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FDG PET/CT

FDG PET/CT. FDG-PET/CT Technical Committee Breakout 081204. Regular meetings of working groups with RSNA administrative support and milestones for delivery during 2009 Regular “SNM cross-over” each TC tcon

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FDG PET/CT

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  1. FDG PET/CT

  2. FDG-PET/CT Technical CommitteeBreakout 081204 • Regular meetings of working groups with RSNA administrative support and milestones for delivery during 2009 • Regular “SNM cross-over” each TC tcon • Communication of recommendations to vendors with reasonable expectation of implementation timeframe • Expanded list of co-variates • New Profiles • QC • Export standards (RIC, cross-check, Bresolin) • De-identification irrespective of medium (DICOM cross-check) • Trials and service apps (public & private label & access) • Performance elements and standards (Yap)

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

  4. Quantitative Imaging Are we there yet?

  5. Tumor Tracking ApplicationSimplifying cancer patient management • Compare, analyze, and track tumor progression with up to six sequential PET/CT studies • SUV-based semi -automatic tumor segmentation • Measurement of changes in tumor volume and metabolic activity • Export tables and graphs or 3D contours

  6. Longitudinal Quantificationin Hybrid Imaging Reality Today with Siemens syngo TrueD • Visualization3 Time Points DisplayMIP TriangulationGating Support • Quantification2D/3D Iso-Contouring1-Click SUVmaxRT Structure Export • TrendingTrending ChartsVOI PropagationDeformable Registration Innovation is in our genes. 6 Siemens Medical Solutions Molecular Imaging

  7. Automatic co-registration of multiple studies • Automatic segmentation of VOI based on % or SUV • CT or PET-guided lesion definition Timepoint 3 Timepoint 2 Timepoint 1

  8. Compare tumors across any number of time points for multiple modalities Gradient-based PET segmentation for more accurate tumor volumes and statistics Export statistics for sharing with referring physicians Accurate registration allows the same region to be compared Difference images highlight variable tumor response Therapy Response Assessment www.mimvista.com

  9. GE PET VCAR…Powerful Longitudinal Analysis • Automatically register serial studies for longitudinal accuracy • Automatically segment and propagate ROIs for efficiency and robustness • Quantify serial changes with a comprehensive set of metrics (SUV, Total Lesion Glycolysis, Functional Volume) and present in tabulated and graphical form • Export tabulated data for easy utilization in 3rd party analysis routines

  10. FDG-PET/CT Technical CommitteeAim • 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 measures by FDG-PET/CT, with • clinical relevance and known sigma.

  11. Pattern for PET SUV Measurements as a Biomarker Digital referenceobject SUV quantitation and ROI computation System and protocol character-ization Covariates, data/version tracking, verification Patient variability and effect size Precursor specifications Serial and multi-center SUV measurements Profile claims SUV change analysis Profile detail specification Uses: PET SUVs as a target- and mechanism-specific biomarker of response Drug development; Business decisions Drug development; Regulatory decisions Patient monitoring; Individualization of therapy

  12. FDG-PETCT Technical Committee Subcommittee Topics [chair] • Quantitation Computation [David Clunie] • Digital Reference Objects – Images [Paul Kinahan] • Covariates rationale (Normalization) [Yuying Hwang] • RoI Definition (and then Adoption) [Tim Turkington] Subcommittee slides deleted for sake of file size need updating to current status

  13. 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

  14. 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 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.

  15. FDG PET/CT

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