The Importance of Imaging in Radiation Oncology for National Clinical Trials Network Protocols

Thomas J. FitzGerald*, Maryann Bishop-Jodoin, Fran Laurie, Elizabeth O'Meara, Christine Davis, Jeffrey Bogart, John A Kalapurakal, Marilyn J. Siegel, Bapsi Chakravarthy, Paul Okunieff, Bruce Haffty, Jeff Michalski, Kenneth Ulin, David S. Followill, Stephen Kry, Michael Knopp, Jun Zhang, Don Rosen, Mark Rosen, Ying XiaoLawrence Schwartz, Janaki Moni, Maria Giulia Cicchetti

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Imaging is essential in successfully executing radiation therapy (RT) in oncology clinical trials. As technically sophisticated diagnostic imaging and RT were incorporated into trials, quality assurance in the National Clinical Trials Network groups entered a new era promoting image acquisition and review. Most trials involving RT require pre- and post-therapy imaging for target validation and outcome assessment. The increasing real-time (before and during therapy) imaging and RT object reviews are to ensure compliance with trial objectives. Objects easily transmit digitally for review from anywhere in the world. Physician interpretation of imaging and image application to RT treatment plans is essential for optimal trial execution. Imaging and RT data sets are used to credential RT sites to confirm investigator and institutional ability to meet trial target volume delineation and delivery requirements. Real-time imaging and RT object reviews can be performed multiple times during a trial to assess response to therapy and application of RT objects. This process has matured into an effective data management mechanism. When necessary, site and study investigators review objects together through web media technologies to ensure the patient is enrolled on the appropriate trial and the intended RT is planned and executed in a trial-compliant manner. Real-time imaging review makes sure: (1) the patient is entered and eligible for the trial, (2) the patient meets trial-specific adaptive therapy requirements, if applicable, and (3) the intended RT is according to trial guidelines. This review ensures the study population is uniform and the results are believable and can be applied to clinical practice.

Original languageEnglish (US)
Pages (from-to)775-782
Number of pages8
JournalInternational Journal of Radiation Oncology Biology Physics
Issue number4
StatePublished - Nov 15 2018

ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research


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