Novel molecular imaging approaches in oncology: towards a more accurate estimation of tumour response.

Purpose of review: With novel therapeutics improving cancer survival rates, the need for accurate treatment response assessment has become increasingly crucial. The Response Evaluation Criteria in Solid Tumours remains the standard imaging method for evaluation of treatment response, yet it has recognized limitations. Molecular imaging with targeted tracers offers earlier and more precise assessment of treatment efficacy, by capturing biological information beyond a change in tumour size. We discuss these recent advances, including tracers in clinical practice, and novel tracers in the pipeline, and how these can improve our assessment of treatment response.

Recent findings: The development of novel tracers is enabling more precise cancer diagnosis, staging and treatment, and enables the use of targeted treatments. Upcoming tracers offer the potential to predict treatment response prior to treatment, eradicating the morbidity associated with ineffective therapy. Improved PET hardware, such as total body PET, allows accurate insights into factors such as tumour uptake kinetics, which can be paired with artificial intelligence tools to allow prediction of tumour characteristics.

Summary: This review summarizes recent advances in molecular imaging, including tracers that target tumour metabolism, tumour microenvironment and other treatable tumour targets. These aim to improve treatment response assessment, with the hope of improving outcomes by offering personalized and timely treatment adjustments.