title: Childhood extracranial neoplasms: the role of imaging in drug development and clinical trials.
abstract: Cancer is the leading cause of death in children older than 1 year of age and new drugs are necessary to improve outcomes. Imaging is crucial to the drug development process and assessment of therapeutic response. In adults, tumours are often assessed with CT using size criteria. Unfortunately, techniques established in adults are not necessarily applicable in children due to differing pathophysiology, ability to cooperate and increased susceptibility to ionising radiation. MRI, in particular quantitative MRI, has to date not been fully utilised in children with extracranial neoplasms. The specific challenges of imaging in children, the potential for functional imaging techniques to inform upon and their inclusion in clinical trials are discussed.
authors.affiliation: Department of Radiology, Royal Marsden NHS Foundation Trust, Downs Road, Sutton, SM2 5PT, Surrey, UK. lfowkes@doctors.org.uk.
authors.forename: Lucy A
authors.initials: LA
authors.lastname: Fowkes
authors.affiliation: Department of Radiology, Royal Marsden NHS Foundation Trust, Downs Road, Sutton, SM2 5PT, Surrey, UK.
authors.forename: Dow-Mu
authors.initials: DM
authors.lastname: Koh
authors.affiliation: Cancer Research UK and EPSRC Cancer Imaging Centre, Institute of Cancer Research, 15 Cotswold Road, Sutton, SM2 5NG, Surrey, UK.
authors.forename: David J
authors.initials: DJ
authors.lastname: Collins
authors.affiliation: Cancer Research UK and EPSRC Cancer Imaging Centre, Institute of Cancer Research, 15 Cotswold Road, Sutton, SM2 5NG, Surrey, UK.
authors.forename: Neil P
authors.initials: NP
authors.lastname: Jerome
authors.affiliation: Department of Radiology, Royal Marsden NHS Foundation Trust, Downs Road, Sutton, SM2 5PT, Surrey, UK.
authors.forename: David
authors.initials: D
authors.lastname: MacVicar
authors.affiliation: Nuclear Medicine & PET Department, Royal Marsden NHS Foundation Trust, Downs Road, Sutton, SM2 5PT, Surrey, UK.
authors.forename: Sue C
authors.initials: SC
authors.lastname: Chua
authors.affiliation: Paediatric Drug Development Unit, Children and Young People's Unit, Royal Marsden NHS Foundation Trust, Downs Road, Sutton, SM2 5PT, Surrey, UK.
authors.forename: Andrew D J
authors.initials: AD
authors.lastname: Pearson
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002986:Clinical Trials as Topic / Q000379:methods*; D015195:Drug Design; D016903:Drug Monitoring / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D009369:Neoplasms / Q000175:diagnosis* / Q000188:drug therapy*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome
keywords: Children; Clinical trials; Computed tomography; Magnetic resonance imaging; Metabolic imaging; Neoplasm; Research