# Multi-Modality Quantitative Imaging for Evaluation of Response to Cancer Therapy

> **NIH NIH U01** · JOHNS HOPKINS UNIVERSITY · 2020 · $441,491

## Abstract

Bone metastases are common in advanced cancers including prostate adenocarcinoma, where there is
evidence of bone metastases in more than 70% of patients with advanced disease. Despite their prevalence
and the important clinical implications, there is currently no widely accepted quantitative imaging
assessment for response to therapy. Assessment of response or progression is typically made based on
visual interpretation of bone scintigraphy in conjunction with CT and serum markers. The goal of this project
is thus to develop, validate, and advance to clinical practice multi-modality quantitative metrics for assessing
response of bone metastases to therapy. Combined SPECT-CT systems and the implementation of robust
compensation methods has enabled the development of quantitative SPECT imaging methods, which have
recently become clinically available. Here we propose to exploit the nexus of these developments via the
following 3 aims. (1) Using simulation and phantom studies, we will first optimize and evaluate methods for
quantitative SPECT/CT (QSPECT) imaging of Tc-99m MDP. We propose to expand the phantom studies to
a QIN cooperative project in order to evaluate the methods across different scanners and centers. (2)
Based on these QSPECT methods, we will develop, optimize, and characterize quantitative bone SPECT
indices for assessing response to therapy. Computing these indices will involve semi-automatic
segmentation of bone and bone lesions, implemented in an integrated software tool. The indices calculated
will include the number of lesions, bone lesion burden, and change in lesion uptake with therapy. We will
characterize the variability of the indices using realistic simulations and in pre-therapy test-retest studies. (3)
Finally, we will apply the methods and validate them in current clinical trials of new therapeutic regimens for
bone metastatic castrate-resistant prostate cancer. In these studies, we will evaluate the methods in terms
of time to progression and will compare the methods in vivo to similar quantitative metrics estimated from
Na18F PET/CT. We will also investigate the amount of additional information provided by whole-body MRI
and PSMA PET/CT. We will make the methods and images available to the QIN and propose to organize
challenges of segmentation and response metrics to take advantage of the QIN-wide interest in these
areas. Together, these quantitative imaging tools and studies will provide a validated approach for
quantitative imaging-based evaluation of response in bone metastases that is readily clinically
implementable with only a minor increase in cost relative to clinical standard bone scintigraphy.

## Key facts

- **NIH application ID:** 9939461
- **Project number:** 5U01CA140204-08
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Yong Du
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $441,491
- **Award type:** 5
- **Project period:** 2011-09-19 → 2023-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9939461

## Citation

> US National Institutes of Health, RePORTER application 9939461, Multi-Modality Quantitative Imaging for Evaluation of Response to Cancer Therapy (5U01CA140204-08). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9939461. Licensed CC0.

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