Report of the National Heart, Lung, and Blood Institute Working Group on the Translation of Cardiovascular Molecular Imaging

Imaging has become an indispensable tool in cardiovascular research, clinical trials, and medical practice. Traditional imaging modalities provide primarily anatomic as well as some physiological information. The emerging field of molecular imaging aims to expand beyond these traditional targets to visualize specific biochemical structures or biological processes. Platforms under exploration for molecular imaging include ultrasound, single-photon emission computed tomography (SPECT), positron emission tomography (PET), computed tomography (CT), magnetic resonance imaging (MRI), and optical techniques, such as fluorescence-mediated tomography (FMT) and catheter-based sensors. Ultimately, molecular imaging may allow clinicians to reach beyond anatomy to visualize the expression and activity of particular molecules, cells, or functions that influence disease progression, outcome, and/or responsiveness to therapeutics. The last 3 decades have seen explosive growth in the application of cardiovascular molecular imaging, as demonstrated by a recent PubMed search (Figure). Despite basic science advances, translation into clinically available agents and techniques has lagged. In September 2009 the National Heart, Lung, and Blood Institute (NHLBI) convened a working group of experts in the fields of molecular imaging and cardiovascular disease to assess the current state of molecular imaging and its application to cardiovascular diseases, to identify areas where cardiovascular molecular imaging was likely to have an impact, to explore barriers to the translation of molecular imaging toward clinical application, and to inform the NHLBI on national priorities for the promotion of translation of cardiovascular molecular imaging. Here, we summarize state-of-the-art technologies, their challenges, clinical needs, and specific recommendations of the working group. Figure. Cardiovascular molecular imaging publications from 1987 to 2010. The Scopus database was searched for the terms “molecular” and “imaging” in the title or abstract, and the results obtained were then restricted further by searching on “cardiovascular.” The results obtained from the restricted search were then checked manually to include only original research articles …