OBJECTIVEThe arrival of precision medicine plan brings new opportunities and challenges for patients undergoing precision diagnosis and treatment of malignant tumors. With the development of medical imaging, information on different modality imaging can be integrated and comprehensively analyzed by imaging fusion system. This review aimed to update the application of multimodality imaging fusion technology in the precise diagnosis and treatment of malignant tumors under the precision medicine plan. We introduced several multimodality imaging fusion technologies and their application to the diagnosis and treatment of malignant tumors in clinical practice.

DATE SOURCESThe data cited in this review were obtained mainly from the PubMed database from 1996 to 2016, using the keywords of "precision medicine", "fusion imaging", "multimodality", and "tumor diagnosis and treatment".

STUDY SELECTIONOriginal articles, clinical practice, reviews, and other relevant literatures published in English were reviewed. Papers focusing on precision medicine, fusion imaging, multimodality, and tumor diagnosis and treatment were selected. Duplicated papers were excluded.

RESULTSMultimodality imaging fusion technology plays an important role in tumor diagnosis and treatment under the precision medicine plan, such as accurate location, qualitative diagnosis, tumor staging, treatment plan design, and real-time intraoperative monitoring. Multimodality imaging fusion systems could provide more imaging information of tumors from different dimensions and angles, thereby offing strong technical support for the implementation of precision oncology.

CONCLUSIONUnder the precision medicine plan, personalized treatment of tumors is a distinct possibility. We believe that multimodality imaging fusion technology will find an increasingly wide application in clinical practice.

Humans ; Multimodal Imaging ; methods ; Neoplasms ; diagnosis ; Precision Medicine ; methods

Background: Ongoing efforts have been made to identify new neuroimaging markers to track amyotrophic lateral sclerosis (ALS) progression. This study aimed to explore the monitoring value of multimodal magnetic resonance imaging (MRI) in the disease progression of ALS. Methods: From September 2015 to March 2017, ten patients diagnosed with ALS in Peking Union Medical College Hospital completed head MRI scans at baseline and during follow-up. Multimodal MRI analyses, including gray matter (GM) volume measured by voxel-based morphometry; cerebral blood flow (CBF) evaluated by arterial spin labeling; functional connectivity, including low-frequency fluctuation (fALFF) and regional homogeneity (ReHo), measured by resting-state functional MRI; and integrity of white-matter (WM) fiber tracts evaluated by diffusion tensor imaging, were performed in these patients. Comparisons of imaging metrics were made between baseline and follow-up using paired t-test. Results: In the longitudinal comparisons, the brain structure (GM volume of the right precentral gyri, left postcentral gyri, and right thalami) and perfusion (CBF of the bilateral temporal poles, left precentral gyri, postcentral gyri, and right middle temporal gyri) in both motor and extramotor areas at follow-up were impaired to different extents when compared with those at baseline (all P < 0.05, false discovery rate adjusted). Functional connectivity was increased in the motor areas (fALFF of the right precentral gyri and superior frontal gyri, and ReHo of right precentral gyri) and decreased in the extramotor areas (fALFF of the bilateral middle frontal gyri and ReHo of the right precuneus and cingulate gyri) (all P < 0.001, unadjusted). No significant changes were detected in terms of brain WM measures. Conclusion Multimodal MRI could be used to monitor short-term brain changes in ALS patients.
Adult ; Amyotrophic Lateral Sclerosis ; diagnostic imaging ; physiopathology ; Brain ; diagnostic imaging ; Cerebrovascular Circulation ; Disease Progression ; Female ; Humans ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Multimodal Imaging ; methods ; Prospective Studies

Prostate cancer is the most common malignancy in the urinary system of males. The remarkable biological and clinical heterogeneity of prostate cancer poses challenges to the initial diagnosis, differential diagnosis, treatment, and prognosis of the disease. Positron emission tomography/computed tomography (PET/CT) is an ideal imaging tool for noninvasive interrogation of underlying tumor biology. Recently, there are a variety of molecular imaging paths and radiopharmaceuticals for the diagnosis and treatment of prostate cancer. This article reviews the current state and prospects of the application of PET in the diagnosis of prostate cancer.
Humans ; Male ; Molecular Imaging ; methods ; Multimodal Imaging ; methods ; Positron-Emission Tomography ; Prognosis ; Prostatic Neoplasms ; diagnostic imaging ; Radiopharmaceuticals ; Tomography, X-Ray Computed

Adult ; Aged ; Diffusion Magnetic Resonance Imaging ; Embolism, Fat ; diagnostic imaging ; Female ; Humans ; Intracranial Embolism ; diagnostic imaging ; Male ; Middle Aged ; Multimodal Imaging ; Neuroimaging ; methods ; Tomography, X-Ray Computed

OBJECTIVETo assess the clinical value of (18)F-FDGPET/CT in the diagnosis of larynx carcinoma. Methods Forty-seven patients with larynx carcinoma or suspected larynx carcinoma underwent (18)F-FDG PET/CT examination within a week before therapy. The value of (18)F-FDG PET/CT in the diagnosis and staging of the malignancy was compared with that of unenhanced contrast CT.

METHODSForty-seven patients with larynx carcinoma or suspected larynx carcinoma underwent (18)F-FDG PET/CT examination within a week before therapy. The value of (18)F-FDG PET/CT in the diagnosis and staging of the malignancy was compared with that of unenhanced contrast CT.

RESULTSAmong the 47 patients, a definite diagnosis of larynx carcinomas was established pathologically in 43 patients. For detection of primary tumors, the sensitivity, specificity and accuracy of (18)F-FDG PET/CT were 95.3%, 75% and 93.6%, as compared with 74.4%, 50%, and 72.3% with unenhanced contrast CT scan, respectively, showing significant differences in the diagnostic sensitivity and accuracy between the two modalities (Χ=7.340, P=0.007; Χ=7.532, P=0.006). Twenty-six of the 43 patients were identified to have lymph node metastasis, for which (18)F-FDG PET/CT showed a significantly higher diagnostic sensitivity than unenhanced contrast CT (92.3% vs 61.5%, Χ=6.933, P=0.008). In the 46 excised lymph nodes from 19 patients, 26 were found positive for metastasis, for which (18)F-FDG PET/CT showed a diagnostic sensitivity of 92%, significant higher than that with unenhanced contrast CT (64%, Χ=5.71, P=0.017). PET/CT detected synchronous tumor in one case. (18)F-FDG PET/CT resulted in a change of staging in 34.9% of the patients, including upstaging in 14 patients and down-staging in one patient.

CONCLUSION(18)F-FDG PET/CT can be an important means for diagnosis and initial staging of larynx carcinoma.

Adult ; Aged ; Carcinoma ; diagnostic imaging ; Female ; Fluorodeoxyglucose F18 ; Humans ; Laryngeal Neoplasms ; diagnostic imaging ; Middle Aged ; Multimodal Imaging ; methods ; Positron-Emission Tomography ; Tomography, X-Ray Computed

Deep brain stimulation (DBS) surgery is an important treatment for patients with Parkinson's disease in the middle and late stages. The accuracy of the implantation of electrode at the location of the nuclei directly determines the therapeutic effect of the operation. At present, there is no single imaging method that can obtain images with electrodes, nuclei and their positional relationship. In addition, the subthalamic nucleus is small in size and the boundary is not obvious, so it cannot be directly segmented. In this paper, a complete end-to-end DBS effect evaluation pipeline was constructed using magnetic resonance (MR) data of T1, T2 and SWI weighted by DBS surgery. Firstly, the images of preoperative and postoperative patients are registered and normalized to the same coordinate space. Secondly, the patient map is obtained by non-rigid registration of brain map and preoperative data, as well as the preoperative nuclear cluster prediction position. Then, a three-dimensional (3D) image of the positional relationship between the electrode and the nucleus is obtained by using the electrode path in the postoperative image and the result of the nuclear segmentation. The 3D image is helpful for the evaluation of the postoperative effect of DBS and provides effective information for postoperative program control. After analysis, the algorithm can achieve a good registration between the patient's DBS surgical image and the brain map. The error between the algorithm and the expert evaluation of the physical coordinates of the center of the thalamus is (1.590 ± 1.063) mm. The problem of postoperative evaluation of the placement of DBS surgical electrodes is solved.
Brain Mapping ; methods ; Deep Brain Stimulation ; Electrodes, Implanted ; Humans ; Imaging, Three-Dimensional ; Magnetic Resonance Imaging ; Multimodal Imaging ; Parkinson Disease ; surgery ; Subthalamic Nucleus

Cone-Beam Computed Tomography ; methods ; Four-Dimensional Computed Tomography ; methods ; Humans ; Image Processing, Computer-Assisted ; methods ; Magnetic Resonance Imaging ; methods ; Multimodal Imaging ; methods ; Neoplasms ; diagnosis ; diagnostic imaging ; radiotherapy ; Positron-Emission Tomography ; Radiotherapy, Computer-Assisted ; methods ; Tomography, X-Ray Computed

A new head and neck location frame for positron emission tomography (PET) and computed tomography (CT) cross-modality medical image fusion in radiotherapy was developed. The solid mark bars of N form in the old designed CT location frame were replaced by closed hollow pipes which could be filled with different developer solutions before CT or PET scan, respectively. Nine points of external marker used for registration and fusion were obtained in CT images and PET images, respectively. The locations of the two sets of nine points showed the method of registration to be effective and accurate in achieving the PET and CT image fusion. This method, based on its characteristics of simple structure and easy-to-use, can be of wide application in clinical setting.
Head ; anatomy & histology ; diagnostic imaging ; Humans ; Image Interpretation, Computer-Assisted ; instrumentation ; methods ; Multimodal Imaging ; methods ; Neck ; anatomy & histology ; diagnostic imaging ; Positron-Emission Tomography ; methods ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted ; instrumentation ; methods ; Tomography, X-Ray Computed ; methods

Adult ; Aged ; Bone Neoplasms ; diagnosis ; secondary ; Diffusion Magnetic Resonance Imaging ; methods ; Female ; Follow-Up Studies ; Humans ; Liver Neoplasms ; diagnosis ; secondary ; Male ; Middle Aged ; Multimodal Imaging ; methods ; Nasopharyngeal Neoplasms ; diagnosis ; Positron-Emission Tomography ; Tomography, X-Ray Computed ; Whole Body Imaging ; methods

Aged ; Asian People ; Humans ; Image-Guided Biopsy/methods* ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Multimodal Imaging/methods* ; Prostate/pathology* ; Prostatic Neoplasms/pathology* ; Rectum/diagnostic imaging* ; Robotic Surgical Procedures/methods* ; Ultrasonography