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Epilogue: Setting tiny targets for greater goals...

Nature Clinical Practice Cardiovascular Medicine volume 5, pages S112–S113 (2008)Cite this article

Molecular imaging comprises development of strategies for targeting subcellular processes and, as such, has been primarily considered a research tool. That such a perception persists despite multiple molecular imaging procedures now being embedded in our daily clinical practice is ironic. Myocardial perfusion assessment by thallium-201 evaluates the integrity of potassium channels of the sarcolemma, and hence myocellular viability. Technetium-99m-labeled sestamibi and tetrofosmin myocardial perfusion tracers interrogate mitochondrial competence. Radiotracers such as pyrophosphate that target intramitochondrial complexes identify recent myocardial necrosis, whereas antimyosin antibodies detect breaches in the sarcolemmal membrane. Thus, advances in nuclear techniques have led to pioneering the concept of molecular imaging into clinically relevant diagnostic as well as therapeutic (for cancer treatment) targets. Echocardiography, MRI and optical imaging have followed suit by employing targeted microbubbles (echocardiography) and iodine contrast-filled liposomes (CT) for targeting various cardiac structures.

The burgeoning knowledge of subcellular processes has permitted the development of complex strategies for molecular imaging. The availability of transgenic mouse models of cardiovascular disorders has made the application and the study of molecular imaging more convenient. Furthermore, development of imaging devices—such as micro-single-photon emission CT (SPECT), PET, CT and MRI—and hybrid systems (e.g. SPECT–CT and PET–MRI) has facilitated imaging processes and the superimposition of functional information over morphologic background. Identification of targets that are prominently overexpressed in the diseased tissue has provided high target-to-background contrast for hot-spot imaging. Alternatively, identification of moieties that are conspicuously absent from the target tissue would allow cold-spot imaging.

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Authors and Affiliations

  1. Chief of the Nuclear Medicine Division, V Dilsizian is Professor of Medicine and Radiology, and Director of Cardiovascular Nuclear Medicine and PET Imaging at the University of Maryland Hospital and School of Medicine, Baltimore, MD,

    Vasken Dilsizian

  2. J Narula is Professor of Medicine and Chief of the Cardiovascular Medicine Division at the University of California, Irvine, Irvine, CA, USA.,

    Jagat Narula

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  1. Vasken Dilsizian
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  2. Jagat Narula
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Correspondence to Vasken Dilsizian or Jagat Narula.

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Dilsizian, V., Narula, J. Epilogue: Setting tiny targets for greater goals.... Nat Rev Cardiol 5 (Suppl 2), S112–S113 (2008). https://doi.org/10.1038/ncpcardio1238

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