PET is a very complex imaging modality with many potential sources of human, technical and biological bias and variation that can reduce the accuracy and precision of the results of an individual scan. The greater this variation is across all the scans contributing to a given study, the lower the statistical power of the study becomes and the harder it is to detect an effect. Carefully controlling protocols so that bias and variation are kept to a minimum is therefore essential if PET is to be used most effectively.
Clinical trials involving PET face specific technical and logistical issues associated with standardisation of protocols and the rapid turn-around times necessary for clinical decision making. This is particularly true for multicentre trials where standardisation of all aspects of the procedure is necessary if meaningful and publishable data is to be obtained.
The establishment of networks of accredited scanning sites operating to rigorous standards is recognised as the way to achieve this.
The NCRI PET Clinical Trials Network
In 2008, the UK PET Research Network formally established the NCRI PET Clinical Trials Network, which currently consists of more than 50 PET sites that have all been accredited and adhere to the same standards. A central 'Core Lab' based at St Thomas' provides a service that delivers independent quality control (QC) and site accreditation for PET centres participating in multicentre cancer trials, central management of image data and assessment of all acquired images to verify adherence to the trial protocol and assess image quality.
The NCRI PET Clinical Trials Network is intended to provide researchers access to the expertise and resources to conduct cancer clinical trials involving PET along with a co-ordination function for UK-based PET trials. It is based on the PET clinical trials network established by the St Thomas' group in London, which has successfully co-ordinated five completed and ongoing UK and international multicentre studies involving more than 20 PET sites.
Both the NCRI PET Trials Network and Core Lab received three years of funding from NCRI Partners (CR-UK, DH, MRC, Wales and Scotland) for 2012-2015.
- Cancer Research UK
- Department of Health
- Medical Research Council
- Chief Scientist Office, Scotland
- National Institute for Social Care and Health Research, Wales
The Experimental Cancer Medicine Centres (ECMC) network also provided funding from August 2015 to March 2016 to allow the Core Lab to become self-sufficient. The PET Core Lab is now at this stage and funding is obtained through individual clinical trials during the grant application process. Funding is currently underwritten by the King's College London & Guy's and St Thomas' PET Centre.