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Kiessling F, Schulz V. Perspectives of Evidence-Based Therapy Management. Nuklearmedizin 2023; 62:314-322. [PMID: 37802059 DOI: 10.1055/a-2159-6949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/08/2023]
Abstract
BACKGROUND Therapeutics that specifically address biological processes often require a much finer selection of patients and subclassification of diseases. Thus, diagnostic procedures must describe the diseases in sufficient detail to allow selection of appropriate therapy and to sensitively track therapy response. Anatomical features are often not sufficient for this purpose and there is a need to image molecular and pathophysiological processes. METHOD Two imaging strategies can be pursued: molecular imaging attempts to image a few biomarkers that play key roles in pathological processes. Alternatively, patterns describing a biological process can be identified from the synopsis of multiple (non-specific) imaging markers, possibly in combination with omics and other clinical findings. Here, AI-based methods are increasingly being used. RESULTS Both strategies of evidence-based therapy management are explained in this review article and examples and clinical successes are presented. In this context, reviews of clinically approved molecular diagnostics and decision support systems are listed. Furthermore, since reliable, representative, and sufficiently large datasets are further important prerequisites for AI-assisted multiparametric analyses, concepts are presented to make data available in a structured way, e. g., using Generative Adversarial Networks to complement databases with virtual cases and to build completely anonymous reference databases. CONCLUSION Molecular imaging and computer-assisted cluster analysis of diagnostic data are complementary methods to describe pathophysiological processes. Both methods have the potential to improve (evidence-based) the future management of therapies, partly on their own but also in combined approaches. KEY POINTS · Molecular imaging and radiomics provide valuable complementary disease biomarkers.. · Data-driven, model-based, and hybrid model-based integrated diagnostics advance precision medicine.. · Synthetic data generation may become essential in the development process of future AI methods..
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Affiliation(s)
- Fabian Kiessling
- Universitätsklinikum Aachen, Lehrstuhl für Experimentelle Molekulare Bildgebung, Aachen, Germany
- Group Aachen, Fraunhofer-Institut für Digitale Medizin MEVIS, Bremen, Germany
| | - Volkmar Schulz
- Universitätsklinikum Aachen, Lehrstuhl für Experimentelle Molekulare Bildgebung, Aachen, Germany
- Group Aachen, Fraunhofer-Institut für Digitale Medizin MEVIS, Bremen, Germany
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Schwenck J, Sonanini D, Cotton JM, Rammensee HG, la Fougère C, Zender L, Pichler BJ. Advances in PET imaging of cancer. Nat Rev Cancer 2023:10.1038/s41568-023-00576-4. [PMID: 37258875 DOI: 10.1038/s41568-023-00576-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/17/2023] [Indexed: 06/02/2023]
Abstract
Molecular imaging has experienced enormous advancements in the areas of imaging technology, imaging probe and contrast development, and data quality, as well as machine learning-based data analysis. Positron emission tomography (PET) and its combination with computed tomography (CT) or magnetic resonance imaging (MRI) as a multimodality PET-CT or PET-MRI system offer a wealth of molecular, functional and morphological data with a single patient scan. Despite the recent technical advances and the availability of dozens of disease-specific contrast and imaging probes, only a few parameters, such as tumour size or the mean tracer uptake, are used for the evaluation of images in clinical practice. Multiparametric in vivo imaging data not only are highly quantitative but also can provide invaluable information about pathophysiology, receptor expression, metabolism, or morphological and functional features of tumours, such as pH, oxygenation or tissue density, as well as pharmacodynamic properties of drugs, to measure drug response with a contrast agent. It can further quantitatively map and spatially resolve the intertumoural and intratumoural heterogeneity, providing insights into tumour vulnerabilities for target-specific therapeutic interventions. Failure to exploit and integrate the full potential of such powerful imaging data may lead to a lost opportunity in which patients do not receive the best possible care. With the desire to implement personalized medicine in the cancer clinic, the full comprehensive diagnostic power of multiplexed imaging should be utilized.
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Affiliation(s)
- Johannes Schwenck
- Werner Siemens Imaging Center, Department of Preclinical Imaging and Radiopharmacy, Eberhard Karls University of Tübingen, Tübingen, Germany
- Nuclear Medicine and Clinical Molecular Imaging, Department of Radiology, Eberhard Karls University of Tübingen, Tübingen, Germany
- Cluster of Excellence iFIT (EXC 2180) 'Image-Guided and Functionally Instructed Tumour Therapies', Eberhard Karls University, Tübingen, Germany
| | - Dominik Sonanini
- Werner Siemens Imaging Center, Department of Preclinical Imaging and Radiopharmacy, Eberhard Karls University of Tübingen, Tübingen, Germany
- Medical Oncology and Pulmonology, Department of Internal Medicine, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - Jonathan M Cotton
- Werner Siemens Imaging Center, Department of Preclinical Imaging and Radiopharmacy, Eberhard Karls University of Tübingen, Tübingen, Germany
- Cluster of Excellence iFIT (EXC 2180) 'Image-Guided and Functionally Instructed Tumour Therapies', Eberhard Karls University, Tübingen, Germany
| | - Hans-Georg Rammensee
- Cluster of Excellence iFIT (EXC 2180) 'Image-Guided and Functionally Instructed Tumour Therapies', Eberhard Karls University, Tübingen, Germany
- Department of Immunology, IFIZ Institute for Cell Biology, Eberhard Karls University of Tübingen, Tübingen, Germany
- German Cancer Research Center, German Cancer Consortium DKTK, Partner Site Tübingen, Tübingen, Germany
| | - Christian la Fougère
- Nuclear Medicine and Clinical Molecular Imaging, Department of Radiology, Eberhard Karls University of Tübingen, Tübingen, Germany
- Cluster of Excellence iFIT (EXC 2180) 'Image-Guided and Functionally Instructed Tumour Therapies', Eberhard Karls University, Tübingen, Germany
- German Cancer Research Center, German Cancer Consortium DKTK, Partner Site Tübingen, Tübingen, Germany
| | - Lars Zender
- Cluster of Excellence iFIT (EXC 2180) 'Image-Guided and Functionally Instructed Tumour Therapies', Eberhard Karls University, Tübingen, Germany
- Medical Oncology and Pulmonology, Department of Internal Medicine, Eberhard Karls University of Tübingen, Tübingen, Germany
- German Cancer Research Center, German Cancer Consortium DKTK, Partner Site Tübingen, Tübingen, Germany
| | - Bernd J Pichler
- Werner Siemens Imaging Center, Department of Preclinical Imaging and Radiopharmacy, Eberhard Karls University of Tübingen, Tübingen, Germany.
- Cluster of Excellence iFIT (EXC 2180) 'Image-Guided and Functionally Instructed Tumour Therapies', Eberhard Karls University, Tübingen, Germany.
- German Cancer Research Center, German Cancer Consortium DKTK, Partner Site Tübingen, Tübingen, Germany.
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Kiessling F, Schulz V. Perspectives of Evidence-Based Therapy Management. ROFO-FORTSCHR RONTG 2022; 194:728-736. [PMID: 35545101 DOI: 10.1055/a-1752-0839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Therapeutics that specifically address biological processes often require a much finer selection of patients and subclassification of diseases. Thus, diagnostic procedures must describe the diseases in sufficient detail to allow selection of appropriate therapy and to sensitively track therapy response. Anatomical features are often not sufficient for this purpose and there is a need to image molecular and pathophysiological processes. METHOD Two imaging strategies can be pursued: molecular imaging attempts to image a few biomarkers that play key roles in pathological processes. Alternatively, patterns describing a biological process can be identified from the synopsis of multiple (non-specific) imaging markers, possibly in combination with omics and other clinical findings. Here, AI-based methods are increasingly being used. RESULTS Both strategies of evidence-based therapy management are explained in this review article and examples and clinical successes are presented. In this context, reviews of clinically approved molecular diagnostics and decision support systems are listed. Furthermore, since reliable, representative, and sufficiently large datasets are further important prerequisites for AI-assisted multiparametric analyses, concepts are presented to make data available in a structured way, e. g., using Generative Adversarial Networks to complement databases with virtual cases and to build completely anonymous reference databases. CONCLUSION Molecular imaging and computer-assisted cluster analysis of diagnostic data are complementary methods to describe pathophysiological processes. Both methods have the potential to improve (evidence-based) the future management of therapies, partly on their own but also in combined approaches. KEY POINTS · Molecular imaging and radiomics provide valuable complementary disease biomarkers.. · Data-driven, model-based, and hybrid model-based integrated diagnostics advance precision medicine.. · Synthetic data generation may become essential in the development process of future AI methods.. CITATION FORMAT · Kiessling F, Schulz V, . Perspectives of Evidence-Based Therapy Management. Fortschr Röntgenstr 2022; DOI: 10.1055/a-1752-0839.
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Affiliation(s)
- Fabian Kiessling
- Universitätsklinikum Aachen, Lehrstuhl für Experimentelle Molekulare Bildgebung, Aachen, Germany.,Group Aachen, Fraunhofer-Institut für Digitale Medizin MEVIS, Bremen, Germany
| | - Volkmar Schulz
- Universitätsklinikum Aachen, Lehrstuhl für Experimentelle Molekulare Bildgebung, Aachen, Germany.,Group Aachen, Fraunhofer-Institut für Digitale Medizin MEVIS, Bremen, Germany
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Pan X, Zhu J, Xu Z, Xiao Q, Zhou X, Xu K, Li C, Jiang Y, Wang Y, Xue Z, Lei P, He Y. 68Ga-WRWWWW Is a Potential Positron Emission Tomography Probe for Imaging Inflammatory Diseases by Targeting Formyl Peptide Receptor 2. Mol Pharm 2022; 19:1368-1377. [PMID: 35393860 DOI: 10.1021/acs.molpharmaceut.1c00922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Inflammation plays a significant role in many physiological and pathological processes. Molecular imaging could provide functional as well as anatomical information for visualizing various inflammatory diseases. Advancements in imaging tracers for inflammation would improve the accuracy of diagnosis and monitoring, thus facilitating patient care. The positron emission tomography (PET) imaging tracer, 68Ga-labeled antagonist peptide Trp-Arg-Trp-Trp-Trp-Trp (WRWWWW, WRW4), targets formyl peptide receptor 2 (FPR2), which is in turn widely distributed in a variety of tissues and is associated with many inflammatory diseases. In the current study, we aimed to investigate the potential of 68Ga-WRW4 for detecting and monitoring inflammatory lesions in mice. We established an inflammation mouse model by the intramuscular injection of turpentine oil into the left thigh. WRW4 was labeled with 68Ga with an overall radiochemical yield >90% and radiochemical purity >99%. 68Ga-WRW4 uptake in inflamed muscle peaked on day 2 (1.14 ± 0.01 percentage of the injected dose per gram of tissue (%ID/g)) and the uptake ratio of inflammatory/normal muscle also reached a maximum (12.36 ± 2.35). Strong PET signals were detected in the left thigh at 60 min after the injection of 68Ga-WRW4 in experimental mice, but weak or no signals were detected in mice in the blocking and control groups. 68Ga-WRW4 uptake was in agreement with the dynamics of immune cell infiltration during the inflammatory reaction. These results suggest that 68Ga-WRW4 is a promising PET tracer suitable for the noninvasive detection of FPR2 expression and for monitoring inflammatory activity in inflammation-bearing mice.
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Affiliation(s)
- Xin Pan
- Department of Nuclear Medicine, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, Hubei Province 430071, China
| | - Jiaxu Zhu
- Department of Nuclear Medicine, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, Hubei Province 430071, China
| | - Zhuoshuo Xu
- Department of Immunology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Qin Xiao
- Department of Nuclear Medicine, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, Hubei Province 430071, China
| | - Xiaoqi Zhou
- Department of Immunology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Kui Xu
- Department of Nuclear Medicine, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, Hubei Province 430071, China
| | - Chongjiao Li
- Department of Nuclear Medicine, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, Hubei Province 430071, China
| | - Yaqun Jiang
- Department of Nuclear Medicine, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, Hubei Province 430071, China
| | - Yichun Wang
- Department of Nuclear Medicine, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, Hubei Province 430071, China
| | - Zejian Xue
- Department of Nuclear Medicine, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, Hubei Province 430071, China
| | - Ping Lei
- Department of Immunology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Yong He
- Department of Nuclear Medicine, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, Hubei Province 430071, China
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Duatti A. Matched pairs of radioactive and paramagnetic isotopes. Nucl Med Mol Imaging 2022. [DOI: 10.1016/b978-0-12-822960-6.00138-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Bolzati C, Spolaore B. Enzymatic Methods for the Site-Specific Radiolabeling of Targeting Proteins. Molecules 2021; 26:3492. [PMID: 34201280 PMCID: PMC8229434 DOI: 10.3390/molecules26123492] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/28/2021] [Accepted: 05/31/2021] [Indexed: 12/19/2022] Open
Abstract
Site-specific conjugation of proteins is currently required to produce homogenous derivatives for medicine applications. Proteins derivatized at specific positions of the polypeptide chain can actually show higher stability, superior pharmacokinetics, and activity in vivo, as compared with conjugates modified at heterogeneous sites. Moreover, they can be better characterized regarding the composition of the derivatization sites as well as the conformational and activity properties. To this aim, several site-specific derivatization approaches have been developed. Among these, enzymes are powerful tools that efficiently allow the generation of homogenous protein-drug conjugates under physiological conditions, thus preserving their native structure and activity. This review will summarize the progress made over the last decade on the use of enzymatic-based methodologies for the production of site-specific labeled immunoconjugates of interest for nuclear medicine. Enzymes used in this field, including microbial transglutaminase, sortase, galactosyltransferase, and lipoic acid ligase, will be overviewed and their recent applications in the radiopharmaceutical field will be described. Since nuclear medicine can benefit greatly from the production of homogenous derivatives, we hope that this review will aid the use of enzymes for the development of better radio-conjugates for diagnostic and therapeutic purposes.
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Affiliation(s)
- Cristina Bolzati
- Institute of Condensed Matter Chemistry and Technologies for Energy ICMATE-CNR, Corso Stati Uniti, 4, I-35127 Padova, Italy
| | - Barbara Spolaore
- Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Via Marzolo, 5, I-35131 Padova, Italy
- CRIBI Biotechnology Center, University of Padua, Viale G. Colombo, 3, I-35131 Padova, Italy
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