Transcript Document

Kiosk Content
FDG PET/CT
Draft 3
FDG-PET/CT Technical Committee
Aims 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
FDG-PET/CT Technical Committee
Achievements and Next Steps
As an example, sub-team #5 (Digital Reference Standard) has
a)
acquired images of a single reference phantom from multiple vendors’
scanners,
b)
compared the DICOM header information,
c)
harmonized the standard with the AAPM/SNM Task Group 146.
Next steps are to
1)
agree with major vendors the procedure for distributing and beta-testing a
digital image set,
2)
test them on 3rd party review stations, and
3)
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.
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
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
Value
H, M, L
Quantitation Computation
Documentation of terms
Image Quality Metrics
High
High
Medium
RoI Definition*
Dynamic Range lesion
size**
High
High
Priority
H, M, L
Feasibility
H, M, L
High
High
High
High
High
High
High
*Adoption 2010-11,
Defined in 2008
Quick Hits
High
**Ideal Phantom
2010-11 Current
phantom by 2008
Monitoring Rx Benefit = Individualized
Medicine
Convergence of Biomarkers and Diagnostics
H/o Commercial Dx
Biomarkers become Dx
Individuals - thresholds
Populations – means
Categorical, staging
Continuous, quantitative
Workflow/# studies
Automation/bias
Binary – choice of Rx
Longitudinal – Rx effect
Quantifying the effects of drugs in development
may beg access to biomarkers as diagnostics
Version 10
Kiosk proposed content
• 1-Statement of Purpose
• 2-Main Subgroups
• 3-activities to date
• 4-Bulleted next steps (3-6)
Statement of Purpose
Foster 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
FDG-PETCT Technical Committee
Subcommittees Progress to Date
Quantitation Computation
* References
[David Clunie]
FDG-PETCT Technical Committee
Subcommittees Progress to Date
Software version tracking
* References
[Daniel Gagnon]
FDG-PETCT Technical Committee
Subcommittees Progress to Date
Digital Reference Objects – Images
[Paul Kinahan]
1.
Collected PET/CT images of the same reference phantom from scanners from GE, Philips,
Siemens
2.
Image data is being collated and compared w.r.t. DICOM header information
3.
Initiated [will do!] manufacturer-driven discussion on methods for distributing and testing a
purely digital version of the reference phantom
4.
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
FDG-PETCT Technical Committee
Subcommittees Progress to Date
Covariates rationale (Normalization)
Subcommittee in development stage
* References
[Yuying Hwang]
FDG-PETCT Technical Committee
Subcommittees Progress to Date
RoI Definition (and then Adoption)
* References
[Tim Turkington]
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/ ]
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
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!”
Appendices
AACR
SNM
NCIA*
UPICT
EORTC
CDISC
FDA
NCI
NIST
QIBA
AMI
SMI
ASCO
IRATS
ACRIN
NEMA
MITA
AAPM
PhRMA
Topic
F
V
H
Calibration Phantoms – Build and use
H
M
2009
H
H
2010-11
M
H
2010-11
Chair
Step 1 Use Existing Phantoms
Image Quality Metrics
Step 2 Characterization appropos of
low, high radiation
Scanner
QC Patient/Image/Visit
?Repeat Scan
(Near term, Current
practice)
Enhanced PET Object Adoption
L
M
>2011
Minimum Measurable Lesion
H
H
2009
M
2010-11
H
2008 (define)
Dynamic Range
Current Phantom, Ideal Phantom
Longitudinal Quantitation
Qualitative – New Lesion Threshold
ROI Definition
Draw boundary
H
2010-11 (adopt)
Turkington + vCT
Topic
F
V
Data Extraction
H M
Analysis (in ROI)
H
Chair
1) 2008
2)
2009
1) Factors in Decision
2) Recommended Choice
Digital Ref Object
Software Phantom
Reference Data Set
Version Tracking
H H
2008
Gagnon-vendors
Image? Quantification
H H
2008
Kinahan-SNM
Raw Data To Reconstruction
M M
2010-11
(Black Box)
Topic
F
V
H
Chair
1) H
H
1) 2008
2) 2010-11
MacGuiresend
requests and
will compile
list
Clunie
Software Phantom Reference Data Set
Image ? Data ?
Covariates/Normalizations
Serum Glucose
2) H
LBM
1) Factors in rationale
2) Build normalization into products
Quantitation Computation
H
H
2008
M
M
>2011
H
H
2009
Document Terms
Inputs QC
Interoperability
Results Encoding
Topic
F
V
H
Contrast
L
L
2010-11
Prostheses
L
L
2010-11
Define Factors in Low vs. High Dose (RADS)
H
H
2008
Define factors and rationale
L
Artifact
Recommendations
Combination Scanning
RECIST & PET
2010-11
Chair
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