Hybrid PET/MR combines the exceptional molecular sensitivity of PET with the high resolution and versatility of MR imaging. Simultaneous data acquisition additionally promises the use of MR to enhance the quality of PET images, for example, by respiratory motion correction. This advantage is especially relevant in thoracic and abdominal areas to improve the visibility of small lesions with low radiotracer uptake and to enhance uptake quantification. In this work, the applicability and performance of an MR-based method of respiratory motion correction for PET tumor imaging was evaluated in phantom and patient studies. Methods: PET list-mode data from a motion phantom with 22 Na point sources and 5 patients with tumor manifestations in the thorax and upper abdomen were acquired on a simultaneous hybrid PET/MR system. During the first 3 min of a 5-min PET scan, the respiration-induced tissue deformation in the PET field of view was recorded using a sagittal 2-dimensional multislice gradient echo MR sequence. MR navigator data to measure the location of the diaphragm were acquired throughout the PET scan. Respiration-gated PET data were coregistered using the MR-derived motion fields to obtain a single motion-corrected PET dataset. The effect of motion correction on tumor visibility, delineation, and radiotracer uptake quantification was analyzed with respect to uncorrected and gated images. Results: Image quality in terms of lesion delineation and uptake quantification was significantly improved compared with uncorrected images for both phantom and patient data. In patients, in head-feet line profiles of 14 manifestations, the slope became steeper by 66.7% (P 5 0.001) and full width at half maximum was reduced by 20.6% (P 5 0.001). The mean increase in maximum standardized uptake value, lesion-to-background ratio (contrast), and signal-to-noise ratio was 28.1% (P 5 0.001), 24.7% (P 5 0.001), and 27.3% (P 5 0.003), respectively. Lesion volume was reduced by an average of 26.5% (P 5 0.002). As opposed to the gated images, no increase in background noise was observed.However, motion correction performed worse than gating in terms of contrast (211.3%, P 5 0.002), maximum standardized uptake value (210.7%, P 5 0.003), and slope steepness (219.3%, P 5 0.001). Conclusion: The proposed method for MR-based respiratory motion correction of PET data proved feasible and effective. The short examination time and convenience (no additional equipment required) of the method allow for easy integration into clinical routine imaging. Performance compared with gating procedures can be further improved using list-mode-based motion correction. Hybri d PET/MR imaging systems combine the high molecular sensitivity of PET and the superior resolution and versatility of MR imaging for improved tumor imaging (1). Furthermore, systems capable of simultaneous PET/MR data acquisition can improve PET image quality and radiotracer uptake quantification by the use of MR-based correction methods, for example, for respiratory motion.Respiratory moti...

MR/PET imaging of the lung is feasible and provides diagnostic image quality in the assessment of pulmonary masses. Similar lesion characterization and tumor stage were found in comparing PET/CT and MR/PET images in most patients.

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Examinations of pulmonary lesions in a simultaneous whole-body MR/PET system provide diagnostic image quality in both modalities. Although DWI and FDG-PET reflect different tissue properties, there may very well be an association between the measures of both methods most probably because of increased cellularity and glucose metabolism of FDG-avid pulmonary lesions. A voxelwise DWI and FDG-PET correlation might provide a more sophisticated spatial characterization of pulmonary lesions.

Hybrid PET/MR systems have recently entered clinical practice. Thus, the accuracy of MR-based attenuation correction in simultaneously acquired data can now be investigated. We assessed the accuracy of 4 methods of MR-based attenuation correction in lesions within soft tissue, bone, and MR susceptibility artifacts: 2 segmentation-based methods (SEG1, provided by the manufacturer, and SEG2, a method with atlas-based susceptibility artifact correction); an atlas-and pattern recognition-based method (AT&PR), which also used artifact correction; and a new method combining AT&PR and SEG2 (SEG2wBONE). Methods: Attenuation maps were calculated for the PET/MR datasets of 10 patients acquired on a whole-body PET/MR system, allowing for simultaneous acquisition of PET and MR data. Eighty percent iso-contour volumes of interest were placed on lesions in soft tissue (n 5 21), in bone (n 5 20), near bone (n 5 19), and within or near MR susceptibility artifacts (n 5 9). Relative mean volume-of-interest differences were calculated with CT-based attenuation correction as a reference. Results: For soft-tissue lesions, none of the methods revealed a significant difference in PET standardized uptake value relative to CT-based attenuation correction (SEG1, 22.6% 6 5.8%; SEG2, 21.6% 6 4.9%; AT&PR, 24.7% 6 6.5%; SEG2wBONE, 0.2% 6 5.3%). For bone lesions, underestimation of PET standardized uptake values was found for all methods, with minimized error for the atlas-based approaches (SEG1, 216.1% 6 9.7%; SEG2, 211.0% 6 6.7%; AT&PR, 26.6% 6 5.0%; SEG2wBONE, 24.7% 6 4.4%). For lesions near bone, underestimations of lower magnitude were observed (SEG1, 212.0% 6 7.4%; SEG2, 29.2% 6 6.5%; AT&PR, 24.6% 6 7.8%; SEG2wBONE, 24.2% 6 6.2%). For lesions affected by MR susceptibility artifacts, quantification errors could be reduced using the atlas-based artifact correction (SEG1, 254.0% 6 38.4%; SEG2, 215.0% 6 12.2%; AT&PR, 24.1% 6 11.2%; SEG2w-BONE, 0.6% 6 11.1%). Conclusion: For soft-tissue lesions, none of the evaluated methods showed statistically significant errors. For bone lesions, significant underestimations of 216% and 211% occurred for methods in which bone tissue was ignored (SEG1 and SEG2). In the present attenuation correction schemes, uncorrected MR susceptibility artifacts typically result in reduced attenuation values, potentially leading to highly reduced PET standardized uptake values, rendering lesions indistinguishable from background. While AT&PR and SEG2wBONE show accurate results in both soft tissue and bone, SEG2wBONE uses a two-step approach for tissue classification, which increases the robustness of prediction and can be applied retrospectively if more precision in bone areas is needed. Hybr id PET/MR systems have recently been introduced into clinical practice and are attracting increasing interest in the research and clinical communities (1-3). While PET/CT is an established hybrid modality with a wide range of applications, specific application trends for PET/MR are currently under investigation (4-7). MR-based atten...