Anne Menkens, PhD and Daniel Sullivan, MD
Academic Radiology 2000, April 7(4), 306-8
Three years ago, the National Cancer Institute recognized the great untapped potential that imaging technology holds for cancer and identified it as an area of extraordinary opportunity. With this designation, the Biomedical Imaging Program (CIP) began a three-year effort aimed at significantly advancing imaging to more fully exploit its promise for cancer research and care. First, NCI established an Imaging Sciences Working Group (ISWG) led by David Bragg, M.D. The ISWG had seven subgroups of experts from diverse disciplines who helped NCI define research needs and opportunities. Based on those recommendations, CIP launched a series of programs to stimulate imaging research in several areas. Here is a summary and status report of some of those programs.
This Program Announcement, issued first in 1997, provides support for 2 years of funding at a level adequate for the initial feasibility testing and generation of experimental preliminary data. There exists a need for innovative and creative approaches leading to new avenues of research, and one way to encourage high risk/high impact research is to provide investigators with the initial resources required to accomplish pilot testing of ideas. Since the inception of this ongoing program, 143 applications have been received, and 39 have been funded.
ACRIN (American College of Radiology Imaging Network) is an NCI-sponsored Cooperative Group that was established in December 1998, to perform multi-institutional clinical trials in diagnostic imaging related to cancer. As a national clinical trials resource, ACRIN provides a stable infrastructure within which to conduct clinical trials. If investigators have an idea for a large-scale clinical trial, but do not have access to sufficient numbers of clinical patients to adequately implement such a trial, ACRIN resources are competitively available. ACRIN has a number of clinical trials in various stages of readiness. The first study will compare clinical FIGO staging to pretreatment evaluation by CT and MRI in cervical cancer. Other studies will include an investigation into the use of positron emission tomography (PET) of lung cancer to determine response to chemotherapy, a randomized clinical trial to determine the usefulness of low-dose, spiral CT imaging for detecting early stage lung cancer, and a comparative analysis of display systems for CT colonography (also referred to as "virtual colonoscopy).
This RFA, issued for funding in FY99, was designed to support research projects addressing the development and application of labeled therapeutic agents as compounds for imaging studies, and/or the development and application of imaging agents as metabolic markers of response to newly-developed therapeutic agents. In response to this RFA, 33 applications were received. 4 of these applications were funded in FY99, and 5 more are being funded in FY00. The funded research focuses on a wide range of cancer therapies using numerous different imaging methodologies, including positron emission tomography (PET), single photon emission computed tomography (SPECT), magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS).
Small animal models, particularly genetically engineered mice, are increasingly recognized as powerful discovery tools in cancer research. Functional, quantitative imaging techniques are an important tool for providing data about biochemical, genetic or pharmacological processes in vivo, and repetitively in the same animal, without having to sacrifice the animal for analysis. This program, issued in FY99 will provide both (a) shared imaging research resources to be used by cancer investigators and (b) research related to small animal imaging technology. Five grants have been issued for this program.
In Vivo Cellular And Molecular Imaging Centers are designed to capitalize on the extraordinary opportunity for studying cancer non-invasively, and in many cases, quantitatively due to recent advances in molecular imaging modalities, and molecular biology. The ICMICs and Pre-ICMICs are designed to facilitate the interaction of scientists from a variety of fields to conduct multidisciplinary research on imaging at the cellular and molecular level. Ten P20 Planning Grants and three P50 Specialized Center Grants will be awarded in FY 00. Pre-ICMIC Planning Grants provide funding for groups to formally plan and establish the organizational and operational structure necessary for new, multidisciplinary collaborative scientific efforts. The 5-year P50 ICMIC grants fund Centers for multidisciplinary research involving imaging and molecular technologies to take full advantage of emerging opportunities. The P50 Specialized Center grants will provide a formal framework through which scientific synergy can occur on a stable and continuing basis.
This RFA, issued in August, 1999, is designed to encourage research on improved imaging methods for the localization, biopsy and image-guided biopsy or therapy of prostate cancer. The specific goals include the development and application of one or more of the following inter-related components: (a) means for measuring local extent of disease using anatomic, metabolic or alternative novel imaging methods, (b) means for improved image-guided biopsy, staging or identification of aggressive cancers by metabolic or alternative novel imaging methods, and (c) means for navigation, control of image-guided therapy or measurement of early biological effects of therapy. Response has been very enthusiastic. Approximately 50 applications were received for R21/R33, with an estimated 6-8 applications to be awarded. Approximately 20 applications were received from small businesses for SBIR/STTR awards. Since the SBIR/STTR is a Program Announcement, the number of applications that are within the payline will determine the number of awards.
Digital Mammography is one of the most promising research areas for improving early detection of breast cancer. However, there is a need for a concerted effort to overcome the problems of displaying the digital mammograms, so that they are accurately interpretable for diagnosis. In 1999, the NCI issued this Program Announcement in order encourage research in this area, from both academic investigators (R01s) and small businesses (SBIR/STTR). Response has so far been less than expected with 11 R01 applications received, one of which was in the fundable range.
This series of four Program Announcements focuses on the development and application of molecular analysis technologies in studies relevant to cancer research. Molecular analysis technologies of interest include those that are entirely novel, or emerging but not currently in broad scale use, or technologies currently in use for one application or set of applications, that are being evaluated for utility for alternative applications. Imaging research, including chemistries, hardware and computational tools to support imaging of molecular species in cells or whole organisms can be supported under this program. Currently, 1 imaging project is funded through this mechanism.
The Unconventional Innovations Program (UIP) seeks proposals that represent the highest potential for revolutionary breakthroughs in the development of technologies to enable the non-intrusive sensing of cancer in the living body coupled to capabilities for monitoring intervention. These approaches typically carry substantial risk of failing to meet long-term objectives. Therefore, the NCI issued this BAA as a demonstration of its commitment to explore these high-risk approaches. The UIP specifically solicits projects to develop technology systems or system components to enable sensing of defined signatures of different cancerous or precancerous cell types or their associated microenvironment in the body in a way that is highly sensitive and specific, yet non-intrusive. The highest priority is for systems that can either support or provide a seamless interface between sensing/detection and intervention. Of the 5 awards that were made in FY99, 4 of them either use imaging or are developing imaging tools as part of a more complex system.
These are joint initiatives from many Institutes and Centers (ICs) of the National Institutes of Health (NIH) to support basic bioengineering research whose outcomes are likely to advance health or health-related research. Bioengineering integrates principles from diverse fields, and the creativity of interdisciplinary teams is resulting in new basic understanding, novel products and innovative technologies. Bioengineering also crosses the boundaries of academia, science, medicine, and industry. These bioengineering projects are often focused on technology development rather than on proving or disproving a scientific hypothesis, and therefore, the NIH review criteria for bioengineering proposals in response to these PA's have been modified to ensure that these proposals are evaluated appropriately and fairly. Applications are encouraged from individual investigators (BRGs) or multidisciplinary groups of investigators (BRPs). Although not limited to imaging research, many applications for both BRGs and BRPs have been submitted by the imaging community.