1. Digital Reference Object Subcommittee Goals 1.Build a common reference DICOM test object (digital reference object or DRO) that can be generated by each scanner and then read on PET DICOM display stations 2.The digital reference object verifies information fidelity for quantitative accuracy in clinical imaging trials 3.It also provides the next step beyond DICOM conformance statement and NEMA acceptance tests for quantitation in clinical practice and clinical trials Current Status 1.Collected PET/CT images of the same reference phantom from scanners from GE, Philips, Siemens 2.Image data collated and compared w.r.t. DICOM header information 3.Contacted Scanner and Display Mfrs to start discussion of DICOM information needed Acceptable process Not complete response yet 4.DICOM images of identical test object acquired on 12 PET/CT scanners of uploaded to database

2. Not meant as a "Consumer's Report" evaluation, but rather to facilitate multi- center comparisons Digital Reference Object Sample images of the IDENTICAL object from 12 different PET and PET/CT scanners

3. Digital Reference Object Specific Tasks Planned: Manufacturer-driven discussion on methods for distributing and testing a purely digital version of the reference phantom Evaluate test digital reference object on 3 rd party review stations Initiate IHE process for manufacturer-driven roll-out Explore potential for moving further up the data generation stream, i.e., closer to raw data

4. Resources needed Expert guidance from pharma on the range of potential end-points of quantitative imaging biomarker clinical trials Information from Clinical Research Organizations on needed data and verification information to be included with digital reference objects Expert information from scanner manufacturers on data encoded in DICOM image headers (same as data used by Quantitation Computation Technical Subcommittee) Assistance by Display Station Vendors in ability and methods of interpreting DICOM image information for SUVs and consensus on data fields needed for digital reference objects Guidance from scanner manufacturers and RSNA on IHE steps for implementation / generation of digital reference objects RSNA support services for meetings and data transfer Attendance by relevant experts from scanner manufacturers on 2-4 conference calls, 1 or 2 reviews of concise documentation, and potentially 1 face-to-face meeting