Imaging in Oncology

Appropriate and adequate imaging is the cornerstone of modern cancer management. Starting from its obvious role in the diagnosis of cancer where imaging is necessary for most cancers to understand the anatomical extent of the disease, imaging plays a role in guiding subsequent therapy decisions. It plays an important role in determining the type of local therapy, if any, especially when metastatic disease needs to be ruled out prior to instituting potentially curative treatment in advanced malignancies. For certain sites of cancer like hepatocellular carcinomas and bone tumors, the diagnosis itself relies on imaging. 

In addition to guiding therapy, imaging is used extensively for assessing its response. Brain imaging with MRI is essential before the surgery to decide on the surgical extent as well as after a surgical resection to document the extent of clearance PET CT based response assessment is becoming the new standard in guiding therapy decisions in patients with hematological malignancies, with favorable responders being spared of long courses of systemic therapy. Advances in nuclear medicine have now allowed development of therapeutic molecular imaging, where specific tumor-targeted antigens are tagged with radioactive nuclides for imaging as well as treatment. 

Image biobank Projects

There are several major image biobanks projects in the world and a recent review noted that 70% of these are located in Europe. Most of the large population-based epidemiological studies investigating the health conditions have associated image biobanks. Examples of studies investigating biobanks of images include Study of Health in Pomerania (SHIP) study, the UK Biobank study, and the German National Cohort study. All of these population-based studies aim to use imaging to identify phenotypic patterns in healthy populations and correlate them with genotypic variations. 

Cancer image banking is unique in that the diagnosis, treatment planning, treatment delivery and response assessment in cancer care is heavily dependent on imaging features. This has led to countries developing cancer imaging archives with a view to amalgamating engineering technological expertise with medical advances in order to improve cancer outcomes. The National Cancer Institute of the United States of America has put in a major drive under the guidance of their National Biomedical Imaging Archive. The project called “The Cancer Imaging Archive” (TCIA) has a rich database of cancer imaging data available for education and research purposes. Similarly, the King's College London and University College of London have jointly started a “Comprehensive Cancer Imaging Centre” (CCIC). The project has received funding from Cancer Research UK (CRUK), The UK Engineering and Physical Sciences Research Council (EPSRC),  UK Medical Research Council (MRC) and  UK Department of Health (DoH). 

The proposed CHAVI ecosystem and motivation for the same
Figure 1: Proposed CHAVI Ecoystem and Motivation for the Project


Motivation for CHAVI

The CHAVI project will allow us to map the imaging dataset in Indian patients. Whilst this will assist us in stimulating “Big Data” research on radiomics and improve cancer education, this project will have the capacity to provide a National Network of Cancer Imaging. This network can help us function as a unit to provide unique personalized answers for Indian Cancer patients. Moreover, the CHAVI network can collaborate with other similar networks worldwide in improving cancer research around the globe, leading to personalized radiomics based management strategy. The data will be available to be used for joint collaborative efforts in treatment decision making and development of improved and novel strategies to fight cancer.