1. ACRIN Fall Meeting 2008 Mitchell Schnall MD, PhD Professor of Radiology University of Pennsylvania ACRIN Network Chair State of ACRIN : 10 years of investment

2. ACRIN Fall Meeting 2008 1.Strategies for Imaging Surveillance of Populations at High Risk for Cancer 2.Imaging Approaches to the Characterization of Disease in Order to Guide Targeted Therapy 3.Biomarkers of Therapeutic Response for Implementation in Clinical Trials and Clinical Care Primary Scientific Objectives

3. ACRIN Fall Meeting 2008 ACRIN ORGANIZATION: 1999 Data and Safety Monitoring Committee Network Chair Network Deputy Chair Advisory Panel Vice Chair Modalities Vice Chair Basic Sciences Vice Chair for Institutional Participants Vice Chair Industry/Insurers Vice Chair Publications Urinary GYN Breast Head & Neck CNS Musculoskeletal Lung Pediatrics Heart & Vasculature Receptor Delivery Sys Nuc Med PET/Spect Ultrasound Conventional/ CT Psychophysics MRI/MRS GI Design & Analysis Network Administration Biostatistical & Data Management Center Vice Chair Disease Sites Functional/Meta- bolic Imaging Interventional Min Invasive Image & Info Tech Outcomes and Quality of Life Economics and Cost Impact Oncologic Pathology Quality Contol Medical Specialties Advisory Comm. Special Populations Physics & Engineering Institutional Participants Vice Chair Methods Scientific Committees

4. ACRIN Fall Meeting 2008 ACRIN Organizational Chart I nstitutional Participants Committee Vice Chair Chris Comstock, MD UCSD Media / Publications and Dissemination Committee Vice Chair Laurie Fajardo, MD University of Iowa Special Populations Elizabeth Patterson, MD Research Associates Wendy Smith, RT Rhode Island Hospital Quality Control Mitchell Schnall, MD, PhD University of Pennsylvania Patient Advocacy Barbara LeStage, MHP Outcomes & Economics Core Laboratory William Black, MD Dartmouth Medical School Advisory Panel Hal Kundel, MD University of Pennsylvania Leadership Council Mitchell Schnall, MD, PhD University of Pennsylvania Biostatistical & Data Management Center Brown University Chair Constantine Gatsonis, PhD Deputy Chair Jeffrey Blume, PhD. Steering Committee Network Chair Mitchell Schnall, MD, PhD University of Pennsylvania Deputy Chairs Anat/Fxn Imaging Denise Aberle, MD UCLA Molecular Imaging Barry Siegel, MD Washington University Abdominal Fergus Coakley, MD Univ Calif San Francisco Head/Neck/CNS Greg Sorensen, MD Massachusetts General Hosp Breast Etta Pisano, MD University North Carolina Thoracic Caroline Chiles, MD Wake Forest University Gynecological Disease Site Committees Scientific Support Committees Experimental Imaging David Mankoff, MD University of Washington Informatics Daniel Rubin Stanford University Core Laboratory PET/Nuc Medicine Barry Siegel, MD Washington University MR/CT Mark Rosen, MD, PhD University of Pennsylvania Ultrasound Working Group Barry Goldberg, MD Thomas Jefferson University NCI Jim Tatum, MD Cancer Imaging Program Network Administration Charles Apgar ACR Philadelphia Data & Safety Monitoring Committee Daniel Sargent, PhD Mayo Clinic Support Committees

5. ACRIN Fall Meeting 2008 Scientific Progress ACRIN Trial Status by Disease Site Disease SiteOpened Completed Accrual In Development Closed Unsuccessfully Breast1410 Abdominal2412 GYN1110 CNS/Head and Neck 1220 Thoracic2111 EISC0 0 2 0

6. ACRIN Fall Meeting 2008 ACRIN Success  117 sites have participated ACRIN trials  Over 76,500patients have been accrued to ACRIN trials  Over 20 million images have been collected into the ACRIN database  Over 70 abstract presented  10 ACRIN research presentation scheduled at RSNA 2008  Over 50 Scientific publications  3 NEJM/1JAMA

7. ACRIN Fall Meeting 2008 The National CTC Trial Results Make it to Times Square

8. ACRIN Fall Meeting 2008 Extending ACRIN’s Impact  Awarded RO1 for establishing VIEW  Imaging core lab services to the cooperative groups  Partner with QARC and CALGB  Established ACRIN PA  Supported by PA tobacco fund  Cartilage Assessment  Radial DCE MRI  Amyloid imaging  Coronary CTA  *Developed the ACRIN Cardiovascular Committee  ACRIN “projects” *initiative supported by the ACRIN Fund for Imaging Innovation

9. ACRIN Fall Meeting 2008 Challenges  Strong scientific pipeline  Balance in the research portfolio  Focus on imaging science  Engagement of clinical community  Maintaining accrual  Build publication record

10. ACRIN Fall Meeting 2008 Case Accrual

11. ACRIN Fall Meeting 2008 Cost per case has been increasing Assuming 6 committees: 73 cases/committee/year

12. ACRIN Fall Meeting 2008 Primary Scientific Objectives Presentation to Steering Committee  Written Concept  Trial PI / Committee Chair Present ACRIN SCIENTIFIC COMMITTEES Review Idea  Impact  Feasibility  Strategy Develop Concept  Assemble Experts  Symposium at Fall Meeting  Define Imaging Approach  Identify Collaborators ACRIN STEERING COMMITTEE Review with Respect to:  Scientific Impact  Generalizability of Technology  Feasibility  Cost Individual Investigators Committee Members Cooperative Groups Trial Ideas Outcome Economics Biostatistics Steering Committee Response  Approve for Development and CTEP Concept Submission  Disapprove  Request Revision Patient Advocacy Special Populations INPUT from ACRIN Resources Imaging Core Lab

13. ACRIN Fall Meeting 2008 Committee Meeting Publications Patient Accrual Protocol Pipeline