Specific Aims

1. Validate the use of CT colonography to screen for colorectal polyps
2. Develop functional imaging biomarkers to predict and monitor therapeutic response for solid tumors in the abdomen and pelvis
3. Develop an imaging approach to whole-body surveillance for metastasis and recurrence of solid tumors
4. Determine the optimal imaging strategy for screening patients with chronic hepatitis B and C for hepatocellular carcinoma.

Future Plans Overview

Based on the validated dataset from ACRIN 6664, a multireader, multicase trial of computer aided detection (CAD) for virtual colonoscopy is planned. Linked with the ACRIN objectives of targeting at-risk populations and earlier diagnosis, it addresses the next generation of questions for CT colonography.

Research is planned to extend functional imaging of tumor response to therapy through several studies. ECOG E2804 (ACRIN 6676) will investigate dynamic contrast MRI (DCE-MRI) as a marker of response of renal cell carcinoma to targeted therapy, and a substudy of SWOG S0438 (ACRIN 6675) is designed to evaluate FDG-PET as a marker of response of malignant melanoma to targeted therapy. The committee also will look to develop prostate MRSI as a functional imaging technique to characterize prostate cancer to predict and monitor radiation therapy responsiveness.

Essential to the imaging surveillance strategy for metastasis and recurrence is the assessment of lymph node status. A trial of Combidex MRI will be activated to evaluate the ability of this targeted agent to detect lymph node metastasis from bladder carcinoma. This protocol has implications beyond this organ system in the development of an MRI-based whole-body surveillance strategy.

The development of optimal imaging strategies to detect early hepatocellular (HCC) carcinoma in at-risk populations is being pursued. This aim is related to the current work on the ACRIN 6673 trial, in that early detection and accurate depiction of HCC will provide the best opportunity for localized treatment approaches.