{"title":"Clinical Applications of Advanced Ultrasound Imaging.","authors":"Martin Krix, Anne Rix","doi":"10.1007/978-3-032-21415-7_8","DOIUrl":"10.1007/978-3-032-21415-7_8","url":null,"abstract":"<p><p>Ultrasound is a noninvasive imaging modality that provides anatomical and functional information of various human body areas. It is one of the most widely used imaging modalities worldwide, with frequent use in oncology. Novel ultrasound techniques, such as elastography and contrast-enhanced ultrasound, have evolved and have led to new clinical applications beyond conventional anatomical imaging with conventional ultrasound or blood flow assessment using Doppler ultrasound. Contrast-enhanced ultrasound (CEUS) uses microbubbles as a contrast medium, and specific contrast-enhanced ultrasound techniques have been developed, making CEUS an extremely sensitive imaging modality. Classic microbubbles remain strictly intravascular due to their size and can be detected down to the capillary level. Together with the most recent techniques (super-resolution imaging), bubbles even allow for an extremely high spatial resolution ultrasound imaging beyond the wavelength barrier. This chapter within Recent Results in Cancer Research Under Molecular Imaging in Oncology provides an overview of current applications in humans. Since specific microbubbles are not yet available as commercial products and their wide clinical use is still limited, results of first experiences with molecular ultrasound imaging in humans are presented. Furthermore, to give an overview in a broader sense-not only of molecular ultrasound imaging but also of contrast-enhanced ultrasound for molecular or specific diagnosis-also related studies with nonspecific, commercial ultrasound contrast agents are briefly described within the field of molecular diagnosis and monitoring of targeted therapies in oncology. Furthermore, first experiences in humans with super-resolution ultrasound imaging as a potential breakthrough technique are presented.</p>","PeriodicalId":39880,"journal":{"name":"Recent Results in Cancer Research","volume":"225 ","pages":"823-833"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147983836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Molecular Ultrasound Imaging.","authors":"Anne Rix, Jasmin Baier, Fabian Kiessling","doi":"10.1007/978-3-032-15314-2_17","DOIUrl":"10.1007/978-3-032-15314-2_17","url":null,"abstract":"<p><p>Contrast-enhanced ultrasound (CEUS) imaging is a valuable tool for preclinical and clinical diagnostics. The most frequently used ultrasound contrast agents are microbubbles. Besides them, novel nano-sized materials are under investigation, which are briefly discussed in this chapter. For molecular CEUS, the ultrasound contrast agents are modified to actively target disease-associated molecular markers with a site-specific ligand. The most common markers for tumor imaging are related to neoangiogenesis, like the vascular endothelial growth factor receptor-2 (VEGFR2) and α<sub>v</sub>β<sub>3</sub>-Integrin. In this chapter, applications of molecular ultrasound to longitudinally monitor receptor expression during tumor growth, to detect neovascularization, and to evaluate therapy responses are described. Furthermore, we report on the first clinical trials of molecular CEUS with VEGFR2-targeted phospholipid microbubbles showing promising results regarding patient safety and its ability to detect tumors of the prostate, breast, and ovary. The chapter closes with an outlook on ultrasound theranostics, where (targeted) ultrasound contrast agents are used to increase the permeability of tumor tissues and to support drug delivery.</p>","PeriodicalId":39880,"journal":{"name":"Recent Results in Cancer Research","volume":"224 ","pages":"557-581"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147964988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Ultrasound Imaging.","authors":"Georg Schmitz, Stefanie Dencks","doi":"10.1007/978-3-032-15314-2_5","DOIUrl":"10.1007/978-3-032-15314-2_5","url":null,"abstract":"<p><p>Ultrasound imaging has played an important role in oncological imaging for more than five decades now. It can be applied in all tissues that are not occluded by bone or gas-filled regions. The quality of ultrasound images benefitted strongly from improved electronics, advanced reconstruction algorithms, and increased computational power. To the morphological imaging, several functional imaging methods were added: Flow visualization became possible by Doppler techniques, and the elastic properties of tissues can be imaged by elastographic methods with transient shear wave imaging. In the beginning of molecular imaging, ultrasound with its contrast based on mechanical tissue properties was an unlikely candidate to play a role. However, with contrast agents consisting of micrometer-sized gas bubbles, which can be imaged with high sensitivity, ligands addressing targets in the vascular wall could be used. Because even single bubbles can be detected, this led to various ultrasound molecular imaging techniques and the ongoing development of clinical molecular contrast media. In this chapter, the basic properties of ultrasonic imaging, like its contrast mechanisms and spatiotemporal resolution, are discussed. The image formation and its change from line-oriented scanning to full-volume reconstructions are explained. Then, the ultrasound contrast media and imaging techniques are introduced. Finally, emerging new methods like super-resolution vascular imaging demonstrate the ongoing development in this field.</p>","PeriodicalId":39880,"journal":{"name":"Recent Results in Cancer Research","volume":"224 ","pages":"149-168"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147965131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Clinical PET/MR.","authors":"Wolfgang Weber","doi":"10.1007/978-3-032-21415-7_7","DOIUrl":"10.1007/978-3-032-21415-7_7","url":null,"abstract":"<p><p>Oncologic imaging has been a major focus of clinical research on PET/MR imaging over the last 10 years. Studies so far have shown that PET/MR with <sup>18</sup>F-fluorodeoxyglucose (FDG) overall provides a similar accuracy for tumor staging as FDG PET/CT. The effective radiation dose of whole-body FDG PET/MR is more than 50% lower than for FDG PET/CT, making PET/MR particularly attractive for imaging of children. However, the longer acquisition times and higher costs have so far limited broader clinical use of PET/MR technology for whole-body staging. With the currently available technology, PET/MR appears more promising for loco-regional staging of diseases for which MR is the anatomical imaging modality of choice. These include brain tumors, head and neck cancers, gynecologic malignancies, and prostate cancer. For instance, PET imaging with ligands of prostate-specific membrane antigen, combined with multi-parametric MR, appears promising for the detection of prostate cancer and differentiation from benign prostate pathologies as well as for the detection of local recurrences. The combination of functional parameters from MR, such as apparent diffusion coefficients, and molecular parameters from PET, such as receptor densities or metabolic rates, is feasible in clinical studies, but clinical applications for this multimodal and multi-parametric imaging approach still need to be defined.</p>","PeriodicalId":39880,"journal":{"name":"Recent Results in Cancer Research","volume":"225 ","pages":"803-821"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147983807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Laura Providência, Charalampos Tsoumpas, Adriaan A Lammertsma
{"title":"Total Body PET.","authors":"Laura Providência, Charalampos Tsoumpas, Adriaan A Lammertsma","doi":"10.1007/978-3-032-15314-2_4","DOIUrl":"10.1007/978-3-032-15314-2_4","url":null,"abstract":"<p><p>Total body PET, or long axial field-of-view PET, is a PET scanner with an extended axial coverage compared with conventional PET scanners. The significant gain in sensitivity of these systems enables shorter scanning times, delayed imaging or lower injected activities, making PET imaging accessible to a broader range of patient groups, including children, pregnant women, and intensive care patients. Non-invasive quantification is made possible by scanning dynamically most of the body in a single bed position, with most organs of interest within the field-of-view. Furthermore, it makes it possible to perform research in areas such as organ-axes and multi-tracer PET. This chapter provides a comprehensive overview of what this system has to offer to the field of oncology, starting from a theoretical point of view, moving on to possible clinical applications and concluding with a discussion of still underexplored areas and future possibilities.</p>","PeriodicalId":39880,"journal":{"name":"Recent Results in Cancer Research","volume":"224 ","pages":"115-148"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147965100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Christopher M Waldmann, Klaus Kopka, Stefan Wagner
{"title":"<sup>18</sup>F-Labeled Small-Molecule and Low-Molecular-Weight PET Tracers for the Noninvasive Detection of Cancer.","authors":"Christopher M Waldmann, Klaus Kopka, Stefan Wagner","doi":"10.1007/978-3-032-15314-2_9","DOIUrl":"10.1007/978-3-032-15314-2_9","url":null,"abstract":"<p><p>Non-invasive molecular imaging of cancer by means of the hybrid imaging modalities PET/CT and PET/MRI represents a powerful diagnostic tool in modern nuclear medicine. Radiotracers labeled with the prominent positron-emitter fluorine-18 are routinely used to target and visualize distinct biological structures dysregulated in the progression of cancer. Such tracers are therefore capable of detecting oncological pathologies in vivo at the cellular and subcellular levels in a timely manner and are thereby used for early detection of cancer as well as monitoring for treatment response in a personalized manner. This chapter describes a variety of important <sup>18</sup>F-labeled radiopharmaceuticals that are frequently used in oncological PET imaging. Small-molecule and low-molecular-weight radiotracers for the detection of glucose utilization, amino acid transport, membrane lipid synthesis, cell proliferation, cell death, hypoxia, estrogen receptor status, DNA repair, tumor stroma, and bone mineralization of tumors are introduced. Radiotracers targeting the prostate-specific membrane antigen (PSMA) and the somatostatin receptor subtype 2 (SSTR2) expression are introduced as diagnostic companions in the important field of oncological radionuclide theranostics.The structural properties, common radiochemical synthesis approaches, as well as in vivo metabolism and accumulation mechanisms of the clinically most important <sup>18</sup>F-labeled radiotracers are described.</p>","PeriodicalId":39880,"journal":{"name":"Recent Results in Cancer Research","volume":"224 ","pages":"319-342"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147964869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hans-Jürgen Pietzsch, Cristina Müller, Roger Schibli, Constantin Mamat
{"title":"Single Photon Emission Computed Tomography Tracer.","authors":"Hans-Jürgen Pietzsch, Cristina Müller, Roger Schibli, Constantin Mamat","doi":"10.1007/978-3-032-15314-2_8","DOIUrl":"10.1007/978-3-032-15314-2_8","url":null,"abstract":"<p><p>Single-photon emission computed tomography (SPECT) is the state-of-the-art imaging modality in nuclear medicine, although only a few new SPECT tracers have become available in the past 20 years. Critical for the future success of SPECT is the design of new and specific tracers for the detection, localization, and staging of a disease and for monitoring therapy. The utility of SPECT imaging to address oncologic questions is dependent on radiotracers that ideally exhibit excellent tissue penetration, high affinity to the tumor-associated target structure, specific uptake and retention in the malignant lesions, and rapid clearance from non-targeted tissues and organs. In general, a target-specific SPECT radiopharmaceutical can be divided into two main parts: a targeting biomolecule (e.g., small molecular compound, peptide, antibody fragment) and a γ-radiation-emitting radionuclide (e.g., <sup>99m</sup>Tc, <sup>123</sup>I). If radiometals are used as the radiation source, a bifunctional chelator is needed to link the radionuclide to the targeting entity. In a rational SPECT tracer design, these single components have to be critically evaluated in order to achieve a balance among the demands for adequate target binding and a rapid clearance of the radiotracer. In recent years, the theranostic combination of γ-emitters with therapeutic radionuclides (α, β<sup>-</sup>) was forced. The focus of this chapter is to depict recent developments of tumor-targeted SPECT radiotracers for imaging of cancer diseases. Possibilities for optimization of tracer design and potential causes for design failure are discussed and highlighted with selected examples.</p>","PeriodicalId":39880,"journal":{"name":"Recent Results in Cancer Research","volume":"224 ","pages":"255-318"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147965050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Daniel Razansky, Sandeep Kumar Kalva, Vipul Gujrati, Vasilis Ntziachristos
{"title":"Optical and Optoacoustic Imaging.","authors":"Daniel Razansky, Sandeep Kumar Kalva, Vipul Gujrati, Vasilis Ntziachristos","doi":"10.1007/978-3-032-15314-2_6","DOIUrl":"10.1007/978-3-032-15314-2_6","url":null,"abstract":"<p><p>This chapter explores how medical imaging has evolved beyond simple visual observation to include advanced optical technologies for disease detection. Traditionally, clinicians relied heavily on human vision, either directly or through video systems, for identifying abnormalities during examinations, surgeries, and endoscopic procedures. While high-definition white-light and stereoscopic imaging enhance these capabilities, they still fundamentally depend on what the human eye can distinguish.Optical coherence tomography (OCT) marked a significant advance by providing high-resolution images below the tissue surface, particularly benefiting ophthalmology and, more recently, cardiology. However, OCT is limited to morphological contrast and cannot capture molecular information.Thus, this chapter introduces two innovative light-based modalities. The first modality, Fluorescence Molecular Imaging (FMI), leverages targeted fluorescent agents to highlight molecular features in living tissues. Recently, FMI has moved beyond older approaches that used non-specific dyes like Indocyanine Green (ICG) to targeted dyes that enable visualization of molecular details. The second modality, optoacoustic imaging, uses light to excite ultrasound waves within tissue to generate high-resolution images at greater depths than traditional optical techniques. This modality can resolve spectral signatures of molecules or agents, providing comprehensive views of tissue structure, function, and molecular composition. Together, these advances in FMI and optoacoustic imaging promise more sensitive, specific, and non-invasive disease detection and characterization, signaling a new era in clinical imaging.</p>","PeriodicalId":39880,"journal":{"name":"Recent Results in Cancer Research","volume":"224 ","pages":"169-211"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147964978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Uwe Haberkorn, Clemens Kratochwil, Eduards Mamlins, Yuriko Mori, Frederik L Giesel
{"title":"Internal Radiation Therapy.","authors":"Uwe Haberkorn, Clemens Kratochwil, Eduards Mamlins, Yuriko Mori, Frederik L Giesel","doi":"10.1007/978-3-032-21415-7_16","DOIUrl":"10.1007/978-3-032-21415-7_16","url":null,"abstract":"<p><p>Targeted therapies are applied to increase the efficiency of antitumor treatment by simultaneously decreasing side effects. This can be achieved using carrier molecules that specifically bind to target structures or areas with remodeling activity. These carrier molecules may be coupled to chemotherapeutic drugs or to radioactive isotopes. In most cases, these carrier molecules are antibodies against tumor antigens, peptides, or small molecules which are binders for overexpressed receptors on tumor cells. The paradigm of endoradiotherapy is exemplified by the peptidic tracer DOTATOC which binds to somatostatin receptors and recently also small molecule inhibitors with high affinity for the prostate-specific membrane antigen.</p>","PeriodicalId":39880,"journal":{"name":"Recent Results in Cancer Research","volume":"225 ","pages":"1015-1042"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147983841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dorde Komljenovic, Philipp Biegger, Helen Abeln, Mark E Ladd
{"title":"Multifunctional Magnetic Resonance Imaging Probes.","authors":"Dorde Komljenovic, Philipp Biegger, Helen Abeln, Mark E Ladd","doi":"10.1007/978-3-032-15314-2_7","DOIUrl":"10.1007/978-3-032-15314-2_7","url":null,"abstract":"<p><p>Magnetic resonance imaging is characterized by high spatial resolution and unsurpassed soft tissue discrimination. Development and characterization of both intrinsic and extrinsic magnetic resonance (MR) imaging probes in the last decade has further strengthened the pivotal role MR imaging holds in the assessment of cancer in preclinical and translational settings. Sophisticated chemical modifications of a variety of nanoparticulate probes hold the potential to deliver valuable multifunctional tools applicable in diagnostics and/or treatment in human oncology. MR imaging suffers from a lack of sensitivity achievable by, e.g., nuclear medicine imaging methods. Advantages of including additional functionality/functionalities in a probe suitable for MR imaging are thus numerous, comprising the addition of fundamentally different imaging information (diagnostics), drug delivery (therapy), or the combination of both (theranostics). In recent years, we have witnessed a plethora of preclinical multimodal or multifunctional imaging probes being published, mainly as proof-of-principle studies, yet only a handful remain readily applicable in clinical settings. This chapter summarizes recent innovations in the development of multifunctional MR imaging probes and discusses the suitability of these probes for clinical transfer.</p>","PeriodicalId":39880,"journal":{"name":"Recent Results in Cancer Research","volume":"224 ","pages":"213-253"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147964957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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