8/8/2019 Roadmap for Molecular Imaging in Emerging Economies – A Focus on Nuclear Imaging. Dr. Jyotsna Rao and Dr. Rao…

http://slidepdf.com/reader/full/roadmap-for-molecular-imaging-in-emerging-economies-a-focus-on-nuclear 1/1Carestream Health, Inc.

ROADMAP FOR MOLECULAR IMAGING IN EMERGINGECONOMIES – A FOCUS ON NUCLEAR IMAGING.

Jyotsna Rao* and Rao V. L. Papineni

Carestream Molecular Imaging, 4 Research Dr., Woodbridge,CT, 06525, USA

*Apollo Gleneagles PET-CT Centre, Hyderabad, India.

"Molecular Imaging - Wisdom To See For Maladies ToDr. Rao V. L. Pap

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Discussion: Although incidence of cancer in India is less than that of the West, with urbanization, increase in incidence of various cancers is expected,specifically lung, breast and colon and the high population a lso gives high absolute numbers of cancer patients. Cancer imaging modalities for screening,early detection, staging and restaging will be different in emerging economies like India since the sites of cancer are different based on the socio economicconditions. For example, India has one of the highest incidences of the cervical and head and neck cancers in the world. It also has one fifth of the worldtuberculosis patients. Therefore, as a point of demonstration, a non specific tracer like FDG will not help completely in patient management in the longterm. There is therefore a need for new tracers specific to disease processes and multimodality imaging to compensate for deficiencies in each modality.New specific tracer and multimodality imaging will ultimately bring cost effective management. Bringing these new technologies is not possible in isolationin emerging economies. Therefore there is a great need for global collaborative projects which will shed new light on current thinking in cancermanagement. The same ideas can be extrapolated to cardiac and neurology imaging with higher incidence of cardiovascular disease andneurodegenerative disease like Alzheimer’s expected in the future with increases in aging population.Conclusion: Results indicate that along with improving existing imaging technology, there is a need for new tracers and multi modality imaging particularly

in cancer, infectious and cardiovascular disease in India.

Emerging economies such as India are planning theirresources and infrastructure with a focus on health carewhich includes prevention, early diagnosis and timelytreatment with cost effective measures.

Aim: To evaluate the importance and role of molecularimaging, particularly nuclear imaging, in healthcare ofemerging economies such as India.

Material and methods: A literature search with regardsto epidemiology of commonly prevalent disease,available facilities and projected needs was done withemphasis on new technology which may benefit overallhealth care through molecular imaging.

Results: 80600 new cases of cancer are diagnosed inIndia every year with lung, pharynx, esophagus, tongueand stomach most common in men and cervix, breast,ovary, esophagus and oral cancers, most common in

women in the given order. Of note, is that one fifth of theworld’s cervical cancer comes from India and one thirdof all cancers in India originate in the head and neckregion. Prevention and early diagnosis can help improveprognosis in most patients. New radiation techniquesand new chemotherapeutic regimens targetingprocesses such angiogenesis and hypoxia will needtracers other than non specific FDG. Ischemiccardiovascular disease forms 31% of noncommunicabledisease in India with inflammatory myocarditis due tosarcoidosis and tuberculosis also contributing tomorbidity and mortality. By 2020, India will have thelargest number of cardiovascular patients with one thirdof deaths occurring due to it. Aging of the population andlonger survival in India has led to more patients beingdiagnosed with neurodegenerative disorders. Molecularimaging particularly PET has started becomingimportant in managing neurological and cardiovasculardisease. Although, there is improved management of

infection, tuberculosis still contributes to 3.7 milliondeaths every year and forms a fifth of the world’sincidence. India has about 200 gamma and 20 PET/CTcameras currently with 10 cyclotrons. F18 FDG, N13ammonia and F18 NaF are the radio tracers in commonuse. Preclinical imaging, particularly with non radioactivetechniques is in the nascent stage.

Courtesy of Prof. M.A. Pozo, Cerebral Cartography Center, Uni. Comp. Madrid.

18F-FMISO

Bridge between pre-clinical animalmodels and human studies essential.

Robust pre-clinical validation of newtracers needed

Chemistry (Academia)

Healthcare

Novel Tracers and Imaging Agents

MultimodalityPET/NIRF

Nanotechnology PET/MR/NIRF