Innovative approaches in cancer imaging supported by the National Cancer Institute's $160-million Cancer Imaging Program will give researchers new tools and clinicians better diagnostic and treatment options.

In September, the National Cancer Institute (NCI) awarded $7.1 million to the Molecular Imaging Center at the Washington University School of Medicine in Saint Louis, MO. The 5-year grant will support research on technologies that allow researchers to observe and track cancer at the cellular level. In one effort, scientists have developed cell-penetrating peptides coupled to imaging probes that light up only in the presence of caspase, a critical enzyme in apoptosis.

In a technique developed by Washington University researchers, caspase-activated cell-penetrating peptides track the progress of apoptosis in RGC-5 cells, shown with high-resolution wide-field fluorescence microscopy. On top, cells are healthy; below, cells have started to kill themselves after exposure to ionomycin. [Images courtesy Washington University School of Medicine]

In a technique developed by Washington University researchers, caspase-activated cell-penetrating peptides track the progress of apoptosis in RGC-5 cells, shown with high-resolution wide-field fluorescence microscopy. On top, cells are healthy; below, cells have started to kill themselves after exposure to ionomycin. [Images courtesy Washington University School of Medicine]

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This Washington University project is just one exciting example of cancer-imaging research overall, as innovative approaches give researchers new tools and clinicians better diagnostic and treatment options, says Paula Jacobs, PhD, associate director of the NCI's Cancer Imaging Program (CIP). Each year, the CIP funds about $160 million in imaging research, including early-stage work and clinical trials.

Among other highly promising imaging technologies, Jacobs says, is visualized genomics: Following the genetic changes in a tumor as a disease progresses could help clinicians track the course of a patient's disease and provide information about whether the tumor has acquired a mutation that confers resistance to a particular drug.

“As tissue genomics change, it may be possible to monitor them by noninvasive imaging, as opposed to biopsy,” which isn't always practical, says Jacobs. The CIP is working on automated image-analysis methods to determine whether genetic changes can be correlated with features in imaging scans. The group is using patient images paired with biopsies from The Cancer Genome Atlas project.

Another new imaging technology, photoacoustic imaging, combines the low risk and deep-tissue–viewing capabilities of ultrasound with the resolution of optical imaging. This approach employs a laser to warm and expand tissue, priming it to give off an acoustic signal that can be viewed on ultrasound. The method is being studied in early clinical work at Stanford University and Washington University. “It uses no radiation and will probably be cheaper than PET [positron emission tomography] or MRI,” says Jacobs.

In a third emerging set of imaging technologies, materials scientists are driving advances in image-based therapies by developing drug carriers that show up on imaging scans, Jacobs notes. These multifunctional nanoparticles could allow doctors to confirm that a drug got to the right place.

Closer to the clinic, researchers are beginning to test image-guided therapy. The I-SPY 2 breast cancer trial is evaluating whether MRI scans given both before and during treatment can aid in predicting treatment outcomes. “Imaging should lead to personalized treatment,” says Jacobs.