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Unmet Needs in Imaging Modalities


Joseph Cavallo, MD, MBA, and Dushyant Sahani, MD, discuss unmet needs in imaging modality technology and the contrasting agents used.

Joseph Cavallo, MD, MBA: Continuing with this discussion on generics and additional resiliency, do you see any opportunities that remain in the field or unmet needs where there are additional opportunities for generics to enter the industry?

Dushyant Sahani, MD: Contrast media is so critical for various imaging modalities now, although CT [computed tomography] and MRI [magnetic resonance imaging] are the high-volume users. But even in nuclear medicine, we use tracers, which is the contrast media, ultrasound, [and] we have contrast media available. A lot of image-guided therapies are being performed using contrast media. I feel that the success we will see from the use of generics on the CT and MRI side will translate into more opportunities in other areas on ultrasound, as well as in nuclear medicine for molecular imaging, [positron emission tomography] CTs, and so on. This will improve access to high-quality imaging globally. It will really improve the diagnostic standards globally. It will [also] benefit patients and referring private providers. Any ambiguity that exists because of lack of clarity on images can be overcome by use of contrast media. I think it’s a matter of time. We are at the inflection point with the 2 agents that are available. We will see a lot of activity over time; people will gain confidence, and there will be greater adoption of these agents. It might start at different parts of the world, and eventually it will lead to a moment of more generic agents that are available for other modalities beyond CT and MRI. It’s an exciting time. And as I said at the start, having more choices empowers individuals to make those decisions. Some of those motivations could be financial, other motivations could be just having access to safer and cheaper agents to improve care delivery.

Joseph Cavallo, MD, MBA: I don’t think I can say much better. It is an exciting time. And any means we have to improve the access and equity of imaging it’s both diagnostic and therapeutic benefits to not [only] the United States but [also] the entire world at large. I’m all for anything that can achieve those goals.

Dushyant Sahani, MD: I think branded agents, which have been there for several decades now, can continue to innovate in the premium segment. They can invest in areas of unmet need [with] more cellularly targeted or molecularly targeted agents. I think there will be a huge demand for those agents as we move in the era of precision medicine. Having those diagnostic capabilities, along with [information technology] informatics and [artificial intelligence] tools to integrate information with diagnostic imaging data, will be foundational to fundamentally transform care delivery from how it is practiced to more precision medicine. That is the future we all have envisioned. This way will motivate the companies with branded agents to invest in and innovate new contrast agents. To give you an example: On CT the side, we have seen so much progress on the image acquisition and recon with spectral, and now photon counting CT, but the real value of these techniques is with new contrast agents. The contrast is different than iodine, both oral [and] intravenous contrast media. We want different type of agents, different molecules [that] can be discriminated with using advanced CT techniques. Then we can envision the full potential of these advanced techniques. Currently, just the conventional contrast media remains a barrier for advanced applications of these techniques. There is a huge market there as well, so I don’t think anyone should feel insecure with the availability of generic market. If you look at pharmacology, if you look at media as drugs, there are generics available that people continue to use. The branded has their market continues to grow because they can invest a lot of those resources on research and development. I [don’t] think there will be winners and losers; there will be more winners. It’s all about how [well] you play this.

Joseph Cavallo, MD, MBA: That’s a great way to look at it. Dr Sahani, thank you so much for sharing your expertise with me and the audience today. We’ve all learned a lot from you, and I look forward to seeing the different pathways that our field and contrast agents in particular take in the future.

Dushyant Sahani, MD: Thank you, Dr Cavallo, for this time and for the opportunity to discuss this very important topic. It’s an exciting time, and I think we will continue to make major progress and all these options that are available just opens up new opportunities.

Transcript is AI-generated and edited for clarity and readability.

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