Imaging plays a major and growing role in noninvasively assessing cancer biology in pre-clinical studies and clinical trials. Imaging is now being used to personalize therapies in clinical practice. In early and advanced clinical trials of cancer therapeutics, imaging can provide key information on the mechanisms of action of the treatment, including whether target lesions are present, if the target lesion is "hit" by the therapy, if the cancer is responding and if tumor progression has occurred. Elements of these measurements are an important part of many studies involving cancer therapy conducted at the Kimmel Cancer Center.
Qualitative imaging is now being complemented by sophisticated quantitative approaches. The Imaging Response Assessment Core was established to assure access to advanced imaging technologies, including quantitative PET, MRI, and CT.
consultation and guidance on the proper choice
design and use of imaging studies in clinical trials
expert reviews of clinical protocols to assure that the imaging protocol and analysis plans are appropriate for the chosen task
state-of-the-art prompt and accurate assessment of tumor response, using standardized anatomic and metabolic response criteria, including:
o Response Evaluation Criteria In Solid Tumors (RECIST) 1.1
o PET Response Criteria in Solid Tumors (PERCIST) 1.0
o image archival, anonymization, and data import/export
o developing documents, protocols and forms to assist in studies performed at one or multiple sites
o regulatory guidance on radiation exposure and molecular imaging agents
o assisting in development of nontraditional imaging metrics for response assessment, including participation in ACRIN and ECOG trials
o improving quantitative imaging collaborations among Kimmel Cancer Center investigators and imaging specialists.
Future plans include new and advanced computing and software platforms to continue to provide robust quantitative analyses of single and multimodality imaging studies of cancer treatment response with current and emerging imaging tools. Core experts will provide input into study design and analysis to lead to more appropriate, accurate and reproducible imaging in cancer therapy studies performed at Johns Hopkins and in collaboration with other institutions. Appropriate quantitative imaging will benefit clinical cancer therapy trials of all phases and should accelerate translational cancer research.