer treatments. Beyond logistical and technical challenges, moving new imaging tests from the laboratory to the clinic requires a compelling use case that will benefit patients and/or improve cost-effectiveness, and it requires the collaboration of imagers, oncologists, and industry to reach its true clinical potential.
authors.affiliation: Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia.
authors.forename: David A
authors.initials: DA
authors.lastname: Mankoff
authors.affiliation: Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Farwell
authors.affiliation: Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia.
authors.forename: Amy S
authors.initials: AS
authors.lastname: Clark
authors.affiliation: Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Pryma
mesh_terms: D000970:Antineoplastic Agents / Q000493:pharmacokinetics; D014408:Biomarkers, Tumor / Q000378:metabolism; D006801:Humans; D057054:Molecular Imaging / Q000379:methods*; D058990:Molecular Targeted Therapy / Q000379:methods; D009369:Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000378:metabolism; D049268:Positron-Emission Tomography / Q000379:methods; D057285:Precision Medicine / Q000379:methods*
chemical_list: D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor