Nanotechnology and Imaging

Nanotechnology has the opportunity to enhance the detection of pathology in a specific and sensitive manner. The ability to overcome barriers such as the blood-brain barrier could allow more accurate imaging of the central nervous system.1 3

With enhanced specificity, markers of early-stage disease in malignancy could localize tumors before they progress and become incurable by conventional methods. This targeted approach could then utilize the same systems to deliver therapeutic agents at high concentrations to the tumor thus limiting the side effects and damage to the individual.

The current mainstays of medical diagnosis with traditional circulating contrast media utilize broadly untargeted approaches. These techniques are well established and use contrast media to enhance the differentiation of structures. New diagnostic pharmaceuticals used in medical imaging are now being developed, which can be considered as nanotechnologies. Magnetic resonance imaging (MRI) has been used clinically for targeted imaging with gadolinium-basedM and iron oxide-based^ nanoparticles for the enhancement of conventional diagnostic modalities. This latter modality has allowed the development of techniques to accurately stage nodal disease in prostate cancer.15 In addition, low-density lipid nanoparticles have been used to enhance ultrasound imaging. 1 6 For each current imaging discipline it could be possible to develop nanoparticles that can provide enhanced detection and subsequently targeted therapeutic capabilities.17

Second-generation super paramagnetic compounds of cross-linked iron oxide have also been developed. 1 8,19 Such dendritic nanoparticles have multiple arms that can complex with targeting moieties, such as antibodies or enzyme substrates, permitting both magnetic and optical properties. In Switzerland, Mattei et al.20 have taken another approach using nanocolloid for the descriptive mapping of sentinel lymph node (SLN) anatomy using fusion imaging between single-photon emission computed tomography (SPECT) and CT following intraprostatic injection of technetium-99m (9 9m Tc) nanocolloid.20 Scintigraphy was performed 1 hour later, and fusion images with CT were scored blindly by an experienced radiologist and nuclear medicine physician. An average of ten lymph nodes were detected per patient (range: 2-19). The location of lymph nodes was highly variable and they concluded that the lymphatic drainage of the prostate appears to be more extensive than previously described in the literature. Presacral and common iliac regions seem to be primary rather than secondary drainage sites. Para-aortic and inguinal lymph nodes previously have not been considered primary drainage sites, which suggests that significant portions of SLN are not resected with routine extended or radical pelvic lymphadenectomy. A similar approach has been used in patients diagnosed with penile cancer21 and in bladder cancer by Liedberg et al. with 70 MBq 99mTc nanocolloid.22 These research-based techniques could produce highly relevant imaging for the treatment of patients with urological malignancies, especially in the context of determining localized prostate cancer. However, more research is required to validate these techniques.

As well as utilizing conventional imaging modalities, nanotechnology has the potential to revolutionize molecular diagnostics to elucidate the key molecular defects for a particular disease. This process will require high-throughput detection devices that require nanogram quantities of analytics and reagents. With the current cost of molecular diagnostics escalating, it may be that increased use will inevitably expose these sophisticated tests to the economies of scale and decrease costs, making such testing available at the bedside.

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