The private sector, short of funding, is finding NIH a useful source of support. As large-scale biomedical research becomes prevalent and as industry's early-stage R&D productivity falters, both parties have an interest in collaborating more than in the past. But in general, NIH isn't set up to manage the transformation of so many promising discoveries into clinically useful products. It's determined to change that situation with the introduction in October of this year of a "roadmap" for collaborations of many kinds. Even before this event, however, NCI, the largest institute within NIH, had undertaken several public-private programs to expedite development of new products. The institute's experiences illustrate some of advantages and pitfalls of public-private initiatives.

Diagnostic imaging systems such as CT/PET and MR/PET, which bring together in vivo anatomical and functional information in the same device or at the same workstation, offer a real opportunity for expanding the clinical utility of molecular imaging. But to drive adoption of these new combination systems will require data showing that their use changes therapeutic decision-making. For the most part, these data are at least several years away, with most of the work today in cancer, where in vivo imaging has been shown to better evaluate tumor type, guide radiation therapy, and change chemotherapy management. In the meantime, suppliers of imaging equipment to hospitals and research institutions are collaborating with academics and companies that are developing new radiotracers and other molecular probes. Such moves are not typical for these organizations, which, like IVD companies, traditionally have placed their bets on selling products into mature markets, rather than innovative R&D-oriented projects.

As scientific innovation in molecular imaging explodes, experts believe the big payoff will be in clinical, rather than research, applications. But absent validating clinical data, businesses remain hesitant to jump into the field.