The fusion of anatomic and physiologic imaging in the management of patients with cancer

Imaging is of major clinical importance in the noninvasive evaluation and m anagement of patients with cancer. Computed tomography (CT) and other anato mic imaging modalities, such as magnetic resonance imaging (MRI) or ultraso und, have a high diagnostic ability by visualizing lesion morphology and by providing the exact localization of malignant sites. Nuclear medicine prov ides information on the function and metabolism of cancer. Over the last de cade, there have been numerous attempts to combine data obtained from diffe rent imaging techniques. Fused images of nuclear medicine and CT (or to a l esser extent, MRI) overcome the inherent limitations of both modalities. Va luable physiologic information benefits from a precise topographic localiza tion. Coregistered data have been shown to be useful in the evaluation of p atients with cancer at diagnosis and staging, in monitoring the response to treatment, and during follow up, for early detection of recurrence. Time-c onsuming and difficult realignment and computation for fusion of independen t studies have, until now, limited the use of registration techniques to pi lot studies performed in a small number of patients. The development of the new technology of single photon emission computed tomography/CT and positr on emission tomography/CT that allows for combined functional and anatomic data acquisition has the potential to make fusion an everyday clinical tool . Copyright (C) 2001 by W.B. Saunders Company.