New imaging techniques in cancer management
| Autor: | S. J. Gwyther |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
medicine.medical_specialty
Contrast Media Bioinformatics Neoplasms Medical imaging Medicine Humans Stage (cooking) Ultrasonography medicine.diagnostic_test biology Neovascularization Pathologic business.industry Cancer Magnetic resonance imaging Hematology medicine.disease Magnetic Resonance Imaging Surgery Clinical trial Functional imaging Oncology Positron-Emission Tomography Cancer cell biology.protein Antibody business Tomography X-Ray Computed |
| Zdroj: | Annals of oncology : official journal of the European Society for Medical Oncology. 16 |
| ISSN: | 0923-7534 |
| Popis: | Cancer continues to be one of the major causes of death worldwide in the 21st century, responsible for 6 million (12%) of the worldwide total deaths [1]. Throughout their lifetime, one in three people will suffer from cancer and one in four will die from it. The number and proportion of people developing cancer will inevitably rise as the overall world population ages. In the year 2000, 10 million new cases of cancer were diagnosed worldwide, which is expected to rise to 15 million by the year 2020 [1]. This highlights our current inability to provide effective treatment to significantly prolong the lives of such patients (where significantly means a matter of several years, not weeks or months), with an acceptable quality of life. It also infers an inability to detect cancer at an early enough stage to allow curative treatment. The standard treatments for cancer have classically consisted of various cytotoxic agents, used as single agents or in combination to kill rapidly dividing cells. These drugs make no distinction between cancer cells and normal rapidly dividing cells, such as white blood cells. Unfortunately, these drugs have a narrow therapeutic range. Current clinical trials employ anatomical imaging as a surrogate to determine potentially active agents by measuring a decrease in anatomical size of tumours during treatment. ‘Active’ drugs decrease tumours by predetermined, though arbitrary, degrees (response rates), and for a predetermined minimum time span [2, 3]. Recent advances in the understanding and development of molecular biology have stemmed from genomic studies, including sequencing the human genome, proteomic and bioinformatic studies [4–6]. These are largely in vitro studies and preclinical animal tumour models, but have led to the identification of specific molecular pathways and targets and genetic mutations associated with cancers that regulate molecular and metabolic pathways. The aim is to identify tumour-specific molecular receptors and block them with specific agents, either drugs or antibodies, thereby preventing tumours from growing, though not necessarily killing the tumour cells, whilst having no effect on normal cells and physiology. Medical imaging can be adapted to assess molecular effects on tumour growth and metastatic potential, although they may be unable to measure a given parameter directly. Instead, ‘downstream’ effects associated with tumour modulation can be measured [6]. Dynamic or functional imaging techniques have been developed that demonstrate physiological changes within tumours. Pre-existing imaging modalities, ultrasound (US), computed tomography (CT) and magnetic resonance imaging (MRI), have been adapted to measure tumours over time; using contrast agents and the differential uptake between tumours and normal tissue can be used to measure blood flow, blood volume and perfusion. From these studies, uptake curves characteristic for tumours can be constructed (Figure 1). |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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