Grimm J, Wunder A
Center for Molecular Imaging Research, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.
Rofo. 2005 Mar;177(3):326-37. doi: 10.1055/s-2005-857946.
The recent years have seen significant advances in both molecular biology, allowing the identification of genes and pathways related to disease, and imaging technologies that allow for improved spatial and temporal resolution, enhanced sensitivity, better depth penetration, improved image processing, and beneficial combinations of different imaging modalities. These advances have led to a paradigm shift in the scope of diagnostic imaging. The traditional role of radiological diagnostic imaging is to define gross anatomy and structure in order to detect pathological abnormalities. Available contrast agents are mostly non-specific and can be used to image physiological processes such as changes in blood volume, flow, and perfusion but not to demonstrate pathological alterations at molecular levels. However, alterations at the anatomical-morphological level are relatively late manifestations of underlying molecular changes. Using molecular probes or markers that bind specifically to molecular targets allows for the non-invasive visualization and quantitation of biological processes such as gene expression, apoptosis, or angiogenesis at the molecular level within intact living organisms. This rapidly evolving, multidisciplinary approach, referred to as molecular imaging, promises to enable early diagnosis, can provide improved classification of stage and severity of disease, an objective assessment of treatment efficacy, and a reliable prognosis. Furthermore, molecular imaging is an important tool for the evaluation of physiological and pathophysiological processes, and for the development of new therapies. This article comprises a review of current technologies of molecular imaging, describes the development of contrast agents and various imaging modalities, new applications in specific disease models, and potential future developments.
近年来,分子生物学取得了重大进展,使得与疾病相关的基因和信号通路得以识别;成像技术也有了显著进步,实现了更高的空间和时间分辨率、更高的灵敏度、更好的深度穿透性、更优的图像处理能力以及不同成像模式的有益结合。这些进展导致了诊断成像领域的范式转变。传统放射诊断成像的作用是界定大体解剖结构,以检测病理异常。现有的造影剂大多是非特异性的,可用于对诸如血容量、血流和灌注变化等生理过程进行成像,但无法在分子水平显示病理改变。然而,解剖形态学水平的改变是潜在分子变化的相对晚期表现。使用与分子靶点特异性结合的分子探针或标记物,能够在完整的活体生物体内对基因表达、细胞凋亡或血管生成等生物过程进行分子水平的非侵入性可视化和定量分析。这种迅速发展的多学科方法,即分子成像,有望实现早期诊断,能够改进疾病分期和严重程度的分类,对治疗效果进行客观评估,并提供可靠的预后判断。此外,分子成像还是评估生理和病理生理过程以及开发新疗法的重要工具。本文综述了当前分子成像技术,描述了造影剂和各种成像模式的发展、在特定疾病模型中的新应用以及未来可能的发展方向。