Division of Cardiovascular Diseases Strategic Plan

Goals in Enabling Technologies and Methodologies for Cardiovascular Disease

1.8. Develop improved imaging technology for diagnosis and therapy of cardiovascular diseases

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The CV imaging field continues to grow at a rapid rate, providing a broad range of opportunities for diagnosing CV disease and guiding therapies. The improving resolution of anatomical imaging techniques such as computed tomography (CT) and the development of novel sequences for magnetic resonance imaging (MRI) are making these technologies ever more powerful. Development of targeted molecular and cellular imaging probes and technologies generates new possibilities for studying disease processes beyond the mere the structure of biological systems. The use of molecular imaging also has the potential for monitoring individual responses to therapy, bringing personalized medicine closer. The rapid growth in biocomputational capabilities is enabling image registration to bring together information from different complementary imaging modalities, in turn facilitating image-guided interventions and surgical planning.

Strategies to Accomplish this Goal May Entail:

Basic Research:

  • Develop improved probes for molecular imaging of disease processes. An example may be the development of ligands to differentiate stable aortic aneurysms from those with a high probability of rapid progression.
  • Develop better probes for tracking the long-term location and cell fate of transplanted cells. For example, determine the role and fate of transplanted mesenchymal stem cells in the treatment of peripheral artery disease.
  • Improve image registration tools to facilitate multimodality imaging.
  • Combine images together with computational models of blood flow and tissue mechanics to provide tools for interventional and surgical planning. For example, the use of MRI and computational biology to plan surgery in children with congenital heart disease.
  • Develop improved devices for noninvasive and minimally invasive interventions.
  • Improve tools for image analysis and computer-aided detection/diagnosis.

Translational Research:

  • Optimize CT imaging protocols to maximize data quality while minimizing radiation exposure. An example is the use of CT in the pediatric congenital heart disease population.
  • Develop clinically usable probes for tracking the location and cellular fate of transplanted cells.
  • Validate molecular imaging probes in clinically relevant large animal models of disease.
  • Test software and hardware for image-guided interventions in large animal models.
  • Develop algorithms to facilitate analysis and comparison of repeated imaging studies for disease progression/regression.

Clinical Research:

  • Perform clinical studies with new image-guided intervention devices. An example is the use of real-time MRI-guided catheters for radiofrequency ablation of arrhythmias.
  • Apply imaging for pre-surgical planning. For example, the use of high-resolution intraventricular ultrasound to assess valvular function and optimize repair strategy.
  • Move molecular imaging probes and technologies into the clinic. An example is the use of probes directed to ligands expressed early in rejection to obviate the need for biopsies in cardiac transplant patients.
  • Use imaging tools in conjunction with other biomarkers to predict and assess response to therapy.

Contributing Sources:

September 2008

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