Chicago–April 12–Yesterday, at the Biotechnology Industry Organization's annual convention (BIO 2006), I attended a panel on the intriguing topic "Molecular Imaging: Disruption on the Horizon." Thomas Meade, a biochemist at Northwestern University began his talk, "Seeing is Believing: Diagnostics in the 21st Century," by showing a photo of a doctor carrying a little black bag. "My great uncle had all of his diagnostic equipment in that little black bag," explained Meade. "We are trying to return a time when all the diagnostics a doctor needs can be carried in a little black bag."
We're not there yet, but Meade wowed the audience (or at least me) with a movie of a living 14 day mouse embryo in which features as small as 8 cells could be seen. The embryo image could also be manipulated so that individual organs could be viewed in isolation. Meade obtains his supersharp images by using various smart contrast agents. He foresees a time when diagnostics can be made so powerful that they become therapies. Essentially contrast molecules will be combined with therapeutic molecules that will only become activated if the diagnostic detects illness, say, cancer.
Michael Klimas from GE Health outlined a transition from detecting "late disease" model which deploys medicine in reaction once illness has been diagnosed to an "early health" model which allows for preventive steps to be taken before a person becomes sick. Vastly improved diagnostic imaging will drive this transition. For example, the new ultrafast 64-slice CT scanner enables "virtual angiography" and detects coronary disease without contrast molecules. However, Klimas is concerned that insurance companies may not want to cover such early health images because they will argue that the person is not actually sick.
Michael Silver from the health care intelligence company Sg2 predicts that imaging will become a vital tool in early detection of cancer and that such scans will be done in a physician's office rather than in a hospital.
Meade explained that in vitro diagnostics, e.g., blood tests, will initially detect disease. Then patients will be shuttled immediately to medical imaging to determine the extent and severity of disease. "In 20 years pathologists will be out of business because you won't have to cut, slice or dice to diagnose an illness. No more biopsies," boldly predicted Meade. The age of a Star Trek medical tricorder is just around the corner.