Assessment of the technology for functional imaging in cancer

Functional imaging can address hitherto irresolvable questions about cancer biology in both research and practice. In the clinic, by combining features of systemic and local disease markers into reference standards for the diagnosis of new disease entities functional imaging has the potential to literally redefine illness. Clinical assessments can be conducted at two levels: establishment of new reference standards, and evaluation of successor technologies that will substitute for a reference standard in practice. A union of functional imaging with anatomical criteria of disease has shown great promise in the management of numerous cancers. More work is required to use functional imaging to develop 'functional' approaches to diagnosis and therapy. Many methodologies exist for the acquisition of primary data on imaging technology efficacy. A form of economic cost-effectiveness modelling called iterative decision analysis can be used to set research and service priorities. Cancer clinicians need to take an increased role in functional imaging research, as they have primary expertise in the development and use of treatments modifying cell and tissue function.