PET and NMR dual acquisition (PANDA): applications to isolated, perfused rat hearts

Preclinical Imaging of Cardiovascular Disesase

Noninvasive imaging techniques, such as SPECT, PET, CT, echocardiography, or MRI, have become essential in cardiovascular research. They allow for the evaluation of biological processes in vivo without the need for invasive procedures. Nuclear imaging methods, such as SPECT and PET, offer numerous advantages, including high sensitivity, reliable quantification, and the potential for serial imaging. Modern SPECT and PET imaging systems, equipped with CT and MRI components in order to get access to morphological information with high spatial resolution, are capable of imaging a wide range of established and innovative agents in both preclinical and clinical settings. This review highlights the utility of SPECT and PET imaging as powerful tools for translational research in cardiology. By incorporating these techniques into a well-defined workflow- similar to those used in clinical imaging- the concept of "bench to bedside" can be effectively implemented.

PET/MR Technology: Advancement and Challenges

When this article was written, it coincided with the 11th anniversary of the installation of our PET/MR device in Munich. In fact, this was the first fully integrated device to be in clinical use. During this time, we have observed many interesting behaviors, to put it kindly. However, it is more critical that in this process, our understanding of the system also improved - including the advantages and limitations from a technical, logistical, and medical perspective. The last decade of PET/MRI research has certainly been characterized by most sites looking for a "key application." There were many ideas in this context and before and after the devices became available, some of which were based on the earlier work with integrating data from single devices. These involved validating classical PET methods with MRI (eg, perfusion or oncology diagnostics). More important, however, were the scenarios where intermodal synergies could be expected. In this review, we look back on this decade-long journey, at the challenges overcome and those still to come.

The use of positron emission tomography/magnetic resonance imaging in dementia: A literature review

OBJECTIVES

Positron emission tomography-magnetic resonance imaging (PET/MRI) is an emerging hybrid imaging system in clinical nuclear medicine. Research demonstrates a comparative utility to current unimodal and hybrid methods, including PET-computed tomography (PET/CT), in several medical subspecialities such as neuroimaging. The aim of this review is to critically evaluate the literature from 2016 to 2021 using PET/MRI for the investigation of patients with mild cognitive impairment or dementia, and discuss the evidence base for widening its application into clinical practice.

METHODS

A comprehensive literature search using the PubMed database was conducted to retrieve studies using PET/MRI in relation to the topics of mild cognitive impairment, dementia, or Alzheimer's disease between January 2016 and January 2021. This search strategy enabled studies on all dementia types to be included in the analysis. Studies were required to have a minimum of 10 human subjects and incorporate simultaneous PET/MRI.

RESULTS

A total of 116 papers were retrieved, with 39 papers included in the final selection. These were broadly categorised into reviews (12), technical/methodological papers (11) and new data studies (16). For the current review, discussion focused on findings from the new data studies.

CONCLUSIONS

PET/MRI offers additional insight into the underlying anatomical, metabolic and functional changes associated with dementia when compared with unimodal methods and PET/CT, particularly relating to brain regions including the hippocampus and default mode network. Furthermore, the improved diagnostic utility of PET/MRI, as reported by radiologists, offers improved classification of dementia patients, with important implications for clinical management.

Clinical pediatric positron emission tomography/magnetic resonance program: a guide to successful implementation

Children with malignancies undergo recurrent imaging as part of tumor diagnosis, staging and therapy response assessment. Simultaneous positron emission tomography (PET) and magnetic resonance (MR) allows for decreased radiation exposure and acts as a one-stop shop for disease in which MR imaging is required. Nevertheless, PET/MR is still less readily available than PET/CT across institutions. This article serves as a guide to successful implementation of a clinical pediatric PET/MR program based on our extensive clinical experience. Challenges include making scanners more affordable and increasing patient throughput by decreasing total scan time. With improvements in workflow and robust acquisition protocols, PET/MR imaging is expected to play an increasingly important role in pediatric oncology.

Development of a PET/OMRI combined system for simultaneous imaging of positron and free radical probes for small animals

PURPOSE

Positron emission tomography (PET) has high sensitivity for imaging radioactive tracer distributions in subjects. However, it is not possible to image free radical distribution in a subject by PET. Since free radicals are quite reactive, they are related to many diseases, including but not limited to cancer, inflammation, strokes, and heart disease. The Overhauser enhanced magnetic resonance imaging (OMRI) is so far the only method that images free radical distribution in vivo. By combining PET and OMRI, a new hybrid imaging modality might be developed that can simultaneously image the radioactive tracer and free radical distributions. For this purpose, the authors developed a PET/OMRI combined system for small animals.

METHODS

The developed PET/OMRI system used an optical fiber-based PET system combined with a permanent magnet-based OMRI system. The optical fiber-based PET system uses flexible optical fiber bundles. Eight optical fiber-based block detectors were arranged in a 56 mm diameter ring to form a PET system. The LGSO blocks were located inside the field-of-view (FOV) of the OMRI, and the position sensitive photomultiplier tubes were positioned behind the OMRI to minimize the interference between the PET and the OMRI. The OMRI system used a 0.0165 T permanent magnet. The system has an electron spin resonance coil to enhance the MRI signal using the Overhauser effect to image the free radical in the FOV of the PET/OMRI system.

RESULTS

The spatial resolution and sensitivity of the optical fiber-based PET system were 1.2 mm FWHM and 1.2% at the central FOV, respectively. The OMRI system imaged the distribution of a nitroxyl radical (NXR) solution. The interference between PET and OMRI was small. Simultaneous imaging of the positron radiotracer and the NXR solution was successfully conducted with the developed PET/OMRI system for phantom and small animal studies.

CONCLUSIONS

The authors developed a PET/OMRI combined system with the potential to provide interesting new results in molecular imaging research, such as in vivo molecular and free radical distributions.

Development of an MRI-compatible digital SiPM detector stack for simultaneous PET/MRI

Advances in solid-state photon detectors paved the way to combine positron emission tomography (PET) and magnetic resonance imaging (MRI) into highly integrated, truly simultaneous, hybrid imaging systems. Based on the most recent digital SiPM technology, we developed an MRI-compatible PET detector stack, intended as a building block for next generation simultaneous PET/MRI systems. Our detector stack comprises an array of 8 × 8 digital SiPM channels with 4 mm pitch using Philips Digital Photon Counting DPC 3200-22 devices, an FPGA for data acquisition, a supply voltage control system and a cooling infrastructure. This is the first detector design that allows the operation of digital SiPMs simultaneously inside an MRI system. We tested and optimized the MRI-compatibility of our detector stack on a laboratory test bench as well as in combination with a Philips Achieva 3 T MRI system. Our design clearly reduces distortions of the static magnetic field compared to a conventional design. The MRI static magnetic field causes weak and directional drift effects on voltage regulators, but has no direct impact on detector performance. MRI gradient switching initially degraded energy and timing resolution. Both distortions could be ascribed to voltage variations induced on the bias and the FPGA core voltage supply respectively. Based on these findings, we improved our detector design and our final design shows virtually no energy or timing degradations, even during heavy and continuous MRI gradient switching. In particular, we found no evidence that the performance of the DPC 3200-22 digital SiPM itself is degraded by the MRI system.

Small animal cardiovascular MR imaging and spectroscopy

The use of MR imaging and spectroscopy for studying cardiovascular disease processes in small animals has increased tremendously over the past decade. This is the result of the remarkable advances in MR technologies and the increased availability of genetically modified mice. MR techniques provide a window on the entire timeline of cardiovascular disease development, ranging from subtle early changes in myocardial metabolism that often mark disease onset to severe myocardial dysfunction associated with end-stage heart failure. MR imaging and spectroscopy techniques play an important role in basic cardiovascular research and in cardiovascular disease diagnosis and therapy follow-up. This is due to the broad range of functional, structural and metabolic parameters that can be quantified by MR under in vivo conditions non-invasively. This review describes the spectrum of MR techniques that are employed in small animal cardiovascular disease research and how the technological challenges resulting from the small dimensions of heart and blood vessels as well as high heart and respiratory rates, particularly in mice, are tackled.

Organomatics and organometrics: Novel platforms for long-term whole-organ culture

Organ culture systems are instrumental as experimental whole-organ models of physiology and disease, as well as preservation modalities facilitating organ replacement therapies such as transplantation. Nevertheless, a coordinated system of machine perfusion components and integrated regulatory control has yet to be fully developed to achieve long-term maintenance of organ function ex vivo. Here we outline current strategies for organ culture, or organomatics, and how these systems can be regulated by means of computational algorithms, or organometrics, to achieve the organ culture platforms anticipated in modern-day biomedicine.

Simultaneous PET/MR imaging of the brain: feasibility of cerebral blood flow measurements with FAIR-TrueFISP arterial spin labeling MRI

BACKGROUND

Hybrid positron emission tomography/magnetic resonance imaging (PET/MRI) with simultaneous data acquisition promises a comprehensive evaluation of cerebral pathophysiology on a molecular, anatomical, and functional level. Considering the necessary changes to the MR scanner design the feasibility of arterial spin labeling (ASL) is unclear.

PURPOSE

To evaluate whether cerebral blood flow imaging with ASL is feasible using a prototype PET/MRI device.

MATERIAL AND METHODS

ASL imaging of the brain with Flow-sensitive Alternating Inversion Recovery (FAIR) spin preparation and true fast imaging in steady precession (TrueFISP) data readout was performed in eight healthy volunteers sequentially on a prototype PET/MRI and a stand-alone MR scanner with 128 × 128 and 192 × 192 matrix sizes. Cerebral blood flow values for gray matter, signal-to-noise and contrast-to-noise ratios, and relative signal change were compared. Additionally, the feasibility of ASL as part of a clinical hybrid PET/MRI protocol was demonstrated in five patients with intracerebral tumors.

RESULTS

Blood flow maps showed good delineation of gray and white matter with no discernible artifacts. The mean blood flow values of the eight volunteers on the PET/MR system were 51 ± 9 and 51 ± 7 mL/100 g/min for the 128 × 128 and 192 × 192 matrices (stand-alone MR, 57 ± 2 and 55 ± 5, not significant). The value for signal-to-noise (SNR) was significantly higher for the PET/MRI system using the 192 × 192 matrix size (P < 0.01), the relative signal change (δS) was significantly lower for the 192 × 192 matrix size (P = 0.02). ASL imaging as part of a clinical hybrid PET/MRI protocol could successfully be accomplished in all patients in diagnostic image quality.

CONCLUSION

ASL brain imaging is feasible with a prototype hybrid PET/MRI scanner, thus adding to the value of this novel imaging technique.

Effects of MR surface coils on PET quantification

PURPOSE

The goal of this work was to investigate the effects of MRI surface coils on attenuation-corrected PET emission data. The authors studied the cases where either an MRI or a CT scan would be used to provide PET attenuation correction (AC). Combined MR/PET scanners that use the MRI for PET AC (MR-AC) face the challenge of absent surface coils in MR images and thus cannot directly account for attenuation in the coils. Combining MR and PET images could be achieved by transporting the subject on a stereotactically registered table between independent MRI and PET scanners. In this case, conventional PET CT-AC methods could be used. A challenge here is that high atomic number materials within MR coils cause artifacts in CT images and CT based AC is typically not validated for coil materials.

METHODS

The authors evaluated PET artifacts when MR coils were absent from AC data (MR-AC), or when coil attenuation was measured by CT scanning (CT-AC). They scanned PET phantoms with MR surface coils on a clinical PET/CT system and used CT-AC to reconstruct PET data. The authors then omitted the coil from the CT-AC image to mimic the MR-AC scenario. Images were acquired using cylinder and anthropomorphic phantoms. They evaluated and compared the following five scenarios: (1) A uniform cylinder phantom and head coil scanned and reconstructed using CT-AC; (2) similar emission data (with head coil present) were reconstructed without the head coil in the AC data; (3) the same cylinder scanned without the head coil present (reference scan); (4) a PET torso phantom with a full MR torso coil present in both PET and CT; (5) only half of the separable torso coil present in the PET/CT acquisition. The authors also performed analytic simulations of the first three scenarios.

RESULTS

Streak artifacts were present in CT images containing MR surface coils due to metal components. These artifacts persisted after the CT images were converted for PET AC. The artifacts were significantly reduced when half of the separable coil was removed during the scan. CT scans tended to over-estimate the linear attenuation coefficient (micro) of the metal components when using conventional methods for converting from CT number to micro(511 keV). Artifacts were visible outside the phantom in some of the PET emission images, corresponding to the MRI coil geometry. However, only subtle artifacts were apparent in the emission images inside the phantoms. On the other hand, the PET emission image quantitative accuracy was significantly affected: the activity was underestimated by 19% when AC did not include the head coil, and overestimated by 28% when the CT-AC included the head coil.

CONCLUSIONS

The presence of MR coils during PET or PET/CT scanning can cause subtle artifacts and potentially important quantification errors. Alternative CT techniques that mitigate artifacts should be used to improve AC accuracy. When possible, removing segments of an MR coil prior to the PET/CT exam is recommended. Further, MR coils could be redesigned to reduce artifacts by rearranging placement of the most attenuating materials.

PET imaging of cardiac hypoxia: opportunities and challenges

Myocardial hypoxia is a major factor in the pathology of cardiac ischemia and myocardial infarction. Hypoxia also occurs in microvascular disease and cardiac hypertrophy, and is thought to be a prime determinant of the progression to heart failure, as well as the driving force for compensatory angiogenesis. The non-invasive delineation and quantification of hypoxia in cardiac tissue therefore has the potential to be an invaluable experimental, diagnostic and prognostic biomarker for applications in cardiology. However, at this time there are no validated methodologies sufficiently sensitive or reliable for clinical use. PET imaging provides real-time spatial information on the biodistribution of injected radiolabeled tracer molecules. Its inherent high sensitivity allows quantitative imaging of these tracers, even when injected at sub-pharmacological (≥pM) concentrations, allowing the non-invasive investigation of biological systems without perturbing them. PET is therefore an attractive approach for the delineation and quantification of cardiac hypoxia and ischemia. In this review we discuss the key concepts which must be considered when imaging hypoxia in the heart. We summarize the PET tracers which are currently available, and we look forward to the next generation of hypoxia-specific PET imaging agents currently being developed. We describe their potential advantages and shortcomings compared to existing imaging approaches, and what is needed in terms of validation and characterization before these agents can be exploited clinically.

From molecules to man: the dawn of a vitreous man

One of the greatest challenges to study the structure, function, and molecules in the living brain is that it is enclosed within the skull and difficult to access. Although biopsies are feasible, they are invasive, could lead to functional impairments, and in any case will only provide a small regional sample that is not necessarily reflecting the entire brain. Since the beginning of the twentieth century, in vivo imaging has gradually, and steadily, matured into non-invasive techniques that enable the repeated investigation of the structural, functional, cellular, and molecular composition of the brain. Not only is this information of great importance to scientists aiming to understand how the brain works, but these techniques are also essential to physicians who use imaging to diagnose and treat disease. The current book is a collection of 29 cutting-edge methods and protocols that are used in the current field of neuroimaging.

Small-animal molecular imaging methods

The ability to trace or identify specific molecules within a specific anatomic location provides insight into metabolic pathways, tissue components, and tracing of solute transport mechanisms. With the increasing use of small animals for research, such imaging must have sufficiently high spatial resolution to allow anatomic localization as well as sufficient specificity and sensitivity to provide an accurate description of the molecular distribution and concentration.

METHODS

Imaging methods based on electromagnetic radiation, such as PET, SPECT, MRI, and CT, are increasingly applicable because of recent advances in novel scanner hardware and image reconstruction software and the availability of novel molecules that have enhanced sensitivity in these methodologies.

RESULTS

Small-animal PET has been advanced by the development of detector arrays that provide higher resolution and positron-emitting elements that allow new molecular tracers to be labeled. Micro-MRI has been improved in terms of spatial resolution and sensitivity through increased magnet field strength and the development of special-purpose coils and associated scan protocols. Of particular interest is the associated ability to image local mechanical function and solute transport processes, which can be directly related to the molecular information. This ability is further strengthened by the synergistic integration of PET with MRI. Micro-SPECT has been improved through the use of coded aperture imaging approaches as well as image reconstruction algorithms that can better deal with the photon-limited scan data. The limited spatial resolution can be partially overcome by integrating SPECT with CT. Micro-CT by itself provides exquisite spatial resolution of anatomy, but recent developments in high-spatial-resolution photon counting and spectrally sensitive imaging arrays, combined with x-ray optical devices, hold promise for actual molecular identification by virtue of the chemical bond lengths of molecules, especially biopolymers.

CONCLUSION

Given the increasing use of small animals for evaluating new clinical imaging techniques and providing more insight into pathophysiologic phenomena as well as the availability of improved detection systems, scanning protocols, and associated software, the sensitivity and specificity of molecular imaging are increasing.

Combined PET/MR Imaging — Technology and Applications

The combination of PET and MR in one imaging device has certain advantages over conventional imaging modalities. These include: no additional radiation dose from the MR, superior soft tissue contrast and a multitude of tracers for PET. Certain technical challenges exist when designing a PET/MR system. On the one hand these stem from the presence of the strong MR magnetic field and the addition of PET components to the MR system. Different approaches are presented to overcome these technical obstacles ranging from long optical fibers to systems that use semiconductor light detectors for photon counting. The applications of combined PET/MR are profound in the field of oncology and allow imaging of the four main processes in cancer formation: apoptosis resistance, angiogenesis, proliferation and metastasis. PET/MR has also many clinical and research applications in neurology and cardiology. Alternative techniques such as image fusion, hyperpolarized imaging, 17 O imaging and whole body diffusion are discussed in respect to their relevance regarding PET/MR. Simultaneous multifunctional and anatomical imaging using PET/MR has a great potential to impact biomedical imaging in research and clinic.

Pre-clinical PET/MR: technological advances and new perspectives in biomedical research

INTRODUCTION

Combined PET/MRI allows for multi-parametric imaging and reveals one or more functional processes simultaneously along with high-resolution morphology. Especially in small-animal research, where high soft tissue contrast is required, and the scan time as well as radiation dose are critical factors, the combination of PET and MRI would be beneficial compared with PET/CT.

DEVELOPMENT

In the mid-1990's, several research groups used different approaches to integrate PET detectors into high-field MRI. First, systems were based on optical fibres guiding the scintillation light to the PMT's, which reside outside the fringe magnetic field. Recent advances in gamma ray detector technology, which were initiated mainly by the advent of avalanche photodiodes (APD's) as well as the routine availability of fast scintillation materials like lutetium oxyorthosilicate (LSO), paved the way towards the development of fully magnetic-field-insensitive high-performance PET detectors.

TECHNOLOGY

Current animal PET/MR technologies are reviewed and pitfalls when engineering a full integration of a PET and a high-field MRI are discussed. Compact PET detectors can be integrated in small-bore, high-field MRI tomographs. Detailed performance evaluations have shown that the mutual interference between the two imaging systems could be minimized. The performance of all major MR applications, ranging from T1- or T2-weighted imaging up to echo-planar imaging (EPI) for functional MRI (fMRI) or magnetic resonance spectroscopy (MRS), could be maintained, even when the PET insert was built into the MRI and acquiring PET data simultaneously. Similarly, the PET system performance was not influenced by the static magnetic field or applied MRI sequences.

APPLICATIONS

Initial biomedical research applications range from the combination of functional information from PET with the anatomical information from the MRI to multi-functional imaging combining metabollic PET and MRI data.

DISCUSSION

Compared to other multi-modality approaches PET/MR offers a multitude of complementary function and anatomical information. The ability to obtain simultaneous PET and MRI data with this new imaging modality could have tremendous impact on small animal imaging research.

A fusion PET-MRI system with a high-resolution research tomograph-PET and ultra-high field 7.0 T-MRI for the molecular-genetic imaging of the brain

We have developed a positron emission tomography (PET) and magnetic resonance imaging (MRI) fusion system for the molecular-genetic imaging (MGI) of the in vivo human brain using two high-end imaging devices: the HRRT-PET, a high-resolution research tomograph dedicated to brain imaging on the molecular level, and the 7.0 T-MRI, an ultra-high field version used for morphological imaging. HRRT-PET delivers high-resolution molecular imaging with a resolution down to 2.5 mm full width at half maximum (FWHM), which allows us to observe the brain's molecular changes using the specific reporter genes and probes. On the other front, the 7.0 T-MRI, with submillimeter resolution images of the cortical areas down to 250 mum, allows us to visualize the fine details of the brainstem areas as well as the many cortical and subcortical areas. The new PET-MRI fusion imaging system will provide many answers to the questions on neurological diseases as well as cognitive neurosciences. Some examples of the answers are the quantitative visualization of neuronal functions by clear molecular and genetic bases, as well as diagnoses of many neurological diseases such as Parkinson's and Alzheimer's. The salient point of molecular-genetic imaging and diagnosis is the fact that they precede the morphological manifestations, and hence, the early and specific diagnosis of certain diseases, such as cancers.

Simultaneous PET-MRI: a new approach for functional and morphological imaging

Noninvasive imaging at the molecular level is an emerging field in biomedical research. This paper introduces a new technology synergizing two leading imaging methodologies: positron emission tomography (PET) and magnetic resonance imaging (MRI). Although the value of PET lies in its high-sensitivity tracking of biomarkers in vivo, it lacks resolving morphology. MRI has lower sensitivity, but produces high soft-tissue contrast and provides spectroscopic information and functional MRI (fMRI). We have developed a three-dimensional animal PET scanner that is built into a 7-T MRI. Our evaluations show that both modalities preserve their functionality, even when operated isochronously. With this combined imaging system, we simultaneously acquired functional and morphological PET-MRI data from living mice. PET-MRI provides a powerful tool for studying biology and pathology in preclinical research and has great potential for clinical applications. Combining fMRI and spectroscopy with PET paves the way for a new perspective in molecular imaging.

PET/MRI hybrid imaging: devices and initial results

The combination of functional and morphological imaging technologies such as positron emission tomography (PET) and X-ray computed tomography (CT) has shown its value in the clinical and preclinical field. However, CT provides only very limited soft-tissue contrast and exposes the examined patient or laboratory animal to a high X-ray radiation dose. In comparison to CT, magnetic resonance tomography (MRI) provides excellent soft-tissue contrast and allows for nuclear magnetic resonance spectroscopy (NMRS) or functional MRI (fMRI). Thus, the combination of PET and MRI has been pursued for several years. First approaches have succeeded using conventional photo multiplier tube (PMT) technology together with light fibers to transfer scintillation light away from the high magnetic field. Latest PET/MRI developments use solid-state light detectors that can be operated even at high magnetic fields. Initial pilot studies with prototype animal PET/MRI systems have shown promising results by combining high resolution morphology with multifunctional information isochronously.

Simultaneous acquisition of magnetic resonance spectroscopy (MRS) data and positron emission tomography (PET) images with a prototype MR-compatible, small animal PET imager

Multi-modality imaging (such as PET-CT) is rapidly becoming a valuable tool in the diagnosis of disease and in the development of new drugs. Functional images produced with PET, fused with anatomical images created by MRI, allow the correlation of form with function. Perhaps more exciting than the combination of anatomical MRI with PET, is the melding of PET with MR spectroscopy (MRS). Thus, two aspects of physiology could be combined in novel ways to produce new insights into the physiology of normal and pathological processes. Our team is developing a system to acquire MRI images and MRS spectra, and PET images contemporaneously. The prototype MR-compatible PET system consists of two opposed detector heads (appropriate in size for small animal imaging), operating in coincidence mode with an active field-of-view of approximately 14 cm in diameter. Each detector consists of an array of LSO detector elements coupled through a 2-m long fiber optic light guide to a single position-sensitive photomultiplier tube. The use of light guides allows these magnetic field-sensitive elements of the PET imager to be positioned outside the strong magnetic field of our 3T MRI scanner. The PET scanner imager was integrated with a 12-cm diameter, 12-leg custom, birdcage coil. Simultaneous MRS spectra and PET images were successfully acquired from a multi-modality phantom consisting of a sphere filled with 17 brain relevant substances and a positron-emitting radionuclide. There were no significant changes in MRI or PET scanner performance when both were present in the MRI magnet bore. This successful initial test demonstrates the potential for using such a multi-modality to obtain complementary MRS and PET data.

Multimodality in vivo imaging systems: twice the power or double the trouble?

Many different types of radiation have been exploited to provide images of the structure and function of tissues inside a living subject. Each imaging modality is characterized by differing resolutions on the spatial and temporal scales, and by a different sensitivity for measuring properties related to morphology or function. Combinations of imaging modalities that integrate the strengths of two modalities, and at the same time eliminate one or more weaknesses of an individual modality, thus offer the prospect of improved diagnostics, therapeutic monitoring, and preclinical research using imaging approaches. This review discusses the advantages and challenges in developing multimodality imaging systems for in vivo use, highlights some successful combinations that are now routinely used in the clinic and in research, and discusses recent advances in multimodality instrumentation that may offer new opportunities for imaging.

A reevaluation of the roles of hexokinase I and II in the heart

Hexokinase is responsible for glucose phosphorylation, a process fundamental to regulating glucose uptake. In some tissues, hexokinase translocates to the mitochondria, thereby increasing its efficiency and decreasing its susceptibility to product inhibition. It may also decrease free radical formation in the mitochondria and prevent apoptosis. Whether hexokinase translocation occurs in the heart is controversial; here, using immunogold labeling for the first time, we provide evidence for this process. Rat hearts (6 groups, n = 6/group), perfused with either glucose- or glucose + oleate (0.4 mmol/l)-containing buffer, were exposed to 30-min insulin stimulation, ischemia, or control perfusion. Hexokinase I (HK I) and hexokinase II (HK II) distributions were then determined. In glucose-perfused hearts, HK I-mitochondrial binding increased from 0.41 +/- 0.04 golds/mm in control hearts to 0.71 +/- 0.10 golds/mm after insulin and to 1.54 +/- 0.38 golds/mm after ischemia (P < 0.05). Similarly, HK II-mitochondrial binding increased from 0.16 +/- 0.02 to 0.53 +/- 0.08 golds/mm with insulin and 0.44 +/- 0.07 golds/mm after ischemia (P < 0.05). Under basal conditions, the fraction of HK I that was mitochondrial bound was five times greater than for HK II; insulin and ischemia caused a fourfold increase in HK II binding but only a doubling in HK I binding. Oleate decreased hexokinase-mitochondrial binding and abolished insulin-mediated translocation of HK I. Our data show that mitochondrial-hexokinase binding increases under insulin or ischemic stimulation and that this translocation is modified by oleate. These events are isoform specific, suggesting that HK I and HK II are independently regulated and implying that they perform different roles in cardiac glucose regulation.

Preclinical imaging of mammary intraepithelial neoplasia with positron emission tomography

Small-animal imaging with positron emission tomography (PET) has become a valuable tool for evaluating preclinical models of breast cancer and other diseases. In this review, we examine a number of issues related to preclinical imaging studies with PET, using transgenic models of ductal carcinoma in situ and metastasis as specific examples. We discuss imaging components such as reconstruction, normalization, and extraction of quantitative parameters. We also analyze the effect of longitudinal correlations on cohort size and present some simple statistical techniques for determining cohort sizes that may be helpful in designing preclinical imaging studies. We describe studies that are greatly facilitated by access to non-invasive imaging data including a study involving multiple endpoints and another investigating metastasis. We conclude with a brief survey of emerging approaches in small-animal PET imaging.

Recent developments and future trends in nuclear medicine instrumentation

Molecular imaging using high-resolution single-photon emission computed tomography (SPECT) and positron emission tomography (PET) has advanced elegantly and has steadily gained importance in the clinical and research arenas. Continuous efforts to integrate recent research findings for the design of different geometries and various detector technologies of SPECT and PET cameras have become the goal of both the academic comcameras have become the goal of both the academic community and nuclear medicine industry. As PET has recently become of more interest for clinical practice, several different design trends seem to have developed. Systems are being designed for "low cost" clinical applications, very high-resolution research applications (including small-animal imaging), and just about everywhere in-between. The development of dual-modality imaging systems has revolutionized the practice of nuclear medicine. The major advantage being that SPECT/PET data are intrinsically aligned to anatomical information from the X-ray computed tomography (CT), without the use of external markers or internal landmarks. On the other hand, combining PET with Magnetic Resonance Imaging (MRI) technology is scientifically more challenging owing to the strong magnetic fields. Nevertheless, significant progress has been made resulting in the design of a prototype small animal PET scanner coupled to three multichannel photomultipliers via optical fibers, so that the PET detector can be operated within a conventional MR system. Thus, many different design paths are being pursued--which ones are likely to be the main stream of future commercial systems? It will be interesting, indeed, to see which technologies become the most popular in the future. This paper briefly summarizes state-of-the art developments in nuclear medicine instrumentation. Future prospects will also be discussed.

Dobutamine responsiveness, PET mismatch, and lack of necrosis in low-flow ischemia: is this hibernation in the isolated rat heart?

The clinical hallmarks of hibernating myocardium include hypocontractility while retaining an inotropic reserve (using dobutamine echocardiography), having normal or increased [18F]fluoro-2-deoxyglucose-6-phosphate (18FDG6P) accumulation associated with decreased coronary flow [flow-metabolism mismatch by positron emission tomography (PET)], and recovering completely postrevascularization. In this study, we investigated an isolated rat heart model of hibernation using experimental equivalents of these clinical techniques. Rat hearts (n = 5 hearts/group) were perfused with Krebs-Henseleit buffer for 40 min at 100% flow and 3 h at 10% flow and reperfused at 100% flow for 30 min (paced at 300 beats/min throughout). Left ventricular developed pressure fell to 30 +/- 8% during 10% flow and recovered to 90 +/- 7% after reperfusion. In an additional group, this recovery of function was found to be preserved over 2 h of reperfusion. Electron microscopic examination of hearts fixed at the end of the hibernation period demonstrated a lack of ischemic injury and an accumulation of glycogen granules, a phenomenon observed clinically. In a further group, hearts were challenged with dobutamine during the low-flow period. Hearts demonstrated an inotropic reserve at the expense of increased lactate leakage, with no appreciable creatine kinase release. PET studies used the same basic protocol in both dual- and globally perfused hearts (with 250MBq 18FDG in Krebs buffer +/- 0.4 mmol/l oleate). PET data showed flow-metabolism "mismatch;" whether regional or global, 18FDG6P accumulation in ischemic tissue was the same as (glucose only) or significantly higher than (glucose + oleate) control tissue (0.023 +/- 0.002 vs. 0.011 +/- 0.002 normalized counts. s-1x g-1x min-1, P < 0.05) despite receiving 10% of the flow. This isolated rat heart model of acute hibernation exhibits many of the same characteristics demonstrated clinically in hibernating myocardium.

An improved analytical detector response function model for multilayer small-diameter PET scanners

The optimization of spatial resolution is a critical consideration in the design of small-diameter positron emission tomography (PET) scanners for animal imaging, and is often addressed with Monte Carlo simulations. As a faster and simpler solution, we have developed a new analytical model of the PET detector response function, and implemented the model for a small single-slice, multilayer PET scanner. The accuracy of the model has been assessed by comparison with both Monte Carlo simulations and experimental measurements published in the literature. Results from the analytical model agreed well with the Monte Carlo method, being noise free and two to three orders of magnitude faster. The only major discrepancy was a slight underestimation of the width of the point spread function by the analytical method as inter-crystal scatter is neglected. We observed good agreement between the predictions of the model and experimental measurements. For two large-diameter scanners additional discrepancies were seen due to photon acollinearity, which is not considered in the model. We have shown that the simple and fast analytical detector response function model can provide accurate estimates of spatial resolution for small-diameter PET scanners, and could be a useful tool for several applications, complementing or cross-validating other simulation methods.

Simultaneous PET and NMR

There is currently great interest in combining data from different imaging modalities, either by image registration methods that are performed after the data has been acquired or using new devices that can acquire data from two modalities simultaneously, or near simultaneously. In this paper a small prototype NMR-compatible PET scanner capable of acquiring PET images simultaneously with either NMR images or NMR spectra is described. In an associated paper [1], Pamela Garlick describes some investigations of cardiac metabolism that have been made using this system. One of the main challenges in constructing an NMR-compatible PET scanner is that photomultiplier tubes, which are an essential element of nearly all current PET systems, will not function in a high magnetic field. In collaboration with Simon Cherry and the Crump Institute of Biomedical Imaging at UCLA Medical School, a small (5.4 cm diameter) NMR-compatible PET scanner that will operate within the bore of an NMR magnet has been developed. Long optical fibres are used to transport light from the scintillation crystals that form the detector head to photomultiplier tubes situated in a low magnetic field region several metres from the magnet. This system has been used to perform simultaneous PET and NMR spectroscopy measurements with a 9.4T spectroscopy system, and has also been used to obtain simultaneous PET and MR images in several MRI scanners including a 4.7T small bore animal imaging system. Current efforts in the development of this technology are directed at experimental studies on small animals, both because this is less demanding technically and because it is in this area that applications are likely to appear first. However, there is no reason in principle why human PET-MR would not be feasible. Below, work with the prototype system and the next stage in its development are described, and some of the future possibilities and challenges are discussed.

In vivo quantification of localized neuronal activation and inhibition in the rat brain using a dedicated high temporal-resolution beta +-sensitive microprobe

Understanding brain disorders, the neural processes implicated in cognitive functions and their alterations in neurodegenerative pathologies, or testing new therapies for these diseases would benefit greatly from combined use of an increasing number of rodent models and neuroimaging methods specifically adapted to the rodent brain. Besides magnetic resonance (MR) imaging and functional MR, positron-emission tomography (PET) remains a unique methodology to study in vivo brain processes. However, current high spatial-resolution tomographs suffer from several technical limitations such as high cost, low sensitivity, and the need of restraining the animal during image acquisition. We have developed a beta(+)-sensitive high temporal-resolution system that overcomes these problems and allows the in vivo quantification of cerebral biochemical processes in rodents. This beta-MICROPROBE is an in situ technique involving the insertion of a fine probe into brain tissue in a way very similar to that used for microdialysis and cell electrode recordings. In this respect, it provides information on molecular interactions and pathways, which is complementary to that produced by these technologies as well as other modalities such as MR or fluorescence imaging. This study describes two experiments that provide a proof of concept to substantiate the potential of this technique and demonstrate the feasibility of quantifying brain activation or metabolic depression in individual living rats with 2-[(18)F]fluoro-2-deoxy-d-glucose and standard compartmental modeling techniques. Furthermore, it was possible to identify correctly the origin of variations in glucose consumption at the hexokinase level, which demonstrate the strength of the method and its adequacy for in vivo quantitative metabolic studies in small animals.

Novel approaches to imaging brain tumors

Brain imaging techniques are assuming a greater range of roles in neuro-oncology. New techniques promise earlier recognition of the spread of tumors to the brain, which is useful in staging of disseminated disease, as well as better definition of small lesions associated with presentations of epilepsy. There is the promise that entirely noninvasive, specific diagnosis of brain tumors may become possible. Imaging methods are being used increasingly to direct and monitor therapy. Preoperative and intraoperative imaging are being used for guiding tumor surgery. An exciting potential goal for greater use of imaging is in the individualization of medical therapies either by analysis of in vitro responses or by visualization of drug responses on the tumor in situ. An important focus for technical development is in the robust integration of complementary information to allow optimization of the sensitivity and specificity of multimodal examinations.

The future of magnetic resonance-based techniques in neurology

Magnetic resonance techniques have become increasingly important in neurology for defining: 1. brain, spinal cord and peripheral nerve or muscle structure; 2. pathological changes in tissue structures and properties; and 3. dynamic patterns of functional activation of the brain. New applications have been driven in part by advances in hardware, particularly improvements in magnet and gradient coil design. New imaging strategies allow novel approaches to contrast with, for example, diffusion imaging, magnetization transfer imaging, perfusion imaging and functional magnetic resonance imaging. In parallel with developments in hardware and image acquisition have been new approaches to image analysis. These have allowed quantitative descriptions of the image changes to be used for a precise, non-invasive definition of pathology. With the increasing capabilities and specificity of magnetic resonance techniques it is becoming more important that the neurologist is intimately involved in both the selection of magnetic resonance studies for patients and their interpretation. There is a need for considerably improved access to magnetic resonance technology, particularly in the acute or intensive care ward and in the neurosurgical theatre. This report illustrates several key developments. The task force concludes that magnetic resonance imaging is a major clinical tool of growing significance and offers recommendations for maximizing the potential future for magnetic resonance techniques in neurology.

A new system for the metabolic investigation of the isolated, perfused rat heart

NMR spectroscopy is an invaluable technique in metabolic investigations of isolated, perfused hearts. Most studies employ global perfusion methods together with an NMR coil that surrounds the heart and thus detects signals from its entirety. The present report describes the construction and testing of a novel, two surface-coil probe, in combination with a dual-perfused heart preparation, that enables spectra to be collected independently from the two coronary beds of the rat heart.(31)P NMR spectra of perfused rat hearts in which the septum and right ventricle have been made ischaemic, while the free left ventricular wall is fully perfused, demonstrate the powerful potential of this new system.

A study of artefacts in simultaneous PET and MR imaging using a prototype MR compatible PET scanner

We have assessed the possibility of artefacts that can arise in attempting to perform simultaneous positron emission tomography (PET) and magnetic resonance imaging (MRI) using a small prototype MR compatible PET scanner (McPET). In these experiments, we examine MR images for any major artefacts or loss in image quality due to inhomogeneities in the magnetic field, radiofrequency interference or susceptibility effects caused by operation of the PET system inside the MR scanner. In addition, possible artefacts in the PET images caused by the static and time-varying magnetic fields or radiofrequency interference from the MR system were investigated. Biological tissue and a T2-weighted spin echo sequence were used to examine susceptibility artefacts due to components of the McPET scanner (scintillator, optical fibres) situated in the MR field of view. A range of commonly used MR pulse sequences was studied while acquiring PET data to look for possible artefacts in either the PET or MR images. Other than a small loss in signal-to-noise using gradient echo sequences, there was no significant interaction between the two imaging systems. Simultaneous PET and MR imaging of simple phantoms was also carried out in different MR systems with field strengths ranging from 0.2 to 4.7 T. The results of these studies demonstrate that it is possible to acquire PET and MR images simultaneously, without any significant artefacts or loss in image quality, using our prototype MR compatible PET scanner.