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Proceedings Paper

Virtual clinical trials using 3D PET imaging
Author(s): Paul E. Kinahan; Darrin Byrd; Kristen Wangerin; Mark Muzi; Lanell Peterson; Brenda Kurland; Jennifer Specht; Hannah Linden
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Paper Abstract

Positron emission tomography (PET) imaging has emerged as a standard component for cancer diagnosis treatment and has increasing use in clinical trials of new therapies for cancer and other diseases. The use of PET imaging to assess response to therapy and its ability to measure change in radiotracer uptake is motivated by its potential for quantitative accuracy and high sensitivity. However, the effectiveness depends upon a number of factors, including both the bias and variance in the pre- and post-therapy reconstructed images. Despite all the attention paid to image reconstruction algorithms, little attention has been paid to the impact on task performance of the choice of algorithm or its parameters, even for FBP or OSEM. We have developed a method, called a 'virtual clinical trial', to evaluate the ability of PET imaging to measure response to cancer therapy in a clinical trial setting. Here our goal is to determine the impact of a fully-3D PET reconstruction algorithm and parameters on clinical trial power. Methods: We performed a virtual clinical trial by generating 90 independent and identically distributed PET imaging study realizations for each of 22 original dynamic 18F-FDG breast cancer patient studies pre- and post- therapy. Each noise realization accounted for known sources of uncertainty in the imaging process, specifically biological variability and quantum noise determined by the PET scanner sensitivity and/or imaging time, as well as the trade-offs introduced by the reconstruction algorithm in bias versus variance. Results: For high quantum noise levels, due to lower PET scanner sensitivity or shorter scan times, quantum noise has a measurable effect on signal to noise ratio (SNR) and study power. However, for studies with moderate to low levels of quantum noise, biological variability and other sources of variance determine SNR and study power. In other words, the choice of the fully-3D PET reconstruction algorithm and parameters has minimal impact on task performance. Conclusions: For many clinical trials, the variance aspects of 3D PET and reconstruction method and parameters have minimal to no impact. Variance for other factors, and bias introduced by changes in 3D PET reconstruction between scans can dramatically impact the utility of clinical trials that rely on quantitative accuracy.

Paper Details

Date Published: 28 May 2019
PDF: 5 pages
Proc. SPIE 11072, 15th International Meeting on Fully Three-Dimensional Image Reconstruction in Radiology and Nuclear Medicine, 1107238 (28 May 2019); doi: 10.1117/12.2535582
Show Author Affiliations
Paul E. Kinahan, Univ of Washington (United States)
Darrin Byrd, Univ of Washington (United States)
Kristen Wangerin, GE Healthcare (United States)
Mark Muzi, Univ. of Washington (United States)
Lanell Peterson, Univ. of Washington (United States)
Brenda Kurland, Univ. of Pittsburgh (United States)
Jennifer Specht, Univ. of Washington (United States)
Seattle Cancer Care Alliance (United States)
Hannah Linden, Univ. of Washington (United States)
Seattle Cancer Care Alliance (United States)

Published in SPIE Proceedings Vol. 11072:
15th International Meeting on Fully Three-Dimensional Image Reconstruction in Radiology and Nuclear Medicine
Samuel Matej; Scott D. Metzler, Editor(s)

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