Molecular Imaging Programs in the United States

Rationale and Objectives

We sought to identify and describe the characteristics of molecular imaging (MI) programs in the United States and to determine the factors considered critical for their future.

Materials and Methods

In a cross-sectional study, a validated survey was sent to members of the Society of Chairmen in Academic Radiology Departments (SCARD) in the United States, and 26 variables were studied.

Results

The response rate was 40.3%; 67.9% of the departments surveyed have an MI program. The main focus of 47.4% of departments is oncology. The number of radiologists working for the department was the only variable found to be significantly positively correlated with (1) number of researchers in the MI program, (2) number of MI modalities available, (3) total number of grants, and (4) having ongoing MI clinical trials. These four variables plus the number of federal grants and the space used by MI programs were independent of the geographical region, hospital size (number of beds), and department size (number of radiological examinations per year). All the MI programs received grants during 2005. Only 16.1% have no alliances with industry. Among all the departments, 82% identified staff training and recruitment as the keys for success; 78.57% considered oncology the most important future application of MI and cancer management the hospital service most affected by MI.

Conclusion

MI programs are starting to be more widespread throughout the United States, and the trend is for more academic radiology departments to become engaged in MI activities; their development is independent of department characteristics. Radiology departments strongly agreed about the key components for success of MI initiatives and the areas that will be most affected by MI applications.

The American College of Radiology (ACR) definition of molecular imaging (MI) as “the spatially localized and/or temporally resolved sensing of molecular cellular processes in vivo” reveals the enormous potential of MI as a means to diagnose and monitor disease ( ). The potential of MI is starting to be fulfilled, with its identification by the National Institute of Biomedical Imaging and Bioengineering (NIBIB) as a field that will address critical biomedical research and health care needs in the next 5 years ( ). The entire imaging field is at a crossroads, with molecularly targeted imaging agents expected to expand and revolutionize conventional imaging methods ( ).

MI studies have revealed important biological processes related primarily to cancer and cardiovascular and neurological diseases ( ) that will allow their pathogenesis to be studied in intact microenvironments of living systems ( ). In cancer, emerging genomic and proteomic technologies can transform clinical management and lead the way to personalized care ( ). The management of cardiovascular diseases has benefited from the revelation of new aspects of atherosclerosis and will continue as MI is used to detect clinical atheroma ( ). Neurology has received some assistance from MI based on magnetic resonance (MR) and positron emission tomography (PET) for the diagnosis and management of Alzheimer’s and Parkinson’s diseases ( ). Other applications such as monocrystalline iron oxide nanocompound (MION) MR-based techniques and near-infrared optical tomography have not found their way into clinical applications, rendering them attractive for research but irrelevant to general radiologists and raising expectations of which MI technologies will be incorporated into daily clinical practices and how.

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Materials and methods

Survey

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Statistical Methods

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Results

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General Characteristics

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Table 1

Sample Demographics

Variable Respondents (n) MI program 19 No MI program 9 Total 28 Region (n) Northeast 9 Midwest 8 Southwest 4 South 4 Pacific 3 Total 28 Hospital size (No. of beds) <200 1 200−500 5 >500 22 Total 28 Radiological exams (n) <200,000 4 200,000−400,000 11 >400,000 13 Total 28 MI year of foundation 1998 1 1999 1 2000 2 2001 3 2002 5 2003 9 2004 11 2005 19 Main focus (No. of programs) Oncology 9 Neuroscience 3 Technology 3 Cardiovascular 3 Contrast/tracer 1 Total 19

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