The future of medicine lies in treatments that are tailored to individual patients’ needs. This approach directs the appropriate care to each patient and maximizes healthcare outcomes. Today, “precision” medicine is a growing movement that utilizes information about an individual’s biology to personalize healthcare decision making. Advanced medical imaging has emerged as an important complement to this nascent trend leading to enhanced diagnosis, informed treatment options and targeted treatments.
Enhanced diagnosis
One example is mammography. While standard mammography is a proven screening technology, it can miss tumors, particularly in women with dense breast tissue. Breast imaging innovation has led to life-saving technologies for all women – such as magnetic resonance imaging (MRI), ultrasound and positron emission mammography and molecular breast imaging (MBI) – that detect cancer earlier, leading to higher survival rates. Breast tomosynthesis and stereoscopic digital mammography (DM) also provide 3D images that increase diagnostic accuracy and reduce false positives. In fact, a landmark study in the June 25 issue of the Journal of the American Medical Association found that digital 3D mammography increased the invasive breast cancer detection rate while decreasing the rate of false positives, which correlates to fewer unnecessary biopsies and saves the patient from needless worry and anxiety. Because of these innovations in imaging, women with dense breast tissue are more likely to have their cancer detected early, when it is more likely to be treated successfully.
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Informed treatment options
Positron emission tomography (PET) imaging can identify where malignant cancers have spread in the body and monitor the effectiveness of chemotherapy. Additionally, by identifying less aggressive cancers, this powerful combination approach can help better target treatment. The use of PET has become routine in the preoperative staging and treatment process for patients with lung cancer. A recent study published in the Journal of Nuclear Medicine confirms the real-world effectiveness of PET in avoiding unnecessary surgery for patients with newly diagnosed non-small cell lung cancer. Another study published in the American Journal of Radiology underscores the role of PET in the overall management of cervical cancer, the third most common cause of cancer mortality in the United States.
Computed tomography (CT) and magnetic resonance imaging (MRI) can help physicians determine whether a stroke was caused by a blood clot, which is critical because clot-busting drugs can worsen symptoms—or kill—if a stroke is not caused by a clot. By finding the right treatment for the nearly 800,000 Americans who suffer strokes annually, imaging saves lives.
Reduced radiation exposure
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Today, it’s no longer necessary to take a one-size-fits-all approach to patient care. Medical imaging can now be tailored to the individual patient, with dose settings that ensure image quality even while reducing radiation dose to the patient. Because of these innovations, dose can be optimized for patients of all sizes.
For example, new advanced adaptive image filters identify image features and make processing adjustments to reduce dose while maintaining diagnostic image quality. In cardiac imaging, these filters have been shown to help clinicians lower dose while maintaining high quality images of the coronary anatomy for a broad range of patient sizes.
Thanks to the work of scanner manufacturers and organizations like Image Gently, many new techniques can be used to dramatically reduce radiation exposure in children. Pre-loaded pediatric protocol selection tools facilitate emergency care and reduce medical errors by helping clinicians determine appropriate dose levels and utilize appropriate techniques for pediatric patients. Removable grids can reduce the amount of radiation administered to pediatric patients during interventional X-ray procedures. Specially designed child-friendly equipment helps put little patients at ease, eliminating the need to use sedation or perform repeat imaging.
Targeted treatments
Image-guided radiation therapy (IGRT) helps radiologists target tumors with great precision while limiting harm to healthy cells. This is especially useful in treating moving organs, such as the lungs, or tumors located near critical organs like the heart. Research has demonstrated the benefits of this approach in terms of patient outcomes: in one study, prostate cancer patients treated with IGRT fared significantly better three years after treatment than those who did not receive IGRT.
Intensity-modulated radiation therapy (IMRT) is another type of advanced radiation therapy used to treat cancer and noncancerous tumors with multiple small radiation beams of varying intensities. This technology controls and shapes the beam throughout the course of treatment to fit the shape of the patient’s tumor, thereby reducing exposure of healthy tissue and limiting treatment side effects.
Imaging and radiation therapy manufacturers are committed to developing detection and treatment technologies that will lead this precision approach to patient care. Personalized medicine is made possible in part due to the increasingly sophisticated diagnostic capabilities that the industry continues to invest in and make available to the medical community and their patients.
Gail Rodriguez is the executive director of the Medical Imaging & Technology Alliance. She has worked in the nuclear medicine industry for eighteen years in various sales, marketing, training and management roles. Gail has been involved in imaging policy since 2008 when she served as policy and membership director for the Institute for Molecular Technologies. She has a Ph.D. in Political Science from the University of Kansas with an emphasis on health policy.
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