Integrated precision medicine by combining quantitative imaging techniques with quantitative genomics for improved decision making

Abstract

Disclosed herein is a combined multi-modality biomarker method for identification and treatment of a disease comprising performing quantitative and/or semi-quantitative molecular imaging on a patient; where the semi-quantitative imaging includes a cut-off; measuring a first plurality of parameters from the quantitative and/or semi-quantitative molecular imaging; simultaneously or sequentially performing a liquid biopsy on the patient; measuring a second plurality of quantitative and/or semi-quantitative molecular parameters from the liquid biopsy; developing an algorithm that combines one or more of the first plurality of parameters and one or more of the second plurality of parameters; where the algorithm is operative to identify a disease and/or predict a course of treatment and/or monitoring the patient; and treating the patient with the course of treatment generated by the algorithm.

What is claimed is: 
     
         1 . A system comprising:
 a microprocessor; where the microprocessor is operative to:   collect and store a first plurality of parameters obtained from quantitative or semi-quantitative molecular imaging conducted on a patient;   collect and store a second plurality of parameters obtained from a liquid biopsy conducted on the patient; and   generate an algorithm that uses one or more parameters from the first plurality of parameters and one or more parameters from the second plurality of parameters; where the algorithm provides a course of therapy to the patient; and wherein the patient performs the course of treatment.   
     
     
         2 . The system of  claim 1 , wherein the first plurality of parameters are obtained prior to the second plurality of parameters. 
     
     
         3 . The system of  claim 1 , wherein the second plurality of parameters are obtained prior to the first plurality of parameters. 
     
     
         4 . The system of  claim 1 , where the course of treatment includes ruling out and avoiding unnecessary treatments, reducing overtreatment, probabilistic analysis of the disease(s) that the patient may be suffering from, screening and therapy planning, monitoring of patient wellness, or a combination thereof. 
     
     
         5 . The system of  claim 1 , where information received from the first plurality of parameters is used to modify information received from the second plurality of parameters. 
     
     
         6 . The system of  claim 1 , where information received from the second plurality of parameters is used to modify information received from the first plurality of parameters. 
     
     
         7 . The system of  claim 1 , where information received from the first plurality of parameters and/or from the second plurality of parameters is used to generate a weighted data set that is used for decision making. 
     
     
         8 . The system of  claim 1 , wherein the quantitative molecular imaging includes quantitative functional multi-parametric molecular imaging. 
     
     
         9 . The system of  claim 8 , wherein the quantitative functional multi-parametric molecular imaging includes x-ray computed tomography, magnetic resonance imaging, functional magnetic resonance imaging, ultrasound and single-photon emission computed tomography, positron emission tomography, or a combination thereof. 
     
     
         10 . The system of  claim 2 , wherein the first plurality of parameters include standardized uptake value, metabolic tumor volume, total lesion glycolysis, Ki, VB [Patlak, Logan], K1, k2, k3, k4, or a combination thereof. 
     
     
         11 . The system of  claim 1 , wherein the liquid biopsy is non-invasive and is conducted on a body fluid. 
     
     
         12 . The system of  claim 3 , wherein the second plurality of parameters includes molecular information from circulating tumor cells, circulating-free DNA, circulating-free RNA, circulating-free nucleic acids, circulating tumor DNA (ctDNA), circulating tumor RNA (ctRNA), circulating tumor nucleic acids (ctNA), mutational load/burden, fraction of genome altered, microsatellite instability, mismatch repair deficiency, methylated tumor DNA fraction, nucleosomal organization/fragmentation of circulating free or tumor DNA or a combination of any of the foregoing second plurality of parameters. 
     
     
         13 . The system of  claim 1 , wherein the quantitative functional multi-parametric molecular imaging includes the use of a radioactive tracer that comprises fluorine. 
     
     
         14 . The system of  claim 11 , wherein the body fluid is blood, urine, or a combination thereof. 
     
     
         15 . The system of  claim 1 , wherein the algorithm is a predictive algorithm. 
     
     
         16 . The system of  claim 1 , where the system is used for screening, diagnosis, staging, treatment planning, decision-making, monitoring, after care, or a combination thereof. 
     
     
         17 . The system of  claim 1 , where the quantitative and/or semi-quantitative molecular imaging is performed prior to the liquid biopsy. 
     
     
         18 . The system of  claim 1 , where the liquid biopsy is performed prior to the quantitative and/or semi-quantitative molecular imaging. 
     
     
         19 . The system of  claim 1 , where the course of therapy includes ruling out and avoiding unnecessary treatments, reducing overtreatment, probabilistic analysis of the disease(s) that the patient may be suffering from, screening and therapy planning, monitoring of patient wellness, or a combination thereof.