癌症诊断技术的进步:改进与局限。

Technological advancements in cancer diagnostics: Improvements and limitations.

机构信息

University of Missouri-Kansas City, Kansas City, Missouri, USA.

Central Research Facility, Sri Ramachandra Institute of Higher Education and Research Porur, Chennai, India.

出版信息

Cancer Rep (Hoboken). 2023 Feb;6(2):e1764. doi: 10.1002/cnr2.1764. Epub 2023 Jan 6.

Abstract

BACKGROUND

Cancer is characterized by the rampant proliferation, growth, and infiltration of malignantly transformed cancer cells past their normal boundaries into adjacent tissues. It is the leading cause of death worldwide, responsible for approximately 19.3 million new diagnoses and 10 million deaths globally in 2020. In the United States alone, the estimated number of new diagnoses and deaths is 1.9 million and 609 360, respectively. Implementation of currently existing cancer diagnostic techniques such as positron emission tomography (PET), X-ray computed tomography (CT), and magnetic resonance spectroscopy (MRS), and molecular diagnostic techniques, have enabled early detection rates and are instrumental not only for the therapeutic management of cancer patients, but also for early detection of the cancer itself. The effectiveness of these cancer screening programs are heavily dependent on the rate of accurate precursor lesion identification; an increased rate of identification allows for earlier onset treatment, thus decreasing the incidence of invasive cancer in the long-term, and improving the overall prognosis. Although these diagnostic techniques are advantageous due to lack of invasiveness and easier accessibility within the clinical setting, several limitations such as optimal target definition, high signal to background ratio and associated artifacts hinder the accurate diagnosis of specific types of deep-seated tumors, besides associated high cost. In this review we discuss various imaging, molecular, and low-cost diagnostic tools and related technological advancements, to provide a better understanding of cancer diagnostics, unraveling new opportunities for effective management of cancer, particularly in low- and middle-income countries (LMICs).

RECENT FINDINGS

Herein we discuss various technological advancements that are being utilized to construct an assortment of new diagnostic techniques that incorporate hardware, image reconstruction software, imaging devices, biomarkers, and even artificial intelligence algorithms, thereby providing a reliable diagnosis and analysis of the tumor. Also, we provide a brief account of alternative low cost-effective cancer therapy devices (CryoPop®, LumaGEM®, MarginProbe®) and picture archiving and communication systems (PACS), emphasizing the need for multi-disciplinary collaboration among radiologists, pathologists, and other involved specialties for improving cancer diagnostics.

CONCLUSION

Revolutionary technological advancements in cancer imaging and molecular biology techniques are indispensable for the accurate diagnosis and prognosis of cancer.

摘要

背景

癌症的特征是恶性转化的癌细胞不受控制地增殖、生长和浸润,超出其正常边界进入相邻组织。它是全球范围内的主要死因,2020 年导致全球约 1930 万新诊断病例和 1000 万人死亡。仅在美国,估计新诊断病例和死亡人数分别为 190 万和 60.936 万。正电子发射断层扫描(PET)、X 射线计算机断层扫描(CT)和磁共振波谱(MRS)等现有癌症诊断技术以及分子诊断技术的实施,实现了早期检测率,不仅对癌症患者的治疗管理至关重要,而且对癌症本身的早期检测也至关重要。这些癌症筛查计划的有效性在很大程度上取决于准确识别癌前病变的速度;识别率的提高可以实现更早的发病治疗,从而降低长期侵袭性癌症的发病率,并改善整体预后。尽管这些诊断技术具有非侵入性和在临床环境中更容易获得的优势,但存在一些局限性,例如最佳目标定义、高信号与背景比以及相关伪影,这些限制了特定类型深部肿瘤的准确诊断,此外还存在相关的高成本。在本综述中,我们讨论了各种成像、分子和低成本诊断工具以及相关技术进步,以更好地了解癌症诊断,为癌症的有效管理提供新的机会,特别是在低收入和中等收入国家(LMICs)。

最新发现

在此,我们讨论了正在利用的各种技术进步,这些技术进步用于构建各种新的诊断技术,这些技术结合了硬件、图像重建软件、成像设备、生物标志物,甚至人工智能算法,从而提供了肿瘤的可靠诊断和分析。此外,我们还简要介绍了替代的低成本有效的癌症治疗设备(CryoPop®、LumaGEM®、MarginProbe®)和图像存档与通信系统(PACS),强调了放射科医生、病理学家和其他相关专业之间进行多学科合作的必要性,以改善癌症诊断。

结论

癌症成像和分子生物学技术的革命性技术进步对于癌症的准确诊断和预后是不可或缺的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/08cf/9940009/7fbdedb9aaf3/CNR2-6-e1764-g004.jpg

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