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ROADMAP FOR MOLECULAR IMAGING IN EMERGING

ECONOMIES – 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.

Emerging economies such as India are planning their

resources and infrastructure with a focus on health care
which includes prevention, early diagnosis and timely
treatment with cost effective measures.

Aim: To evaluate the importance and role of molecular

imaging, particularly nuclear imaging, in healthcare of
emerging economies such as India.

Material and methods: A literature search with regards

to epidemiology of commonly prevalent disease,
available facilities and projected needs was done with
emphasis on new technology which may benefit overall
health care through molecular imaging.

Results: 80600 new cases of cancer are diagnosed in

India every year with lung, pharynx, esophagus, tongue
and 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 the
world’s cervical cancer comes from India and one third
of all cancers in India originate in the head and neck
region. Prevention and early diagnosis can help improve
prognosis in most patients. New radiation techniques
and new chemotherapeutic regimens targeting Bridge between pre-clinical animal
processes such angiogenesis and hypoxia will need models and human studies essential.
tracers other than non specific FDG. Ischemic
Robust pre-clinical validation of new
cardiovascular disease forms 31% of noncommunicable tracers needed
disease in India with inflammatory myocarditis due to
sarcoidosis and tuberculosis also contributing to
morbidity and mortality. By 2020, India will have the Chemistry (Academia)
largest number of cardiovascular patients with one third
of deaths occurring due to it. Aging of the population and Healthcare
18F-FMISO

longer survival in India has led to more patients being Courtesy of Prof. M.A. Pozo, Cerebral Cartography Center, Uni. Comp. Madrid.

diagnosed with neurodegenerative disorders. Molecular

imaging particularly PET has started becoming
important in managing neurological and cardiovascular Novel Tracers and Imaging Agents
disease. Although, there is improved management of
infection, tuberculosis still contributes to 3.7 million
deaths every year and forms a fifth of the world’s Multimodality
incidence. India has about 200 gamma and 20 PET/CT PET/NIRF
cameras currently with 10 cyclotrons. F18 FDG, N13 Nanotechnology PET/MR/NIRF
ammonia and F18 NaF are the radio tracers in common
use. Preclinical imaging, particularly with non radioactive
techniques is in the nascent stage.

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 also 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 economic
conditions. 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 world
tuberculosis patients. Therefore, as a point of demonstration, a non specific tracer like FDG will not help completely in patient management in the long
term. 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 isolation
in emerging economies. Therefore there is a great need for global collaborative projects which will shed new light on current thinking in cancer
management. The same ideas can be extrapolated to cardiac and neurology imaging with higher incidence of cardiovascular disease and
neurodegenerative 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.

© Carestream Health, Inc. "Molecular Imaging - Wisdom To See For Maladies To Flee"
Dr. Rao V. L. Papineni