The development of molecular medicine and our understanding of the processes of disease have been mirrored by the development of molecular techniques for imaging. Most of the current work involves cancer as this is where there is the most extensive knowledge of what happens at a cellular level. Examples of this include the use of specific agents such as Tc-99m annexin-V to identify apoptosis as soon as 24 hours after administration of cytotoxic chemotherapy and Tc-99m or F-18 RGD peptides to identify active angiogenesis and using imaging to demonstrate the effect anti-angiogenic drugs such as taxanes. PET techniques have also developed form simple F-18 FDG to look at cell metabolism to F-18 FMISO which can identify hypoxic tissue.C-11 methionine amino-acid uptake and C-11 acetate fatty acid metabolism Receptor imaging has developed from use in neuroendocrine tumours using somatostatin receptors to other hormones such as oestrogen and gastrin. In addition there has been work in the brain and in particular the use of imaging of pre-synaptic dopamine receptors by I-123 Ioflupane There has been a close and growing relationship between our expansion of knowledge of the molecular basis of disease and our ability to image these processes in-vivo using scintigraphic techniques.
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