Esmofir Educational Webinars 2016
ESMOFIR has started in May 2016 to offer a series of educational webinars with various topics related to molecular and functional imaging.
Past Webinars 2016
1. Therapy Monitoring in Oncology – RECIST and beyond
With the broad introduction of imaging-based therapy monitoring in oncology, criteria-based reporting methods were established to ensure standardized and reproducible results for response evaluation of oncologic patients in clinical studies. Response Evaluation Criteria in Solid Tumors (RECIST), as the most widely used morphological, size-based evaluation system, has been accepted by the FDA and the EMA for the definition of study endpoints within clinical trials based on the imaging assessment of change in tumor burden under primarily cytotoxic therapy. In recent years a broad range of novel molecular cancer therapeutics were introduced into clinical use. Among these are anti-angiogenic therapies, like tyrosine kinase inhibitors, which have shown their effectiveness in the treatment of several different tumor entities. These new therapy regimes demonstrated significant effects on tumor angiogenesis and tumor metabolism, but often only subtle effects on tumor morphology, particularly in early stages of tumor treatment. Established methods of monitoring cytotoxic tumor therapies, such as RECIST have been shown to be not sufficiently sensitive for monitoring the early therapeutic effects of molecular anti-cancer agents to allow for a timely differentiation of responders from non-responders.
The complementary acquisition of morphological, functional and molecular information using hybrid imaging techniques (PET/CT, PET/MRI) allows for a higher sensitivity and specificity in the detection of tumor manifestations and the timely differentiation of responders from non-responders using different tracers and in various tumor entities. Dedicated tracers such as [18F]-FDG, [68Ga]-DOTA-TATE, [68Ga]-PSMA und [18F]-DOPA allow for the visualization of glucose metabolism, tumor receptor and protein expression, or enzymatic activity, depending on indication and tumor entity. As novel cancer treatments allow for extended survival of frequently chronic tumor patients, modified response criteria are increasingly integrating functional imaging information (e.g. glucose metabolism in Cheson criteria/Lugano Classification) to further improve the standardized and reproducible assessment of therapy response by imaging studies.
2. Functional Renal Imaging
Renal Diseases often do not show morphological correlate in cross-sectional imaging. Functional imaging techniques assess renal function and ultrastructure beyond gross morphology. Contrast-enhanced techniques allow to quantify renal perfusion and filtration, whereas diffusion-weighted imaging methods investigate renal cellularity and microcirculation as well as tubular diffusion anisotropy. BOLD imaging can be used to probe the functional reserve of kidneys.