Effects of magnetic fields of up to 9.4 T on resolution and contrast of PET images as measured with an MR-BrainPET

Application of PET/MRI in Gynecologic Malignancies

The diagnosis, treatment, and management of gynecologic malignancies benefit from both positron emission tomography/computed tomography (PET/CT) and MRI. PET/CT provides important information on the local extent of disease as well as diffuse metastatic involvement. MRI offers soft tissue delineation and loco-regional disease involvement. The combination of these two technologies is key in diagnosis, treatment planning, and evaluating treatment response in gynecological malignancies. This review aims to assess the performance of PET/MRI in gynecologic cancer patients and outlines the technical challenges and clinical advantages of PET/MR systems when specifically applied to gynecologic malignancies.

Fast 3D kernel computation method for positron range correction in PET

Objective. The positron range is a fundamental, detector-independent physical limitation to spatial resolution in positron emission tomography (PET) as it causes a significant blurring of underlying activity distribution in the reconstructed images. A major challenge for positron range correction methods is to provide accurate range kernels that inherently incorporate the generally inhomogeneous stopping power, especially at tissue boundaries. In this work, we propose a novel approach to generate accurate three-dimensional (3D) blurring kernels both in homogenous and heterogeneous media to improve PET spatial resolution.Approach. In the proposed approach, positron energy deposition was approximately tracked along straight paths, depending on the positron stopping power of the underlying material. The positron stopping power was derived from the attenuation coefficient of 511 keV gamma photons according to the available PET attenuation maps. Thus, the history of energy deposition is taken into account within the range of kernels. Special emphasis was placed on facilitating the very fast computation of the positron annihilation probability in each voxel.Results. Positron path distributions of¹⁸F in low-density polyurethane were in high agreement with Geant4 simulation at an annihilation probability larger than 10^-2∼ 10^-3of the maximum annihilation probability. The Geant4 simulation was further validated with measured¹⁸F depth profiles in these polyurethane phantoms. The tissue boundary of water with cortical bone and lung was correctly modeled. Residual artifacts from the numerical computations were in the range of 1%. The calculated annihilation probability in voxels shows an overall difference of less than 20% compared to the Geant4 simulation.Significance. The proposed method is expected to significantly improve spatial resolution for non-standard isotopes by providing sufficiently accurate range kernels, even in the case of significant tissue inhomogeneities.

Evaluating the impact of different positron emitters on the performance of a clinical PET/MR system

PURPOSE

The positron range and prompt gamma emission are distinctive with different positron emitters. The performance assessment of an integrated PET/MR scanner with these positron emitters is required for related applications, as the magnetic field interferes with the positron propagation. Such an assessment is to be performed on the United Imaging uPMR 790 integrated PET/MR system.

METHODS

The performance measurement methods were modified based on NEMA NU 2-2012, involving ¹⁸ F, ⁶⁴ Cu, ⁶⁸ Ga, ⁸⁹ Zr, and ¹²⁴ I as positron emitters. The NEMA IEC phantom was used for evaluations of image qualities. An agarose cap was wrapped around the point source for tissue-simulating spatial resolution measurement. The count rate performance was assessed with selected positron emitters. Images of a 3D-printed Derenzo phantom and representative patients were also acquired.

RESULTS

The image quality measurement showed that all five positron emitters were suitable for the PET/MR system studied. However, due to the magnetic field, the image of the point source showed an elongated comet-tail feature, which could be eliminated by a tissue-simulating cap. This effect is more obvious in ¹²⁴ I and ⁶⁸ Ga, due to their long positron ranges. The imaging ability with various positron emitters was further validated with the count rate assessment, the Derenzo phantom, and the clinical images.

CONCLUSIONS

Different positron emitters could be effectively imaged by the PET/MR system tested. The resolution measurement strategy proposed could be applied to measure PET spatial resolution in the magnetic field. This article is protected by copyright. All rights reserved.

Expanding the PET radioisotope universe utilizing solid targets on small medical cyclotrons

Molecular imaging with medical radioisotopes enables the minimally-invasive monitoring of aberrant biochemical, cellular and tissue-level processes in living subjects. The approach requires the administration of radiotracers composed of radioisotopes attached to bioactive molecules, the pairing of which considers several aspects of the radioisotope in addition to the biological behavior of the targeting molecule to which it is attached. With the advent of modern cellular and biochemical techniques, there has been a virtual explosion in potential disease recognition antigens as well as targeting moieties, which has subsequently opened new applications for a host of emerging radioisotopes with well-matched properties. Additionally, the global radioisotope production landscape has changed rapidly, with reactor-based production and its long-defined, large-scale centralized manufacturing and distribution paradigm shifting to include the manufacture and distribution of many radioisotopes via a worldwide fleet of cyclotrons now in operation. Cyclotron-based radioisotope production has become more prevalent given the commercial availability of instruments, coupled with the introduction of new target hardware, process automation and target manufacturing methods. These advances enable sustained, higher-power irradiation of solid targets that allow hospital-based radiopharmacies to produce a suite of radioisotopes that drive research, clinical trials, and ultimately clinical care. Over the years, several different radioisotopes have been investigated and/or selected for radiolabeling due to favorable decay characteristics (i.e. a suitable half-life, high probability of positron decay, etc.), well-elucidated chemistry, and a feasible production framework. However, longer-lived radioisotopes have surged in popularity given recent regulatory approvals and incorporation of radiopharmaceuticals into patient management within the medical community. This review focuses on the applications, nuclear properties, and production and purification methods for some of the most frequently used/emerging positron-emitting, solid-target-produced radioisotopes that can be manufactured using small-to-medium size cyclotrons (≤24 MeV).

Monte Carlo Simulations of the GE Signa PET/MR for Different Radioisotopes

NEMA characterization of PET systems is generally based on ¹⁸F because it is the most relevant radioisotope for the clinical use of PET. ¹⁸F has a half-life of 109.7 min and decays into stable ¹⁸O via β+ emission with a probability of over 96% and a maximum positron energy of 0.633 MeV. Other commercially available PET radioisotopes, such as ⁸²Rb and ⁶⁸Ga have more complex decay schemes with a variety of prompt gammas, which can directly fall into the energy window and induce false coincidence detections by the PET scanner.

Expanding PET-applications in life sciences with positron-emitters beyond fluorine-18

Positron-emission-tomography (PET) has become an indispensable diagnostic tool in modern nuclear medicine. Its outstanding molecular imaging features allow repetitive studies on one individual and with high sensitivity, though no interference. Rather few positron-emitters with near favourable physical properties, i.e. carbon-11 and fluorine-18, furnished most studies in the beginning, preferably if covalently bound as isotopic label of small molecules. With the advancement of PET-devices the scope of in vivo research in life sciences and especially that of medical applications expanded, and other than "standard" PET-nuclides received increasing significance, like the radiometals copper-64 and gallium-68. Especially during the last decades, positron-emitters of other chemical elements have gotten into the focus of interest, concomitant with the technical advancements in imaging and radionuclide production. With known nuclear imaging properties and main production methods of emerging positron-emitters their usefulness for medical application is promising and even proven for several ones already. Unfortunate decay properties could be corrected for, and β⁺-emitters, especially with a longer half-life, provided new possibilities for application where slower processes are of importance. Further on, (bio)chemical features of positron-emitters of other elements, among there many metals, not only expanded the field of classical clinical investigations, but also opened up new fields of application. Appropriately labelled peptides, proteins and nanoparticles lend itself as newer probes for PET-imaging, e.g. in theragnostic or PET/MR hybrid imaging. Furthermore, the potential of non-destructive in-vivo imaging with positron-emission-tomography directs the view on further areas of life sciences. Thus, exploiting the excellent methodology for basic research on molecular biochemical functions and processes is increasingly encouraged as well in areas outside of health, such as plant and environmental sciences.

Positron-emitting radionuclides for applications, with special emphasis on their production methodologies for medical use

A survey of the positron-emitting radionuclides over the whole mass range of the Periodic Table of Elements was carried out. As already known, positrons are preferably emitted from light mass neutron deficient radionuclides. Their emission from heavier mass nuclides is rather rare. The applications of positron annihilation in three areas, namely materials research, plant physiology and medical diagnosis, are reported. The methods of production of positron emitters are discussed, with emphasis on radionuclides presently attracting more attention in theranostics and multimodal imaging. Some future perspectives of radionuclide development technologies are considered.

NEMA NU 2-2007 performance characteristics of GE Signa integrated PET/MR for different PET isotopes

BACKGROUND

Fully integrated PET/MR systems are being used frequently in clinical research and routine. National Electrical Manufacturers Association (NEMA) characterization of these systems is generally done with ¹⁸F which is clinically the most relevant PET isotope. However, other PET isotopes, such as ⁶⁸Ga and ⁹⁰Y, are gaining clinical importance as they are of specific interest for oncological applications and for follow-up of ⁹⁰Y-based radionuclide therapy. These isotopes have a complex decay scheme with a variety of prompt gammas in coincidence. ⁶⁸Ga and ⁹⁰Y have higher positron energy and, because of the larger positron range, there may be interference with the magnetic field of the MR compared to ¹⁸F. Therefore, it is relevant to determine the performance of PET/MR for these clinically relevant and commercially available isotopes.

METHODS

NEMA NU 2-2007 performance measurements were performed for characterizing the spatial resolution, sensitivity, image quality, and the accuracy of attenuation and scatter corrections for ¹⁸F, ⁶⁸Ga, and ⁹⁰Y. Scatter fraction and noise equivalent count rate (NECR) tests were performed using ¹⁸F and ⁶⁸Ga. All phantom data were acquired on the GE Signa integrated PET/MR system, installed in UZ Leuven, Belgium.

RESULTS

¹⁸F, ⁶⁸Ga, and ⁹⁰Y NEMA performance tests resulted in substantially different system characteristics. In comparison with ¹⁸F, the spatial resolution is about 1 mm larger in the axial direction for ⁶⁸Ga and no significative effect was found for ⁹⁰Y. The impact of this lower resolution is also visible in the recovery coefficients of the smallest spheres of ⁶⁸Ga in image quality measurements, where clearly lower values are obtained. For ⁹⁰Y, the low number of counts leads to a large variability in the image quality measurements. The primary factor for the sensitivity change is the scale factor related to the positron emission fraction. There is also an impact on the peak NECR, which is lower for ⁶⁸Ga than for ¹⁸F and appears at higher activities.

CONCLUSIONS

The system performance of GE Signa integrated PET/MR was substantially different, in terms of NEMA spatial resolution, image quality, and NECR for ⁶⁸Ga and ⁹⁰Y compared to ¹⁸F. But these differences are compensated by the PET/MR scanner technologies and reconstructions methods.

PET/MRI Hybrid Systems

Over the last decade, the combination of PET and MRI in one system has proven to be highly successful in basic preclinical research, as well as in clinical research. Nowadays, PET/MRI systems are well established in preclinical imaging and are progressing into clinical applications to provide further insights into specific diseases, therapeutic assessments, and biological pathways. Certain challenges in terms of hardware had to be resolved concurrently with the development of new techniques to be able to reach the full potential of both combined techniques. This review provides an overview of these challenges and describes the opportunities that simultaneous PET/MRI systems can exploit in comparison with stand-alone or other combined hybrid systems. New approaches were developed for simultaneous PET/MRI systems to correct for attenuation of 511 keV photons because MRI does not provide direct information on gamma photon attenuation properties. Furthermore, new algorithms to correct for motion were developed, because MRI can accurately detect motion with high temporal resolution. The additional information gained by the MRI can be employed to correct for partial volume effects as well. The development of new detector designs in combination with fast-decaying scintillator crystal materials enabled time-of-flight detection and incorporation in the reconstruction algorithms. Furthermore, this review lists the currently commercially available systems both for preclinical and clinical imaging and provides an overview of applications in both fields. In this regard, special emphasis has been placed on data analysis and the potential for both modalities to evolve with advanced image analysis tools, such as cluster analysis and machine learning.

Advances in PET/MR instrumentation and image reconstruction

The combination of positron emission tomography (PET) and MRI has attracted the attention of researchers in the past approximately 20 years in small-animal imaging and more recently in clinical research. The combination of PET/MRI allows researchers to explore clinical and research questions in a wide number of fields, some of which are briefly mentioned here. An important number of groups have developed different concepts to tackle the problems that PET instrumentation poses to the exposition of electromagnetic fields. We have described most of these research developments in preclinical and clinical experiments, including the few commercial scanners available. From the software perspective, an important number of algorithms have been developed to address the attenuation correction issue and to exploit the possibility that MRI provides for motion correction and quantitative image reconstruction, especially parametric modelling of radiopharmaceutical kinetics. In this work, we give an overview of some exemplar applications of simultaneous PET/MRI, together with technological hardware and software developments.

Cross section measurements of 75As(α,xn)76,77,78Br and 75As(α,x)74As nuclear reactions using the monitor radionuclides 67Ga and 66Ga for beam evaluation

For the production of the medically interesting radionuclides 76Br and 77Br cross sections of α-particle induced reactions on arsenic, leading to the formation of 76,77,78Br as well as to the non-isotopic impurity 74As, were measured from their thresholds up to 37 MeV. Sediments of elemental arsenic were used as targets and irradiated, using the established stacked-foil technique. In order to remove discrepancies of the existing literature data, the cross section ratios of the monitor nuclides 67Ga/66Ga were used for determination of the α-particle energies as well as the effective beam current through all the stacks, thus inferring the experimental cross sections. Compared with the available excitation functions the new data indicate slightly divergent curve shapes. In the case of 76Br the excitation function seems to be shifted to somewhat lower α-particle energies, and also the maximum cross section of the formation of 77Br tends to be slightly lower compared with the curve recommended to date. In the case of a re-evaluation, these new data should be taken into account, as they may contribute to enhance the accuracy of the excitation functions.

Electrodynamics and radiofrequency antenna concepts for human magnetic resonance at 23.5 T (1 GHz) and beyond

OBJECTIVE

This work investigates electrodynamic constraints, explores RF antenna concepts and examines the transmission fields (B 1 (+) ) and RF power deposition of dipole antenna arrays for (1)H magnetic resonance of the human brain at 1 GHz (23.5 T).

MATERIALS AND METHODS

Electromagnetic field (EMF) simulations are performed in phantoms with average tissue simulants for dipole antennae using discrete frequencies [300 MHz (7.0 T) to 3 GHz (70.0 T)]. To advance to a human setup EMF simulations are conducted in anatomical human voxel models of the human head using a 20-element dipole array operating at 1 GHz.

RESULTS

Our results demonstrate that transmission fields suitable for (1)H MR of the human brain can be achieved at 1 GHz. An increase in transmit channel density around the human head helps to enhance B 1 (+) in the center of the brain. The calculated relative increase in specific absorption rate at 23.5 versus 7.0 T was below 1.4 (in-phase phase setting) and 2.7 (circular polarized phase setting) for the dipole antennae array.

CONCLUSION

The benefits of multi-channel dipole antennae at higher frequencies render MR at 23.5 T feasible from an electrodynamic standpoint. This very preliminary finding opens the door on further explorations that might be catalyzed into a 20-T class human MR system.

Simultaneous Multiparametric PET/MRI with Silicon Photomultiplier PET and Ultra-High-Field MRI for Small-Animal Imaging

Visualization of biologic processes at molecular and cellular levels has revolutionized the understanding and treatment of human diseases. However, no single biomedical imaging modality provides complete information, resulting in the emergence of multimodal approaches. Combining state-of-the-art PET and MRI technologies without loss of system performance and overall image quality can provide opportunities for new scientific and clinical innovations. Here, we present a multiparametric PET/MR imager based on a small-animal dedicated, high-performance, silicon photomultiplier (SiPM) PET system and a 7-T MR scanner.

METHODS

A SiPM-based PET insert that has the peak sensitivity of 3.4% and center volumetric resolution of 1.92/0.53 mm(3) (filtered backprojection/ordered-subset expectation maximization) was developed. The SiPM PET insert was placed between the mouse body transceiver coil and gradient coil of a 7-T small-animal MRI scanner for simultaneous PET/MRI. Mutual interference between the MRI and SiPM PET systems was evaluated using various MR pulse sequences. A cylindric corn oil phantom was scanned to assess the effects of the SiPM PET on the MR image acquisition. To assess the influence of MRI on the PET imaging functions, several PET performance indicators including scintillation pulse shape, flood image quality, energy spectrum, counting rate, and phantom image quality were evaluated with and without the application of MR pulse sequences. Simultaneous mouse PET/MRI studies were also performed to demonstrate the potential and usefulness of the multiparametric PET/MRI in preclinical applications.

RESULTS

Excellent performance and stability of the PET system were demonstrated, and the PET/MRI combination did not result in significant image quality degradation of either modality. Finally, simultaneous PET/MRI studies in mice demonstrated the feasibility of the developed system for evaluating the biochemical and cellular changes in a brain tumor model and facilitating the development of new multimodal imaging probes.

CONCLUSION

We developed a multiparametric imager with high physical performance and good system stability and demonstrated its feasibility for small-animal experiments, suggesting its usefulness for investigating in vivo molecular interactions of metabolites, and cross-validation studies of both PET and MRI.

Innovations in Small-Animal PET/MR Imaging Instrumentation

Multimodal imaging has led to a more detailed exploration of different physiologic processes with integrated PET/MR imaging being the most recent entry. Although the clinical need is still questioned, it is well recognized that it represents one of the most active and promising fields of medical imaging research in terms of software and hardware. The hardware developments have moved from small detector components to high-performance PET inserts and new concepts in full systems. Conversely, the software focuses on the efficient performance of necessary corrections without the use of CT data. The most recent developments in both directions are reviewed.

The Effect of Magnetic Field on Positron Range and Spatial Resolution in an Integrated Whole-Body Time-Of-Flight PET/MRI System

Simultaneous imaging systems combining positron emission tomography (PET) and magnetic resonance imaging (MRI) have been actively investigated. A PET/MR imaging system (GE Healthcare) comprised of a time-of-flight (TOF) PET system utilizing silicon photomultipliers (SiPMs) and 3-tesla (3T) MRI was recently installed at our institution. The small-ring (60 cm diameter) TOF PET subsystem of this PET/MRI system can generate images with higher spatial resolution compared with conventional PET systems. We have examined theoretically and experimentally the effect of uniform magnetic fields on the spatial resolution for high-energy positron emitters. Positron emitters including ¹⁸F, ¹²⁴I, and ⁶⁸Ga were simulated in water using the Geant4 Monte Carlo toolkit in the presence of a uniform magnetic field (0, 3, and 7 Tesla). The positron annihilation position was tracked to determine the 3D spatial distribution of the 511-keV gammy ray emission. The full-width at tenth maximum (FWTM) of the positron point spread function (PSF) was determined. Experimentally, ¹⁸F and ⁶⁸Ga line source phantoms in air and water were imaged with an investigational PET/MRI system and a PET/CT system to investigate the effect of magnetic field on the spatial resolution of PET. The full-width half maximum (FWHM) of the line spread function (LSF) from the line source was determined as the system spatial resolution. Simulations and experimental results show that the in-plane spatial resolution was slightly improved at field strength as low as 3 Tesla, especially when resolving signal from high-energy positron emitters in the air-tissue boundary.

Multimodal neuroimaging in humans at 9.4 T: a technological breakthrough towards an advanced metabolic imaging scanner

The aim of this paper is twofold: firstly, to explore the potential of simultaneously acquiring multimodal MR-PET-EEG data in a human 9.4 T scanner to provide a platform for metabolic brain imaging. Secondly, to demonstrate that the three modalities are complementary, with MRI providing excellent structural and functional imaging, PET providing quantitative molecular imaging, and EEG providing superior temporal resolution. A 9.4 T MRI scanner equipped with a PET insert and a commercially available EEG device was used to acquire in vivo proton-based images, spectra, and sodium- and oxygen-based images with MRI, EEG signals from a human subject in a static 9.4 T magnetic field, and demonstrate hybrid MR-PET capability in a rat model. High-resolution images of the in vivo human brain with an isotropic resolution of 0.5 mm and post-mortem brain images of the cerebellum with an isotropic resolution of 320 µm are presented. A (1)H spectrum was also acquired from 2 × 2 × 2 mm voxel in the brain allowing 12 metabolites to be identified. Imaging based on sodium and oxygen is demonstrated with isotropic resolutions of 2 and 5 mm, respectively. Auditory evoked potentials measured in a static field of 9.4 T are shown. Finally, hybrid MR-PET capability at 9.4 T in the human scanner is demonstrated in a rat model. Initial progress on the road to 9.4 T multimodal MR-PET-EEG is illustrated. Ultra-high resolution structural imaging, high-resolution images of the sodium distribution and proof-of-principle (17)O data are clearly demonstrated. Further, simultaneous MR-PET data are presented without artefacts and EEG data successfully corrected for the cardioballistic artefact at 9.4 T are presented.