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Objectives: Precision medicine requires the measurement, quantification, and cataloging of medical characteristics to identify the most effective medical intervention. However, the amount of available data exceeds our current capacity to extract meaningful information. We examine the informatics needs to achieve precision medicine from the perspective of quantitative imaging and oncology. Methods: The National Cancer Institute (NCI) organized several workshops on the topic of medical imaging and precision medicine. The observations and recommendations are summarized herein. Results: Recommendations include: use of standards in data collection and clinical correlates to promote interoperability; data sharing and validation of imaging tools; clinician's feedback in all phases of research and development; use of open-source architecture to encourage reproducibility and reusability; use of challenges which simulate real-world situations to incentivize innovation; partnership with industry to facilitate commercialization; and education in academic communities regarding the challenges involved with translation of technology from the research domain to clinical utility and the benefits of doing so. Conclusions: This article provides a survey of the role and priorities for imaging informatics to help advance quantitative imaging in the era of precision medicine. While these recommendations were drawn from oncology, they are relevant and applicable to other clinical domains where imaging aids precision medicine., Competing Interests: Disclosure The authors report no conflicts of interest in this work., (Georg Thieme Verlag KG Stuttgart.)

Imaging biomarkers (IBs) are integral to the routine management of patients with cancer. IBs used daily in oncology include clinical TNM stage, objective response and left ventricular ejection fraction. Other CT, MRI, PET and ultrasonography biomarkers are used extensively in cancer research and drug development. New IBs need to be established either as useful tools for testing research hypotheses in clinical trials and research studies, or as clinical decision-making tools for use in healthcare, by crossing 'translational gaps' through validation and qualification. Important differences exist between IBs and biospecimen-derived biomarkers and, therefore, the development of IBs requires a tailored 'roadmap'. Recognizing this need, Cancer Research UK (CRUK) and the European Organisation for Research and Treatment of Cancer (EORTC) assembled experts to review, debate and summarize the challenges of IB validation and qualification. This consensus group has produced 14 key recommendations for accelerating the clinical translation of IBs, which highlight the role of parallel (rather than sequential) tracks of technical (assay) validation, biological/clinical validation and assessment of cost-effectiveness; the need for IB standardization and accreditation systems; the need to continually revisit IB precision; an alternative framework for biological/clinical validation of IBs; and the essential requirements for multicentre studies to qualify IBs for clinical use.

A group of experts on very large databases, quantitative imaging, data format standards development, image management and communications, and related technologies for cancer imaging met at a recent workshop sponsored by the BIP and discussed the key issues confronting this field. The BIP received recommendations regarding steps that can be taken to advance the technology and take advantage of the opportunities to improve collaboration and utility in cancer imaging. There are tremendous opportunities to change radically the way we use image information. These opportunities are most obvious in clinical research, in which we seek to advance the dissemination and use of cancer image data in research and practice. Important opportunities and new modes of information use are provided by supporting the entire "information cycle" of creation, dissemination, and collaboration in addition to image organization, access, presentation, and preservation. To learn more, visit the BIP Web site at www3 .cancer.gov/bip/steer_iasc.htm and join the image archive listserver at the NIH (ARCHIVE-COMM-L, available online at list.nihgov). These resources are open and available to all.

Ammonia and 6-glutamine, labeled with N-13, were tested as imaging agents for a variety of spontaneous canine tumors. The imaging capabilities of these compounds were compared with each other, with other scanning agents, and with radiologic and pathologic procedures. Good agreement between positive gamma images and postmortem findings occurred in 11 of 15 cases with [13N] ammonia as the localizing agent. Eight of the nine scans using [13N] glutamine as the imaging agent showed positive correlation with postmortem findings. In cases where both ammonia and glutamine were used to image the same lesion, no qualitative differences in tumor uptake were found between the two.