Delikatny Edward J, Poptani Harish
Molecular Imaging Laboratory, Department of Radiology, University of Pennsylvania School of Medicine, B6 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104, USA.
Radiol Clin North Am. 2005 Jan;43(1):205-20. doi: 10.1016/j.rcl.2004.07.004.
MR-based molecular imaging is a science in infancy. Current clinical contrast agents are often geared toward the assessment of gross physiologic function, rather than targeting specific biochemical pathways. The development of specific targeted smart contrast agents for Food and Drug Administration approval or clinical trials has only begun. The fact that MR imaging can obtain images of extremely high resolution, coupled with its ability to simultaneously assess structure and function through the use of targeted contrast agents indicates that MR will play a pivotal role in clinical molecular imaging of the future. Many of the challenges that face MR imaging and spectroscopy are inherent to all modalities in the rapidly growing field of molecular imaging. The development of smart contrast agents to report on receptor function, and to monitor gene expression or the results of gene therapy in humans is paramount. These compounds need to undergo rigorous testing to be approved for clinical use: the assessment of acute toxicity, pharmacokinetics, long-term accumulation, and subsequent chronic effects. For receptor-targeted contrast agents, the degree of receptor occupancy and the intrinsic agonist or antagonist properties of the probe that may affect normal cellular function need to be determined to avoid undesired side effects. The particular problems that face MR imaging, those of sensitivity and target specificity, need to be overcome. Signal amplification achieved through high relaxivity contrast agents containing multiple paramagnetic centers, or of larger superparamagnetic particles, is the first step in this direction. The modulation of relaxivity through oligomerization, or other modifications that cause restriction of rotational motions, shows great promise for improving the discriminative powers of MR imaging, and may permit multiple targets to be assessed simultaneously. Moreover, the introduction of smart indicators that lead to changes in spectroscopic properties will allow further discrimination to be achieved through the implementation of chemical shift or spectroscopic imaging. The growing number of MR imaging applications in this rapidly expanding field point to a bright future for MR imaging in molecular imaging.
基于磁共振成像(MR)的分子成像尚处于起步阶段。目前的临床造影剂往往侧重于评估大体生理功能,而非针对特定生化途径。用于食品药品监督管理局(FDA)批准或临床试验的特异性靶向智能造影剂的研发才刚刚开始。MR成像能够获取极高分辨率的图像,并且通过使用靶向造影剂能够同时评估结构和功能,这表明MR将在未来的临床分子成像中发挥关键作用。在快速发展的分子成像领域,MR成像和光谱学面临的许多挑战是所有成像方式所共有的。研发用于报告受体功能、监测人类基因表达或基因治疗结果的智能造影剂至关重要。这些化合物需要经过严格测试才能获批用于临床:评估急性毒性、药代动力学、长期蓄积以及后续的慢性影响。对于受体靶向造影剂,需要确定受体占有率以及可能影响正常细胞功能的探针的内在激动剂或拮抗剂特性,以避免出现不良副作用。需要克服MR成像所面临的特殊问题,即灵敏度和靶点特异性问题。通过含有多个顺磁中心的高弛豫率造影剂或更大的超顺磁颗粒实现信号放大,是朝着这个方向迈出的第一步。通过低聚或其他导致旋转运动受限的修饰来调节弛豫率,对于提高MR成像的鉴别能力显示出巨大潜力,并且可能允许同时评估多个靶点。此外,引入导致光谱特性发生变化的智能指示剂,将通过实施化学位移或光谱成像实现进一步的鉴别。在这个快速扩展的领域中,MR成像应用的不断增加预示着其在分子成像方面有着光明的未来。