Lindner Jonathan R, Morello Matteo
Cardiovascular Division and Robert M. Berne Cardiovascular Research Center, University of Virginia, Charlottesville.
Circulation. 2024 Dec 3;150(23):1885-1897. doi: 10.1161/CIRCULATIONAHA.124.066522. Epub 2024 Dec 2.
Conventional forms of noninvasive cardiovascular imaging that evaluate morphology, function, flow, and metabolism play a vital role in individual treatment decisions, often based on guidelines. Innovations in molecular imaging have enhanced our ability to spatially quantify the expression of a wider array of disease-related proteins, genes, or cell types, or the activity of specific pathogenic pathways. These techniques, which usually rely on design of targeted imaging probes, have already been used extensively in cancer medicine and have now become part of cardiovascular care in conditions such as amyloidosis and sarcoidosis. The recognition that common cardiovascular conditions are caused by a substantial diversity of pathobiologic pathways and the diversity of therapies available for use have rekindled interest in expanding the role of molecular imaging of tissue phenotype to improve precision in diagnosis and therapeutic decision-making. The intent of this article is to raise awareness and understanding of approaches to molecular or cellular imaging of phenotype with targeted probes, and their potential to promote the principles of precision medicine. Also addressed are the diverse roles of molecular imaging to improve precision and efficiency of new drug development at the stages of candidate identification, preclinical testing, and clinical trials.
评估形态、功能、血流和代谢的传统非侵入性心血管成像形式在个体治疗决策中起着至关重要的作用，这些决策通常基于指南。分子成像的创新提高了我们在空间上量化更多与疾病相关的蛋白质、基因或细胞类型的表达，或特定致病途径活性的能力。这些技术通常依赖于靶向成像探针的设计，已经在癌症医学中广泛应用，现在已成为诸如淀粉样变性和结节病等病症心血管护理的一部分。认识到常见心血管疾病是由大量不同的病理生物学途径引起的，以及可用治疗方法的多样性，重新激发了人们对扩大组织表型分子成像作用的兴趣，以提高诊断和治疗决策的精准度。本文旨在提高人们对使用靶向探针进行表型分子或细胞成像方法的认识和理解，以及它们促进精准医学原则的潜力。还讨论了分子成像在候选物识别、临床前测试和临床试验阶段改善新药开发的精准度和效率方面的不同作用。
