50% of the UK population born after 1960 will be diagnosed with some form of cancer during their lifetime. Medical imaging is used for diagnosis in 60% of all patient care episodes and plays a vital role in almost all cancer diagnosis, monitoring and treatment. The use of imaging throughout the care chain, specifically in oncology, has increased dramatically over the last decade. Healthcare professionals involved are being overwhelmed by the quantity and complexity of data. In addition, radiology imaging databases are moving from Picture Archiving and Communication System (PACS) to Vendor Neutral Archive (VNA) systems. Reimbursement models are shifting dramatically across major markets, e.g. the US due to the Affordable Care Act. To address these issues, Blackford will develop a Lesion Tracking prototype integrating both our existing state-of-the-art registration and new, innovative segmentation algorithms. Lesion Tracking will be a workflow for a Vendor Neutral Pre- Processing Platform (VNP3) that will allow broader market penetration for Blackford’s highly advanced image processing technology. It will also create a resource- and time-efficient mechanism for developing a suite of new, clinically-focused applications and allow improved collaboration with academics seeking to commercialise research. Lesion Tracking will improve the efficiency of cancer diagnosis and monitoring which requires interplay between many components, all geared towards accelerating radiologist assessment and referring clinician understanding. It will address shortfalls in current systems that are rare and/or incomplete. While some components are data management driven, some require a higher level of technical innovation, namely registration and semi-automated segmentation/measurement. We predict that the combination of these components will drive a 50-70% increase in lesion tracking productivity.