What is digital imaging

Advanced digital imaging and molecular diagnostics - breaking new ground in oncology

Imaging is essential to oncology. Detecting a tumor as early as possible, its exact anatomical assignment in relation to the surrounding healthy tissues, the representation of the local tumor spread with possible surrounding infiltration, the visualization of the biological and heterogeneous growth behavior as well as the early detection of possible distant sources of spread are important for the planning of an individual treatment and the associated later forecast. Even the pathological diagnosis of cancer is often based on the precision of a tissue sample obtained by an imaging-guided biopsy. Imaging methods are also required to carry out the respective therapy, for therapy monitoring and for follow-up checks for the early detection of recurrences or metastases. But not only the diagnosis of the cancer itself, but also the diagnosis of all other, tumor-accompanying and therapy-related diseases often requires an imaging method.

On the basis of all available clinical and laboratory findings and, in particular, the results of imaging and histological examinations, the further therapeutic approach is planned individually in an interdisciplinary tumor conference. Imaging is also fundamental for the early recognition of the individual therapy success in order to change the previously adopted treatment concept in the event of a lack of response. The development of new therapy methods is also based in part on imaging-based biomarkers that are used both to include the patient in clinical studies and as an endpoint for the success of the therapy.

The imaging methods for whole-body diagnostics (CT, MRT, PET) have developed astonishingly over the last 50 years due to the rapid advances in medical technology as well as computer and information technology. In the meantime, precise, non-invasive, three-dimensional insights into anatomical and functional changes in the body can be visualized and assigned with high spatial resolution within a very short time. The use of special radiopharmaceuticals makes it possible, in particular, to visualize tumor biological properties such as metabolic activity and receptor density. “Hybrid procedures” such as PET-CT and PET-MRT, with which the advantages of morphological and functional-biological imaging can be combined, provide a variety of therapy-relevant information individually for each patient in one examination. Powerful computers and methods of artificial intelligence also make it possible to develop algorithms with which the increasingly extensive, complex amounts of data can be processed automatically and thus support and accelerate the diagnosis process. The various articles in this special issue are dedicated to these interesting developments in advanced digital imaging and molecular diagnostics in oncology. The article by C. Dreher and S. Bickelhaupt for early detection and screening shows in particular the importance of imaging for secondary and tertiary prevention. P. Sandach et al. are dedicated to the possibilities of molecular imaging, which has made considerable progress in the development of special radiotracers or molecular probes for the visualization of tumor-specific molecular structures and metabolic changes. If these molecular probes are also coupled to therapeutic radionuclides (so-called theranostics), the field of diagnostics extends to that of therapy. F. Schaab et al. provide an overview of interventional radiological therapy methods that are increasingly being used as minimally invasive strategies. a. gain in importance in the palliative therapy of tumors. Imaging methods are also increasingly being used in surgical oncology. The possibilities and importance of modern intraoperative imaging for visualizing the target areas (such as intraparenchymal tumor boundaries) or risk structures (e.g. vessels or nerves to be protected) that are initially not directly accessible to the eye during surgery are discussed in the article by L. Maier-Hein et al. also worked out in particular under the aspect of navigation of surgical instruments. The communication of considerably large amounts of image data and image information poses a particular challenge. This topic is addressed by T. Persigehl et al. dealt with, and the current developments in structured diagnosis and therapy monitoring are discussed. F. Stögbauer et al. provide an insight into the modern methods of "liquid biopsy", in which molecular markers are measured in body fluids in order to obtain non-invasive or minimally invasive information about the presence or relapse of a tumor disease. This special issue is rounded off by an article by J. Kleesiek et al. on the topic of artificial intelligence and machine learning in radiology. The recent advances in computer technology and bioinformatics give hope for enormous, previously unimaginable advances in this area.

This exciting special issue gives readers interesting insights into the modern developments in digital imaging and molecular diagnostics and their significance for clinical oncology. Our special thanks therefore go to the proven authors for their excellent contributions. These provide an authentic overview of a new, promising diagnostic breakthrough in oncology, ultimately with the aim of further improving the prognosis of tumor patients.

For the editors

H.-P. Gourmet

For the editors

P. M. Schlag

Author information


  1. Radiology Dept., German Cancer Research Center, Foundation under Public Law, Im Neuenheimer Feld 280, 69120, Heidelberg, Germany

    Prof. Dr. med. Dipl.-Phys. Heinz-Peter Schlemmer

  2. Charité Comprehensive Cancer Center, Berlin, Germany

    P. M. Schlag

Corresponding author

Correspondence to Prof. Dr. med. Dipl.-Phys. Heinz-Peter Schlemmer.

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H.-P. Schlemmer and P.M. Schlag indicate that there is no conflict of interest.

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Schlemmer, HP., Schlag, P.M. Advanced digital imaging and molecular diagnostics - breaking new ground in oncology. oncologist26, 2-3 (2020). https://doi.org/10.1007/s00761-019-00700-w

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