Molecular imaging in nuclear cardiology: Pathways to individual precision medicine
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Department of Nuclear Medicine, Hannover Medical School, Translational Cardiovascular Molecular Imaging, Hannover, Germany
Received Jul 23, 2020; Revised Jul 29, 2020 doi:10.1007/s12350-020-02319-6
Growth of molecular imaging bears potential to transform nuclear cardiology from a primarily diagnostic method to a precision medicine tool. Molecular targets amenable for imaging and therapeutic intervention are particularly promising to facilitate risk stratification, patient selection and exquisite guidance of novel therapies, and interrogation of systems-based interorgan communication. Non-invasive visualization of pathobiology provides valuable insights into the progression of disease and response to treatment. Specifically, inflammation, fibrosis, and neurohormonal signaling, central to the progression of cardiovascular disease and emerging therapeutic strategies, have been investigated by molecular imaging. As the number of radioligands grows, careful investigation of the binding properties and added-value of imaging should be prioritized to identify high-potential probes and facilitate translation to clinical applications. In this review, we discuss the current state of molecular imaging in cardiovascular medicine, and the challenges and opportunities ahead for cardiovascular molecular imaging to navigate the path from diagnosis to prognosis to personalized medicine. Key Words: Positron emission tomography Æ Cardiovascular disease Æ Inflammation Æ Fibrosis Æ Sympathetic nervous system Abbreviations FAP Fibroblast activation protein MI Myocardial infarction
INTRODUCTION As cardiovascular precision medicine embraces molecular-targeted therapies, the identification of at-risk and likely-to-respond patients takes on greater importance. Imaging to non-invasively quantify these molecular targets can provide incremental value in Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12350-020-02319-6) contains supplementary material, which is available to authorized users. The authors of this article have provided a PowerPoint file, available for download at SpringerLink, which summarizes the contents of the paper and is free for re-use at meetings and presentations. Search for the article DOI on SpringerLink.com. The authors have also provided an audio summary of the article, which is available to download as ESM, or to listen to via the JNC/ASNC Podcast.
selecting appropriate patient populations for selective and expensive therapies. Accordingly, nuclear cardiology finds itself at a critical junction, where the pathway demarcated by image-guided oncology may direct the future of cardiovascular molecular imaging. Conventional nuclear cardiology assesses myocardial perfusion, viability, function, and scar—i.e., measurements of Reprint requests: J. T. Thackeray, PhD, Department of Nuclear Medicine, Hannover Medical School, Translational Cardiovascular Molecular Imaging, Carl Neuberg Str 1, 30625 Hannover, Germany; [email protected] J Nucl Cardiol 1071-3581/$34.00 C
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