Mitchell Schnall MD, PhD Professor of Radiology University of Pennsylvania ACRIN Network Chair

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

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

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

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

5. Scientific Progress Disease Site Opened Completed Accrual In Development Closed Unsuccessfully Breast 1 4 1 0 Abdominal 2 4 1 2 GYN 1 1 1 0 CNS/Head and Neck 1 2 2 0 Thoracic 2 1 1 1 EISC 0 0  2  0 ACRIN Trial Status by Disease Site

6. 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. The National CTC Trial Results Make it to Times Square

8. 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. Challenges • Strong scientific pipeline • Balance in the research portfolio • Focus on imaging science • Engagement of clinical community • Maintaining accrual • Build publication record

10. Case Accrual

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

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

13. Committee Meeting PublicationsPatient AccrualProtocol Pipeline