Dialogue

This issue of Yale Medicine is devoted to bioimaging technology. In our feature section we explore the history of biomedical imaging and examine how scientists at Yale are developing new ways of seeing smaller and smaller structures. Advances in imaging technology over the last several decades have enabled an ever more detailed view of the internal structures of organisms as well as their functions, from the level of molecules and cells to that of tissues, organs, and body. The pace of technological development is rapidly increasing, with the result that we can now see, in high resolution, things that we could only guess at before. Below, Dean Robert J. Alpern, M.D., discusses the importance of imaging in science and medicine and what the future may bring.

When we talk about imaging at Yale School of Medicine, what does that encompass?
Imaging includes everything from crystallography to microscopy at the highest resolution, to X-rays, CT scans, MR, SPECT, and PET. It’s any technology that allows us to visualize biologically relevant structures and processes.

Why is it important?
A rate-limiting factor in science now is access to the latest technology. For instance, our ability to understand how the brain functions is presently limited by the availability of technologies that allow us to measure the function of individual neurons, parts of neurons, and even molecules within each specific neuron. Traditionally, the best medical schools invest in the best scientific talent and then equip those individuals with the best available technology. We’re investing in a third element, which is research in new technologies, so we can advance the state of the art. We want our scientists to invent the new technologies, which is already happening.

How will imaging change science and medicine in the future?
One way is the example that I alluded to earlier. I think the functional definition of all the circuits in the brain will come only from improved technologies in brain imaging. Another area where it might help is the use of imaging to identify new biomarkers. For instance, right now we’re very good at using imaging to see if someone has prostate cancer. But can we tell if the prostate cancer is the type that needs to be taken out because it’s going to metastasize? Or if it’s the one that’s going to sit there and not metastasize? If you combined spectroscopy with imaging, by studying the metabolism of those cells, could you find something that determines whether they’ll metastasize? If you could, you would spare many patients unnecessary treatment, and you would lower health care costs at the same time. These are benefits that would accrue across medicine and science.