1. Scanner Validation via the SNM Clinical Trials Network Phantom Program Paul E. Christian Molecular Imaging Program Huntsman Cancer Institute University of Utah

2. Scanner Validation Sub-Committee
Purpose: Ensure scanner meets certain performance criterion needed for multi-center clinical trials via a clinical simulation phantom exercise.

3. Validate scanner performance
PET lesion detectability not consistent across vendors.
Imaging/processing protocols not consistent between sites.
SUV measurements not consistent across vendors nor sites.
PET data submitted to FDA for multi-center drug studies not deemed reliable.
Goal: Generate measurement tool to validate reliable multi-center PET data

4. Quality Control Dose Calibrator CT Scanner PET Scanner CT checks
Calibration
Inspection
PET Scanner
Blank scan
Constancy
PET and CT alignment
Record of PMs and calibrations

5. Courtesy: Paul E. Christian
Scanner Constancy
Courtesy: Paul E. Christian

6. Commonly Used PET Phantoms
Commercial phantoms
IEC
NEMA NU-2
ACRIN
ACR
AAPM
QIBA
CROs

7. NEMA-IEC NU-2 Phantom 68Ge resin filled phantom 270.8 day T1/2
4.6 mCi Bkgd 0.44 mCi/ml
Spheres 1.75 mCi/ml
4:1 sphere/background ratio
Atten Coeff mm2/g at 511keV
59+-7 HU

8. Ten Sites, Three vendors (GE 4-PET/CT, 2-PET; Philips 1-PET/CT; Siemens 3-PET/CT)
Kinahan, Doot, U Wash.

9. CTN Oncology Chest Phantom
Clinical simulator to measure:
Lesion detectability
Lesion quantitation
Image noise / texture

10. CTN Oncology Chest Phantom
Fill with F-18 FDG
Precision Filling Technique
Clinical Concentration
Fixed Lesion/Background Ratio

11. Precision 18F Fillable Phantom
Repeat studies using
a precision filling
technique with F-18
Paul E. Christian, Keith Bigham, unpublished data 2008

12. Imaging Process Fill phantom (precise technique)
Performing imaging according
to prescribed protocol
Image after specific time delay
Reconstruction parameters
MD to identify lesions
Submit images for review
Quantitative measurements (SUVmax and SUVave)
At site
At core lab

13. Evaluation Criterion:
Clinical Simulation Phantoms Evaluate: Image performance -Accuracy of dose -Acquisition -Reconstruction/filter -Interpretation # Lesions detected Location of detected lesions SUV measurements (site) -Verify SUVs at core lab -Evaluate DICOM images (core lab)
Image quality of PET/CT scanner -Uniformity -Resolution -Contrast -Noise -PET/CT alignment -Lesion detectability -Attenuation correction -Quantitative accuracy

14. Scanner Quantitative Validation
Assessment:
SUV background accuracy
Lesion SUV accuracy
DICOM transfer valid
Validation of SUV DICOM

15. Scanner Validation Progress
17 scanners validated to date
13 sites
11 more sites have phantoms
20+ additional sites scheduled
(worldwide expansion)

16. Scanner Validation Site Problems
DICOM image compatibility
Ability to provide quantitative images
Ability to provide accurate SUVs
Scanner operation/calibration
Dose calibrator

17. Scanner Validation Sub-Committee
2010 Goals:
Testing brain imaging phantom

18. Scanner Validation Sub-Committee
2010 Goals:
Testing myocardial perfusion imaging phantom
(3 clinical scenarios)

19. Scanner Validation Sub-Committee
Accomplishments:
Development of scanner validation process
Implement review and quality assurance testing
Provide on-line phantom instructional video
Administration of oncology demonstration project
Oncology phantom imaging at 40+ sites
Development of myocardial perfusion phantom
Development of brain phantom

20. Scanner Validation Sub-Committee
2010 Goals:
Streamline phantom qualification program
Develop central archive for images
Develop process for long term maintenance and administration of phantom site qualification
Implement multi-site testing of brain and cardiac phantoms