CTSC:TTIC.090109

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Agenda

1. Consultations
2. DCE-MRI update
3. MRI safety (download) here
4. Standardization of cross-site imaging acquisition

Harvard Translational Imaging Consortium Meeting Minutes September 1, 2009

In attendance:

• Valerie Humblet
• Gordon Harris
• Simon Warfield
• Jeff Yap
• Wendy Plensiak
• Mark Anderson
• Randy Gollub
• Yong Gao
• Annick Van den Abbeele
• Gordon Williams
• Bill Hanlon
• Bob Lenkinski
• Ron Kikinis

1. Update on imaging consultation requests

• There was no new consultation this week.

2. DCE-MRI update

• Jeff, Wendy and Ron have been working on the DCE-MRI (breast) data set sent by Kasia Macura (Hopkins) in preparation of the educational session at the ACRIN meeting on September 30, 2009 in Arlington, VA.
  • They are concerns that even if we can clearly see the tumor shrinking, the intensity values of the images before and after don't look the same. They look almost like if different sequences were used. Even normal breast tissue look different. They will get back in touch with Kasia to check that she sent the right data.
  • If those data turned out to be not usable for the ACRIN meeting, Bob has some lung data that are very interesting because they require registration before doing the DCE-MRI analysis. He will take to the owner of the data to ask permission to share them.

3. MRI Safety

• Valerie put together a tutorial called: MRI safety, guidelines for safe MR pratice. The tutorial is based on he MRI safety training from BIDMC, MGH, CHB, MIT and BWH plus information from the RSNA withe paper on MRI safety.
• Members reviewed the slides.
  • Pregnancy is still controversial, especially when it comes to research and IRB approval. While pregnant women are scanned regularly for clinical reasons, the current guidelines are to exclude pregnant women from research studies. Each IRB establishes its own guidelines regarding the consent form. In some institution, if the women is not able to confirm that she is not pregnant and/or give the date of her last menstruation period, she is offered a pregnancy test. If she declines the test, she is not accepted in the study. In order to help investigator get IRB approval for their MRI scans, Valerie will collect IRB text fron BIDMC, Martinos Center and CHB to get some downloadable template on how to write the consent form the right way.
  • The FDA now recommends that magnetic field up to 8T (and not 4T anymore) are safe for individual 1 month and older
• Once the slides have been reviewed and vetted by all the members, we will submit the tutorial to the different institutions to get their approval. The next step will be to put in on the Catalyst website.

4. Standardization of cross-site imaging acquisition

• The questions of quality control during acquisition, protocol compliance, introduction of research requirements to clinical environment were brought during the discussion. Those are important issues, no matter what the imaging technology is (MRI, US, PET, CT). As Annick mentioned, nationally there is a lot of attention to it. It is a great case for the Harvard Catalyst, if we can do it here within our institution, we would be able to set standards nationally.
  • The first goal will be to push the standards internally. Bruce suggested to maybe try with the easiest modality. Simon agreed that it is an excellent idea to create standardization for clinical trial internally.
  • Jeff mentioned that at Dana Farber, they did it with PET phantoms and got good results but nothing was done on the clinical side yet. Annick added that TIMC has many similar data on CT.
  • Simon mentioned that Ellen Grant at CHB works on standardizing some protocols for pediatric MS between MGH, MIT and CHB.
  • BIDMC asked CHB (Simon in particular) for imaging protocols for newborns in the NICU. Bob will check if they have been implemented.
  • Randy did a consultation on a multi-center stroke study, it contains sequences for acute stroke (MRI and CT)
• Plan of action:
  • Valerie will gather the multi-site protocols already on hands.
  • Gordon Williams suggested that the imaging consortium could put together a proposal for the next round of pilot grant. Everybody agreed. The goal would be to get funded to scan subjects at each institution, do a test-retest of subjects at different sites with different modalities. It might get more complicated for CT because if the radiations.
  • One important question to answer will be: we have to use clinical resources, they are highly variable, how can we overcome that (ex: presence of the investigator during each scan). Standardizing the environment before the imaging is done is a important functional thing to do.
  • US is trying to standardize its practice, cardiovascular US would be a useful example. Annick added that US is the one that appears to be the less reliable so it would be extremely important to show that we can do the standardization.
  • The imaging consortium decided to form a small sub committee responsible for this project: Jeff will be responsible on the PET side, Bob agreed to be part of it, Todd would be in charge of US. The members also suggested that Bruce would be a good leader. Valerie will be the administrative lead of the subgroup.