Spatiotemporal molecular imaging is a critical part of spatiotemporal molecular medicine

Spatiotemporal molecular medicine aims to emphasize the importance of integrating multi‐dimensional aspects of clinical medicine and molecular medicine ‐ “a four‐dimensional and dynamical picture of the disease by integrating clinical spatialization, temporalization, phenome, and molecular multi‐omics for disease diagnosis, therapy, and prognosis”. 1 From an anatomical point, the “four‐dimensional” aspects were proposed to be the length, width, and height, with time of organ/tissue development in physiological and pathophysiological conditions. From a disease perspective, the four‐dimensions should include the initiation and development of disease, severity and category of disease, compliance and subjective symptoms of patients, as well as overview and manipulations from clinicians. From a diagnostic point of view, we should consider dynamic monitoring, various methodologies (e.g., real‐time polymerase chain reaction, mass spectrometer, computed tomography, pathology), biomarker quality and quantity (e.g., gene, protein, cell, image), and accuracy and repeatability. The most important issue of spatiotemporal molecular medicine is to integrate those “four‐dimensions” from various points with molecular phenotypes and to perform clinical practices at molecular levels. The present editorial addresses the importance, uniqueness, realizability, and challenges of spatiotemporal molecular images as a critical part of spatiotemporal molecular medicine. The spatiotemporal molecular image is defined as the dynamics and positioning of molecular events in clinical images (e.g., X‐ray, computerized tomography [CT], nuclear magnetic resonance [NMR], positron emission tomography‐CT [PET‐CT], ultrasound, interventional radiology, and electrocardiogram), as shown in Figure 1A. It is a comprehensive integration of clinical images, pathological morphology, and molecular profiles (e.g., genome, proteome, metabolome, and transcriptome) by principles and methodologies of clinical trans‐omics. 2 Open in a separate window FIGURE 1 Proposed workflow of spatiotemporal molecular images. Clinical images of the organ anatomy are collected from e.g., X‐ray, computerized tomography (CT), nuclear magnetic resonance (NMR), positron emission tomography‐CT (PET‐CT), ultrasound, interventional radiology, and electrocardiogram (A). The three‐dimensional organ‐wide architectures and images can be re‐established by multiple transverse and longitudinal sections of tissues or clinical images (B). Histological sections of the organ are corresponded to clinical images (C) and then formed into an overlap by image matching (D), from which the histological structures of the organ are expected to be referred from clinical images. Spatial transcriptomes can simultaneously be performed on those histological sections in order to understand cell‐cell interactions, transcriptional signals, and phenotypes within the certain area (E) as well as mRNA expression within the cell (F). Multiple images at gene, cell, tissue, and organ levels are integrated into organ‐wide spatiotemporal molecular images using artificial intelligence, computerized programming and modeling, and visualization (G)