Thoracic Imaging 2003 - Society of Thoracic Radiology

TUESDAY
164
NCI Update for Thoracic Radiology
Edward V. Staab, M.D.
Chief, Diagnostic Imaging Branch
BIP/DCTD/NCI
The objectives of this lecture are to:
1. Describe the overall strategic plan for diagnostic imaging
and interventional radiology in cancer research.
2. Explain the importance of imaging and radiologists in the
advancement of our knowledge in cancer biology and in the
care of cancer patients.
3. Provide an update on the current targeted areas for imaging
research in Preclinical studies.
4. Explain the advances in clinical imaging trial research and
the growing awareness and participation by radiologists in
clinical trials
5. Promote participation in the development of new knowledge
by the attendees.
6. Review current trials in imaging of cancer and image guided
therapy of cancer specifically related to the thorax.
The National Cancer Institute has recognized imaging of
cancer as an extraordinary opportunity for several years. The
development of imaging assessment to tumor biology in animal
systems and human cancers in parallel with our advancing
molecular understanding of the malignant state is an important
priority for the National Cancer Institute. To meet the challenges
of this extraordinary opportunity the Biomedical Imaging
Program was developed five years ago and has had a remarkable
growth rate.
The challenge to imaging is to make earlier and more accurate
diagnoses for cancer patients that will reduce the number of
required invasive therapies, enhance a physicians ability to monitor
patient response to treatment and ultimately make a positive
affect on the quality of life of cancer patients. Imaging potentially
can be used for developing new drugs and other therapeutics
because it provides physiological, morphological and
molecular information non-invasively. This means that measurements
can be made regarding the time-related distribution of
drugs and tissue responses without disturbing the milieu. This is
the unique information that can be garnered from imaging and
what makes it an extraordinary opportunity for cancer research.
In addition, imaging is being promoted for targeting tissue for
various interventional treatments. This includes image guided
radiation therapy and surgery, delivery of specific therapies to
focused areas and application of a number of other technologies
for eradicating cancerous tissue.
The American College of Radiology Imaging Network
(ACRIN) is one of nine cooperative groups in the National
Cancer Institute established to conduct clinical trials in cancer
patients. It was funded in March of 1999 and is currently undergoing
review for renewal of its grant. It has received additional
support via supplements for two very large screening trials, the
National Lung Screening Trial (NLST) and the Digital
Mammography Imaging Screening Trial (DMIST). Relevant to
this conference, NLST is a randomized control trial of 50,000
high-risk patients with smoking history to determine the value
of low-dose CT screening for lung cancer. ACRIN has combined
its resources with the PLCO contract investigators to conduct
this trial. Each entity will enroll 25,000 participants by
April 2004. These patients will be followed for eight years to
determine the primary endpoint, overall mortality. In addition,
10,000 of the ACRIN participants will undergo extensive evaluation
addressing the effect of screening on smoking cessation,
quality of life issues, cost effectiveness and the collection of
body fluids and tissues for future biomarker research.
Cancer Imaging is being developed for pre-clinical studies
directed at the development of new therapeutic methods. To this
end the Biomedical Imaging Program has developed initiatives
to identify new imaging agents, test these in pre-clinical models
and foster their acceptance by regulatory agencies. The BIP has
invested in several areas of infrastructure needs to accomplish
these tasks. These include:
• Centers for Molecular Imaging which bring together a
variety of different scientists and imaging technologies
• Small animal imaging research programs (SAIRP’s) to
develop the field of animal imaging
• Development of contrast agents and enhancers (DCIDE) to
help bring the new agents through the regulatory system
• Imaging agent databases
• Cancer imaging trials
• Clinical Imaging databases
• Imaging informatics
• Optimization and standardization of technological platforms
• Image guided tools and methods
The practicing radiologist should have an understanding of
the research that is currently going on that will change the way
patients are diagnosed and treated in the future. This talk will
present the current framework for the development of new ways
to diagnose and treat patients with cancer.
For further information please contact us at the numbers
below or access the relevant websites.
Biomedical Imaging Program/DCTD/NCI
6130 Executive Blvd. EPN. Suite 6000
Rockville, MD 20892-7440
Tel: 301-496-9531
FAX: 301-4803507
BIP Web Site: cancer.gov/bip/
NIH Web Site: www.nih.gov