Making Molecular Imaging a Clinical Tool for Precision Oncology: A Review

JAMA Oncol. 2017 May 1;3(5):695-701. doi: 10.1001/jamaoncol.2016.5084.


Importance: Individualized cancer treatment, tailored to a particular patient and the tumor's biological features (precision oncology), requires a detailed knowledge of tumor biology. Biological characterization is typically performed on biopsy material, but this approach can present challenges for widespread and/or heterogeneous disease and for performing serial assays to infer changes in response to therapy. Molecular imaging is a complementary approach that provides noninvasive and quantitative measures of the in vivo biology of the full disease burden and is well suited to serial assay.

Observations: Molecular imaging can provide unique information to guide precision oncology that includes measuring the regional expression of therapeutic targets, measuring drug pharmacokinetics, measuring therapy pharmacodynamics, and providing a marker of therapeutic efficacy that is highly indicative of outcome. Thus far, most trials of novel molecular imaging in oncology have been small, single-center trials. Only a few methods have progressed to multicenter trials and even fewer have become part of clinical practice.

Conclusions and relevance: Molecular imaging holds great promise for precision oncology, complementing tissue-based markers to guide more effective, less toxic, and more cost-effective cancer treatments. Beyond logistical and technical challenges, moving new imaging tests from the laboratory to the clinic requires a compelling use case that will benefit patients and/or improve cost-effectiveness, and it requires the collaboration of imagers, oncologists, and industry to reach its true clinical potential.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents / pharmacokinetics
  • Biomarkers, Tumor / metabolism
  • Humans
  • Molecular Imaging / methods*
  • Molecular Targeted Therapy / methods
  • Neoplasms / diagnostic imaging*
  • Neoplasms / drug therapy
  • Neoplasms / metabolism
  • Positron-Emission Tomography / methods
  • Precision Medicine / methods*


  • Antineoplastic Agents
  • Biomarkers, Tumor