From the June 2018 issue of HealthCare Business News magazine
By Eric M. Rohren
The field of medicine is undergoing phenomenal changes in parallel with exciting developments in the fields of genetics, chemistry, and computer science.
Increasingly, the formulaic patterns that guided medical decision-making in the past are being adjusted and refined by empirical data derived from human biology and pathophysiology, not only at a population level, but at a very personal level. In fact, the term “personalized care” is taking on new meaning with the advent of technologies capable of interrogating the fundamental biological machinery of disease within an individual patient, and in a short enough span of time to allow for specific and targeted actions to be taken based on that knowledge.
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In the field of imaging, this is illustrated by the remarkable advances being made in molecularly-targeted diagnostics and therapeutics. For many years, imaging physicians have had the ability to employ medical imaging in the care of the patient, including X-rays, CT scans and MR scans. Most imaging techniques give information about structure, such as whether a patient’s bone is fractured. However, there exists a specific subset of imaging, Nuclear Medicine, which is based on function rather than structure. In this field, various compounds are attached to small amounts of radioactive materials. When these radioactive compounds, termed radiotracers, are injected into the body, they target various tissues or organs based on the biological behavior of the particular compound used. By using a sensitive camera, such as Positron Emission Tomography (PET), images are then obtained that show the distribution of the radiotracer. These images are often supplemented with additional imaging, such as a CT scan, to precisely show the location of the radiotracer inside the body.
The ability to target specific tissues in the body with nuclear medicine has opened up new possibilities in many medical fields, particularly in the field of Oncology. With regard to men’s health, new agents are being developed for the detection of prostate cancer. One of the latest to be approved for medical use is 18F-fluciclovine, marketed under the name Axumin. When injected into the bloodstream, this radiotracer localizes to many tissues in the body, but is targeted particularly strongly to prostate cancer cells. A PET/CT scan performed with 18F-fluciclovine can detect very small deposits of prostate cancer cells, allowing for the design of the best therapy for a patient, such as surgery, radiation therapy, or chemotherapy. Such an approach can be very helpful in the scenario of rising serum PSA (an indicator of recurrent cancer), identifying sites of disease which may be undetected by other imaging tests.