Review   Molecular imaging: Bridging the gap between neuroradiology and neurohistology S. Heckl1, R. Pipkorn2, T. Nägele1, U. Vogel3, W. Küker1 and K. Voigt1 1Department of Neuroradiology, University of Tübingen, Medical School, Germany, 2Central Section of Peptide Synthesis, German Cancer Research Center Heidelberg, Germany and 3Department of Pathology, University of Tübingen, Medical School, Germany Offprint requests to: Stefan Heckl, MD, Department of Neuroradiology, University of Tübingen, Medical School, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany. Fax: 07071-29-5638. e-mail: stefan.heckl@med.uni-tuebingen.de   Summary. Historically, in vivo imaging methods have largely relied on imaging gross anatomy. More recently it has become possible to depict biological processes at the cellular and molecular level. These new research methods use magnetic resonance imaging (MRI), positron emission tomography (PET), near-infrared optical imaging, scintigraphy, and autoradiography in vivo and in vitro. Of primary interest is the development of methods using MRI and PET with which the progress of gene therapy in glioblastoma (herpes simplex virus­thymidine kinase) and Parkinson's disease can be monitored and graphically displayed. The distribution of serotonin receptors in the human brain and the duration of serotonin- receptor antagonist binding can be assessed by PET. With PET, it is possible to localize neurofibrillary tangles (NFTs) and ß-amyloid senile plaques (APs) in the brains of living Alzheimer disease (AD) patients. MR tracking of transplanted oligodendrocyte progenitors is feasible for determining the extent of remyelinization in myelin-deficient rats. Stroke therapy in adult rats with subventricular zone cells can be monitored by MRI. Transgene expression (ß-galactosidase, tyrosinase, engineered transferrin receptor) can also be visualized using MRI. Macrophages can be marked with certain iron-containing contrast agents which, through accumulation at the margins of glioblastomas, ameliorate the visual demarcation in MRI. The use of near-infrared optical imaging techniques to visualize matrix-metalloproteinases and cathepsin B can improve the assessment of tumor aggressiveness and angiogenesis-inhibitory therapy. Apoptosis could be detected using near-infrared optical imaging representation of caspase 3 activity and annexin B. This review demonstrates the need for neurohistological research if further progress is to be made in the emerging but burgeoning field of molecular imaging. Histol. Histopathol. 19, 651-668 (2004) Key words: Molecular imaging, Magnetic resonance imaging, Gadolinium, Positron emission tomography, Near-infrared optical imaging DOI: 10.14670/HH-19.651