Promise and pitfalls of quantitative imaging in oncology clinical trials

• Published in: Magnetic resonance imaging Vol. 30; no. 9; pp. 1301 - 1312
• Main Authors: Kurland, Brenda F., Gerstner, Elizabeth R., Mountz, James M., Schwartz, Lawrence H., Ryan, Christopher W., Graham, Michael M., Buatti, John M., Fennessy, Fiona M., Eikman, Edward A., Kumar, Virendra, Forster, Kenneth M., Wahl, Richard L., Lieberman, Frank S.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 01.11.2012
• Subjects: Apoptosis; Biomarkers - metabolism; Cancer; Cell Differentiation; Clinical trials; Clinical Trials as Topic; Diagnostic Imaging - methods; Drug Delivery Systems; Humans; Magnetic Resonance Imaging - methods; Medical Oncology - methods; MRI; Neoplasms - diagnosis; Neoplasms - therapy; PET; Positron-Emission Tomography - methods; Quantitative imaging; Radiology; Signal Transduction; Tomography, X-Ray Computed - methods; Clinical trials; CT; Quantitative imaging; MRI; PET; Cancer
• ISSN: 0730-725X; 1873-5894; 1873-5894
• DOI: 10.1016/j.mri.2012.06.009

Quantitative imaging using computed tomography, magnetic resonance imaging and positron emission tomography modalities will play an increasingly important role in the design of oncology trials addressing molecularly targeted, personalized therapies. The advent of molecularly targeted therapies, exemplified by antiangiogenic drugs, creates new complexities in the assessment of response. The Quantitative Imaging Network addresses the need for imaging modalities which can accurately and reproducibly measure not just change in tumor size but changes in relevant metabolic parameters, modulation of relevant signaling pathways, drug delivery to tumor and differentiation of apoptotic cell death from other changes in tumor volume. This article provides an overview of the applications of quantitative imaging to phase 0 through phase 3 oncology trials. We describe the use of a range of quantitative imaging modalities in specific tumor types including malignant gliomas, lung cancer, head and neck cancer, lymphoma, breast cancer, prostate cancer and sarcoma. In the concluding section, we discuss potential constraints on clinical trials using quantitative imaging, including complexity of trial conduct, impact on subject recruitment, incremental costs and institutional barriers. Strategies for overcoming these constraints are presented.