Elsevier

Seminars in Oncology

Volume 35, Issue 5, October 2008, Pages 460-469
Seminars in Oncology

The American College of Radiology Imaging Network—Clinical Trials of Diagnostic Imaging and Image-Guided Treatment

https://doi.org/10.1053/j.seminoncol.2008.07.010Get rights and content

The American College of Radiology Imaging Network (ACRIN) is the youngest of the National Cancer Institute (NCI) cooperative groups. ACRIN trials are directed towards evaluating the applications of diagnostic imaging and image-guided treatment to cancer. As ACRIN begins its third funding cycle, the organization is increasingly emphasizing several themes: linking imaging surveillance to pre-imaging testing for disease to improve the efficiency of cancer screening; the evaluation of imaging tests as biomarkers for molecular and physiologic processes in cancer; the standardization and validation of imaging tests to predict and monitor response to treatment; improved characterization of the extent and biology of cancer; and the translation of new emerging technologies from first-in-human testing to multicenter trials. ACRIN is poised to pursue its own research agenda, collaborate with other research entities to address key issues in cancer care, and place at the service of the other cooperative groups its electronic infrastructure to improve imaging in therapeutic trials. ACRIN's pursuit of its unique mission as the sole cooperative group directed principally toward diagnosis has made the network an integral part of the cancer research community.

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The Formation of ACRIN

The American College of Radiology Imaging Network (ACRIN) is the youngest of the National Cancer Institute (NCI)-funded clinical trials cooperative groups, having been founded in 1999.1 It also is the only one of the cooperative groups whose primary mission is focused on diagnostic, rather than therapeutic, medical technologies. The need for such a consortium was made apparent by a number of trends in the 1990s: the growing importance of imaging to cancer care, the increasing employment of

Organization and Operations

From the start, ACRIN understood that, to be successful it would have to develop an integrated and effective organization in a decentralized and widely disseminated setting. To achieve this, ACRIN makes maximum use of the capabilities afforded by modern electronic communications and the Internet. Importantly, ACRIN was the first major multicenter trials group with nearly all data collection and study management done via the Web. To this end, ACRIN developed a proprietary software program that

The Goals of ACRIN

Since the initial response to the 1998 RFA until the present, ACRIN's “overarching goals” have evolved only in minor ways.

Through clinical trials of diagnostic imaging and image-guided treatment technologies, ACRIN seeks to develop information that will:

• Improve the length and quality of lives of cancer patients;

• Result in the earlier diagnosis of cancer; and

• Lead to effective monitoring of patients at risk for cancer.

ACRIN has pursued these goals by addressing its trials to the full

Methodologic Perspective

As noted above, ACRIN studies address a broad spectrum of questions related to imaging. Additionally, responding to the rapid speed of evolution of imaging technology, the network evaluates both emerging and established modalities and formulates study designs and evaluation criteria that are appropriate for each phase of development of imaging technology. Responding to the growing need for information on the role and impact of imaging in the overall process of diagnosis and care of cancer

The Evolution of ACRIN's Scientific Strategy

It would be hard to argue that ACRIN employed a defined strategy for trial selection and development during its most formative years. While the responders to the initial RFA were required to proffer ideas for possible ACRIN trials, the awarding of the grants did not require that these ideas actually be transformed into clinical trials. Despite this, the majority of the ideas put forth in the initial RFA response did eventually become a part of the ACRIN research portfolio. It would be fair to

The Selection of ACRIN Trials

The scientific committees are charged with developing and periodically updating disease site-specific strategies to guide their deliberations of which trial concepts they will entertain in the context of the organizational strategy. Each committee prioritizes trial ideas (which may still come from any source) and determines which ideas to develop into initial concepts and forward to the Steering Committee for consideration. An extensive document of scientific committee strategies was developed

Key ACRIN Trials

ACRIN has been involved in 29 trials since it began operations and accrued around 75,000 subjects. The protocols and forms for all active and analyzed ACRIN trials are posted on the website and available for use by any interested investigator. While all of ACRIN trials have been carefully vetted to ensure they address important cancer-related questions, some that have had or are expected to have in the future particularly significant impact. Three of these are large screening trials that have

ACRIN in the Future

ACRIN is cognizant that as the organization matures, more will be expected of it. The network will undergo its first major change in leadership in 2008, as Dr Mitchell Schnall succeeds ACRIN's founding Chair, Dr Bruce Hillman. ACRIN also expects to initiate its third funding cycle with a very imposing agenda. Over its first 9 years of existence, ACRIN has developed a set of unique resources: a track record of successfully conducting imaging clinical trials; the infrastructure to conduct

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