# Tumour measurements on imaging for clinical trial: A national picture of service provision

## TL;DR

This paper examines the inconsistent provision of tumor measurement services for oncology trials in the UK and identifies key challenges like training and funding.

## Contribution

The study provides a national overview of service provision and highlights barriers to effective imaging tumor measurement in clinical trials.

## Key findings

- There is substantial variation in tumor measurement service provision across the UK.
- Only 20% of service providers have dedicated training, and 29% receive robust financial reimbursement.
- Workforce pressures and limited infrastructure contribute to service inconsistencies.

## Abstract

Radiological response evaluation metrics such as RECIST 1.1 inform critical endpoints in oncology trials. The UK was the 6th highest recruiter into oncology trials worldwide between 1999 and 2022, with almost 9000 oncology trials registered during the same period. However, the provision of tumour measurements for oncology trials is often ad hoc and patchy across the NHS. The aim of this work was to understand the barriers to providing an effective imaging tumour measurement service, gain insight into service delivery models and consider the successes and challenges from the perspective of both service providers and end users.

An electronic survey was distributed to those who provide tumour measurement response review for clinical trials (service providers) and those that request and use such measurements in trial activities (service users).

Responses from 35 sites demonstrated substantial variation in service provision across the UK. Despite workforce pressures, service is largely delivered through radiologists with a minority utilising radiographer role extension. Only 20% of the service providers had dedicated training and 29% received robust financial reimbursement.

Service variation is likely a consequence of limited training, education and infrastructure to support robust service, compounded by increasing radiology workload and workforce pressures.