(2013) A strategy for multimodal deformable image registration to integrate PET/MR into radiotherapy treatment planning,

HighlightsDiscussion of DW imaging protocols and imaging setup.Discussion of mono- and bi-exponential models for quantitative parameter extraction.Review of recent publications investigating potential benefits of using DWI in RT, including detailed synoptic table.Detailed discussion of geometric and quantitative accuracy of DW imaging and DW-derived parameters.

The phase behavior of protein solutions is affected by additives such as crowder molecules or salts. In particular, upon addition of multivalent counterions, a reentrant condensation can occur; i.e., protein solutions are stable for low and high multivalent ion concentrations but aggregating at intermediate salt concentrations. The addition of monovalent ions shifts the phase boundaries to higher multivalent ion concentrations. This effect is found to be reflected in the protein interactions, as accessed via small-angle X-ray scattering. Two simulation schemes (a Monte Carlo sampling of the counterion binding configurations using the detailed protein structure and an analytical coarse-grained binding model) reproduce the shifts of the experimental phase boundaries. The results support a consistent picture of the protein interactions responsible for the phase behavior. The repulsive Coulomb interaction is varied by the binding of multivalent counterions and additionally screened by any increase of the ionic strength. The attractive interaction is induced by the binding of multivalent ions, most likely due to ion bridging between protein molecules. The overall picture of these competing interactions provides interesting insight into possible mechanisms for tailoring interactions in solutions via salt effects.

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Background and purposeFunctional PET/MRI has great potential to improve radiotherapy planning (RTP). However, data integration requires imaging with radiotherapy-specific patient positioning. Here, we investigated the feasibility and image quality of radiotherapy-customized PET/MRI in head-and-neck cancer (HNC) patients using a dedicated hardware setup.Material and methodsTen HNC patients were examined with simultaneous PET/MRI before treatment, with radiotherapy and diagnostic scan setup, respectively. We tested feasibility of radiotherapy-specific patient positioning and compared the image quality between both setups by pairwise image analysis of 18F-FDG-PET, T1/T2-weighted and diffusion-weighted MRI. For image quality assessment, similarity measures including average symmetric surface distance (ASSD) of PET and MR-based tumor contours, MR signal-to-noise ratio (SNR) and mean apparent diffusion coefficient (ADC) value were used.ResultsPET/MRI in radiotherapy position was feasible – all patients were successfully examined. ASSD (median/range) of PET and MR contours was 0.6 (0.4–1.2) and 0.9 (0.5–1.3) mm, respectively. For T2-weighted MRI, a reduced SNR of −26.2% (−39.0–−11.7) was observed with radiotherapy setup. No significant difference in mean ADC was found.ConclusionsSimultaneous PET/MRI in HNC patients using radiotherapy positioning aids is clinically feasible. Though SNR was reduced, the image quality obtained with a radiotherapy setup meets RTP requirements and the data can thus be used for personalized RTP.