Specialists in Imaging
for Clinical Research

Spire Sciences brings unparalleled experience and expertise in central image analysis to your clinical trials.

Helping bring new therapies into clinical use faster


Our team of specialized radiologists and imaging scientists is dedicated to imaging for clinical trials, and has helped bring numerous new therapies to regulatory approval. Our imaging experts and specialized reading systems ensure that your study achieves the highest reading accuracy and efficiency possible, out-performing other central imaging services.

We value close working relationships with our sponsors' development teams and bring decades of experience and insight to ensuring the success of clinical trials that use medical imaging.

We provide the most accurate image analyses, trustworthy scientific advice and beneficial innovations to reduce uncertainty, time and cost in therapeutic development.

Pharma's Radiology Department

Unlike other providers that offer imaging as only one of many services, we specialize in imaging. Radiology for clinical trials is all we do.

About Spire


Our mission is to improve world health by helping bring new and better therapies into clinical use faster through excellence in imaging for clinical trials.

In contrast to contract research organizations and core labs that offer image analysis as only one of many services, Spire Sciences is focused exclusively on central image analysis. Our expert radiologists are among the most experienced and accomplished in the world, and our reading processes and systems are the most sophisticated and error free in the industry, providing unsurpassed reading performance across multiple therapeutic areas.

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We don't just collaborate with key opinion leaders, they are in the leadership of our company, designing and directing our processes and systems to achieve superior results.
Charles Peterfy, MD, PhD

Charles Peterfy, MD, PhD

Founder and Chief Executive Officer

Dr. Peterfy is an internationally recognized leader in imaging for clinical trials, and has been developing, validating and implementing innovative imaging techniques for clinical trials for over 35 years. Over that time, Dr. Peterfy founded multiple organizations providing imaging services for clinical trials and advancing research and education in this unique application of radiology, and developed numerous imaging outcome measures, imaging techniques and positioning devices that have become standards in clinical trials in key diseases, including inflammatory arthritis, degenerative joint disease and certain tumors.

Leader in Clinical-Trial Imaging

Over 35 years pioneering imaging techniques and endpoints for clinical trials

Founded multiple organizations advancing imaging for clinical trials

Personally read thousands of images for clinical trials across a variety of diseases

Academic and Professional Background

American Board certified radiologist, with fellowship training from UCSF

PhD in Pharmacology and Therapeutics from McGill University

Radiology faculty at UCSF

Former Director of Arthritis and MRI Research for OARG at UCSF

Former Chair of Imaging Working Group for NIH Osteoarthritis Initiative

Former member of Board of Directors, Intersocietal Accreditation Commission

Co-Chair of MRI Working Group, OMERACT (Outcome Measures in Rheumatology)

Key Contributions

Co-founded Synarc Inc., the largest imaging core lab globally, currently Clario

Founded Spire Sciences Inc., focused on excellence in imaging for clinical trials in specific disease areas

Co-founded ISEMIR (International Society for Imaging in Rheumatology)

Developed multiple imaging techniques and endpoints that have become standards for clinical trials in inflammatory arthritis, osteoarthritis and certain tumors

Education

MD, McGill University, Canada (1985)

PhD, Pharmacology & Therapeutics, McGill University (1989)

American Board of Radiology certification (1991)

Radiology fellowship, University of California San Francisco (UCSF) (1992)

Professional Activities

Director of Arthritis and MRI Research for Osteoporosis and Arthritis Research Group at UCSF (1992 - 2000)

Co-founder, Chief Scientific Officer, Executive VP of Synarc Inc. (1998 - 2009)

Largest imaging core lab in the world

Became Clario in 2021

Co-founder, President of ISEMIR (International Society for Imaging in Rheumatology) (2006 - 2021)

Non-profit organization advancing research and education

Founder, CEO of Spire Sciences Inc. (2009 - present)

Focusing on excellence in imaging for clinical trials of specific disease

Board of Directors, IAC (Intersocietal Accreditation Commission) (2016 - 2021)

Non-profit organization establishing standards and guidelines for accrediting MRI facilities throughout the US

Innovations and inventions for clinical trials imaging

Inflammatory arthritis

Syn-X-RA and newer X-Frame

For reproducible, side-verified X-ray of hands, wrists and feet

The standard in X-ray trials of rheumatoid arthritis for past 25 years

RAMRIS (Rheumatoid Arthritis MRI Scoring)

In conjunction with the OMERACT (Outcome Measures in Rheumatology Clinical Trials) MRI Working Group

The standard in MRI trials of rheumatoid arthritis for past 22 years

Syn-M-RA and newer M-Frame

For reproducible, side-verified MRI of hands and wrists

The standard in MRI trials of rheumatoid arthritis for past 21 years

CARLOS (Cartilage Loss Score)

The standard in MRI trials of rheumatoid arthritis for past 10 years

PsAMRIS (Psoriatic Arthritis MRI Scoring)

In conjunction with the OMERACT MRI Working Group

The standard for MRI trials of psoriatic arthritis for past 10 years

Osteoarthritis

MRI quantification of articular cartilage in knee and hand

First validated method for quantifying cartilage with MRI (1994)

Fixed-flexion X-ray technique

The standard for X-ray trials in osteoarthritis trials for past 25 years

SynaFlexer and newer FixedFlexionFrame and reference standard

For reproducible fixed-flexion X-ray, with magnification correction

The standard for X-ray trials in osteoarthritis trials for past 25 years

WORMS (Whole Organ MRI Scoring)

Most widely used multi-feature MRI assessment for MRI trials of osteoarthritis for past 20 years

Fixed-location joint-space narrowing measurement for knee osteoarthritis

Outperforms conventional X-ray measurements

HOAMRIS (Hand Osteoarthritis MRI Scoring)

In conjunction with the OMERACT MRI Working Group

The standard for MRI trials of hand osteoarthritis for past 10 years

Oncology

TVS (Tumor Volume Score) for Tenosynovial Giant Cell Tumor (TGCT)

The standard for TGCT trials for past 10 years

Modified RECIST (Response Evaluation Criteria for Solid Tumors) for TGCT

The standard for TGCT trials for past 10 years

TDS (Tissue Damage Scoring)

The standard for TGCT trials for past 10 years

Automated tumor response indicating measurement tool

Reducing variability and error in RECIST assessments

Automated follow-up tumor selection verification

Reducing variability and error in tumor measurement

Publications and committee work

Authored 2 medical textbooks and over 200 scientific articles and book chapters

Chaired Imaging Working Group for NIH Osteoarthritis Initiative

Public-private partnership, and largest natural history study of osteoarthritis ever conducted

Co-chair MRI Working Group, OMERACT (Outcome Measures in Rheumatology)

International organization developing standards for trials using MRI

American College of Rheumatology (ACR) Rheumatoid Arthritis Clinical Trials Task Force

Chair, Standardizing Radiography and CT, Imaging as a Biomarker: Standards for Change Measurements in Therapy

National Institute of Standards and Technologies (NIST)

Harmonization of Imaging Review Charters and Integration of Imaging in Therapeutic Development

Drug Information Association (DIA), Food and Drug Administration (FDA)

Participated in numerous other standardization committees and advisory boards

Charles Peterfy, MD, PhD is an American Board certified radiologist with fellowship training from University of California San Francisco (UCSF) and a PhD in Pharmacology and Therapeutics from McGill University. He was attending radiologist at UCSF for seven years where he also served as Director of Arthritis and MRI Research for the Osteoporosis and Arthritis Research Group, which conducted numerous clinical trials and epidemiological studies through the university.

In 1998, Dr. Peterfy co-founded Synarc Inc, which became the largest imaging core lab in the world by 2000. He served as its Chief Scientific Officer and Executive Vice President for 11 years. As Synarc grew, it expanded beyond imaging to include a broad range of services for clinical research, and in 2021 it became Clario, a general CRO.

In 2009, Dr. Peterfy left Synarc, and formed Spire Sciences, to bring the focus back to imaging, particularly excellence in imaging for diseases that needed special expertise, and where he felt Spire could make a significant positive impact and out-perform other imaging core labs.

Spire Sciences succeeded in those objectives, as evidenced by having been trusted to read the majority of clinical trials worldwide that used imaging in those key therapeutic areas for the past 15 years, having developed many of the outcome measures and imaging techniques that have become the standards for clinical trials in those areas.

Dr. Peterfy was the first to develop and validate a technique for quantifying articular cartilage in the knee and hand using MRI 30 years ago. He developed the fixed-flexion X-ray technique and positioning frame (SynaFlexer and the newer Fixed Flexion Frame), which has been the most widely used method for radiographically evaluating the knee in osteoarthritis for more than 25 years. He also developed fixed-location joint-space width measurement for monitoring osteoarthritis progression more sensitively than possible with conventional minimum joint-space width measurement. He also developed the Whole Organ MRI Scoring method, WORMS, which has been the most widely used multi-feature MRI assessment method for evaluating osteoarthritis in epidemiological studies and clinical trials for over 25 years.

In 2002, Dr. Peterfy in conjunction with the OMERACT (Outcome Measures in Rheumatology Clinical Trials) MRI Working Group, which he co-chairs, developed the RAMRIS (Rheumatoid Arthritis MRI Scoring) method for evaluating rheumatoid arthritis in clinical trials. He also co-developed PsAMRIS (Psoriatic Arthritis MRI Scoring) and HOAMRIS (Hand Osteoarthritis MRI Scoring). These methods have been the most widely used for evaluating inflammatory arthritis, and are currently the standards for clinical trials using MRI. Dr. Peterfy also developed CARLOS (Cartilage Loss Score), the most commonly used method for monitoring cartilage loss in rheumatoid arthritis with MRI, and he invented the Syn-X-RA and X-frame positioning devices for error-free radiography of the hand and foot in arthritis, along with the Syn-M-RA and M-frame devices for reproducible MRI of the hand and wrist in arthritis trials.

He chaired the Imaging Working Group of the NIH Osteoarthritis Initiative, one of the first public-private partnerships between NIH and the pharmaceutical industry and the largest natural history study of osteoarthritis ever conducted, and he supervised the collection and central quality control of the images for that historic study, which are available to the public worldwide for clinical research.

In 2006, he co-founded the International Society for Imaging in Rheumatology, ISEMIR, a non-profit organization aimed at advancing imaging in rheumatology through research and education, and he served as its President until it was shut down in 2021 in the wake of the Covid pandemic.

He also served on the Board of Directors of the Intersocietal Accreditation Commission (IAC) from 2016 to 2021, establishing standards and guidelines for accrediting imaging facilities throughout the US.

In Oncology, Dr. Peterfy developed several outcome measures specially designed for Tenosynovial Giant Cell Tumor (TGCT), arguably the most difficult tumor of all to measure longitudinally in clinical trials because of its diffuse nature, highly irregular shape, ill-defined margins, local invasiveness and asymmetrical growth. These measures include modified-RECIST for TGCT, the Tumor Volume Score (TVS) and the multi-feature Tissue Damage Scoring method (TDS), which out-performed RECIST 1.1 and expand on it in clinically meaningful ways. Using these methods, Spire Sciences has read the images for most if not all trials of TGCT globally over the past 11 years, for which effective therapies, sometimes even curative, are now available in the clinic, when before the options available to these patients were extremely limited.

Dr. Peterfy has authored two textbooks and over 200 scientific articles and book chapters, and participated in numerous standardization committees, scientific advisory boards and expert panels for advancing imaging in clinical trials.

Caroline Reinhold, MD, MSc

Caroline Reinhold, MD, MSc

Vice President, Oncology

Dr. Reinhold is an internationally recognized leader in oncological and gynecological imaging, and has been developing, validating, and implementing oncological imaging techniques, and classification and reporting imaging systems used world-wide for over 25 years.

Leader in clinical trials imaging

Over 25 years pioneering imaging techniques, biomarkers and classification systems for clinical trials

Expert in artificial intelligence, with numerous peer-reviewed publications and lectures on the accuracy, ethics, governance, and implementation of AI in medical imaging

Extensive experience leading large, multicenter imaging clinical trials

Personally read thousands of images for clinical trials for oncological and gynecological indications

Professional background and key contributions

American Board certified radiologist, with fellowship training from Yale University

MSc in Epidemiology and Biostatistics from McGill University

Professor and former Interim Chair, Department of Radiology at McGill University

Associate Chair of Research, Department of Radiology at McGill University

Awarded over $8M in grant funding from prestigious agencies

Co-founder and Director of the Augmented Imaging Precision Health Laboratory (AIPHL) at the Research Institute of the McGill University Health Center

Co-Chair of the Ovarian-Adnexal Reporting & Data System (O-RADS) of the American College of Radiology

Former Vice Chair, MRI track of the Ovarian-Adnexal Reporting & Data System (O-RADS) of the American College of Radiology

MRI lead for the International Federation of Gynecology and Obstetrics (FIGO) Menstrual Disorders Adenomyosis subcommittee

Former Director of the Clinical Trials Imaging Unit at the Research Institute of the McGill University Health Center

Former Medical Director of Oncology, Synarc Inc., the largest imaging core lab in the world (became Clario in 2021)

Education

MD, McGill University, Canada (1984)

American Board of Radiology Certification (1990)

Abdominal Imaging Fellowship, Yale University (1991)

MSc, Epidemiology and Biostatistics, McGill University (2000)

Innovations in clinical trials imaging

Co-developed a standardized reporting/classification system for MRI-based diagnosis of uterine adenomyosis

With the International Federation of Gynecology and Obstetrics (FIGO) Menstrual Disorders Adenomyosis subcommittee

Co-developed a standardized lexicon and risk stratification system for the MRI classification of adnexal masses (O-RADS MRI)

With the American College of Radiology

Co-developed automated RECIST response indicating measurement tool

Spire Sciences

Co-developed automated follow-up tumor selection verification

Spire Sciences

Leadership roles

Medical Director of Oncology, Synarc Inc. (1999 - 2010)

Largest imaging core lab in the world

Became Clario in 2021

Associate Chair of Research, Department of Radiology at McGill University (2015 - present)

Secured over $8M in grant funding from prestigious agencies

Vice Chair, MRI track of the Ovarian-Adnexal Reporting & Data System (O-RADS) (2016 - 2023)

American College of Radiology

MRI lead for the International Federation of Gynecology and Obstetrics (FIGO) Menstrual Disorders Adenomyosis subcommittee (2018 - present)

Interim Chair of the Department of Radiology at McGill University (2019 - 2021)

Director of the Clinical Trials Imaging Unit at the Research Institute of the McGill University Health Center (2019 - 2021)

Co-founder and Director of the Augmented Imaging Precision Health Laboratory (AIPHL) (2019 - present)

Research Institute of the McGill University Health Center

Co-chair of the Ovarian-Adnexal Reporting & Data System (O-RADS) (2023 - 2025)

American College of Radiology

Vice President of Oncology, Spire Sciences Inc. (2014 - present)

Publications and committee work

Authored 4 textbooks and over 350 scientific articles and book chapters

Participated in numerous standardization committees, scientific advisory boards and expert panels advancing imaging for clinical trials in oncology and gynecology

Caroline Reinhold, MD, MSc is Vice-President of Oncology at Spire Sciences. Dr. Reinhold is an internationally recognized leader in oncological and gynecological imaging, and has been developing, validating, and implementing oncological imaging techniques, and classification and reporting imaging systems used world-wide for over 25 years. She has extensive experience in leading large multicenter imaging clinical trials both for industry and academia. She is also an international recognized leader in the field of artificial intelligence with numerous peer-reviewed publications and has lectured on the accuracy, ethics, governance, and implementation of AI solutions in medical imaging.

Dr. Reinhold is an American board-certified radiologist with fellowship training from Yale University and an MSc in Epidemiology and Biostatistics from McGill University. She is Associate Chair of Research for the Department of Radiology at McGill University, co-founder and director of the Augmented Imaging Precision Health Laboratory (AIPHL) at the Research Institute of the McGill University Health Center, prior interim Chair and Director of the Clinical Trials Imaging Unit at the Center of Innovative Medicine at the Research Institute of the McGill University Health Center. She is currently also co-chair of the Ovarian-Adnexal Reporting & Data System (O-RADS) of the American College of Radiology, and is the MRI lead for the International Federation of Gynecology and Obstetrics (FIGO) Menstrual Disorders Adenomyosis subcommittee.

In 1999, Dr. Reinhold joined Synarc Inc. (currently Clario Inc.), which was at the time the largest imaging core lab in the world, and she served as its Medical Director of Oncology for 10 years. In that capacity she developed Synarc's oncology service line. In 2010, Dr. Reinhold returned to academia and clinical radiology, but consulted and read clinical trials images for Spire Sciences. In 2024, she became VP of Oncology for Spire Sciences to extend its superior reading processes and systems to a broader range of oncological indications.

Dr. Reinhold has authored 4 textbooks and over 350 scientific articles and book chapters, and participated in numerous standardization committees, scientific advisory boards and expert panels advancing imaging for clinical trials in oncology and gynecology.

Peter Countryman, PhD

Peter Countryman, PhD

Chief Operating Officer

Dr. Countryman is Chief Operating Officer at Spire Sciences, and has worked with Dr. Peterfy and Dr. Reinhold for 3 decades on developing clincial trial imaging processes and systems.

Systems Expert in Clinical Trial Imaging

29 years experience in Clinical Trial Imaging development and operations

Expert systems design for central image quality control and analysis

Expert in international regulations and security for imaging in clinical trials

Academic and Professional Background

PhD in Physics from Stanford University (1988)

Faculty at UCSF, developing image analysis software for clinical trials at OARG

Original member at founding of Synarc (now Clairo)

Senior Software Architect, then Product Manager

Original member at founding of Spire Sciences

Scientific Director, now Chief Operating Officer

Key Contributions and Developments

Developed Synarc's medical image database/archive system (IMDA)

Led development of systems for NIH Osteoarthritis Initiative

Developed systems infrastructure for Spire Sciences, including PACS, relational databases, and image reading/reporting software

Developed improved image quality and reconstruction methods for PET

Created a virtual environment with cloud-hosted servers and VPN access for Spire Sciences

Peter Countryman, PhD is Chief Operating Officer at Spire Sciences. Dr. Countryman received his PhD in Physics from Stanford University and worked for several years in the field of PET imaging, making use of his knowledge of nuclear medicine instrumentation and his scientific programming skills to improve the image quality of a sodium-iodide based PET system, and to develop an image reconstruction technique for PET with limited projections.

In 1995, he joined the faculty of the University of California San Francisco (UCSF) and oversaw the development of viewing software for clinical trials conducted by the Osteoporosis and Arthritis Research Group (OARG).

He joined Synarc (now Clario) at its founding in 1998 as Senior Software Architect, and quickly advanced to Product Manager, serving as liaison between the scientific staff and the engineering department. He played a major part in the design and development of Synarc's medical image database/archive system (IMDA), and led the development of the systems supporting the NIH Osteoarthritis Initiative (OAI). In 2009, Dr. Countryman joined Spire Sciences at its founding, and served as Senior Scientist and Scientific Director before becoming Chief Operating Officer. He developed the computing infrastructure at Spire, including Spire's PACS (Picture Archival and Communications System), relational databases and software for reading images and producing reports. Spire Sciences functions in a virtual environment, with all servers hosted in the cloud, and all users accessing the data through a virtual private network.

Dr. Countryman is also expert in international regulations and security with respect to Clinical Trial Imaging.

Explore our Services

Our focus is accuracy in image analysis, as this is the most important determinant of statistical power in clinical trials. We accomplish this by integrating unparalleled excellence in image reading with meticulous quality control and experienced multi-site protocol design.

Integrating key elements of imaging

Image acquisition

Image analysis

Protocol Design

Spire Sciences' experts have designed hundreds of imaging protocols for clinical trials and have the scientific and technological knowledge and the practical hands-on experience needed to turn the scientific needs of a study into practical reality.

Training & Quality Control

Image analyses can be only as accurate as the quality of the images is able to support. Spire Sciences has trained hundreds of sites around the world and knows what it takes to produce the highest-quality images for central analysis.

Expert Radiologists

Spire Sciences' radiologists are among the most experienced and expert specialists in Clinical Trial Imaging in the world. Each has decades of experience and delivers reading accuracy and throughput speeds that are unparalleled in the industry.

Reading System

Designed by radiologists for radiologists, Spire Science’s reading system is more closely aligned with how radiologists actually approach image analysis, enabling more accurate and timely reading results than those of other imaging core labs.

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By properly integrating these interdependent elements of imaging, Spire Sciences is able to deliver unparalleled reading accuracy and throughput speed for clinical trials.

Disease Areas

Inflammatory Arthritis

Rheumatoid Arthritis

Psoriatic Arthritis

Spondyloarthropathy

Inflammatory Arthritis

Osteoarthritis

Knee

Hip

Hand

Osteoarthritis

Oncology

Solid Tumors

Solid Tumors with Immune-based Therapy

Tenosynovial Giant Cell Tumor

Hematology/Lymphoma

Reporting and Data System (RADS)

Oncology

Gynecology

Adenomyosis

Endometriosis

Leiomyomas

Gynecological Oncology

Gynecology

Spire Portal

Spire's sponsors, their CROs and participating study sites receive access to Spire's online Portal, where they can find up-to-date study progress and site performance data. Individual sites can see their own performance results and compare those to aggregate data from all the sites, so they can see where they rank with respect to patient enrollment, screening failure rate, image quality metrics, query resolution, and other relevant parameters.

Managing site performance has become increasingly important, as worldwide shortages in imaging technologists, radiologists and other staff make it more challenging for clinical facilities to support research.

spire portal
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We are proud of what we've done and grateful to have been able to be part of so many impactful therapeutic development programs, some of which constituted real breakthroughs in difficult disease areas.

Charles Peterfy