BICL has been the leading image analysis provider for all large aNGF/TrkA clinical trials in the context of osteoarthritis over the last 12 years, with the largest being Pfizer’s Tanezumab program. The BICL pool of expert readers includes 15 MSK academic radiologists with 5 of them being full Professor of Radiology at highly ranked US and European Universities. BICL has vast expertise in trial design, eligibility screening and safety assessment. This recent publication summarizes these experiences and gives practical advice for the planning and execution of aNGF/TrkA programs. Image example illustrate important safety finings and a flow diagram for imaging work-up and safety assessment is presented.