Novel Quantitative Techniques in Hybrid (PET-MR) Imaging of Brain Tumors

Advancements in Positron Emission Tomography/Magnetic Resonance Imaging and Applications to Diagnostic Challenges in Neuroradiology

Since the clinical adoption of magnetic resonance (MR) in medical imaging, MR has proven to be a workhorse in diagnostic neuroradiology, with the ability to provide superb anatomic detail as well as additional functional and physiologic data, depending on the techniques utilized. Positron emission tomography/computed tomography has also shown irreplaceable diagnostic value in certain disease processes of the central nervous system by providing molecular and metabolic information through the development of numerous disease-specific PET tracers, many of which can be utilized as a diagnostic technique in and of themselves or can provide a valuable adjunct to information derived from MR. Despite these advances, many challenges still remain in neuroradiology, particularly in malignancy, neurodegenerative disease, epilepsy, and cerebrovascular disease. Through improvements in attenuation correction, motion correction, and PET detectors, combining the 2 modalities of PET and MR through simultaneous imaging has proven feasible and allows for improved spatial and temporal resolution without compromising either of the 2 individual modalities. The complementary information offered by both technologies has provided increased diagnostic accuracy in both research and many clinical applications in neuroradiology.

Performance Comparison of Different Readouts for Position-Sensitive Solid-State Photomultiplier Arrays

A thorough comparison of five different readouts for reading out a 2 × 2 array of 5 mm × 5 mm position-sensitive solid-state photomultipliers (PS-SSPM) was undertaken. The five readouts include reading out the 20 signals (16 position and 4 timing) individually, two signal multiplexing readouts, and two position decoding readouts. Flood histogram quality, signal-to-noise ratio (SNR) and energy resolution were compared at different bias voltage (27.0 V to 32.0 V, at 0.5 V intervals) and at a fixed temperature of 0 °C by coupling a 6 × 6 array of 1.3 mm × 1.3 mm × 20 mm polished LSO crystals to the center of the PS-SSPM array. The timing resolution was measured at a bias voltage of 31.0 V (optimal bias voltage in terms of flood histogram quality). The best flood histogram quality value and signal-to-noise were 7.3 ± 1.6 and 33.5 ± 3.1, respectively, and were obtained by shaping and digitizing the 16 position signals individually. The capacitive charge-division readout is the simplest readout among the five evaluated but still resulted in good performance with a flood histogram quality value of 3.3 ± 0.4 and a SNR of 18.3 ± 1.3. The average energy resolution and the average timing resolution were 15.2 ± 1.2 % and 8.4 ± 1.6 ns for individual signal readout and 15.9 ± 1.2 % and 8.8 ± 1.3 ns by using the capacitive charge-division readout method. These studies show that for an ultra-high spatial resolution applications using the 2 × 2 PS-SSPM array, reading out the 20 signals individually is necessary; whilst the capacitive charge-division readout is a cost-effective readout for less demanding applications.

PET/MRI of central nervous system: current status and future perspective

Imaging plays an increasingly important role in the early diagnosis, prognosis prediction and therapy response evaluation of central nervous system (CNS) diseases. The newly emerging hybrid positron emission tomography/magnetic resonance imaging (PET/MRI) can perform "one-stop-shop" evaluation, including anatomic, functional, biochemical and metabolic information, even at the molecular level, for personalised diagnoses and treatments of CNS diseases. However, there are still several problems to be resolved, such as appropriate PET detectors, attenuation correction and so on. This review will introduce the basic physical principles of PET/MRI and its potential clinical applications in the CNS. We also provide the future perspectives for this field.

KEY POINTS

• PET/MRI can simultaneously provide anatomic, functional, biochemical and metabolic information. • PET/MRI has promising potential in various central nervous system diseases. • Research on the future implementation of PET/MRI is challenging and encouraging.

Multi-contrast attenuation map synthesis for PET/MR scanners: assessment on FDG and Florbetapir PET tracers

Positron Emission Tomography/Magnetic Resonance Imaging (PET/MR) scanners are expected to offer a new range of clinical applications. Attenuation correction is an essential requirement for quantification of PET data but MRI images do not directly provide a patient-specific attenuation map.

Methods We further validate and extend a Computed Tomography (CT) and attenuation map (μ-map) synthesis method based on pre-acquired MRI-CT image pairs. The validation consists of comparing the CT images synthesised with the proposed method to the original CT images. PET images were acquired using two different tracers (¹⁸F-FDG and ¹⁸F-florbetapir). They were then reconstructed and corrected for attenuation using the synthetic μ-maps and compared to the reference PET images corrected with the CT-based μ-maps. During the validation, we observed that the CT synthesis was inaccurate in areas such as the neck and the cerebellum, and propose a refinement to mitigate these problems, as well as an extension of the method to multi-contrast MRI data.

Results With the improvements proposed, a significant enhancement in CT synthesis, which results in a reduced absolute error and a decrease in the bias when reconstructing PET images, was observed. For both tracers, on average, the absolute difference between the reference PET images and the PET images corrected with the proposed method was less than 2%, with a bias inferior to 1%.

Conclusion With the proposed method, attenuation information can be accurately derived from MRI images by synthesising CT using routine anatomical sequences. MRI sequences, or combination of sequences, can be used to synthesise CT images, as long as they provide sufficient anatomical information.