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. 2008 Aug 20;26(24):4012–4021. doi: 10.1200/JCO.2007.14.3065

Table 1.

Sensitivity and Resolution of Cancer Imaging Modalities as a Function of Cell Number and Contrast Agent/Radiotracer Concentration

Modality Typical Voxel/Pixel Dimensions (Resolution) Maximum No. of Cells per Voxel/Pixel Clinically Available Exogenous Contrast Agent(s) Radiotracer/ Contrast Agent Hydrodynamic Diameter* Contrast Agent Concentration per Voxel/Pixel Required for Detection No. of Molecules of Contrast per Voxel/Pixel Required for Detection Notes
US 1 μL (1×1×1 mm) 106 Microbubbles 1 μm NA NA Microbubbles remain intravascular in most tissues
CT 1 μL (1×1×1 mm) 106 Iodine ≈1 nm 0.5 M 3 × 1017 Requirement for molar concentrations precludes targeted imaging
MRI 1 μL (1×1×1 mm) 106 Chelated Gd3+ ≈1 nm 50 μmol/L 3 × 1013 Would require > 107 Gd3+ atoms per cell for detectability
SPECT 1.7 cm3 (12×12×12 mm) 1.7 × 109 99mTc ≈1 nm 0.3 pM 3 × 108 On average approximately 0.2 radioatoms per cell
111In (≈8 × 103 Bq/voxel)
67Ga
PET 0.5 cm3 (8×8×8 mm) 5 × 108 18F ≈1 nm 0.02 pM (≈7 × 102 Bq/voxel) 6 × 106 On average approximately 0.01 radioatoms per cell
Optical (2-D) 0.01 mm2 (0.1×0.1 mm) 103 ICG ≈1 nm ≈10-100 nmol/L 6 × 107§ Surface only NIR fluorescence, requires approximately 104−105 fluorophores per cell for detectability
Optical (3-D) 1 cm3 (1×1×1 cm) 109 ICG ≈1 nm ≈10-100 nmol/L 6 × 1013 NIR tomography-based, requires approximately 104−105 fluorophores per cell for detectability

Abbreviations: US, ultrasound; NA, not applicable; CT, computed tomography; MRI, magnetic resonance imaging; Gd3+, gadolinium; SPECT, single photon emission computed tomography; 99mTc, technetium 99m; 111In, indium 111; 67Ga, gallium 67; PET, positron emission tomography; ICG, indocyanine green; NIR, near-infrared.

*

After conjugation of a targeting molecule to a contrast agent or radiotracer, final hydrodynamic diameter increases proportionally.

Does not take into account the significant effect of background and tissue attenuation on detectability. Values shown are theoretical only.

Assumes 100 counts, 5 minutes scan, SPECT/PET attenuation of 0.2/0.1, sensitivity of 0.02%/0.5%, half-life of 6/1.8 hours, and maximum specific activity.

§

Assuming a tumor thickness of 0.1 mm (10 cells thick).

Approximate resolution at a depth of 10 cm in soft tissue such as breast.