By Mary Lemma

Natalie Serkova, PhD, is associate professor in the Departments of Anesthesiology,Pharmacology and Radiology at the University of Colorado School of Medicine and the director of CU Cancer Center’s Core Facility for animal imaging and nuclear magnetic resonance. The lab provides services on all aspects of animal imaging for theUniversity of Colorado, Colorado State University and Colorado School of Mines.

Dr. Natalie Serkova is a cancer researcher at the University of Colorado Cancer CenterC3: What is physiological imaging and how is it different from other imaging in cancer?

Serkova: It’s much more detailed than the more commonly used anatomical imaging.

The goal of anatomical imaging—using technologies such as ultrasound, computed tomography (CT), magnetic resonance imaging (MRI) and position emission tomography (PET)—has been to see if cancer is present and then, after treatment, to see if it’s still present or changing. That kind of diagnostic isn’t good enough anymore.

Physiological imaging uses advanced imaging protocols (mostly MRI-and PET-based) to detect not only the size but also the specific characteristics of cancer: Is the tumor getting blood supply? Is it metabolically active—that is, taking a lot of nutrients from the blood? Does it contain important diagnostic markers (such as HER2, which is found in breast cancer)? Previously we’ve answered these questions with biopsies—invasive and oftenpainful procedures. Now we’re introducing these tumor-characterizing images into clinical radiological procedures.

Physiological imaging also helps us see how cancer cells are responding to new drug therapies.

C3: Your lab is one of only a few facilities in the country that provide both pre-clinical and clinical physiological imaging. Why are so few institutions doing this?

Serkova: For one thing, it’s very expensive. We provide anatomical, physiological and metabolic imaging using various imaging modalities so the instrumentation for that is highly specialized and expensive. It takes a great deal of effort to seek federal funding in order to be able to purchase and install MRI, PET and CT scanners, and we have to be successful at it.

C3: What sets your lab apart from other facilities?

Serkova: Modern imaging is highly complex and requires strong expertise in physics, engineering and cancer biology. We’re a comprehensive scientific and clinical team with technological, medical and biological backgrounds, so we bridge lab research and clinical care.

Also, most imaging scientists are trained as MRI or PET or CT specialists, but there’s growing interest in applying different imaging to get more information from the same cancer. I’m trained in all three areas, so I’m invited to speak at conferences where most attendees have one specialty. I can speak about the metabolic imaging research we’re doing using these different imaging protocols.

C3: How does small animal imaging, one of your sub-specialties, contribute to the research?

Serkova: Before any procedure can be introduced into the clinics, we have to test it in animal models. Since imaging is non-invasive and doesn’t cause harm or pain, we can use it to follow the same mouse at different treatment points. We have our own animal radiology department for our small four-legged patients that includes animal MRI, PET and CT scanners, which are similar but slightly smaller than clinical scanners. Once we establish which imaging protocol is the best to assess drug response in the mouse, we can apply the same protocols to the human patient treated with the same drug.

C3: What do you consider the most seminal work you have done?

Serkova: With our colleagues in medical oncology we’ve been able to assess the effectiveness of targeted drugs using MRI and PET scans. So, when radiologists see the patient under a particular treatment regimen, they know exactly which imaging protocol to use to see whether the drug is effective.

However, I believe our biggest success is yet to come. We now have a director of radiochemistry, which is unusual among leading institutions. It will allow us to create new radio labeled molecules to further characterize and identify molecular targets in a particular cancer.

C3: What’s your long-term vision; what’s “the next big thing” in imaging research?

Serkova: The next big step for us will be in creating a comprehensive imaging center that will include all necessary components—such as pre-clinical imaging, clinical imaging, radiochemistry, bioengineering and advanced imaging analysis. The future in imaging is in developing a “personalized imaging” protocol for a specific patient using MRI and PET together to get a comprehensive “fingerprint” of each cancer patient.

We’ve already taken our first step by creating the Colorado Translational Research Imaging Center (C-TRIC). Now we have to work on making it successful.