The evolving role of structural and functional imaging in assessment of age-related changes in the body

Aging is an extremely complex, multifactorial, and inevitable process that varies in rate from person to person and that is not fully understood at its most basic levels. Despite this complexity, knowledge of age-related changes and normal variation in organ structure and function is essential to differentiate them from alterations that are associated with pathology. Combined structural and functional imaging, which increasingly is used to assess a multitude of disorders, including cancer, cardiovascular disease, and central nervous system abnormalities, can be applied to study changes in structure and function related to aging. This article reviews the major theories of biological aging and presents our approach and rationale to study age-related changes through quantitative tomographic radiological and scintigraphic approaches. In the series of articles that follow, we have made an attempt to determine age-related changes in volume, attenuation, and function as measured by computed tomography, magnetic resonance imaging, and position emission tomography in the following organs and systems: central nervous system, head and neck, heart and major arteries, lungs, abdominal and pelvic parenchymal organs, gastrointestinal tract, genitourinary tract, breast, bone and bone marrow, joints, and skin. The population examined includes a large number of subjects in all decades of life. We have also made an effort to introduce some new concepts such as partial volume correction and measurements of global metabolic activity of the organs examined, and emphasize the importance of quantitative techniques in such applications. It is our hope that this new initiative will further enhance the role of novel imaging techniques in the management of patients with cancer and other disorders.