Cancer Imaging

The Centre for Medical Imaging uses a range of MRI technologies, artificial intelligence, and advanced imaging techniques for the detection of disease and diagnosis of prostate and colorectal cancers.

Feature: Should whole body MRI become first line in cancer staging?

Following a cancer diagnosis, it is crucial to assess the spread of tumour (if any) to other parts of the body to plan optimal treatment. This spread away from the organ of origin is called metastatic disease. This staging process should ideally be accomplished quickly, with the minimum of risk and inconvenience to patients so their treatment can start as soon as possible. Professor Stuart Taylor discusses the possibilities of whole body MRI in cancer staging.

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Prostate

Using multi-parametric MRI technologies with AI to enable early detection of prostate cancer whilst increasing the rate, and sustainability of a patient-centered screening pathway.

Lead Investigators: Professor Shonit Punwani, Professor David Atkinson

Whole Body

Whole-body MRI imaging at UCL spans development of novel whole-body techniques for detection of disease and assessment of treatment response, to multi-centre evaluation of more evolved methods for cancer imaging.

CMI-led STREAMLINE trials assessed whether single "whole-body" MRI scan could replace multiple, standard tests for colon and lung cancers respectively. Published in parallel in Lancet Gastroenterology and Hepatology, and Lancet Respiratory Medicine in 2018, STREAMLINE found that MRI reduced both staging time and cost, without sacrificing accuracy.

Reacting directly to these findings, NICE commissioned an exceptional surveillance review of their cancer staging guidelines.

Lead Investigator: Professor Stuart Taylor

Colorectal

CT Colonography (CTC) is an advanced imaging technique for the diagnosis of colorectal cancer and its precursor, the adenomatous polyp. It involves rapid CT scanning of the cleansed, distended colon.

Modern computing technology allows 3D rendering of the inside of the colon - 'virtual colonoscopy'. We have been investigating the implementation of CTC within the NHS for several years. Notably, the SIGGAR randomised trials (funded by the NIHR HTA) showed that CT colonography is superior to the older alternative imaging test, barium enema, and equivalent to colonoscopy.

At the time of writing, our current interest is on how CTC is best implemented within the National Bowel Cancer Screening Programme. We have just completed a large, multi-centre study that investigates how radiologists who interpret CTC in the screening programme should be trained and assessed, the PERFECTS study.

Investigators: Dr Andrew Plumb, Professor Steve Halligan, Professor Stuart Taylor

Experts

Prof. David Atkinson

Prof. Steve Halligan

Dr Andrew Plumb

Prof. Shonit Punwani

Prof. Stuart Taylor

Selected publications