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New Imaging Facility Will Advance Clinical Cancer Research

At the Podium – September 2007

By Mark Mintun, MD, and Barry Siegel, MD

With few exceptions, cancer diagnosis and treatment today cannot be accomplished without the use of sophisticated imaging modalities. These essential tools help physicians determine if cancer is present, how extensive it is and how well it is responding to treatment.

In recent years, the technology available to help physicians detect and diagnose cancer has changed dramatically. The fact is, more than half of the modalities used to image tumors and cancer cells had not been fully developed – or didn’t even exist – 35 years ago. This rapid advance requires an in-depth knowledge of how to use these tools and, ideally, a creative vision that supports research into new cancer treatments.

As a National Cancer Institute Comprehensive Cancer Center, the Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine is focused on performing innovative clinical imaging research. Recently, our ability to accomplish this goal was greatly enhanced with the opening of Mallinckrodt Institute of Radiology’s Center for Clinical Imaging Research (CCIR).

Located on the 10th floor of Barnes-Jewish Hospital’s south campus, the CCIR houses a comprehensive range of the most advanced imaging equipment: two MRI scanners, a PET/CT scanner, a CT scanner, an ultrasound imaging system and a conventional PET scanner. The CCIR’s location in the heart of the hospital makes it the only center of its kind in the United States that truly integrates imaging research facilities into a patient-care setting. Our CCIR facilitates clinical research by offering easy access for inpatients and outpatients.

Beyond convenience, the CCIR has improved access for clinical researchers. Prior to establishing the center, imaging studies for patients enrolled in clinical research were performed on equipment primarily devoted to meeting the needs of hospitalized patients. Scheduling conflicts were inevitable. Now, a whole suite of research-dedicated scanners is available to ensure investigators have the time and technology needed to complete their imaging studies. This may mean allowing an hour to collect extra images for a research PET scan that lasts only 20 minutes in a clinical setting. Or using advanced MRI sequences that are not yet in general use. Or calling upon the expertise of the center’s physicians and technicians to help refine and optimize study protocols.

For instance, a researcher wanting to measure how a new chemotherapy regimen stops DNA from replicating or blood vessels from growing may decide to look at tumor shrinkage using CT. But the center’s staff might suggest that a better way to achieve the measurement is a new PET technique that actually shows how fast the tumor is replicating DNA.

This collaborative spirit is at the core of the CCIR’s mission. The center assists investigators in the design, execution and analysis of basic science and translational imaging studies. In so doing, it creates a community for research-based technology exchange that connects imaging scientists, physicians and radiologists across different departments, divisions and, ultimately, different institutions.

Additional support for the work being done by cancer researchers comes from Siteman’s Imaging Response Assessment Team (IRAT). This team is designed to promote the use of effective imaging in clinical research, particularly as a way to assess patients’ response to therapy. One of eight formed nationally through National Cancer Institute grants, the IRAT integrates radiologists into the planning of clinical trials. In effect, its goal is to raise the imaging awareness of investigators and clinicians as they develop studies. It encourages them to incorporate unique techniques that help them gain an early understanding of how drugs are working in phase I and II trials. It also aims to make imaging as easy and efficient as possible – both for radiologists reading films and oncologists conducting research.

Both the CCIR and IRAT provide important opportunities for investigators to expand and enhance their research endeavors. These resources will undoubtedly advance our ability to use imaging to predict patient response to therapy and then adapt treatment accordingly. And they position us as a likely candidate for a greater volume of drug trials, which will be a boon for patients wishing to participate in the important work of finding effective new treatments for cancers of all kinds.

Mark Mintun Mark Mintun, MD, is professor of radiology at Mallinckrodt Institute of Radiology and Washington University School of Medicine.
Barry Siegel Barry Siegel, MD, is professor of radiology at Mallinckrodt Institute of Radiology and Washington University School of Medicine.