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.
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
Selected publications
- Singh S, Rogers H ... Atkinson D, Moore CM ... Punwani S (2022). Avoiding Unnecessary Biopsy after Multiparametric Prostate MRI with VERDICT Analysis: The INNOVATE Study. Radiology. 2022 Dec;305(3): 623-630.
- Taylor SA, Mallett S … Punwani S, Quinn L ... Halligan S; Streamline investigators (2019). Diagnostic accuracy of whole-body MRI versus standard imaging pathways for metastatic disease in newly diagnosed colorectal cancer: the prospective Streamline C trial. Lancet Gastroenterol Hepatol. 2019 Jul;4(7): 529-537.
Halligan S, Wooldrage K, Dadswell E ... SIGGAR investigators (2013). Computed tomographic colonography versus barium enema for diagnosis of colorectal cancer or large polyps in symptomatic patients (SIGGAR): a multicentre randomised trial. Lancet. 2013 Apr 6;381(9873): 1185-93.
- Atkin W, Dadswell E, Wooldrage K ... Halligan S; SIGGAR investigators (2013). Computed tomographic colonography versus colonoscopy for investigation of patients with symptoms suggestive of colorectal cancer (SIGGAR): a multicentre randomised trial. Lancet. 2013 Apr 6;381(9873): 1194-202.
- Plumb AA, Halligan S, Nickerson C, Bassett P, Goddard AF, Taylor SA, Patnick J, Burling D (2014). Use of CT colonography in the English Bowel Cancer Screening Programme. Gut. 2014 Jun;63(6): 964-73.
- Pickhardt PJ, Hassan C, Halligan S, Marmo R (2011). Colorectal cancer: CT colonography and colonoscopy for detection - systematic review and meta-analysis. Radiology. 2011 May;259(2): 393-405.