FDG-PET Biomarker Ctte

Co-chairs: Nathan C. Hall, MD, PhD; John Sunderland, PhD; Jeffrey T. Yap, PhD

RSNA Staff Support: Julie Lisiecki

• Roster

Quantitative FDG-PET Biomarker Committee Mission

Mission: Foster adoption of pragmatic and cost effective standards for accurate and reproducible longitudinal quantitation of biologic parameters with clinical relevance and known sigma

• "Why QIBA?" - Specifics associated with PET-CT device and software manufacturers.

Recent Meetings / Call Summaries

• May 15, 2020
• February 21, 2020
• January 17, 2020

FDG-PET Call Summaries Archive

Nuclear Medicine Combined Biomarker Committee Calls for FDG-PET, Amyloid, SPECT

• Combined Nuclear Medicine Biomarker Committee Call Summaries

Profile Development

Technically Confirmed Profile and Supporting Documents:

• Technically Confirmed QIBA FDG-PET Profile: FDG-PET/CT as an Imaging Biomarker Measuring Response to Cancer Therapy v112 November 14, 2016
• Technically Confirmed Criteria November 14, 2016
• Summary of Changes to the FDG-PET/CT Profile November 14, 2016

Recent updates from Dr. Kinahan for BC review:

• Updated QIBA FDG-PET Profile: FDG-PET/CT as an Imaging Biomarker Measuring Response to Cancer Therapy v111 November 10, 2016

Recent updates from Dr. Turkington for BC review:

• Updated QIBA FDG-PET Profile v110 (edits shown), post Oct 7, 2016 call
• Updated QIBA FDG-PET Profile v110 (clean version), post Oct 7, 2016 call
• QIBA FDG-PET Scanner Checklist, post Oct 7, 2016 call
• QIBA FDG-PET Site Checklist, post Oct 7, 2016 call

Public Comment:

Public Comment Version and Feedback Process - FDG-PET/CT as an Imaging Biomarker Measuring Response to Cancer Therapy

• ARCHIVE

UPICT Protocol Development

• UPICT Oncology FDG-PET CT Protocol, v2.5 Dec-2014
• UPICT Oncology FDG-PET CT Protocol 05-20-2014

• UPICT Oncology FDG-PET CT Protocol 06-07-2013
• UPICT Oncology FDG-PET CT Protocol 05-28-2013
• UPICT Consolidated Statement-Post Call 05-03-2011

FDG-PET Reporting Standards Writing Group

Problem Statement: • Gap between what is reported and what is needed for meta-analysis to determine value of quantitative imaging biomarkers • This is now established in the literature

Group members as of 5/27/2014:

• Paul Kinahan, PhD (Co-Chair)
• Paul Marsden, PhD (Co-Chair)
• Sally F. Barrington, MD
• Anastasia Chalkidou, MD
• Dominique Delbeke, MD, PhD
• Constantine Gatsonis, PhD
• Otto Hoekstra, MD, PhD
• Erich Huang, PhD
• Lisa McShane, PhD
• Dan Sullivan, MD
• Richard L. Wahl, MD

Documents / Call Summaries

Research Papers Analyzing FDG-PET Test-Retest Variability

• Hatt M, Cheze-Le Rest, C, Aboagye EO, et al. Reproducibility of 18F-FDG and 3'-Deoxy-3'-18F-Fluorothymidine PET Tumor Volume Measurements. The Journal of Nuclear Medicine2010; 51(9):1368-1376. [1]

• Kamibayashi T, Tsuchida T, Demura Y, et al. Reproducibility of Semi-quantitative Parameters in FDG-PET Using Two Different PET Scanners: Influence of Attenuation Correction Method and Examination Interval. Academy of Molecular Imaging 2008; 10:162-166.[2]

• Krak NC, Boellaard R, Hoekstra OS, et al. Effects of ROI Definition and Reconstruction Method on Quantitative Outcome and Applicability in a Response Monitoring Trial. European Journal of Nuclear Medicine and Molecular Imaging 2005; 32(3):294–301.[3]

• Minn H, Zasadny KR, Quint LE, Wahl RL. Lung Cancer: Reproducibility of Quantitative Measurements for Evaluating 2-[F-18]-Fluoro-2-deoxy-D-glucose Uptake at PET1. Radiology 1995; 196:167-173.[4]

• Nahmias C, Wahl LM. Reproducibility of Standardized Uptake Value Measurements Determined by 18F-FDG PET in Malignant Tumors. The Journal of Nuclear Medicine 2008; 49(11):1804-1808. [5]

• Nakamoto Y, Zasadny KR, Heikki M, Wahl RL. Reproducibility of Common Semi-quantitative Parameters for Evaluating Lung Cancer Glucose Metabolism with Positron Emission Tomography Using 2-Deoxy-2-[18F] Fluoro-D-Glucose. Molecular Imaging and Biology 2002; 4(2):171-178. [6]

• Velasquez, LM, Boellaard R, Kollia G, et al. Repeatability of 18F-FDG PET in a Multicenter Phase I Study of Patients with Advanced Gastrointestinal Malignancies. The Journal of Nuclear Medicine 2009;50:1646-1654. [7]

• Weber WA, Ziegler SI, Thodtmann R, et al. Reproducibility of Metabolic Measurements in Malignant Tumors Using FDG PET. The Journal of Nuclear Medicine 1999; 40(11):1771-1777. [8]

Working Documents and Reference Materials

• QIBA collaborative manuscript on quantitative imaging of brown fat with PET/CT - link to article
• Updated QIBA FDG-PET Profile v104, post May 24, 2013 call
• Updated QIBA FDG-PET Public Comment Feedback v104, post May 24, 2013 call

• Lung Cancer: Reproducibility of Quantitative Measurements for Evaluating FDG-PET
• 02.17.2012 QIBA FDG-PET Data Warehouse Use Case and Requirements
• Agenda from 02.17.2012 FDG-PET Tech Committee Call
• Covariates Rationale
• Standardized Uptake Value (SUV)
• Quality Control Metrics
• ROI Definition
• Software Version Tracking

• Covariates Rationale SubCtte March 2009
• Digital Reference Objects SubCtte March 2009
• Quality Control Metrics SubCtte March 2009
• Region of Interest SubCtte March 2009
• Software Version Tracking SubCtte March 2009

• NL Standardization Protocol for Quantitative FDG-PET in multi-Center Trials - Dr Ronald Boellaard

The Netherlands Standardization Protocol for Quantitative FDG-PET in Multi-center Trials (English translation of Version 1)

Please keep the following in mind:

The development of this protocol was started about 2005 and approved more than 1 year ago in The Netherlands (NL). However, with gained insight, changes are scheduled to be incorporated in the next version by 2010. The following changes will be made (consider them being applied already or underway):

• Use of oral contrast is now excluded but will be allowed in the next version
• We are currently working on standards for CT as well, including GL for doing CT-QC (in cooperation with the radiologists/radiology societies in NL)
• There will be an upper limit for dosage
• We are working on traceable/calibrated and mutually linked sources for both PET and the dose calibrator and these will be used for absolute (rather than cross-) calibration (but in addition to the cross-calibration using FDG).
• Reconstruction settings given in the protocol are indicative and are likely not applicable for future scanners and software upgrades. Therefore reconstruction parameters should be set such that they provide results that meet the specifications given for the multi-center QC experiments. Same settings should then be applied to patient studies (see also comments under "execptions/special features” and comments made in the paper by Boellaard et al. EJNMMI 2008).
• Various other minor edits/typos/changes

The protocol is not a step-by-step description of the logistics for doing a PET/CT study. However, it has been set up in a somewhat chronological order and may thus be used to populate (copy-paste) such a step-by-step description. Additional work required ... FDG-PET/CT Technical Committee input is highly appreciated.

Submitted by Ronald Boellaard, PhD

• From RECIST to PERCIST: Evolving Considerations for PET Response Criteria in Solid Tumors

Submitted by Richard L. Wahl, MD and Martin A. Lodge, PhD

• 05.19.2009 QIBA FDG-PET/CT Breakout Session Notes

• Draft FDG-PET ICL Logistics Outline

Submitted by Eric S. Perlman, MD

• Reevaluation of the Standardized Uptake Value for FDG: Variations with Body Weight and Methods for Correction - Radiology 1999; 213: 521-525

Slide Presentations

• QIBA Steering Committee Meeting Presentation - Nuclear Medicine Modality Committee (January 2013)
• QIBA Informational Meeting (Dec 1st at RSNA 2008) - Slide Content Review
• QIBA Working Meeting (Dec 4th at RSNA 2008) - FDG-PET/CT Breakout Session Slide Deck
• Fused Images
• Media:FDG-PET11-29.ppt
• QIBA FDG-PET/CT Mission Statement - 2009.03.10
• QIBA Profiling Process-03.31.2009 (Andrew Buckler, MS)
• FDG-PET/CT Technical Committee summary 2009.05.20 Richard Frank

QIBA Funded Projects

Round 1

• VU University Medical Center, The Netherlands

• University of Washington - Digital Reference Object

• Johns Hopkins University School of Medicine

Round 2

• VU University Medical Center, The Netherlands, Round-2
• Johns Hopkins University School of Medicine, Round-2
• Dana-Farber Cancer Institute
• Perlman Advisory Group

Round 3

• Project (C) FDG-PET-CT Profile Field Test (Duke University)
• Project (E) FDG-PET-CT Digital Reference Object (DRO) Extension (University of Washington)

Round 4

• Project (R) FDG-PET-CT Profile Multi-Center Field Test (Duke University)

Round 5

• Project (B) Biologic and Reader Repeatability of FDG and CT Volumetric Parameters (ACRIN 6678 & MERCK) (Johns Hopkins University)

Round 6

• Project (R) SUV Quantification with Point Spread Function PET Reconstruction (Johns Hopkins University)

Ideas for Profile version 2.0

A collection area for ideas to include in the next version of the Profile

A PET Physicist here had this feedback, which I think you will appreciate:

I wish there was a way to accentuate the difference between dose and activity. There is an important distinction with proper definitions. Activity is a measure of decay rate, dps, mCi, MBq, whatever units one prefers. Dose is a measure of energy deposits in matter. A complex phenomena measured in rem, Sv, whatever.