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Veit-Haibach P, Ahlström H, Boellaard R, Delgado Bolton RC, Hesse S, Hope T, Huellner MW, Iagaru A, Johnson GB, Kjaer A, Law I, Metser U, Quick HH, Sattler B, Umutlu L, Zaharchuk G, Herrmann K. International EANM-SNMMI-ISMRM consensus recommendation for PET/MRI in oncology. Eur J Nucl Med Mol Imaging 2023; 50:3513-3537. [PMID: 37624384 PMCID: PMC10547645 DOI: 10.1007/s00259-023-06406-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 08/16/2023] [Indexed: 08/26/2023]
Abstract
PREAMBLE The Society of Nuclear Medicine and Molecular Imaging (SNMMI) is an international scientific and professional organization founded in 1954 to promote the science, technology, and practical application of nuclear medicine. The European Association of Nuclear Medicine (EANM) is a professional non-profit medical association that facilitates communication worldwide between individuals pursuing clinical and research excellence in nuclear medicine. The EANM was founded in 1985. The merged International Society for Magnetic Resonance in Medicine (ISMRM) is an international, nonprofit, scientific association whose purpose is to promote communication, research, development, and applications in the field of magnetic resonance in medicine and biology and other related topics and to develop and provide channels and facilities for continuing education in the field.The ISMRM was founded in 1994 through the merger of the Society of Magnetic Resonance in Medicine and the Society of Magnetic Resonance Imaging. SNMMI, ISMRM, and EANM members are physicians, technologists, and scientists specializing in the research and practice of nuclear medicine and/or magnetic resonance imaging. The SNMMI, ISMRM, and EANM will periodically define new guidelines for nuclear medicine practice to help advance the science of nuclear medicine and/or magnetic resonance imaging and to improve the quality of service to patients throughout the world. Existing practice guidelines will be reviewed for revision or renewal, as appropriate, on their fifth anniversary or sooner, if indicated. Each practice guideline, representing a policy statement by the SNMMI/EANM/ISMRM, has undergone a thorough consensus process in which it has been subjected to extensive review. The SNMMI, ISMRM, and EANM recognize that the safe and effective use of diagnostic nuclear medicine imaging and magnetic resonance imaging requires specific training, skills, and techniques, as described in each document. Reproduction or modification of the published practice guideline by those entities not providing these services is not authorized. These guidelines are an educational tool designed to assist practitioners in providing appropriate care for patients. They are not inflexible rules or requirements of practice and are not intended, nor should they be used, to establish a legal standard of care. For these reasons and those set forth below, the SNMMI, the ISMRM, and the EANM caution against the use of these guidelines in litigation in which the clinical decisions of a practitioner are called into question. The ultimate judgment regarding the propriety of any specific procedure or course of action must be made by the physician or medical physicist in light of all the circumstances presented. Thus, there is no implication that an approach differing from the guidelines, standing alone, is below the standard of care. To the contrary, a conscientious practitioner may responsibly adopt a course of action different from that set forth in the guidelines when, in the reasonable judgment of the practitioner, such course of action is indicated by the condition of the patient, limitations of available resources, or advances in knowledge or technology subsequent to publication of the guidelines. The practice of medicine includes both the art and the science of the prevention, diagnosis, alleviation, and treatment of disease. The variety and complexity of human conditions make it impossible to always reach the most appropriate diagnosis or to predict with certainty a particular response to treatment. Therefore, it should be recognized that adherence to these guidelines will not ensure an accurate diagnosis or a successful outcome. All that should be expected is that the practitioner will follow a reasonable course of action based on current knowledge, available resources, and the needs of the patient to deliver effective and safe medical care. The sole purpose of these guidelines is to assist practitioners in achieving this objective.
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Affiliation(s)
- Patrick Veit-Haibach
- Joint Department Medical Imaging, University Health Network, Mount Sinai Hospital and Women's College Hospital, Toronto General Hospital, 1 PMB-275, 585 University Avenue, Toronto, Ontario, M5G 2N2, Canada
- Joint Department of Medical Imaging, University of Toronto, Toronto, Canada
| | - Håkan Ahlström
- Department of Surgical Sciences, Uppsala University, 751 85, Uppsala, Sweden
- Antaros Medical AB, BioVenture Hub, 431 53, Mölndal, Sweden
| | - Ronald Boellaard
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Roberto C Delgado Bolton
- Department of Diagnostic Imaging (Radiology) and Nuclear Medicine, University Hospital San Pedro and Centre for Biomedical Research of La Rioja (CIBIR), Logroño, La Rioja, Spain
| | - Swen Hesse
- Department of Nuclear Medicine, University of Leipzig Medical Center, Leipzig, Germany
| | - Thomas Hope
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Martin W Huellner
- Department of Nuclear Medicine, University Hospital Zürich, University of Zürich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - Andrei Iagaru
- Department of Radiology, Division of Nuclear Medicine, Stanford University Medical Center, Stanford, CA, USA
| | - Geoffrey B Johnson
- Division of Nuclear Medicine, Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Andreas Kjaer
- Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark
| | - Ian Law
- Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, Copenhagen, Denmark
| | - Ur Metser
- Joint Department of Medical Imaging, University Health Network, Mount Sinai Hospital and Women's College Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Harald H Quick
- High-Field and Hybrid MR Imaging, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Erwin L. Hahn Institute for MR Imaging, University of Duisburg-Essen, Essen, Germany
| | - Bernhard Sattler
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | - Lale Umutlu
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
| | - Greg Zaharchuk
- Division of Neuroradiology, Department of Radiology, Stanford University, 300 Pasteur Drive, Room S047, Stanford, CA, 94305-5105, USA
| | - Ken Herrmann
- Department of Nuclear Medicine, University of Duisburg-Essen and German Cancer Consortium (DKTK), University Hospital Essen, Essen, Germany.
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Koole M, Armstrong I, Krizsan AK, Stromvall A, Visvikis D, Sattler B, Nekolla SG, Dickson J. EANM guidelines for PET-CT and PET-MR routine quality control. Z Med Phys 2023; 33:103-113. [PMID: 36167600 PMCID: PMC10068535 DOI: 10.1016/j.zemedi.2022.08.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 08/25/2022] [Indexed: 01/29/2023]
Abstract
We present guidelines by the European Association of Nuclear Medicine (EANM) for routine quality control (QC) of PET-CT and PET-MR systems. These guidelines are partially based on the current EANM guidelines for routine quality control of Nuclear Medicine instrumentation but focus more on the inherent multimodal aspect of the current, state-of-the-art PET-CT and PET-MR scanners. We briefly discuss the regulatory context put forward by the International Electrotechnical Commission (IEC) and European Commission (EC) and consider relevant guidelines and recommendations by other societies and professional organizations. As such, a comprehensive overview of recommended quality control procedures is provided to ensure the optimal operational status of a PET system, integrated with either a CT or MR system. In doing so, we also discuss the rationale of the different tests, advice on the frequency of each test and present the relevant MR and CT tests for an integrated system. In addition, we recommend a scheme of preventive actions to avoid QC tests from drifting out of the predefined range of acceptable performance values such that an optimal performance of the PET system is maintained for routine clinical use.
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Affiliation(s)
- Michel Koole
- Nuclear Medicine and Molecular Imaging, Department of Imaging and Pathology, KU Leuven, Belgium.
| | - Ian Armstrong
- Nuclear Medicine, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | | | - Anne Stromvall
- Radiation Physics, Department of Radiation Sciences, Umeå universitet, Umeå, Sweden
| | | | - Bernhard Sattler
- Department of Nuclear Medicine, University Medical Centre Leipzig, Leipzig, Germany
| | - Stephan G Nekolla
- Nuklearmedizinische Klinik und Poliklinik, Klinikum rechts der Isar der Technischen Universität München, München, Germany
| | - John Dickson
- Institute of Nuclear Medicine, University College London Hospital, London, United Kingdom
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D’Arienzo M, Mezzenga E, Sarnelli A. Quality controls for hybrid PET/MR. Nucl Med Mol Imaging 2022. [DOI: 10.1016/b978-0-12-822960-6.00191-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Harries J, Jochimsen TH, Scholz T, Schlender T, Barthel H, Sabri O, Sattler B. A realistic phantom of the human head for PET-MRI. EJNMMI Phys 2020; 7:52. [PMID: 32757099 PMCID: PMC7406590 DOI: 10.1186/s40658-020-00320-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 07/16/2020] [Indexed: 12/27/2022] Open
Abstract
Background The combination of positron emission tomography (PET) and magnetic resonance imaging (MRI) (PET-MRI) is a unique hybrid imaging modality mainly used in oncology and neurology. The MRI-based attenuation correction (MRAC) is crucial for correct quantification of PET data. A suitable phantom to validate quantitative results in PET-MRI is currently missing. In particular, the correction of attenuation due to bone is usually not verified by commonly available phantoms. The aim of this work was, thus, the development of such a phantom and to explore whether such a phantom might be used to validate MRACs. Method Various materials were investigated for their attenuation and MR properties. For the substitution of bone, water-saturated gypsum plaster was used. The attenuation of 511 keV annihilation photons was regulated by addition of iodine. Adipose tissue was imitated by silicone and brain tissue by agarose gel, respectively. The practicability with respect to the comparison of MRACs was checked as follows: A small flask inserted into the phantom and a large spherical phantom (serving as a reference with negligible error in MRAC) were filled with the very same activity concentration. The activity concentration was measured and compared using clinical protocols on PET-MRI and different built-in and offline MRACs. The same measurements were carried out using PET-CT for comparison. Results The phantom imitates the human head in sufficient detail. All tissue types including bone were detected as such so that the phantom-based comparison of the quantification accuracy of PET-MRI was possible. Quantitatively, the activity concentration in the brain, which was determined using different MRACs, showed a deviation of about 5% on average and a maximum deviation of 11% compared to the spherical phantom. For PET-CT, the deviation was 5%. Conclusions The comparatively small error in quantification indicates that it is possible to construct a brain PET-MRI phantom that leads to MR-based attenuation-corrected images with reasonable accuracy.
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Affiliation(s)
- Johanna Harries
- Department of Nuclear Medicine, Leipzig University Hospital, Liebigstr. 18, Leipzig, Germany.,Department of Radiation Safety and Medical Physics, Medizinische Hochschule Hannover, Carl-Neuberg Straße 1, Hannover, Germany
| | - Thies H Jochimsen
- Department of Nuclear Medicine, Leipzig University Hospital, Liebigstr. 18, Leipzig, Germany.
| | - Thomas Scholz
- Department of Nuclear Medicine, Leipzig University Hospital, Liebigstr. 18, Leipzig, Germany
| | - Tina Schlender
- Department of Nuclear Medicine, Leipzig University Hospital, Liebigstr. 18, Leipzig, Germany
| | - Henryk Barthel
- Department of Nuclear Medicine, Leipzig University Hospital, Liebigstr. 18, Leipzig, Germany
| | - Osama Sabri
- Department of Nuclear Medicine, Leipzig University Hospital, Liebigstr. 18, Leipzig, Germany
| | - Bernhard Sattler
- Department of Nuclear Medicine, Leipzig University Hospital, Liebigstr. 18, Leipzig, Germany
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Law I, Albert NL, Arbizu J, Boellaard R, Drzezga A, Galldiks N, la Fougère C, Langen KJ, Lopci E, Lowe V, McConathy J, Quick HH, Sattler B, Schuster DM, Tonn JC, Weller M. Joint EANM/EANO/RANO practice guidelines/SNMMI procedure standards for imaging of gliomas using PET with radiolabelled amino acids and [ 18F]FDG: version 1.0. Eur J Nucl Med Mol Imaging 2018; 46:540-557. [PMID: 30519867 PMCID: PMC6351513 DOI: 10.1007/s00259-018-4207-9] [Citation(s) in RCA: 317] [Impact Index Per Article: 52.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 10/29/2018] [Indexed: 01/12/2023]
Abstract
These joint practice guidelines, or procedure standards, were developed collaboratively by the European Association of Nuclear Medicine (EANM), the Society of Nuclear Medicine and Molecular Imaging (SNMMI), the European Association of Neurooncology (EANO), and the working group for Response Assessment in Neurooncology with PET (PET-RANO). Brain PET imaging is being increasingly used to supplement MRI in the clinical management of glioma. The aim of these standards/guidelines is to assist nuclear medicine practitioners in recommending, performing, interpreting and reporting the results of brain PET imaging in patients with glioma to achieve a high-quality imaging standard for PET using FDG and the radiolabelled amino acids MET, FET and FDOPA. This will help promote the appropriate use of PET imaging and contribute to evidence-based medicine that may improve the diagnostic impact of this technique in neurooncological practice. The present document replaces a former version of the guidelines published in 2006 (Vander Borght et al. Eur J Nucl Med Mol Imaging. 33:1374–80, 2006), and supplements a recent evidence-based recommendation by the PET-RANO working group and EANO on the clinical use of PET imaging in patients with glioma (Albert et al. Neuro Oncol. 18:1199–208, 2016). The information provided should be taken in the context of local conditions and regulations.
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Affiliation(s)
- Ian Law
- Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, University of Copenhagen, 9, Blegdamsvej, 2100-DK, Copenhagen Ø, Denmark.
| | - Nathalie L Albert
- Department of Nuclear Medicine, Ludwig-Maximilians-University, Munich, Germany
| | - Javier Arbizu
- Department of Nuclear Medicine, Clínica Universidad de Navarra, University of Navarre, Pamplona, Spain
| | - Ronald Boellaard
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands.,Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Alexander Drzezga
- Department of Nuclear Medicine, University Hospital Cologne, Cologne, Germany
| | - Norbert Galldiks
- Department of Neurology, University Hospital Cologne, Cologne, Germany.,Institute of Neuroscience and Medicine (INM-3, -4), Forschungszentrum Julich, Julich, Germany
| | - Christian la Fougère
- Division of Nuclear Medicine and Clinical Molecular Imaging, Department of Radiology, University of Tübingen, Tübingen, Germany
| | - Karl-Josef Langen
- Institute of Neuroscience and Medicine (INM-3, -4), Forschungszentrum Julich, Julich, Germany.,Department of Nuclear Medicine, RWTH University Aachen, Aachen, Germany
| | - Egesta Lopci
- Department of Nuclear Medicine, Humanitas Clinical and Research Hospital, Rozzano, Italy
| | - Val Lowe
- Department of Radiology, Nuclear Medicine, Mayo Clinic, Rochester, MN, USA
| | - Jonathan McConathy
- Division of Molecular Imaging and Therapeutics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Harald H Quick
- High-Field and Hybrid MR Imaging, University Hospital Essen, Essen, Germany
| | - Bernhard Sattler
- Department for Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | - David M Schuster
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA, USA
| | - Jörg-Christian Tonn
- Department of Neurosurgery, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Michael Weller
- Department of Neurology, University Hospital Zurich, Zurich, Switzerland
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6
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Lücke C, Oppolzer B, Werner P, Foldyna B, Lurz P, Jochimsen T, Brenneis B, Lehmkuhl L, Sattler B, Grothoff M, Barthel H, Sabri O, Gutberlet M. Comparison of volumetric and functional parameters in simultaneous cardiac PET/MR: feasibility of volumetric assessment with residual activity from prior PET/CT. Eur Radiol 2017; 27:5146-5157. [PMID: 28631080 PMCID: PMC5674117 DOI: 10.1007/s00330-017-4896-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 04/24/2017] [Accepted: 05/12/2017] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To compare cardiac left ventricular (LV) parameters in simultaneously acquired hybrid fluorine-18-fluorodeoxyglucose ([18F] FDG) positron emission tomography/magnetic resonance imaging (PET/MRI) in patients with residual tracer activity of upstream PET/CT. METHODS Twenty-nine patients (23 men, age 58±17 years) underwent cardiac PET/MRI either directly after a non-cardiac PET/CT with homogenous cardiac [18F] FDG uptake (n=20) or for viability assessment (n=9). Gated cardiac [18F] FDG PET and cine MR sequences were acquired simultaneously and evaluated blinded to the cross-imaging results. Image quality (IQ), end-diastolic (LVEDV), end-systolic volume (LVESV), ejection fraction (LVEF) and myocardial mass (LVMM) were measured. Pearson correlation and intraclass correlation coefficient (ICC), regression and a Bland-Altman analysis were assessed. RESULTS Except LVMM, volumetric and functional LV parameters demonstrated high correlations (LVESV: r=0.97, LVEDV: r=0.95, LVEF: r=0.91, LVMM: r=0.87, each p<0.05), but wide limits of agreement (LOA) for LVEDV (-25.3-82.5ml); LVESV (-33.1-72.7ml); LVEF (-18.9-14.8%) and LVMM (-78.2-43.2g). Intra- and interobserver reliability were very high (ICC≥0.95) for all parameters, except for MR-LVEF (ICC=0.87). PET-IQ (0-3) was high (mean: 2.2±0.9) with significant influence on LVMM calculations only. CONCLUSION In simultaneously acquired cardiac PET/MRI data, LVEDV, LVESV and LVEF show good agreement. However, the agreement seems to be limited if cardiac PET/MRI follows PET/CT and only the residual activity is used. KEY POINTS • [ 18 F] FDG PET-MRI is feasible with residual [ 18 F] FDG activity in patients with homogenous cardiac uptake. • Cardiac volumes and function assessed by PET/MRI show good agreement. • LVEDV and LVESV are underestimated; PET overestimates LVMM and LVEF. • Cardiac PET and MRI data correlate better when acquired simultaneously than sequentially. • PET and MRI should not assess LV parameters interchangeably.
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Affiliation(s)
- C Lücke
- Department of Diagnostic and Interventional Radiology, University Leipzig - Heart Center, Strümpellstr. 39, 04289, Leipzig, Germany.
| | - B Oppolzer
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | - P Werner
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | - B Foldyna
- Department of Diagnostic and Interventional Radiology, University Leipzig - Heart Center, Strümpellstr. 39, 04289, Leipzig, Germany
- Cardiac MR PET CT Program, Massachusetts General Hospital - Harvard Medical School, Boston, MA, USA
| | - P Lurz
- Clinic for Internal Medicine/Cardiology, University Leipzig - Heart Center, Leipzig, Germany
| | - T Jochimsen
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | - B Brenneis
- Department of Diagnostic and Interventional Radiology, University Leipzig - Heart Center, Strümpellstr. 39, 04289, Leipzig, Germany
| | - L Lehmkuhl
- Radiologische Klinik, Herz- und Gefäß-Klinik GmbH, Bad Neustadt, Germany
| | - B Sattler
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | - M Grothoff
- Department of Diagnostic and Interventional Radiology, University Leipzig - Heart Center, Strümpellstr. 39, 04289, Leipzig, Germany
| | - H Barthel
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | - O Sabri
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | - M Gutberlet
- Department of Diagnostic and Interventional Radiology, University Leipzig - Heart Center, Strümpellstr. 39, 04289, Leipzig, Germany
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Surov A, Stumpp P, Meyer HJ, Gawlitza M, Höhn AK, Boehm A, Sabri O, Kahn T, Purz S. Simultaneous (18)F-FDG-PET/MRI: Associations between diffusion, glucose metabolism and histopathological parameters in patients with head and neck squamous cell carcinoma. Oral Oncol 2016; 58:14-20. [PMID: 27311397 DOI: 10.1016/j.oraloncology.2016.04.009] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 04/03/2016] [Accepted: 04/18/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To analyze possible associations between functional simultaneous (18)F-FDG-PET/MR imaging parameters and histopathological parameters in head and neck squamous cell carcinoma (HNSCC). MATERIAL AND METHODS 11 patients (2 female, 9 male; mean age 56.0years) with biopsy-proven primary HNSCC underwent simultaneous (18)F-FDG-PET/MRI with a dedicated head and neck protocol including diffusion weighted imaging. For each tumor, glucose metabolism was estimated with standardized uptake values (SUV) and diffusion restriction was calculated using apparent diffusion coefficients (ADC). The tumor proliferation index was estimated on Ki 67 antigen stained specimens. Cell count, total nucleic area, and average nucleic area were estimated in each case. Pearson's correlation coefficient was used to analyze possible associations between the estimated parameters. RESULTS The mean SUVmax value was 24.41±6.51, and SUVmean value 15.01±4.07. Mean values (×10(-3)mm(2)s(-1)) of ADC parameters were as follows: ADCmin: 0.65±0.20; ADCmean: 1.28±0.18; and ADCmax: 2.16±0.35. Histopathological analysis identified the following results: cell count 1069.82±388.66, total nucleic area 150771.09±61177.12μm(2), average nucleic area 142.90±57.27μm(2) and proliferation index 49.09±22.67%. ADCmean correlated with Ki 67 level (r=-0.728, p=0.011) and total nucleic area (r=-0.691, p=0.019) and tended to correlate with average nucleic area (r=-0.527, p=0.096). ADCmax correlated with Ki 67 level (r=-0.633, p=0.036). SUVmax also tended to correlate with average nucleic area (r=0.573, p=0.066). Combined parameter SUVmax/ADCmin correlated with average nucleic area (r=0.627, p=0.039). CONCLUSION ADC and SUV values showed significant correlations with different histopathological parameters and can be used as biological markers in HNSCC.
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Affiliation(s)
- Alexey Surov
- Department of Diagnostic and Interventional Radiology, University Hospital of Leipzig, Liebigstrasse 20, 04103 Leipzig, Germany.
| | - Patrick Stumpp
- Department of Diagnostic and Interventional Radiology, University Hospital of Leipzig, Liebigstrasse 20, 04103 Leipzig, Germany
| | - Hans Jonas Meyer
- Department of Radiology, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Str. 40, 06097 Halle, Germany
| | - Matthias Gawlitza
- Department of Diagnostic and Interventional Radiology, University Hospital of Leipzig, Liebigstrasse 20, 04103 Leipzig, Germany
| | - Anne-Kathrin Höhn
- Department of Pathology, University Hospital of Leipzig, Liebigstrasse 20, 04103 Leipzig, Germany
| | - Andreas Boehm
- ENT Department, University Hospital of Leipzig, Liebigstrasse 10-14, 04103 Leipzig, Germany
| | - Osama Sabri
- Department of Nuclear Medicine, University Hospital of Leipzig, Liebigstraße 18, 04103 Leipzig, Germany
| | - Thomas Kahn
- Department of Diagnostic and Interventional Radiology, University Hospital of Leipzig, Liebigstrasse 20, 04103 Leipzig, Germany
| | - Sandra Purz
- Department of Nuclear Medicine, University Hospital of Leipzig, Liebigstraße 18, 04103 Leipzig, Germany
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8
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Jochimsen TH, Zeisig V, Schulz J, Werner P, Patt M, Patt J, Dreyer AY, Boltze J, Barthel H, Sabri O, Sattler B. Fully automated calculation of image-derived input function in simultaneous PET/MRI in a sheep model. EJNMMI Phys 2016; 3:2. [PMID: 26872658 PMCID: PMC4752572 DOI: 10.1186/s40658-016-0139-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 01/29/2016] [Indexed: 12/04/2022] Open
Abstract
Background Obtaining the arterial input function (AIF) from image data in dynamic positron emission tomography (PET) examinations is a non-invasive alternative to arterial blood sampling. In simultaneous PET/magnetic resonance imaging (PET/MRI), high-resolution MRI angiographies can be used to define major arteries for correction of partial-volume effects (PVE) and point spread function (PSF) response in the PET data. The present study describes a fully automated method to obtain the image-derived input function (IDIF) in PET/MRI. Results are compared to those obtained by arterial blood sampling. Methods To segment the trunk of the major arteries in the neck, a high-resolution time-of-flight MRI angiography was postprocessed by a vessel-enhancement filter based on the inertia tensor. Together with the measured PSF of the PET subsystem, the arterial mask was used for geometrical deconvolution, yielding the time-resolved activity concentration averaged over a major artery. The method was compared to manual arterial blood sampling at the hind leg of 21 sheep (animal stroke model) during measurement of blood flow with O15-water. Absolute quantification of activity concentration was compared after bolus passage during steady state, i.e., between 2.5- and 5-min post injection. Cerebral blood flow (CBF) values from blood sampling and IDIF were also compared. Results The cross-calibration factor obtained by comparing activity concentrations in blood samples and IDIF during steady state is 0.98 ± 0.10. In all examinations, the IDIF provided a much earlier and sharper bolus peak than in the time course of activity concentration obtained by arterial blood sampling. CBF using the IDIF was 22 % higher than CBF obtained by using the AIF yielded by blood sampling. Conclusions The small deviation between arterial blood sampling and IDIF during steady state indicates that correction of PVE and PSF is possible with the method presented. The differences in bolus dynamics and, hence, CBF values can be explained by the different sampling locations (hind leg vs. major neck arteries) with differences in delay/dispersion. It will be the topic of further work to test the method on humans with the perspective of replacing invasive blood sampling by an IDIF using simultaneous PET/MRI.
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Affiliation(s)
- Thies H Jochimsen
- Department of Nuclear Medicine, Leipzig University Hospital, Liebigstr. 18, Leipzig, Germany.
| | - Vilia Zeisig
- Department of Nuclear Medicine, Leipzig University Hospital, Liebigstr. 18, Leipzig, Germany
| | - Jessica Schulz
- Max Planck Institute for Human Cognitive and Brain Sciences, Stephanstr. 1a, Leipzig, D-04103, Germany
| | - Peter Werner
- Department of Nuclear Medicine, Leipzig University Hospital, Liebigstr. 18, Leipzig, Germany
| | - Marianne Patt
- Department of Nuclear Medicine, Leipzig University Hospital, Liebigstr. 18, Leipzig, Germany
| | - Jörg Patt
- Department of Nuclear Medicine, Leipzig University Hospital, Liebigstr. 18, Leipzig, Germany
| | - Antje Y Dreyer
- Fraunhofer Institute of Cell Therapy and Immunology, Perlickstr. 1, Leipzig, D-04103, Germany.,Translational Centre for Regenerative Medicine, University Leipzig, Philipp-Rosenthal-Str. 55, Leipzig, D-04103, Germany
| | - Johannes Boltze
- Fraunhofer Institute of Cell Therapy and Immunology, Perlickstr. 1, Leipzig, D-04103, Germany.,Translational Centre for Regenerative Medicine, University Leipzig, Philipp-Rosenthal-Str. 55, Leipzig, D-04103, Germany.,Fraunhofer Research Institution of Marine Biotechnology and Institute for Medical and Marine Biotechnology, University of Lübeck, Lübeck, Germany
| | - Henryk Barthel
- Department of Nuclear Medicine, Leipzig University Hospital, Liebigstr. 18, Leipzig, Germany
| | - Osama Sabri
- Department of Nuclear Medicine, Leipzig University Hospital, Liebigstr. 18, Leipzig, Germany
| | - Bernhard Sattler
- Department of Nuclear Medicine, Leipzig University Hospital, Liebigstr. 18, Leipzig, Germany
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Abstract
OBJECTIVE This review article explores recent advancements in PET/MRI for clinical oncologic imaging. CONCLUSION Radiologists should understand the technical considerations that have made PET/MRI feasible within clinical workflows, the role of PET tracers for imaging various molecular targets in oncology, and advantages of hybrid PET/MRI compared with PET/CT. To facilitate this understanding, we discuss clinical examples (including gliomas, breast cancer, bone metastases, prostate cancer, bladder cancer, gynecologic malignancy, and lymphoma) as well as future directions, challenges, and areas for continued technical optimization for PET/MRI.
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Gawlitza M, Purz S, Kubiessa K, Boehm A, Barthel H, Kluge R, Kahn T, Sabri O, Stumpp P. In Vivo Correlation of Glucose Metabolism, Cell Density and Microcirculatory Parameters in Patients with Head and Neck Cancer: Initial Results Using Simultaneous PET/MRI. PLoS One 2015; 10:e0134749. [PMID: 26270054 PMCID: PMC4536035 DOI: 10.1371/journal.pone.0134749] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Accepted: 06/30/2015] [Indexed: 12/20/2022] Open
Abstract
Objective To demonstrate the feasibility of simultaneous acquisition of 18F-FDG-PET, diffusion-weighted imaging (DWI) and T1-weighted dynamic contrast-enhanced MRI (T1w-DCE) in an integrated simultaneous PET/MRI in patients with head and neck squamous cell cancer (HNSCC) and to investigate possible correlations between these parameters. Methods 17 patients that had given informed consent (15 male, 2 female) with biopsy-proven HNSCC underwent simultaneous 18F-FDG-PET/MRI including DWI and T1w-DCE. SUVmax, SUVmean, ADCmean, ADCmin and Ktrans, kep and ve were measured for each tumour and correlated using Spearman’s ρ. Results Significant correlations were observed between SUVmean and Ktrans (ρ = 0.43; p ≤ 0.05); SUVmean and kep (ρ = 0.44; p ≤ 0.05); Ktrans and kep (ρ = 0.53; p ≤ 0.05); and between kep and ve (ρ = -0.74; p ≤ 0.01). There was a trend towards statistical significance when correlating SUVmax and ADCmin (ρ = -0.35; p = 0.08); SUVmax and Ktrans (ρ = 0.37; p = 0.07); SUVmax and kep (ρ = 0.39; p = 0.06); and ADCmean and ve (ρ = 0.4; p = 0.06). Conclusion Simultaneous 18F-FDG-PET/MRI including DWI and T1w-DCE in patients with HNSCC is feasible and allows depiction of complex interactions between glucose metabolism, microcirculatory parameters and cellular density.
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Affiliation(s)
- Matthias Gawlitza
- Department of Diagnostic and Interventional Radiology, University Hospital of Leipzig, Liebigstraße 20, 04103 Leipzig, Germany
- * E-mail:
| | - Sandra Purz
- Department of Nuclear Medicine, University Hospital of Leipzig, Liebigstraße 18, 04103 Leipzig, Germany
| | - Klaus Kubiessa
- Department of Diagnostic and Interventional Radiology, University Hospital of Leipzig, Liebigstraße 20, 04103 Leipzig, Germany
| | - Andreas Boehm
- ENT-Department, University Hospital of Leipzig, Liebigstraße 10–14, 04103 Leipzig, Germany
| | - Henryk Barthel
- Department of Nuclear Medicine, University Hospital of Leipzig, Liebigstraße 18, 04103 Leipzig, Germany
| | - Regine Kluge
- Department of Nuclear Medicine, University Hospital of Leipzig, Liebigstraße 18, 04103 Leipzig, Germany
| | - Thomas Kahn
- Department of Diagnostic and Interventional Radiology, University Hospital of Leipzig, Liebigstraße 20, 04103 Leipzig, Germany
| | - Osama Sabri
- Department of Nuclear Medicine, University Hospital of Leipzig, Liebigstraße 18, 04103 Leipzig, Germany
| | - Patrick Stumpp
- Department of Diagnostic and Interventional Radiology, University Hospital of Leipzig, Liebigstraße 20, 04103 Leipzig, Germany
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Combined PET/MR: Where are we now? Summary report of the second international workshop on PET/MR imaging April 8-12, 2013, Tubingen, Germany. Mol Imaging Biol 2015; 16:295-310. [PMID: 24668195 DOI: 10.1007/s11307-014-0725-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
This workshop was held a year after the initial positron emission tomography/magnetic resonance (PET/MR) workshop in Tübingen, which was recently reported in this journal. The discussions at the 2013 workshop, however, differed substantially from those of the initial workshop, attesting to the progress of combined PET/MR as an innovative imaging modality. Discussions were focused on the search for truly novel, unique clinical and research applications as well as technical issues such as reliable and accurate approaches for attenuation and scatter correction of PET emission data. The workshop provided hands-on experience with PET and MR imaging. In addition, structured and moderated open discussion sessions, including six dialogue boards and two roundtable discussions, provided input from current and future PET/MR imaging users. This summary provides a snapshot of the current achievements and challenges for PET/MR.
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Integrated PET/MRI for planning navigated biopsies in pediatric brain tumors. Childs Nerv Syst 2014; 30:1399-403. [PMID: 24710719 DOI: 10.1007/s00381-014-2412-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Accepted: 03/27/2014] [Indexed: 10/25/2022]
Abstract
INTRODUCTION An integrated PET/MRI scanner has been used in selected cases of pediatric brain tumor patients to obtain additional metabolic information about lesions for preoperative biopsy planning and navigation. PATIENTS AND METHODS Four patients, age 9-16 years, received PET/MRI scans employing [(11)C]methionine positron emission tomography (PET) and contrast-enhanced 3D-MR sequences for neuronavigation. PET and MR sequences have been matched for neurosurgical guidance. An infrared camera-based neuronavigation system was employed with co-registered MR and PET images fused to hybrid images for preoperative planning, stereotactic biopsy planning, and/or intraoperative guidance. RESULTS All patients showed hot spots of increased amino acid transport in PET and contrast-enhancing lesions in MRI. In three of the four patients, PET hot spots were congruent with contrast-enhancing areas in MRI. In two patients, frame-based stereotactic biopsies were taken from thalamo-mesencephalic lesions. One patient underwent second-look surgery for the suspicion of recurrent malignant glioma of the posterior fossa. One incidental frontal mass lesion was subtotally resected. No complications occurred. Hybrid imaging was helpful during the procedures to obtain representative histopathologic specimens and for surgical guidance during resection. Co-registered images did match with intraoperative landmarks, tumor borders, and histopathologic specimens. CONCLUSION The integrated PET/MRI scanner offers co-registered multimodal, high-resolution data for neuronavigation with reduced radiation exposure compared to PET/CT scans. One examination session provides all necessary data for neuronavigation and preoperative planning, avoiding additional anesthesia in the small patients. Hybrid multimodality imaging may improve safety and yield additional information when obtaining representative histopathologic specimens of brain tumors.
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Drzezga A, Barthel H, Minoshima S, Sabri O. Potential Clinical Applications of PET/MR Imaging in Neurodegenerative Diseases. J Nucl Med 2014; 55:47S-55S. [PMID: 24819417 DOI: 10.2967/jnumed.113.129254] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Neurodegenerative disorders such as Alzheimer disease are among today's most alarming health problems in our aging society. The clinical assessment of neurodegenerative disorders benefits from recent innovations in the field of imaging technology. These innovations include emerging tracers for molecular imaging of neurodegenerative pathology and the introduction of novel integrated PET/MR imaging instruments. Because both PET and MR imaging procedures have shown critical value in the diagnostic work-up of neurodegenerative disorders, the combination of both imaging modalities in the form of an integrated PET/MR imaging system may be of value. This combination includes practical methodologic advantages and an improved workflow facilitated by the combined acquisition of dual-modality data. It offers clinical advantages because of the systematic combination of complementary information, potentially allowing the creation of novel integrated imaging biomarkers. The effectiveness of new disease-modifying treatments may depend on the timely initiation of therapy before irreversible neuronal damage in slowly progressive neurodegenerative disorders. Integrated PET/MR imaging may be able to improve such early diagnosis through both structural and functional information.
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Affiliation(s)
- Alexander Drzezga
- Department of Nuclear Medicine, University of Cologne, Cologne, Germany
| | - Henryk Barthel
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Satoshi Minoshima
- Division of Nuclear Medicine and Radiology, University of Washington Medical Center, Seattle, WA
| | - Osama Sabri
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
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Tian J, Fu L, Yin D, Zhang J, Chen Y, An N, Xu B. Does the novel integrated PET/MRI offer the same diagnostic performance as PET/CT for oncological indications? PLoS One 2014; 9:e90844. [PMID: 24603857 PMCID: PMC3946212 DOI: 10.1371/journal.pone.0090844] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Accepted: 02/04/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND We compared PET/MRI with PET/CT in terms of lesion detection and quantitative measurement to verify the feasibility of the novel integrated imaging modality for oncological applications. METHODOLOGY/PRINCIPAL FINDINGS In total, 285 patients referred to our PET/CT center for oncological indications voluntarily participated in this same-day PET/CT and PET/MRI comparative study. PET/CT images were acquired and reconstructed following routine protocols, and then PET/MRI was performed at a mean time interval of 28±11 min (range 15-45 min). PET/MRI covered the body trunk with a sequence combination of transverse T1WI 3D-volumetric interpolated breath-hold, T2WI turbo spin echo with fat saturation, diffusion-weighted imaging with double b values (50 and 800 s/mm2), and simultaneous PET acquisition over 45 min/5 bed positions. The maximum standardized uptake value (SUVmax) was assessed by manually drawn regions of interest over fluorodeoxyglucose-positive lesions. Among 285 cases, 57 showed no abnormalities, and 368 lesions (278 malignant, 68 benign and 22 undetermined) were detected in 228 patients. When stand-alone modalities were evaluated, PET revealed 31 and 12 lesions missed by CT and MRI, respectively, and CT and MRI revealed 38 and 61 more lesions, respectively, than PET. Compared to CT, MRI detected 40 more lesions and missed 8. In the integrated mode, PET/CT correctly detected 6 lesions misdiagnosed by PET/MRI, but was false-negative in 30 cases that were detected by PET/MRI. The overall diagnosis did not differ between integrated PET/MRI and PET/CT. SUVmax for lesions were slightly higher from PET/MRI than PET/CT but correlated well (ρ = 0.85-0.91). CONCLUSIONS/SIGNIFICANCE The novel integrated PET/MRI performed comparatively to PET/CT in lesion detection and quantitative measurements. PET from either scanner modality offered almost the same information despite differences in hardware. Further study is needed to explore features of integrated PET/MRI not addressed in this study.
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Affiliation(s)
- Jiahe Tian
- Department of Nuclear Medicine, General Hospital of the Chinese People's Liberation Army, Beijing, China
- * E-mail:
| | - Liping Fu
- Department of Nuclear Medicine, General Hospital of the Chinese People's Liberation Army, Beijing, China
| | - Dayi Yin
- Department of Nuclear Medicine, General Hospital of the Chinese People's Liberation Army, Beijing, China
| | - Jinming Zhang
- Department of Nuclear Medicine, General Hospital of the Chinese People's Liberation Army, Beijing, China
| | - Yingmao Chen
- Department of Nuclear Medicine, General Hospital of the Chinese People's Liberation Army, Beijing, China
| | - Ningyu An
- Department of Radiology, Xiyuan, General Hospital of the Chinese People's Liberation Army, Beijing, China
| | - Baixuan Xu
- Department of Nuclear Medicine, General Hospital of the Chinese People's Liberation Army, Beijing, China
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Lyoo CH, Zanotti-Fregonara P, Zoghbi SS, Liow JS, Xu R, Pike VW, Zarate CA, Fujita M, Innis RB. Image-derived input function derived from a supervised clustering algorithm: methodology and validation in a clinical protocol using [11C](R)-rolipram. PLoS One 2014; 9:e89101. [PMID: 24586526 PMCID: PMC3930688 DOI: 10.1371/journal.pone.0089101] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Accepted: 01/14/2014] [Indexed: 11/18/2022] Open
Abstract
Image-derived input function (IDIF) obtained by manually drawing carotid arteries (manual-IDIF) can be reliably used in [11C](R)-rolipram positron emission tomography (PET) scans. However, manual-IDIF is time consuming and subject to inter- and intra-operator variability. To overcome this limitation, we developed a fully automated technique for deriving IDIF with a supervised clustering algorithm (SVCA). To validate this technique, 25 healthy controls and 26 patients with moderate to severe major depressive disorder (MDD) underwent T1-weighted brain magnetic resonance imaging (MRI) and a 90-minute [11C](R)-rolipram PET scan. For each subject, metabolite-corrected input function was measured from the radial artery. SVCA templates were obtained from 10 additional healthy subjects who underwent the same MRI and PET procedures. Cluster-IDIF was obtained as follows: 1) template mask images were created for carotid and surrounding tissue; 2) parametric image of weights for blood were created using SVCA; 3) mask images to the individual PET image were inversely normalized; 4) carotid and surrounding tissue time activity curves (TACs) were obtained from weighted and unweighted averages of each voxel activity in each mask, respectively; 5) partial volume effects and radiometabolites were corrected using individual arterial data at four points. Logan-distribution volume (VT/fP) values obtained by cluster-IDIF were similar to reference results obtained using arterial data, as well as those obtained using manual-IDIF; 39 of 51 subjects had a VT/fP error of <5%, and only one had error >10%. With automatic voxel selection, cluster-IDIF curves were less noisy than manual-IDIF and free of operator-related variability. Cluster-IDIF showed widespread decrease of about 20% [11C](R)-rolipram binding in the MDD group. Taken together, the results suggest that cluster-IDIF is a good alternative to full arterial input function for estimating Logan-VT/fP in [11C](R)-rolipram PET clinical scans. This technique enables fully automated extraction of IDIF and can be applied to other radiotracers with similar kinetics.
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Affiliation(s)
- Chul Hyoung Lyoo
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Paolo Zanotti-Fregonara
- Molecular Imaging Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, United States of America
- University of Bordeaux, CNRS, INCIA, UMR 5287, Talence, France
| | - Sami S. Zoghbi
- Molecular Imaging Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Jeih-San Liow
- Molecular Imaging Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Rong Xu
- Molecular Imaging Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Victor W. Pike
- Molecular Imaging Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Carlos A. Zarate
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Masahiro Fujita
- Molecular Imaging Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Robert B. Innis
- Molecular Imaging Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, United States of America
- * E-mail:
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Region-Based Partial Volume Correction Techniques for PET Imaging: Sinogram Implementation and Robustness. INTERNATIONAL JOURNAL OF MOLECULAR IMAGING 2013; 2013:435959. [PMID: 24455241 PMCID: PMC3877626 DOI: 10.1155/2013/435959] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2013] [Revised: 09/02/2013] [Accepted: 10/03/2013] [Indexed: 11/18/2022]
Abstract
Background/Purpose. Limited spatial resolution of positron emission tomography (PET) requires partial volume correction (PVC). Region-based PVC methods are based on geometric transfer matrix implemented either in image-space (GTM) or sinogram-space (GTMo), both with similar performance. Although GTMo is slower, it more closely simulates the 3D PET image acquisition, accounts for local variations of point spread function, and can be implemented for iterative reconstructions. A recent image-based symmetric GTM (sGTM) has shown improvement in noise characteristics and robustness to misregistration over GTM. This study implements the sGTM method in sinogram space (sGTMo), validates it, and evaluates its performance. Methods. Two 3D sphere and brain digital phantoms and a physical sphere phantom were used. All four region-based PVC methods (GTM, GTMo, sGTM, and sGTMo) were implemented and their performance was evaluated. Results. All four PVC methods had similar accuracies. Both noise propagation and robustness of the sGTMo method were similar to those of sGTM method while they were better than those of GTMo method especially for smaller objects. Conclusion. The sGTMo was implemented and validated. The performance of the sGTMo in terms of noise characteristics and robustness to misregistration is similar to that of the sGTM method and improved compared to the GTMo method.
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Jadvar H, Colletti PM. Competitive advantage of PET/MRI. Eur J Radiol 2013; 83:84-94. [PMID: 23791129 DOI: 10.1016/j.ejrad.2013.05.028] [Citation(s) in RCA: 92] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Revised: 05/20/2013] [Accepted: 05/20/2013] [Indexed: 02/08/2023]
Abstract
Multimodality imaging has made great strides in the imaging evaluation of patients with a variety of diseases. Positron emission tomography/computed tomography (PET/CT) is now established as the imaging modality of choice in many clinical conditions, particularly in oncology. While the initial development of combined PET/magnetic resonance imaging (PET/MRI) was in the preclinical arena, hybrid PET/MR scanners are now available for clinical use. PET/MRI combines the unique features of MRI including excellent soft tissue contrast, diffusion-weighted imaging, dynamic contrast-enhanced imaging, fMRI and other specialized sequences as well as MR spectroscopy with the quantitative physiologic information that is provided by PET. Most evidence for the potential clinical utility of PET/MRI is based on studies performed with side-by-side comparison or software-fused MRI and PET images. Data on distinctive utility of hybrid PET/MRI are rapidly emerging. There are potential competitive advantages of PET/MRI over PET/CT. In general, PET/MRI may be preferred over PET/CT where the unique features of MRI provide more robust imaging evaluation in certain clinical settings. The exact role and potential utility of simultaneous data acquisition in specific research and clinical settings will need to be defined. It may be that simultaneous PET/MRI will be best suited for clinical situations that are disease-specific, organ-specific, related to diseases of the children or in those patients undergoing repeated imaging for whom cumulative radiation dose must be kept as low as reasonably achievable. PET/MRI also offers interesting opportunities for use of dual modality probes. Upon clear definition of clinical utility, other important and practical issues related to business operational model, clinical workflow and reimbursement will also be resolved.
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Affiliation(s)
- Hossein Jadvar
- Division of Nuclear Medicine, Department of Radiology, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA.
| | - Patrick M Colletti
- Division of Nuclear Medicine, Department of Radiology, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
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Catana C, Guimaraes AR, Rosen BR. PET and MR imaging: the odd couple or a match made in heaven? J Nucl Med 2013; 54:815-24. [PMID: 23492887 DOI: 10.2967/jnumed.112.112771] [Citation(s) in RCA: 91] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
PET and MR imaging are modalities routinely used for clinical and research applications. Integrated scanners capable of acquiring PET and MR imaging data in the same session, sequentially or simultaneously, have recently become available for human use. In this article, we describe some of the technical advances that allowed the development of human PET/MR scanners; briefly discuss methodologic challenges and opportunities provided by this novel technology; and present potential oncologic, cardiac, and neuropsychiatric applications. These examples range from studies that might immediately benefit from PET/MR to more advanced applications on which future development might have an even broader impact.
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Affiliation(s)
- Ciprian Catana
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA.
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MR/PET or PET/MRI: does it matter? MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2013; 26:1-4. [PMID: 23385880 DOI: 10.1007/s10334-012-0365-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2012] [Revised: 12/20/2012] [Accepted: 12/21/2012] [Indexed: 01/01/2023]
Abstract
After the very successful clinical introduction of combined PET/CT imaging a decade ago, a hardware combination of PET and MR is following suit. Today, three different approaches towards integrated PET/MR have been proposed: (1) a triple-modality system with a 3T MRI and a time-of-flight PET/CT installed in adjacent rooms, (2) a tandem system with a 3T MRI and a time-of-flight PET/CT in a co-planar installation with a joint patient handling system, and (3) a fully-integrated system with a whole-body PET system mounted inside a 3T MRI system. This special issue of MAGMA brings together contributions from key experts in the field of PET/MR, PET/CT and CT. The various papers share the author's perspectives on the state-of-the-art PET/MR imaging with any of the three approaches mentioned above. In addition to several reviews discussing advantages and challenges of combining PET and MRI for clinical diagnostics, first clinical data are also presented. We expect this special issue to nurture future improvements in hardware, clinical protocols, and efficient post-processing strategies to further assess the diagnostic value of combined PET/MR imaging. It remains to be seen whether a so-called "killer application" for PET/MRI will surface. In that case PET/MR is likely to excel in pre-clinical and selected research applications for now. This special issue helps the readers to stay on track of this exciting development.
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Keller SH, Holm S, Hansen AE, Sattler B, Andersen F, Klausen TL, Højgaard L, Kjær A, Beyer T. Image artifacts from MR-based attenuation correction in clinical, whole-body PET/MRI. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2012; 26:173-81. [PMID: 22996323 DOI: 10.1007/s10334-012-0345-4] [Citation(s) in RCA: 99] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2012] [Revised: 08/14/2012] [Accepted: 09/04/2012] [Indexed: 11/28/2022]
Abstract
PURPOSE Integrated whole-body PET/MRI tomographs have become available. PET/MR imaging has the potential to supplement, or even replace combined PET/CT imaging in selected clinical indications. However, this is true only if methodological pitfalls and image artifacts arising from novel MR-based attenuation correction (MR-AC) are fully understood. RESULTS Here we present PET/MR image artifacts following routine MR-AC, as most frequently observed in clinical operations of an integrated whole-body PET/MRI system. CONCLUSION A clinical adoption of integrated PET/MRI should entail the joint image display and interpretation of MR data, MR-based attenuation maps and uncorrected plus attenuation-corrected PET images in order to recognize potential pitfalls from MR-AC and to ensure clinically accurate image interpretation.
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Affiliation(s)
- Sune H Keller
- Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark.
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