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Imaging in clinical trials.

Murphy P, Koh DM - Cancer Imaging (2010)

Bottom Line: Given the increasing cost to develop a drug, methods are required to characterise early drug efficacy and safety.With the application of conventional morphological imaging techniques and standardised response criteria based on tumour size measurements, imaging continues to be used to define key study end points.However, functional imaging techniques are likely to play an important role in the evaluation of novel therapeutics, although how these methods are to be optimally applied has yet to be clearly established.

View Article: PubMed Central - PubMed

Affiliation: Oncology R&D, GlaxoSmithKline, Uxbridge, UK.

ABSTRACT
Drug development continues to face challenges to successfully progress the most promising drug candidates through the stages of clinical trials. Given the increasing cost to develop a drug, methods are required to characterise early drug efficacy and safety. Imaging techniques are increasingly used in oncological clinical trials to provide evidence for decision making. With the application of conventional morphological imaging techniques and standardised response criteria based on tumour size measurements, imaging continues to be used to define key study end points. However, functional imaging techniques are likely to play an important role in the evaluation of novel therapeutics, although how these methods are to be optimally applied has yet to be clearly established. The specific challenges of standardising multi-centre imaging in the context of clinical trials are highlighted, including the processes for image acquisition, data analysis and radiological review.

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Related in: MedlinePlus

A 46-year-old man with neuroendocrine liver metastasis. Diffusion-weighted MR images (b = 750 s/mm2) before and after targeted treatment shows significant reduction in tumour size of the lesion in the right lobe of the liver. However, corresponding histograms of the distribution of apparent diffusion coefficient (ADC) values within the tumour also show an increase in the median value with a shift of the histogram to the right, in keeping with treatment response.
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Figure 3: A 46-year-old man with neuroendocrine liver metastasis. Diffusion-weighted MR images (b = 750 s/mm2) before and after targeted treatment shows significant reduction in tumour size of the lesion in the right lobe of the liver. However, corresponding histograms of the distribution of apparent diffusion coefficient (ADC) values within the tumour also show an increase in the median value with a shift of the histogram to the right, in keeping with treatment response.

Mentions: DW-MRI probes differences in the mobility of water protons between tissues. Cellular tissues (e.g. tumour tissues) impede the motion of water protons to a greater extent than normal tissues, and thus appear high signal on DW-MRI and return low apparent diffusion coefficient (ADC) values. The ADC is a quantitative measurement that reflects tissue diffusivity. Sequential ADC measurements before and after anticancer treatments can help to establish tumour response to therapy (Fig. 3)[25–27].Figure 3


Imaging in clinical trials.

Murphy P, Koh DM - Cancer Imaging (2010)

A 46-year-old man with neuroendocrine liver metastasis. Diffusion-weighted MR images (b = 750 s/mm2) before and after targeted treatment shows significant reduction in tumour size of the lesion in the right lobe of the liver. However, corresponding histograms of the distribution of apparent diffusion coefficient (ADC) values within the tumour also show an increase in the median value with a shift of the histogram to the right, in keeping with treatment response.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2967134&req=5

Figure 3: A 46-year-old man with neuroendocrine liver metastasis. Diffusion-weighted MR images (b = 750 s/mm2) before and after targeted treatment shows significant reduction in tumour size of the lesion in the right lobe of the liver. However, corresponding histograms of the distribution of apparent diffusion coefficient (ADC) values within the tumour also show an increase in the median value with a shift of the histogram to the right, in keeping with treatment response.
Mentions: DW-MRI probes differences in the mobility of water protons between tissues. Cellular tissues (e.g. tumour tissues) impede the motion of water protons to a greater extent than normal tissues, and thus appear high signal on DW-MRI and return low apparent diffusion coefficient (ADC) values. The ADC is a quantitative measurement that reflects tissue diffusivity. Sequential ADC measurements before and after anticancer treatments can help to establish tumour response to therapy (Fig. 3)[25–27].Figure 3

Bottom Line: Given the increasing cost to develop a drug, methods are required to characterise early drug efficacy and safety.With the application of conventional morphological imaging techniques and standardised response criteria based on tumour size measurements, imaging continues to be used to define key study end points.However, functional imaging techniques are likely to play an important role in the evaluation of novel therapeutics, although how these methods are to be optimally applied has yet to be clearly established.

View Article: PubMed Central - PubMed

Affiliation: Oncology R&D, GlaxoSmithKline, Uxbridge, UK.

ABSTRACT
Drug development continues to face challenges to successfully progress the most promising drug candidates through the stages of clinical trials. Given the increasing cost to develop a drug, methods are required to characterise early drug efficacy and safety. Imaging techniques are increasingly used in oncological clinical trials to provide evidence for decision making. With the application of conventional morphological imaging techniques and standardised response criteria based on tumour size measurements, imaging continues to be used to define key study end points. However, functional imaging techniques are likely to play an important role in the evaluation of novel therapeutics, although how these methods are to be optimally applied has yet to be clearly established. The specific challenges of standardising multi-centre imaging in the context of clinical trials are highlighted, including the processes for image acquisition, data analysis and radiological review.

Show MeSH
Related in: MedlinePlus