Slicer3:UIDesign:WorkingProblems:BCAnalysis:PET

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SUV Analysis for Breast Cancer

Goal

Goal is to accommodate basic RECIST assessment for breast cancer (Response Evaluation Criteria In Solid Tumors). (RECIST is a set of published rules that define when cancer patients improve ("respond"), stay the same ("stable") or worsen ("progression") during treatments).

• Determine features that currently exist in Slicer
• Develop features that don't
• Provide a framework that knits features together in a comfortable workflow.

PET SUV Analysis Workflow

• Segment the tumor by hand (ROI or VOI, can be simple circle or ellipsoid)
• Compute SUV of baseline
  • extract parameters from dicom header including
    • concentration
    • injected activity
    • patient weight
  • SUV = ( concentration (microcuries/cc) / injected activity (microcuries) ) - (patient weight (g))
  • use maximum value
• Compute SUV of followup
  • extract parameters from dicom header including
    • concentration
    • injected activity
    • patient weight
  • SUV = ( concentration (microcuries/cc) / injected activity (microcuries) ) - (patient weight (g))
  • use maximum value
• Normalize ROI by SUVmax
• Resport parameters of interest
  • SUVmax_baseline,
  • SUVmax_followup,
  •  % change
• For multiple tumors, report
  • sum of SUV_baselines
  • sum of SUV_followup
  • percent change

Approach

Started a PET_SUV module in Slicer that

• lets you choose a pre-treatment pet volume
• lets you choose a post-treatment CT volume (if present)
• lets you choose pre & post-treatment label maps.
• displays them in FG/BG with correct LUT
• pulls parameters of interest for SUV calculation from DICOM header
• has entry widget for parameters missing from header
• computes measures of interest as described above.
• no special viewer for now.
• ...

Resources

Display guide

case study MS PPT Slides shows tumor

MS Word document with DICOM tags for SUV

Slicer Display at present

Initial view in Slicer (w/o volume rendering)

PPT files

Slides for Volumetric Analysis (in progress)