Beyond RECIST: molecular and functional imaging techniques for evaluation of response to targeted therapy

Area of Science:

• Oncology
• Radiology
• Molecular Imaging

Background:

• Targeted cancer therapies represent a significant advancement in oncology.
• Traditional cancer treatment evaluation relies on tumor size (RECIST criteria), which is inadequate for new therapies.
• Targeted therapies induce cellular changes like necrosis and cavitation, requiring novel assessment methods.

Purpose of the Study:

• To review novel imaging modalities for evaluating treatment response in pathway-based targeted therapies.
• To correlate imaging techniques with underlying biological mechanisms of targeted agents.
• To guide the selection of optimal imaging methods for new targeted therapies.

Main Methods:

• Briefly discuss the fundamental principles of functional and molecular imaging.
• Analyze the clinical applications of these imaging modalities in targeted therapy.
• Correlate imaging findings with the biological mechanisms targeted by new agents.

Main Results:

• Functional and molecular imaging offer superior insights into treatment response compared to size-based criteria.
• Specific imaging techniques are better suited for evaluating therapies targeting distinct biological pathways.
• Understanding the biological targets is crucial for selecting appropriate imaging modalities.

Conclusions:

• Functional and molecular imaging are critical for accurately assessing targeted cancer therapy efficacy.
• The choice of imaging modality should be guided by the specific biological mechanism of the targeted agent.
• This review provides a framework for selecting the best imaging method for novel targeted therapies.