Today at RSNA 2011, GE Healthcare is showcasing a range of molecular imaging tools designed to enable treatment evaluation earlier in a patient’s care pathway. The company is introducing the new Discovery* PET/CT 710, with 128-slice imaging capabilities, and Q.Suite — a collection of capabilities designed to extend quantitative PET by generating more consistent Standardized Uptake Value (SUV) readings — enabling clinicians to assess treatment response accurately.
During the course of cancer treatment, clinicians traditionally gauge progress by looking for physical changes in the size of a tumor, typically using computed tomography (CT) or magnetic resonance (MR). In many cases, however, metabolic changes in a tumor can be perceived earlier than physical ones, so quantitative PET can give physicians an additional, earlier way to view how well a treatment is working.
“We believe the future of PET imaging lies in treatment assessment,” said Vivek Bhatt, general manager for PET at GE Healthcare. “By getting answers sooner, clinicians can modify treatment strategies without waiting for physical results. This may increase the chance of an effective therapy, which could potentially improve the quality of life and overall outcome for the patient as well as reduce the cost burden of ineffective treatment.”
According to the American Cancer Society in a 2010 report**, the total economic impact of premature death and disability from cancer worldwide was $895 billion in 2008. This figure represents 1.5 percent of the world’s gross domestic product (GDP) and does not include direct medical costs, which would further increase economic impact. Prompted in part by these costs, doctors are seeking quantitative tools to obtain reproducible measurements over a longitudinal patient study. This may enable doctors to assess biological changes in a patient confidently during a course of treatment, and allow them to quickly and accurately modify treatment regimens. Potentially, these tools may contribute to personalized oncology care, improved patient care and reduced expenditures for ineffective treatment.
For quantitative PET to be effective, consistency of SUV measurements between a patient’s baseline scan and subsequent follow-up scans on a single scanner is critical. Variation can occur throughout the PET workflow, in areas from patient management and biology to equipment protocols and performance. Controlling these variables to increase consistency can improve the clinician’s confidence that an SUV change has useful clinical meaning.
Q.Suite is designed to help improve consistency of quantitative measurements in every key area: daily quality control, scanner workflow, motion correction, reconstruction algorithms, and analysis and reporting applications. By combining the capabilities of Q.Suite with updated clinical practices, GE Healthcare believes the consistency of PET measurements can increase dramatically. The goal: a more personalized approach to help raise the standard of care for all patients.
Q.Suite tools for quantitative PET include:
• Q.Freeze — One image, all the counts, motion eliminated. Q.Freeze is designed to be capable of combining the quantitative benefits of 4D phase-matched PET/CT imaging into a single static image, with the goal to use all counts collected to create the image and eliminate motion. Q.Freeze is 510(k) pending at the FDA. Not available for sale in the United States.
• Q.Static — Reducing organ motion effects, quickly and simply. Q.Static represents a starting point for adding basic motion correction techniques to a facility and the opportunity to build towards a full 4D phase-matched workflow. GE Healthcare is designing Q.Static to automatically isolate data when organs are in a low-motion state. The result is a single image series with reduced blurring from organ motion, and therefore more consistent quantitation compared to a static image.
• Q.AC — Attenuation consistency for demanding clinical protocols. GE’s next-generation Q.AC algorithm is designed to reduce potential variance in attenuation correction measurements, helping ensure that the attenuation coefficients used in image reconstruction are accurate.
• Q.Check — A quality control link between the scanner and workstation. As data capture is an important component to quantitative PET, Q.Check is designed to provide an additional level of quality control, establishing a link between the console and workstation to ensure that patient and exam data required for quantitative imaging is saved in the patient file before the exam is finished.
• Q.Core — Accelerating the quantitative imaging workflow. To help address the more sophisticated processing needs of Q.Suite, Q.Core is designed to manage both PET acquisition and reconstruction processing at faster speeds — in a compact footprint.
• PET VCAR — Powerful patient monitoring. Visualizing and analyzing disease and treatment response requires powerful tools. PET VCAR provides automated, interactive access to valuable quantitative information, managing multiple lesions and multiple patient exams over time. PET VCAR now supports the most popular treatment response assessment protocols available in PET/CT imaging, including PERCIST. It has the potential to improve clinicians’ daily reading experience and patient management.
Discovery PET/CT 710 and the tools comprising Q.Suite are not CE marked and cannot be placed on the market or put into service in the relevant countries until it has obtained all required regulatory authorizations. Not available for sale in all markets.
While GE Healthcare currently offers sequential imaging with patient transport to minimize motion, and integrated registration (PET/CT+MR), the company is also focused on developing a fully integrated PET/MR solution capable of time of flight PET imaging and MR spectroscopy. Input from researchers using the current tri-modality system is informing us of the most practical way to move PET/MR into the future. “That’s what we mean by meaningful collaboration,” said Bhatt.
PET/MR is technology in development that represents ongoing research and development efforts. This technology is not a product and may never become a product. PET/MR is not for sale and is not cleared or approved by the U.S. FDA for commercial availability.
Nuclear Medicine Advances from GE Healthcare
Discovery NM/CT 670
GE Healthcare’s hybrid imaging platform — Discovery NM/CT 670 — is designed to help improve workflow while offering excellent dose-management capabilities and overall image quality. After a successful global launch a little over a year ago, the system has been selected by 100 sites around the world. The Discovery NM/CT 670 system combines a newly designed SPECT gantry and GE Healthcare’s latest advancements in nuclear medicine detectors with GE Healthcare’s BrightSpeed* Elite 16 slice CT. Paired with the Xeleris* 3 processing and review workstation, the Discovery NM/CT 670 has the capability to shorten acquisition times and enable more convenient patient scheduling in comparison to separate, conventional SPECT and CT exams. With conventional nuclear hybrid imaging, a bone imaging protocol can take up to 35 minutes. With the Discovery NM/CT 670 and Xeleris• 3, the imaging time can be reduced to as little as 16 minutes.
The new Discovery NM630 with the Xeleris 3 processing and review workstation allows patient dose to be reduced to as low as 50 percent of those of standard nuclear medicine scanning protocols, or the potential for patients to spend significantly less time on the table during exams, without compromising image quality. Engineered to help accommodate more patients than previous generation GE nuclear medicine systems, with its large 28-inch (70cm) wide bore and table capable of handling patients up to 500lbs. (227 kilograms), the Discovery NM630 provides access to a wide variety of patient sizes. The Discovery NM630 is also fully upgradeable to the Discovery NM/CT 670 hybrid imaging platform.
Xeleris 3 — DaTQUANT
Xeleris is the molecular imaging workstation utilized throughout the nuclear medicine product line. With over 7000 Xeleris workstations sold worldwide, GE Healthcare has a commitment to continually advancing technology applications and workflow to meet the challenges facing nuclear medicine professionals. The DaTQUANT application represents a new workflow for the quantification of I-123 Ioflupane brain SPECT images. DaTQUANT enables fast and automated quantification to provide consistent, repeatable and accurate results.
Molecular Breast Imaging Made Possible Through CZT Technology
GE Healthcare is showcasing Discovery* NM750b, a molecular breast-imaging system that may assist in assessment and early detection of breast cancer in women who are at high risk for the disease. The Discovery NM750b Molecular Breast Imaging system utilizes a small FOV gamma camera dedicated for breast imaging based on accumulation of a radioactive tracer in hypermetabolic cancer cells. The innovation of MBI technology is the use of cadmium zinc telluride (CZT) detectors to replace the standard NaI detectors routinely used for gamma cameras, in a dedicated breast and small organ device.
Adopted by more than 100 leading clinicians worldwide, Alcyone technology has become an accepted technology for nuclear cardiology diagnosis. A dedicated nuclear cardiology platform, Alcyone Technology combines cadmium zinc telluride (CZT) detectors, focused pin-hole collimation, stationary data acquisition and 3D reconstruction, to help facilitate workflow efficiency as well as the flexibility to manage patient dose more efficiently with up to four times lower injected dose.† Available on the Discovery* NM 530c and the Discovery NM/CT 570c, Alcyone’s significant improvement in sensitivity and zero equipment motion may enable the potential for new clinical applications for 3D dynamic acquisitions and more accurate access to dynamic function and flow. †
GE Expands FASTlab multi-tracer platform
GE Healthcare is launching new PET tracers to the FASTlab*, a multi-tracer platform for easy and confident production of a broad spectrum of PET tracers. In addition to FDG phosphate and NaF, GE has now released FDG citrate. In the first half of 2012, a clinician’s tracer portfolio can be extended with FMISO (HPLC free) and FLT (HPLC free) for research purposes — all delivered via the single FASTlab platform.
To help support 21 CFR 212 cGMP compliance and facilitate regulatory preparation work, GE provides a combination of DMF type V, describing the FASTlab platform, and DMF type II, outlining the tracer cassette and process. Today, DMF type II is available for both FDG phosphate and citrate formulations and NaF. With the integration of the reagents and accessories into single, validated cassettes, customers are able to meet the most stringent quality control standards across production facilities.
FASTlab’s design takes advantage of disposable bar-coded cassettes, each one preloaded with reagents. That means back-to-back synthesis setup that’s as easy as swapping out the used cassette for a new one.
Customers will benefit from the consistently high yields and shorter synthesis time as compared to manual synthesis, enabling more doses per run and increased daily production capacity. FASTlab can help you address your PET tracer production challenges, minimize your cost and meet your evolving needs.
FASTlab is also a key component of TRACERcenter, one source and one complete solution for enabling compliant PET tracer production.
GE Healthcare at RSNA 2011
Each year in Chicago, the conference of the Radiological Society of North America (RSNA) provides a forum for showcasing the latest innovations in medical imaging. If you are attending the conference, please visit GE Healthcare at booth number 3335 in the McCormick Place south hall. Throughout the week of the event, GE Healthcare will distribute news and information using these digital platforms:
• Digital press kit: newsroom.gehealthcare.com/.
• Twitter: Follow @GEHealthcare and our hashtag #GERSNA
• YouTube channel: youtube.com/gehealthcare
About GE Healthcare
GE Healthcare (gehealthcare.com) provides transformational medical technologies and services that are shaping a new age of patient care. Our broad expertise in medical imaging and information technologies, medical diagnostics, patient monitoring systems, drug discovery, biopharmaceutical manufacturing technologies, performance improvement and performance solutions services help our customers to deliver better care to more people around the world at a lower cost. In addition, we partner with healthcare leaders, striving to leverage the global policy change necessary to implement a successful shift to sustainable healthcare systems.
Our “healthymagination” vision for the future invites the world to join us on our journey as we continuously develop innovations focused on reducing costs, increasing access and improving quality around the world. Headquartered in the United Kingdom, GE Healthcare is a unit of General Electric Company (NYSE: GE). Worldwide, GE Healthcare employees are committed to serving healthcare professionals and their patients in more than 100 countries.
† As compared to nuclear medicine gamma cameras using conventional detectors
* Trademark of General Electric Company
** “The Global Economic Cost of Cancer”, 2010 American Cancer Society.