Changing the Diagnostic Paradigm: Tools for Point-of-Care Pathology

Miniature microscopes are being developed to examine tissue in situ for early anatomic and molecular indicators of disease, in real time, and at cellular resolution. These new devices will lead to a shift from the current diagnostic paradigm of biopsy followed by histopathology and recommended therapy, to one of non-invasive point-of-care diagnosis with the possibility of treatment in the same session. As such, these tools are reducing the time and distance between the patient and the diagnostic event, and changing the practice of medicine. At the same time there is a paradigm shift occurring in medicine moving to disease characterization based on molecular etiologies--this shift is leading to molecularly-targeted imaging, diagnosis, and therapy and will lead to advances in molecularly-targeted prevention. Determining the molecular etiologies of cancer requires new technologies and more integrated approaches, which will in turn lead to early detection and more effective treatment. In the area of biomedical imaging, it will be necessary to develop image-guided approaches for multiplexed molecular characterization of cancer and methods to visualize a small number of cancer initiating cells. Imaging and sensing will need to move from detection limits of 1 cm masses to 1 mm, or even 100 µm diameter masses, and new technologies with this sensitivity need to be developed. Optical imaging has the sensitivity for this level of detection and there are a number of recent advances that will enable the use of optics in the clinic for cancer detection. Optical imaging can provide molecular sensitivity and cellular level resolution and will be useful in informing diagnosis, prognosis and therapy, and for guiding biopsies for multiparameter molecular analyses. To meet these needs, molecular probes are being developed that are activated at the target site and can be used to reveal biomarkers of disease in situ. The emerging combinations of instruments and molecular probe strategies will reveal disease states in finer detail and provide greater information to clinicians for more informed, and directed, therapies. Personalized medicine is really molecular medicine and the new imaging and diagnostic tools that characterize the molecular basis of disease are driving personalized care and early intervention.

Speaker: Christopher Contag, Stanford

Room 232