ISNE - The International Society of Noninvasive Evaluation

Molecular Imaging

ISNE - The International Society of Noninvasive Evaluation

Molecular Imaging emerged in the mid twentieth century as a discipline at the intersection of molecular biology and in vivo imaging. It enables the visualization of the cellular function and the follow-up of the molecular process in living organisms without perturbing them. The multiple and numerous potentialities of this field are applicable to the diagnosis of diseases such as cancer, and neurological and cardiovascular diseases. This technique also contributes to improving the treatment of these disorders by optimizing the pre-clinical and clinical tests of new medication. They are also expected to have a major economic impact due to earlier and more precise diagnosis. Molecular and Functional Imaging has taken on a new direction since the description of the human genome. New paths in fundamental research, as well as in applied and industrial research, render the task of scientists more complex and increase the demands on them. Therefore, a tailor-made teaching program is in order.

Molecular imaging differs from traditional imaging in that probes known as biomarkers are used to help image particular targets or pathways. Biomarkers interact chemically with their surroundings and in turn alter the image according to molecular changes occurring within the area of interest. This process is markedly different from previous methods of imaging which primarily imaged differences in qualities such as density or water content. This ability to image fine molecular changes opens up an incredible number of exciting possibilities for medical application, including early detection and treatment of disease and basic pharmaceutical development. Furthermore, molecular imaging allows for quantitative tests, imparting a greater degree of objectivity to the study of these areas. One emerging technology is MALDI molecular imaging based on mass spectrometry.

Many areas of research are being conducted in the field of molecular imaging. Much research is currently centered on detecting what is known as a predisease state or molecular states that occur before typical symptoms of a disease are detected. Other important veins of research are the imaging of gene expression and the development of novel biomarkers. Organizations such as the SNMMI Center for Molecular Imaging Innovation and Translation (CMIIT) have formed to support research in this field. In Europe, other "networks of excellence" such as DiMI (Diagnostics in Molecular Imaging) or EMIL (European Molecular Imaging Laboratories) work on this new science, integrating activities and research in the field. In this way, a European Master Program "EMMI" is being set up to train a new generation of professionals in molecular imaging.

Recently the term "Molecular Imaging" has been applied to a variety of microscopy and nanoscopy techniques including live-cell microscopy, Total Internal Reflection Fluorescence (TIRF)-microscopy, STimulated Emission Depletion (STED)-nanoscopy and Atomic Force Microscopy (AFM) as here images of molecules are the readout.

Magnetic resonance imaging

Molecular MRI of a mouse brain presenting acute inflammation in the right hemisphere. Whereas un-enhanced MRI failed to reveal any difference between right en left hemispheres, injection of a contrast-agent targeted to inflamed vessels allows to reveal inflammation specifically in the right hemisphere.

MRI has the advantages of having very high spatial resolution and is very adept at morphological imaging and functional imaging. MRI does have several disadvantages though. First, MRI has a sensitivity of around 10−3 mol/L to 10−5 mol/L which, compared to other types of imaging, can be very limiting. This problem stems from the fact that the difference between atoms in the high energy state and the low energy state is very small. For example, at 1.5 teslas, a typical field strength for clinical MRI, the difference between high and low energy states is approximately 9 molecules per 2 million. Improvements to increase MR sensitivity include increasing magnetic field strength, and hyper-polarization via optical pumping, dynamic nuclear polarization or para-hydrogen induced polarization. There are also a variety of signal amplification schemes based on chemical exchange that increase sensitivity.

To achieve molecular imaging of disease biomarkers using MRI, targeted MRI contrast agents with high specificity and high relaxivity (sensitivity) are required. To date, many studies have been devoted to developing targeted-MRI contrast agents to achieve molecular imaging by MRI. Commonly, peptides, antibodies, or small ligands, and small protein domains, such as HER-2 affibodies, have been applied to achieve targeting. To enhance the sensitivity of the contrast agents, these targeting moieties are usually linked to high payload MRI contrast agents or MRI contrast agents with high relaxivities. In particular, the recent development of micron-sized particles of iron oxide (MPIO) allowed to reach unprecedented levels of sensitivity to detect proteins expressed by arteries and veins.

Optical imaging

There are a number of approaches used for optical imaging. The various methods depend upon fluorescence, bioluminescence, absorption or reflectance as the source of contrast.

Optical imaging's most valuable attribute is that it and ultrasound do not have strong safety concerns like the other medical imaging modalities.

The downside of optical imaging is the lack of penetration depth, especially when working at visible wavelengths. Depth of penetration is related to the absorption and scattering of light, which is primarily a function of the wavelength of the excitation source. Light is absorbed by endogenous chromophores found in living tissue (e.g. hemoglobin, melanin, and lipids). In general, light absorption and scattering decreases with increasing wavelength. Below ~700 nm (e.g. visible wavelengths), these effects result in shallow penetration depths of only a few millimeters. Thus, in the visible region of the spectrum, only superficial assessment of tissue features is possible. Above 900 nm, water absorption can interfere with signal-to-background ratio. Because the absorption coefficient of tissue is considerably lower in the near infrared (NIR) region (700-900 nm), light can penetrate more deeply, to depths of several centimeters.[4]

Single photon emission computed tomography

Main article: Single photon emission computed tomography

SPECT image (bone tracer) of a mouse MIP

The development of computed tomography in the 1970s allowed mapping of the distribution of the radioisotopes in the organ or tissue, and led to the technique now called single photon emission computed tomography (SPECT).

The imaging agent used in SPECT emits gamma rays, as opposed to the positron emitters

Xe) gas is one such radio-tracer. It has been shown to be valuable for diagnostic inhalation studies for the evaluation of pulmonary function; for imaging the lungs; and may also be used to assess rCBF. Detection of this gas occurs via a gamma camera—which is a scintillation detector consisting of a collimator, a NaI crystal, and a set of photomultiplier tubes.

By rotating the gamma camera around the patient, a three-dimensional image of the distribution of the radio-tracer can be obtained by employing filtered back projection or other tomographic techniques. The radioisotopes used in SPECT have relatively long half lives (a few hours to a few days) making them easy to produce and relatively cheap. This represents the major advantage of SPECT as a molecular imaging technique, since it is significantly cheaper than either PET or fMRI. However it lacks good spatial (i.e., where exactly the particle is) or temporal (i.e., did the contrast agent signal happen at this millisecond, or that millisecond) resolution. Additionally, due to the radioactivity of the contrast agent, there are safety aspects concerning the administration of radioisotopes to the subject, especially for serial studies.

Near Infrared imaging

Fluorescent probes and labels are an important tool for optical imaging. Some researchers have applied NIR imaging in Rat model of acute myocardial infarction (AMI), using a peptide probe that can binds to apoptotic and necrotic cells.[5] A number of near-infrared (NIR) fluorophores have been employed for in vivo imaging, including Kodak X-SIGHT Dyes and Conjugates, Pz 247, DyLight 750 and 800 Fluors, Cy 5.5 and 7 Fluors, Alexa Fluor 680 and 750 Dyes, IRDye 680 and 800CW Fluors. Quantum dots, with their photostability and bright emissions, have generated a great deal of interest; however, their size precludes efficient clearance from the circulatory and renal systems while exhibiting long-term toxicity.

Several studies have demonstrated the use of infrared dye-labeled probes in optical imaging.

  1. In a comparison of gamma scintigraphy and NIR imaging, a cyclopentapeptide dual-labeled with 111

  2. In and an NIR fluorophore was used to image αvβ3-integrin positive melanoma xenografts.

  3. Near-infrared labeled RGD targeting αvβ3-integrin has been used in numerous studies to target a variety of cancers.

  4. An NIR fluorophore has been conjugated to epidermal growth factor (EGF) for imaging of tumor progression.

  5. An NIR fluorophore was compared to Cy5.5, suggesting that longer-wavelength dyes may produce more effective targeting agents for optical imaging.

  6. Pamidronate has been labeled with an NIR fluorophore and used as a bone imaging agent to detect osteoblastic activity in a living animal.

  7. An NIR fluorophore-labeled GPI, a potent inhibitor of PSMA (prostate specific membrane antigen).

  8. Use of human serum albumin labeled with an NIR fluorophore as a tracking agent for mapping of sentinel lymph nodes.

  9. 2-Deoxy-D-glucose labeled with an NIR fluorophore.

It is important to note that addition of an NIR probe to any vector can alter the vector's biocompatibility and bio-distribution. Therefore, it can not be unequivocally assumed that the conjugated vector will behave similarly to the native form.