© Care strea m Heal th, Inc. ROADMAP FOR MOLECULAR IMAGING IN EMERGING ECONOMIES – A FOCUS ON NUCLEAR IMAGING. Jyotsna Rao* and Rao V. L. Papineni Carestream Molecular Imaging, 4 Research Dr., Woodbridge, CT, 06525, USA *Apollo Gleneagles PET-CT Centre, Hyderabad, India. "Molecular Imaging - Wisdom To See For Maladies To Flee" Dr. Rao V. L. Papineni 737 A Discussion: Although incidence of cancer in India is less than that of the West, with urbanization, increase in incidence of various cancers is expected, specifically lung, breast and colon and the high population a lso gives high absolute numbers of cancer patients. Cancer imaging modalities for screening, early detection, staging and restaging will be different in emerging economies like India since the sites of cancer are different based on the socio economic conditions. For example, India has one of the highest inci dences of the cervical and head and neck cancers i n the world. It also has one fifth of the world tuberculosis patients. Therefore, as a point of demonstration, a non specific tracer like FDG will not help completely in patient management in the long term. There is therefore a need for new tracers specific to disease processes and multimodality imaging to compensate for deficiencies in each modality. New specific tracer and multimodality imaging will ultimately bring cost effective management. Bringing these new technologies is not possible in isolation in emerging economies. Therefore there is a great need for global collaborative projects which will shed new light on current thinking in cancer management. The same ideas can be extrapolated to cardiac and neurology imaging with higher incidence of cardiovascular disease and neurodegenerative disease like Alzheimer’s expected in the future with increases in aging population. Conclusion: Results indicate that along with improving existing imaging technology, there is a need for new tracers and multi modality imaging particularly in cancer, infectious and cardiovascular disease in India. Emerging economies such as India are planning their resources and infrastructure with a focus on health care which includes prevention, early diagnosis and timely treatment with cost effective measures. Aim: To evaluate the importance and role of molecular imaging, particularly nuclear imaging, in healthcare of emerging economies such as India. Material and methods: A literature search with regards to epidemiology of commonly prevalent disease, available facilities and projected needs was done with emphasis on new technology which may benefit overall health care through molecular imaging. Results: 80600 new cases of cancer are diagnosed in India every year with lung, pharynx, esophagus, tongue and stomach most common in men and cervix, breast, ovary, esophagus and oral cancers, most common in women in the given order. Of note, is that one fifth of the world’s cervical cancer comes from India and one third of all cancers in India originate in the head and neck region. Prevention and early diagnosis can help improve prognosis in most patients. New radiation techniques and new chemotherapeutic regimens targeting processes such angiogenesis and hypoxia will need tracers other than non specific FDG. Ischemic cardiovascular disease forms 31% of noncommunicable disease in India with inflammatory myocarditis due to sarcoidosis and tuberculosis also contributing to morbidity and mortality. By 2020, India will have the largest number of cardiovascular patients with one third of deaths occurring due to it. Aging of the population and longer survival in India has led to more patients being diagnosed with neurodegenerative disorders. Molecular imaging particularly PET has started becoming important in managing neurological and cardiovascular disease. Although, there is improved management of infection, tuberculosis still contributes to 3.7 million deaths every year and forms a fifth of the world’s incidence. India has about 200 gamma and 20 PET/CT cameras currently with 10 cyclotrons. F18 FDG, N13 ammonia and F18 NaF are the radio tracers in common use. Preclinical imaging, particularly with non radioactive techniques is in the nascent stage. Courtesy of Prof. M.A. Pozo, Cerebral Cartography Center, Uni. Comp. Madrid. 18 F-FMISO Bridge between pre-clinical animal models and human studies essential. Robust pre-clinical validation of new tracers needed Chemistry (Academia) Healthcare Novel Tracers and Imaging Agents Multimodality PET/NIRF Nanotechnology PET/MR/NIRF