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Opportunities and pitfalls of cancer imaging in clinical trials
1Department of Cancer Studies and Molecular Medicine, University of Leicester, Leicester Royal Infirmary, Infirmary Square, Leicester, UK. bm11@le.ac.uk
Abstract:
Cancer treatment strategies have changed considerably over the past two decades, with increasing emphasis on cancer-specific biological therapies. This situation has led to the incorporation of biomarkers, including those obtained by medical imaging, into trial designs to better understand mechanisms of action and, hopefully, to provide early evidence of treatment efficacy at a molecular or physiological level. Unlike blood tests and tissue samples, an imaging biomarker allows assessment of treatment in the whole tumor, in all tumors in the body, and at multiple time points. This situation has increased the complexity of clinical trials, as each imaging modality has issues related to cost, ease of use, patient compatibility, data analysis, and interpretation. This article reviews strengths and limitations of the current imaging methods available in clinical cancer trials, including MRI, CT, PET, and ultrasonography. The information gained by each test, and the difficulties in acquiring the data and interpreting it are also discussed in order to help researchers plan imaging in clinical trials and interpret data from such studies.
Insights
Medical imaging biomarkers are crucial for modern cancer clinical trials, offering whole-tumor assessment. This review discusses the strengths and limitations of imaging modalities like MRI, CT, PET, and ultrasonography in cancer research.
Area of Science:
- Oncology
- Medical Imaging
- Clinical Trial Design
Background:
- Cancer treatment has shifted towards targeted biological therapies over the past two decades.
- Biomarkers, including medical imaging, are increasingly integrated into clinical trials to assess treatment efficacy.
- Imaging biomarkers offer advantages over traditional methods by evaluating entire tumors and allowing longitudinal assessment.
Purpose of the Study:
- To review the strengths and limitations of current medical imaging modalities used in cancer clinical trials.
- To discuss the information gained and challenges associated with data acquisition and interpretation for each imaging method.
- To aid researchers in planning imaging protocols and interpreting data within clinical trial frameworks.
Main Methods:
- Review of current medical imaging techniques employed in clinical cancer trials.
- Analysis of strengths and limitations of Magnetic Resonance Imaging (MRI), Computed Tomography (CT), Positron Emission Tomography (PET), and Ultrasonography.
- Discussion of practical considerations including cost, usability, patient factors, data analysis, and interpretation.
Main Results:
- Each imaging modality (MRI, CT, PET, ultrasonography) presents unique benefits and drawbacks for cancer clinical trials.
- Challenges exist in data acquisition and interpretation across different imaging techniques, impacting trial design and results.
- Imaging biomarkers provide valuable insights into treatment mechanisms and efficacy at molecular and physiological levels.
Conclusions:
- Medical imaging plays a vital role in contemporary cancer clinical trials, enabling comprehensive assessment of treatment response.
- Understanding the specific strengths, limitations, and practicalities of each imaging modality is essential for successful trial implementation.
- Careful planning and interpretation of imaging data are critical for advancing cancer research and improving patient outcomes.
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