Imaging has a crucial role in the quest for early detection of all types of cancer. Over the past two decades revolutionary techniques, such as PET, have allowed us to identify small tumours and metastases that wouldn't be visible with any other technique, by detecting their metabolic activity. In addition to detection, imaging has a fundamental role in the assessment of whether a tumour is responding favourably to the treatment administered. For example, image-guided radiotherapy has undergone a remarkable transformation in the past decade through innovative technology that allows daily imaging to locate the tumour precisely, and subsequent repositioning of the patient to receive radiation exclusively in the target organ. However, with the significant improvement of these techniques in recent years, comes the challenge of standardization of response criteria, as lesions that may easily be detected on a new scanner might not be detected on an older one.
The articles in this specially commissioned Focus on Imaging from Nature Reviews Clinical Oncology describe the excellent progress made in the field of cancer imaging, and the effect this progress has had in the way we diagnose and treat cancer.
EDITORIAL
Imaging in oncology: lighting the way
M. Teresa Villanueva
doi:10.1038/nrclinonc.2012.208
Nature Reviews Clinical Oncology 9, 667 (2012)
RESEARCH HIGHLIGHT
Imaging: Response in follicular lymphoma can be assessed using PET
Mina Razzak
doi:10.1038/nrclinonc.2012.206
Nature Reviews Clinical Oncology 9, 671 (2012)
REVIEWS
Imaging hypoxia to improve radiotherapy outcome
Michael R. Horsman, Lise Saksø Mortensen, Jørgen B. Petersen, Morten Busk & Jens Overgaard
doi:10.1038/nrclinonc.2012.171
Nature Reviews Clinical Oncology 9, 674-687 (2012)
Hypoxia can affect clinical outcome after radiotherapy, resulting in reduced local tumour control and increased malignant progression. Hence, its detection is of utmost importance, but how can we detect hypoxia? Horsman et al. assess the potential use of imaging to identify hypoxic tumours that would lead to treatment modifications with the aim of improving clinical outcome after radiotherapy.
Image-guided radiotherapy: from current concept to future perspectives
David A. Jaffray
doi:10.1038/nrclinonc.2012.194
Nature Reviews Clinical Oncology 9, 688-699 (2012)
Technological innovations have made possible the integration of imaging technology into the radiation treatment devices to increase the precision and accuracy of radiation delivery. But, this is just the beginning. In this Review, David A. Jaffray discusses the different exciting advances in image-guided radiotherapy to achieve patient-specific radiotherapy treatment courses in the ever evolving field of radiation oncology.
Functional imaging in adult and paediatric brain tumours
Andrew C. Peet, Theodoros N. Arvanitis, Martin O. Leach & Adam D. Waldman
doi:10.1038/nrclinonc.2012.187
Nature Reviews Clinical Oncology 9, 700-711 (2012)
Are there any methods beyond MRI for brain tumours imaging? This Review by Andrew C. Peet and colleagues discusses the additional information that can be obtained by using functional imaging methods—such as diffusion imaging, perfusion imaging and magnetic resonance spectroscopy—and the challenges in determining the best way to incorporate these techniques into routine clinical practice.
PERSPECTIVES
Is there still a role for SPECT–CT in oncology in the PET–CT era?
Rodney J. Hicks & Michael S. Hofman
doi:10.1038/nrclinonc.2012.188
Nature Reviews Clinical Oncology 9, 712-720 (2012)
PET or SPECT, is that the question? Single-photon emission computed tomography (SPECT) and positron emission tomography (PET) are both tomographic techniques that enable 3D-localization of the tumour and can be combined with CT for hybrid imaging; but is one better that the other? In oncology imaging nothing is black or white, and Rod Hicks and Michael Hofman provide us with an in-depth analysis of the advantages and disadvantages of each technique.
Prostate focused ultrasound focal therapy—imaging for the future
Olivier Rouvière, Albert Gelet, Sébastien Crouzet & Jean-Yves Chapelon
doi:10.1038/nrclinonc.2012.136
Nature Reviews Clinical Oncology 9, 721-727 (2012)
Treatment of prostate cancer using high-intensity focused ultrasound (HIFU) focal therapy could be a reliable treatment option but, are we ready for it? This Perspectives article assesses whether our current methods for cancer diagnosis, tissue targeting, and treatment follow up are accurate enough to allow the design of HIFU focal therapy protocols.
Timeline: Imaging in oncology—over a century of advances
Bhuey Sharma, Axel Martin, Susannah Stanway, Stephen R. D. Johnston & Anastasia Constantinidou
doi:10.1038/nrclinonc.2012.195
Nature Reviews Clinical Oncology 9, 728-737 (2012)
Once upon a time, around 100 years ago, there was an X ray image of a sarcoma. From then on, increasingly complex functional imaging techniques were developed and are now applicable in both clinical and research platforms. This Timeline article revisits the achievements of the pioneer techniques in cancer imaging, discussing how they have changed over time and envisioning how imaging will remodel the future of modern oncology.
The clinical evaluation of novel imaging methods for cancer management
Lalitha K. Shankar
doi:10.1038/nrclinonc.2012.186
Nature Reviews Clinical Oncology 9, 738-744 (2012)
The National Cancer Institute (NCI) has invested a great deal of resources into examining imaging modalities and agents to improve image-guided interventions and disease monitoring in cancer. In this Perspectives article, the author describes the efforts of the NCI has made to facilitate clinical trials in imaging.
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