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PET/CT dual-mode scanners? That’s nothing. Soon we’ll have scanners that combine CT, PET, SPECT, conventional X-ray, MRI, ultrasound, optical imaging, even an endoscope and other probes.

So says Ge Wang, PhD, director of the Biomedical Imaging Division of the Virginia Tech-Wake Forest University School of Biomedical Engineering and Sciences. He is lead author of an article predicting the near-future advent of what he calls omni-tomography. We missed the article when it appeared in the open-access journal PLOS ONE back in June, but it’s definitely worth a look.

The article lays out the goal in reverential terms:

The holy grail of biomedical imaging is an integrated system capable of producing tomographic, simultaneous, dynamic observations of highly complex biological phenomena in vivo.

It sketches out two possible designs for such a “grail.” One would incorporate three rings: a C arm–like magnet; a middle ring containing an X-ray tube and detector array and a pair of SPECT detectors; and an outer ring for PET. The other builds on the design of a double doughnut-shaped MRI scanner.

The ability to do multiple scans at once would be incredibly useful, the authors say. “A single session imaging is important to study processes such as ischemia, drug interactions, radiation effects, apoptosis, and many others.”

Omni-tomography would be so effective in early screening for disease, cancer staging, assessment of the effectiveness of therapies, and other aspects of personalized medicine that the authors consider its development inevitable:

We can confidently expect that some form of omni-tomography is certain to be developed in the near future.

Dr. Wang points to the success of PET/CT scanners. “There are no longer any lone PET scanners,” he said, as quoted in a Virginia Tech news release. “Today, all are coupled with computed tomography scanners.”

The news release notes that Dr. Wang was an author of the first papers on spiral multislice/cone-beam CT (1991), bioluminescence tomography (2004), and interior tomography (2007). His prophecies carry some weight.

So we expect omni-tomography will come to pass. The article doesn’t address this, but such a scanner would raise reimbursement issues. Would all modes operate all the time or would some be turned off for simpler procedures? Would insurers reimburse for all modes or for only the ones deemed “necessary” for imaging, say, a broken leg?

It’s going to be interesting.

Related seminar: Computed Body Tomography: The Cutting Edge

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