Download Milestones Horizon/PET-CT Beyond RSNA`08

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
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)
Monitoring Rx Benefit = Individualized Medicine
Convergence of Biomarkers and Diagnostics
H/o Commercial Dx
Biomarkers become Dx
Individuals - thresholds
Population means, s
Categorical, staging
Continuous, quantitative
Workflow/# studies
Automation/bias
Binary – choice of Rx
Longitudinal – monitor Rx
Quantifying the effects of drugs in development
may beg access to biomarkers as diagnostics
Quantitative Imaging
Are we there yet?
Tumor Tracking Application
Simplifying 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
Longitudinal Quantification
in Hybrid Imaging
Reality Today with Siemens syngo TrueD
 Visualization
3 Time Points Display
MIP Triangulation
Gating Support
 Quantification
2D/3D Iso-Contouring
1-Click SUVmax
RT Structure Export
 Trending
Trending Charts
VOI Propagation
Deformable Registration
6
Siemens Medical Solutions
Innovation is in our genes.
Molecular Imaging
1. Automatic co-registration of
multiple studies
2. Automatic segmentation of
VOI based on % or SUV
3. CT or PET-guided lesion
definition
Timepoint 3
Timepoint 2
Timepoint 1
Therapy
Response
Assessment
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
www.mimvista.com
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
FDG-PET/CT Technical Committee
Aim
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.
Pattern for PET SUV Measurements as a Biomarker
Digital
referenc
eobject
SUV
quantitation
and ROI
computation
Precursor specifications
System
and
protocol
characterization
Covariates,
data/version
tracking,
verification
Patient
variability
and effect
size
Serial and multi-center
SUV measurements
Profile claims
Profile detail specification
SUV change analysis
Uses: PET SUVs as a target- and mechanism-specific biomarker of response
A.
B.
C.
Drug development; Business decisions
Drug development; Regulatory decisions
Patient monitoring; Individualization of therapy
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]
Milestones Horizon/PET-CT
Beyond RSNA’08
RSNA ’10 and on
RSNA ‘09
Calibration Phantoms
Characterization Lo, Hi rads
RSNA ‘08
Interoperability of
Results Encoding
Priority
H, M, L
Feasibility
H, M, L
Value
H, M, L
Quantitation Computation
Documentation of terms
Image Quality Metrics
High
High
Medium
RoI Definition*
Dynamic Range lesion size**
High
High
High
High
High
High
High
High
High
*Adoption 2010-11,
Defined in 2008
Quick Hits
High
**Ideal Phantom 201011 Current phantom by
2008
Quantitative Imaging Biomarker Alliance FDGPET/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.
FDG PET/CT