location.^12 In the past, physicians simply had to accept variations between patients
as an imponderable and frustrating complexity of medical practice.^13 Evidence-
based medicine comprehensively balances potential harms and benefits of a partic-
ular diagnostic or therapeutic approach based on randomized clinical trials. This
approach yields guidelines and recommendations for the treatment of a particular
disease or a group of similar clinical entities. The concept of evidence-based
medicine seems to be more disease oriented in comparison to personalized medi-
cine characterized by a strong individual approach. Can we consider these two
concepts to be opposing? Essentially, every physician tries to provide high-quality
medical treatment to the patient in accordance with evidence-based guidelines,
taking into consideration the patient’s age, constitution, comorbidity, and motiva-
tion to endure suggested treatment. Close collaboration between radiologists and
pathologists is mandatory if integrating genomic and proteomic characteristics of
tissues with specific imaging features in a particular patient is to be accomplished.
The future of personalized medicine is based on endeavors to identify bio-
markers of cellular alteration as precursors of a silent or symptomatic disease, as
well as to assess its specific reaction to different therapeutic procedures. Bio-
markers obtained from tissue, blood, and imaging are crucial in personalized
diagnostics and therapy. Prognostic biomarkers are the most intriguing, with a
potential to anticipate disease progression if left untreated. It is of utmost impor-
tance in patients with indolent or slowly progressive disease who can avoid
aggressive treatment and could be switched to “watchful waiting” protocol. Patients
still have to be stratified into smaller subgroups regarding their risk or potential
treatment expectations based on the combination of genetic, biochemical, and
imaging biomarkers.^14 Molecular imaging is one of the most powerful tools for
individualized treatment of oncologic patients at various stages of the decision-
making process.^15 The most challenging task for radiology and imaging is accurate
staging of a particular disease, appropriate selection of patients for a given therapy,
and modification of a specific treatment based on the results of monitoring early in
the course of treatment. Early monitoring of the therapeutic response by PET/CT
imaging has provided a reliable basis for the individualization of further treat-
ment.^16 The importance of imaging in the assessment of therapeutic response
increases due to clinical challenge to discriminate responders and patients who
will not respond as early as possible. The assessment of therapeutic response in an
early phase of treatment is of utmost importance, especially in oncology. Patients
who do not respond lose precious time and experience side effects, such as the
suppression of haematopoiesis and immune system.^17 Early detection of initial or
(^12) European Society of Radiology ( 2011 ).
(^13) Thrall ( 2004 ).
(^14) Nevins et al. ( 2003 ).
(^15) Crommelin et al. ( 2011 ).
(^16) Crommelin et al. ( 2011 ).
(^17) Thrall ( 2004 ).
222 D. Miletic ́et al.