Personally, I found the highlight of the third day of the American College of Radiology (ACR) conference to be the particularly interesting and powerful lecture on imaging in the era of precision medicine. Led by Dr. James Thrall, hundreds of attendees jumped to their feet to applaud the end of his well-received presentation.

A particularly exciting field of medicine is the increasing focus on precision medicine?the idea that patients should be grouped into sub-populations, based on the characteristics (notably the individual phenotype) of their disease or condition. Because there is so much variety in the biology among a group of patients with the same condition, one ?blanket? treatment may not be the best approach for the entire group.  As Dr. Thrall put it, ?in this day and age, there's no such thing as an average patient?.

With examples ranging from oncogenes (such as the BRCA1 mutation carried by Angelina Jolie), to Alzheimer's disease and somatic mutations, the talk highlighted the important role that imaging plays in precision medicine. What imaging provides is information on the occurrence, location, extent and severity of the disease, something that no other method in medicine can offer. This key information leads to the ability to determine the best treatment options and/or track the efficacy of ongoing treatment for a given patient.

An interesting point Dr. Thrall noted is that big pharma is not particularly excited about this ?one-size may not fit all? approach to medical treatments because it marks an era where all drugs may eventually become orphan drugs. This would mean drugs would be either too expensive to feasibly bring to market, or that there simply would not be enough patients to enroll in a clinical trial to test a potential drug and have it gain approval. What this trend in medicine calls for is a paradigm shift in the FDA, whereby precision medicine is better understood and accommodated for in physician mindset, drug approval pathways and related policies.

It does lead me wonder how this trend towards precision medicine will impact our world of medical devices. Imaging aside, it's interesting to think how other medical device manufacturers can better understand and respond to patient sub-populations and specific treatment groups so that they can develop more personalized device solutions going forward. It will definitely be worth watching this space to see what unfolds in the coming years!


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