In the last 3 decades, unparalleled advances in computational processing speed, memory and storage as well as decreased cost and footprint have dramatically accelerated the use of high resolution, three-dimensional (3D) imaging and 3D reconstruction of images acquired with CT, MRI, SPECT, PET and US. In addition, over the last 20 years, there has been an explosion of functional imaging approaches such as perfusion CT and MRI, diffusion MRI, SPECT, Doppler US, and PET using [18F]-fluorodeoxyglucose and other novel tracers. These imaging tools provide improved sensitivity, specificity, precision and accuracy of cancer detection and characterization as well as improved therapy guidance and post-treatment outcomes assessment. However, despite the significant opportunity for cancer clinical research offered by these established and newly discovered imaging tools, there is currently no agreement on: 1) how to facilitate the integration of imaging in cancer clinical research studies; 2) clear definitions for the measurement of tumors and tumor boundaries; 3) how to score response/ progression; and, 4) when and how to integrate novel imaging intermediate endpoints and with appropriately matched therapies. There is a critical need now to exploit and translate these discoveries for use in cancer clinical trials.
Objectives
- To develop new software tools to manage the acquisition and analysis of images and generate standardized reports with quantitative measurements that meet clinical trials requirements for existing endpoints (e.g., RECIST)
- To develop and validate imaging viewing and analysis software tools to measure novel biomarkers of tumor response suitable for use in clinical trials; and,
- To develop software tools that allows for image archiving, sharing and maintaining an anonymised imaging registry/databank as a province-wide resource for cancer imaging biomarker research and development.
Goal 1: Tools for Clinical Trial Imaging Analysis
- Partnering with ClearCanvas to develop a viewer for clinical trial image management
- A set of validated “plugins” for ClearCanvas that will provide automated/semi-automated reports for key imaging endpoints required by current and future clinical trials.
- Accreditation and commissioning procedures to enable the deployment of ClearCanvas among clinical sites engaged in clinical trial image acquisition and reporting.
Goal 2: Establish a Clinical Trial Imaging Research Network
- A networked cohort of clinical/research “nodes” engaged in the application of imaging innovations to clinical trial applications.
- An informatics infrastructure that links the clinical sites and supports a network of radiologists, oncologists and imaging scientists dedicated to improving clinical trial imaging capabilities.
- Establishment of a reference laboratory for accreditation of image-based measurement systems, including a database of reference images.
- Where required and feasible, enable the development of Core/centralized reading capabilities for oncology trials through provision of the enhanced tools and informatics.
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