Will quantitative imaging inch into practice in 2012?

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Lisa Fratt, Editor

Every year, the end of November and beginning of December are marked by the Super Bowl of Radiology—the annual meeting of the Radiological Society of North America (RSNA). It’s a challenge to absorb the host of clinical and informatics advances highlighted at the meeting.

The theme of RSNA 2011—Celebrate the Image—was indeed apt as imaging is behind many of the tremendous advances of the last few decades. For example, advances in imaging have nearly eradicated exploratory laparotomy and diagnostic catheterization.

However, imaging has not yet reached its pinnacle. During a Nov. 30 session at RSNA, Daniel C. Sullivan, MD, professor of radiology at Duke University in Durham, N.C., made the case for quantitative imaging and relied on radiology’s customers, referring physicians, to detail the need.

“CT reports are not useful for the prognosis or treatment of chronic obstructive pulmonary disease [COPD],” according to one pulmonologist and researcher. “We need more information to help us understand the prognosis and therapeutic [effect]. The pictures are beautiful, but the impact of CT on clinical care is not great.”

Quantitative imaging could fill the gap. In the case of patients with CPOD, quantitative data showing the decreases in lung density could aid pulmonologists in assessing the progression of the disease.

The case for quantitative imaging is equally clear in other diseases that plague us today, including cancer and Alzheimer’s disease. In fact, the two diseases illustrate the broad potential of quantitative imaging.

As cancer therapy become ever more precise and personalized, identifying and fine-tuning the optimal treatment plan requires increasingly precise measurements of the disease burden.  Relatively rough estimates, such as traditional RECIST criteria, may no longer suffice with more targeted therapies. Volumetric analysis and quantitative data may provide the data needed to target therapy to the patient’s disease and enable personalized medicine.

In fact, a recent study in Academic Radiology showed the prognostic utility of quantitative measurements of tumor burden in patients with Stage IV nonsmall-cell lung cancer and illustrates the potential of quantitative imaging to stratify patients.

At the same time, quantitative imaging may inform the development of new treatments to halt the progression of Alzheimer’s disease. Specifically, Sullivan explained that the ability to measure change in hippocampal volume could help determine the effectiveness of potential therapies.

We are just at the dawn of quantitative imaging. The next few years will likely see a burgeoning of tools and applications. How will your practice use these tools? As you consider the promise and potential, please let us know.

Best wishes for happy holiday season from all of us at TriMed Media.

Lisa Fratt, editor
lfratt@trimedmedia.com