Imaging approaches for delivery of personalised cancer treatment

Imaging approaches for delivery of personalised cancer treatment CRUK Cancer Imaging Centre Institute of Cancer Research London and Royal Marsden Hospital, London, UK. Theme 5 – Developing whole body multiparametric imaging PRECISION MEDICINE 2. Image heterogeneity of phenotype to predict and monitor treatment response M O Leach, N de. Souza, D-M Koh, G Flux, S Robinson, G ter Haar, J Bamber 3. Image response to targetted treatment DWI b 900 Whole body imaging can evaluate: heterogeneous disease body burden 4. Imaging biomarker driven therapy 5. METHODOLOGY AND INFORMATICS MRIS CT PET SPECT US Subtracted CE ADC Seamless integration with both ICR and open-source applications Repository for multi-centre trials Whole-cohort processing pipelines 3 -D interaction with registered multimodality data DICOM modalities New approaches for functional contrast imaging Normalised Contrast enhanced Imaging 1. Link imaging phenotype to genotype Theme 5 - Informatics and imaging developments Microscopy • whole-slide • confocal • time-lapse Optical CT Carbozantinib (XL 184) promising MET, AXL and VEGFR 2 inhibitor 62 yr metastatic CRPC • absorption • emission • FLIM/FRET Pretreatment OCT IVIS Photoacoustic Differential imaging response Elastography Spectral CZT Combined imaging shows response and action despite differential imaging effects micro x-ray CT Import images with complete metadata regardless of origin b = 900 s 2 / mm 18 F-FDG PET/CT Same interface for both patient and pre-clinical data Increased emphasis on ontology, controlled vocabulary and contentbased image search MALDI genomic Post 6 weeks XL 184 treatment non-DICOM modalities With J de. Bono and DDU DELIVERING A VISION OF PRECISION MEDICINE Clinical need: Response & predictive biomarkers in sclerotic disease orthotopic model of VCa. P prostate cancer Molecular Pathology Therapeutic development Genetics & Epidemiology vehicle Pre treatment PSA 357 12 wks of abiraterone PSA 31. 5 cabozantinib Tc-99 m MDP CANCER IMAGING INNOVATE AND TRANSLATE DELIVER IMAGING BIOMARKERS INTO THE CLINIC at * *** CT *** ADC 879 Day 0 DW-MRI Identify response and resistance Day 0 T Graham, S Robinson ADC 1496 Day 15 Aid detection Stratify patients for targetted therapy CT Day 15 DW-MRI C Messiou Impact: Relate pattern of change in imaging biomarkers to subsequent relapse Drive and guide therapy delivery The research programme encompasses a range of cancer and scientific questions. Questions range from improved detection and diagnosis, prognosis, planning, guidance and response A range of modalities include MR, PET, SPECT, US, opticaland opto-acoustic techniques. research is closely integrated and highly translational. There is emphasis on new biomarkers. Research is closely integrated with a range of other programmes, including drug development, radiotherapy, basic cancer biology, clinical units in major cancers.