Image-guided drug delivery in lung cancer

Lung cancer continues to be the number one cause of cancer-related deaths in the USA. Early identification of the disease, availability of more effective drugs, and improved delivery of such drugs specifically to cancer cells are needed to decrease lung cancer-associated morbidity and mortality. The concept of image-guided drug delivery (IGDD), which envisions the utilization of imaging techniques for quantitative assessments of tumor-targeted drug delivery and therapeutic response, has the potential to make a significant impact in lung cancer. While the anatomic and physiological features of the lung pose distinct problems for imaging drug delivery, several new techniques are emerging that have the potential to overcome these problems. X-ray is a routinely used technique for diagnosing lung cancer; however, positron emission tomography (PET) and magnetic resonance imaging (MRI) are complementary approaches. PET- and MRI-based techniques (such as functional MRI) offer the possibility of imaging the delivery of specific molecules to cancer tissues in the lung. This paper reviews fundamentals of imaging with an emphasis on MRI and to some extent PET, since it will be argued that these techniques are the most promising for development in IGDD for lung cancer. Finally, key literature contributions will be highlighted, which exemplify the current successes in this area.