Phelps M E
Department of Molecular and Medical Pharmacology, Crump Institute for Molecular Imaging, University of California Los Angeles School of Medicine, Box 951735, Los Angeles, CA 90095-1735, USA.
Proc Natl Acad Sci U S A. 2000 Aug 1;97(16):9226-33. doi: 10.1073/pnas.97.16.9226.
Diseases are biological processes, and molecular imaging with positron emission tomography (PET) is sensitive to and informative of these processes. This is illustrated by detection of biological abnormalities in neurological disorders with no computed tomography or MRI anatomic changes, as well as even before symptoms are expressed. PET whole body imaging in cancer provides the means to (i) identify early disease, (ii) differentiate benign from malignant lesions, (iii) examine all organs for metastases, and (iv) determine therapeutic effectiveness. Diagnostic accuracy of PET is 8-43% higher than conventional procedures and changes treatment in 20-40% of the patients, depending on the clinical question, in lung and colorectal cancers, melanoma, and lymphoma, with similar findings in breast, ovarian, head and neck, and renal cancers. A microPET scanner for mice, in concert with human PET systems, provides a novel technology for molecular imaging assays of metabolism and signal transduction to gene expression, from mice to patients: e.g., PET reporter gene assays are used to trace the location and temporal level of expression of therapeutic and endogenous genes. PET probes and drugs are being developed together-in low mass amounts, as molecular imaging probes to image the function of targets without disturbing them, and in mass amounts to modify the target's function as a drug. Molecular imaging by PET, optical technologies, magnetic resonance imaging, single photon emission tomography, and other technologies are assisting in moving research findings from in vitro biology to in vivo integrative mammalian biology of disease.
疾病是生物学过程,正电子发射断层扫描(PET)分子成像对这些过程敏感且能提供信息。这一点在神经系统疾病中生物异常的检测中得到了体现,这些疾病在计算机断层扫描或MRI没有解剖学变化时,甚至在症状出现之前就能被检测到。癌症的PET全身成像提供了以下手段:(i)识别早期疾病;(ii)区分良性和恶性病变;(iii)检查所有器官是否有转移;(iv)确定治疗效果。PET的诊断准确性比传统方法高8 - 43%,并在20 - 40%的患者中改变治疗方案,这取决于临床问题,在肺癌、结直肠癌、黑色素瘤和淋巴瘤中如此,在乳腺癌、卵巢癌、头颈癌和肾癌中也有类似发现。一种用于小鼠的微型PET扫描仪,与人类PET系统协同工作,为从小鼠到患者的代谢、信号转导至基因表达的分子成像分析提供了一项新技术:例如,PET报告基因分析用于追踪治疗性基因和内源性基因的表达位置和时间水平。PET探针和药物正在同时研发——少量作为分子成像探针,用于在不干扰靶点的情况下成像靶点功能,大量则作为药物来改变靶点功能。PET、光学技术、磁共振成像、单光子发射断层扫描及其他技术的分子成像,正在助力将研究成果从体外生物学转化为疾病的体内整合哺乳动物生物学研究。