Kiosk Content FDG PET/CT Draft 3

1. Kiosk Content FDG PET/CT Draft 3

2. FDG-PET/CT Technical CommitteeAims and Objectives The aim of the QIBA FDG-PET/CT Technical Committee is to foster adoption of pragmatic and cost-effective standards for accurate and reproducible quantitation of tumor metabolism via longitudinal measurements by FDG-PET/CT, with clinical relevance and known sigma. • Five specific objectives were identified as having value and feasibility; • 1)      Enable tracking of software versions. • 2)      Identify clinically significant covariates in the quantitation of FDG signal and recommend recording and normalization. • 3)      Compare the various vendors’ computations for quantitation and make recommendations to ensure any patient’s images would yield the same numbers irrespective of vendor. • 4)      Define the parameters for automated setting of regions of interest. • 5)      Develop a Digital Reference Object (image db) for quality control

3. FDG-PET/CT Technical CommitteeAchievements and Next Steps • As an example, sub-team #5 (Digital Reference Standard) has • acquired images of a single reference phantom from multiple vendors’ scanners, • compared the DICOM header information, • harmonized the standard with the AAPM/SNM Task Group 146. • Next steps are to • agree with major vendors the procedure for distributing and beta-testing a digital image set, • test them on 3rd party review stations, and • initiate the IHE process for roll-out. • After delivery of this objective, the team will consider repeating these efforts using a db farther up the data stream, eg raw data.

4. FDG-PETCT Technical Committee Subcommittee Topics [chair] • Quantitation Computation [David Clunie] • Software version tracking [Daniel Gagnon] • Digital Reference Objects – Images [Paul Kinahan] • Covariates rationale (Normalization) [Yuying Hwang] • RoI Definition (and then Adoption) [Tim Turkington] • Editorial in follow-up to Maguire “needs”[Richard Frank] * in some cases just enabling data capture & reporting

5. RSNA ’10 and on Milestones Horizon/PET-CTBeyond RSNA’08 RSNA ‘09 Calibration Phantoms Characterization Lo, Hi rads RoI Definition* Dynamic Range lesion size** RSNA ‘08 Interoperability of Results Encoding Image Quality Metrics Quantitation Computation Documentation of terms High High High High Medium Value H, M, L High High High High High High Feasibility H, M, L High *Adoption 2010-11, Defined in 2008 **Ideal Phantom 2010-11 Current phantom by 2008 Priority H, M, L High Quick Hits

6. H/o Commercial Dx Individuals - thresholds Categorical, staging Workflow/# studies Binary – choice of Rx Biomarkers become Dx Populations – means Continuous, quantitative Automation/bias Longitudinal – Rx effect Monitoring Rx Benefit = Individualized MedicineConvergence of Biomarkers and Diagnostics Quantifying the effects of drugs in development may beg access to biomarkers as diagnostics

7. Version 10

8. Kiosk proposed content • 1-Statement of Purpose • 2-Main Subgroups • 3-activities to date • 4-Bulleted next steps (3-6)

9. Statement of PurposeFoster adoption of… • pragmatic and cost effective standards for • accurate, • reproducible, and • longitudinal • quantitation via FDG-PETCT of • tumor metabolism • with clinical relevance • and known sigma

10. FDG-PETCT Technical Committee Subcommittees Progress to Date • Quantitation Computation [David Clunie] * References

11. FDG-PETCT Technical Committee Subcommittees Progress to Date • Software version tracking [Daniel Gagnon] * References

12. FDG-PETCT Technical Committee Subcommittees Progress to Date • Digital Reference Objects – Images [Paul Kinahan] • Collected PET/CT images of the same reference phantom from scanners from GE, Philips, Siemens • Image data is being collated and compared w.r.t. DICOM header information • Initiated [will do!] manufacturer-driven discussion on methods for distributing and testing a purely digital version of the reference phantom • Harmonized PET/CT reference standard with efforts of AAPM/SNM Task Group 145 • Next Steps: • Test digital reference object (DRO) on 3rd party review stations • Initiate IHE process for manufacturer-driven roll-out • Explore potential for moving further up the data generation stream, i.e., closer to raw data * References

13. FDG-PETCT Technical Committee Subcommittees Progress to Date • Covariates rationale (Normalization) [Yuying Hwang] • Subcommittee in development stage * References

14. FDG-PETCT Technical Committee Subcommittees Progress to Date • RoI Definition (and then Adoption) [Tim Turkington] * References

15. FDG-PETCT Technical Committee Subcommittees Progress to Date • Editorial in follow-up to Maguire1 [Richard Frank] • DONE2 1 Hallett WA, Maguire RP, McCarthy TJ, Schmidt ME, Young H. Considerations for generic oncology FDG-PET/CT protocol preparation in drug development. IDrugs, 2007 Nov; 10(11):791-6. 2 Quantitative Imaging Biomarkers Alliance FDG-PET/CT Working Group Report; Editorial [ http://www.springerlink.com/content/m4572700677q4732/ ]

16. FDG-PETCT Technical Committee Subcommittees Progress to Date • Quantitation Computation [David Clunie] • Software version tracking [Daniel Gagnon] • Digital Reference Objects – Images [Paul Kinahan] • Covariates rationale (Normalization) [Yuying Hwang] • RoI Definition (and then Adoption) [Tim Turkington] • Editorial in follow-up to Maguire “needs” [Richard Frank] * References

17. Next Steps • Chairs convene working groups • Letter to editor in follow-up to Maguire “needs” article • Develop matrices • Identify commonalities within QIBA (eg RoI) • Identify adjacent players, stakeholders • Deliver goods • Report out during RSNA’08 • Reprioritize remaining deliverables, eg “3D and iterative reconstruction has created a quagmire!”

18. Appendices SNM AACR NCIA* UPICT CDISC EORTC FDA NCI NIST QIBA AMI SMI ASCO NEMA MITA IRATS AAPM ACRIN PhRMA

23. Quantitative Imaging Biomarker Alliance FDG-PET/CT Working Group Report Molecular Imaging and Biology1536-1632 (Print) 1860-2002 (Online) RSNA News September 2008, Vol 18, No 9