Combined PET/MR: The Real Work Has Just Started. Summary Report of the Third International Workshop on PET/MR Imaging; February 17–21, 2014, Tübingen, Germany

Bailey, Dale L.; Antoch, Gerald; Bartenstein, Peter; Barthel, Henryk; Beer, Ambros J.; Bisdas, Sotirios; Bluemke, David A.; Boellaard, Ronald; Claussen, Claus D.; Franzius, Christiane; Hacker, Marcus; Hricak, Hedvig; Fougère, Christian la; Gückel, Brigitte; Nekolla, Stephan G.; Pichler, Bernd J.; Purz, Sandra; Quick, Harald H.; Sabri, Osama; Sattler, Bernhard; Schäfer, Jürgen; Schmidt, Holger; Hoff, Joerg van den; Voss, Stephan D.; Weber, Wolfgang; Wehrl, Hans F.; Beyer, Thomas

doi:10.1007/s11307-014-0818-0

Cited by 55 publications

(40 citation statements)

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“…The motivation of excluding acquisitions with missing tissue and tissue swap artifacts was to estimate the reproducibility for standard acquisitions without major image distortions considering that several solutions exist to mitigate the effects of truncation, tissue swaps, and susceptibility effects (3).…”

Section: Reproducibilitymentioning

confidence: 99%

“…The effectiveness of PET/CT is due, in part, to the complementary role of CT in providing both an anatomic framework and reliable, quantitative attenuation values for tissues inside the field of view of the PET for CT-based attenuation correction (2). After the introduction of dual-modality MR and PET imaging (PET/MR), novel clinical applications of hybrid imaging are being actively developed (3). PET/MR imaging has the advantage of offering superior soft-tissue (ST) contrast and a wide array of functional, morphologic, and even metabolic clinical imaging protocols (4) within a single examination.…”

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confidence: 99%

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Reproducibility of MRI Dixon-Based Attenuation Correction in Combined PET/MR with Applications for Lean Body Mass Estimation

et al. 2016

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The aim of this study was to assess the reproducibility of standard, Dixon-based attenuation correction (MR-AC) in PET/MR imaging. A further aim was to estimate a patient-specific lean body mass (LBM) from these MR-AC data. Methods: Ten subjects were positioned in a fully integrated PET/MR system, and 3 consecutive multibed acquisitions of the standard MR-AC image data were acquired. For each subject and MR-AC map, the following compartmental volumes were calculated: total body, soft tissue (ST), fat, lung, and intermediate tissue (IT). Intrasubject differences in the total body and subcompartmental volumes (ST, fat, lung, and IT) were assessed by means of coefficients of variation (CVs) calculated across the 3 consecutive measurements and, again, across these measurements but excluding those affected by major artifacts. All subjects underwent a body composition measurement using air displacement plethysmography (ADP) that was used to calculate a reference LBM ADP . A second LBM estimate was derived from available MR-AC data using a formula incorporating the respective tissue volumes and densities as well as the subject-specific body weights. A third LBM estimate was obtained from a sex-specific formula (LBM Formula ). Pearson correlation was calculated for LBM ADP , LBM MR-AC , and LBM Formula . Further, linear regression analysis was performed on LBM MR-AC and LBM ADP. Results: The mean CV for all 30 scans was 2.1 ± 1.9% (TB). When missing tissue artifacts were excluded, the CV was reduced to 0.3 ± 0.2%. The mean CVs for the subcompartments before and after exclusion of artifacts were 0.9 ± 1.1% and 0.7 ± 0.7% for the ST, 2.9 ± 4.1% and 1.3 ± 1.0% for fat, and 3.6 ± 3.9% and 1.3 ± 0.7% for the IT, respectively. Correlation was highest for LBM MR-AC and LBM ADP (r 5 0.99). Linear regression of data excluding artifacts resulted in a scaling factor of 1.06 for LBM MR-AC . Conclusion: LBM MR-AC is shown to correlate well with standard LBM measurements and thus offers routine LBM-based SUV quantification in PET/MR. However, MR-AC images must be controlled for systematic artifacts, including missing tissue and tissue swaps. Efforts to minimize these artifacts could help improve the reproducibility of MR-AC. Dual -modality PET/CT imaging systems, combining CT with PET into a single imaging system, have become standard for acquiring colocalized metabolic and anatomic information in clinical practice (1). The effectiveness of PET/CT is due, in part, to the complementary role of CT in providing both an anatomic framework and reliable, quantitative attenuation values for tissues inside the field of view of the PET for CT-based attenuation correction (2). After the introduction of dual-modality MR and PET imaging (PET/MR), novel clinical applications of hybrid imaging are being actively developed (3). PET/MR imaging has the advantage of offering superior soft-tissue (ST) contrast and a wide array of functional, morphologic, and even metabolic clinical imaging protocols (4) within a single examination. However, correct att...

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Section: Reproducibilitymentioning

confidence: 99%

mentioning

confidence: 99%

Reproducibility of MRI Dixon-Based Attenuation Correction in Combined PET/MR with Applications for Lean Body Mass Estimation

et al. 2016

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“…Since then, huge progress has been made regarding methodological approaches and technical versatility (27)(28)(29). At present, three major companies specializing in imaging hardware offer PET/MRI with various system designs (30). General expectations for PET/MRI are high.…”

Section: Discussionmentioning

confidence: 99%

[18F]FDG-PET/CT and MRI for initial pelvic lymph node staging in patients with cervical carcinoma: The potential usefulness of [18F]FDG-PET/MRI

et al. 2018

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Abstract. The current study aimed to determine the optimum diagnostic imaging technique out of magnetic resonance imaging (MRI), 18 F-f ludeoxyglucose positron emission tomography/computed tomography ([ 18 F] FDG-PET/CT, otherwise known as PET/CT) and [18 F] FDG-PET/MRI (otherwise known as PET/MRI) for the pelvic lymph node staging (N-staging) of untreated cervical carcinoma (CC). A total of 27 patients were included in the present study. All patients had undergone pre-treatment with PET/CT and MRI ≤45 days prior to undergoing a lymphadenectomy. The results from PET (separated from PET/CT), MRI and the statistically combined results of (virtual) PET/MRI were compared to those from histological analyses (the gold standard). A per-patient-based analysis of the detection of pelvic lymph node metastases indicated that PET/MRI had a sensitivity of 64%. The specificity of PET/CT and MRI were 69 and 62%, respectively. The positive predictive value (PPV) was 69 and 64% for PET/CT and MRI, respectively. The negative predictive value (NPV) was 64 and 62% for PET/CT and MRI, respectively. The sensitivity of the PET-guided PET/MRI and the MRI-guided PET/MRI was 64% for both. The specificity of the PET-guided PET/MRI and the MRI-guided PET/MRI was 77 and 62%, respectively. The PPV was 75% for PET-guided PET/MRI and 64% for MRI-guided PET/MRI, and the NPV was 67 and 62%, respectively. PET/CT and the virtual PET/MRI exhibited the same low sensitivity (64%). PET/MRI exhibited slightly better results than PET/CT regarding specificity (77 vs. 69%, respectively), PPV (75 vs. 69%, respectively) and NPV (67 vs. 64%, respectively). The results of the present study suggested that PET/CT and MRI are not optimal diagnostic modalities, and that PET/MRI does not necessarily lead to better results than PET/CT, in the pelvic N-staging of CC.

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“…Hasta toleransının zorlanmaması, verilen radyoaktivitenin optimum biçimde değerlendirilebilmesi açısından görüntüleme protokolleri, toplam tüm vücut PET/MR görüntüleme süresi 30-45 dakika arasında olacak şekilde düzenlenmelidir (1). Tüm vücut PET/BT görüntülemesi sonrasında alınacak ek bölgesel PET/MR görüntülerinde ise görüntüleme protokolleri ve seçilecek MR sekansları hastanın kliniğine ve görüntülenecek bölgenin özelliklerine göre belirlenmelidir (1,2).…”

Section: Sonuçlarveönerilerunclassified

Gazi Medical Faculty Nuclear Medicine Department’s Experiences for Usage of PET/MRI Between December 2015-February 2017: Clinical Examples of First 1000 Cases

Aydos¹,

Akdemir²,

Özçelik³

et al. 2017

Nts

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Gazi Üniversitesi Tıp Fakültesi, Nükleer Tıp Anabilim Dalı'nda Aralık 2015 ile Şubat 2017 tarihleri arasında toplam 1243 PET/MR görüntülemesi yapılmış olup, bunların 306'sı tüm vücut görüntüleme, 937'si ise bölgesel görüntüleme şeklinde olmuştur. Bölgesel PET/MR görüntülemelerinde en sık yapılan ilk üç görüntüleme; beyin (nöroloji-nöroonkoloji), abdomen ve meme görüntülemeleridir. En sık PET/MR görüntülemesi yapılan ilk üç endikasyon; akciğer nodülü ve akciğer kanserleri, gastrointestinal sistem kanserleri ve meme kanserleridir. Yazıda çeşitli klinik olgu örnekleri gösterilmiştir. Tecrübelerimiz sonucunda, simültane PET/ MR'nin görüntüleme süresi nedeniyle hasta toleransının daha iyi olduğu, iyonize radyasyona daha az maruz bırakması nedeni ile pediatrik grupta tercih edilebileceği, primer/ metastatik beyin tümörlerinde, abdominopelvik tümörler ile yumuşak doku sarkomlarında yüksek rezolüsyonu nedeniyle PET/BT'ye göre daha başarılı olduğu, FDG dışı yeni ajanların multiparametrik MR ile birlikte kullanımının hastalara spesifik yaklaşım potansiyelini artırabileceği düşünülmüştür. Klinik olarak PET/MR'nin etkin biçimde kullanılabilmesi için, tüm vücut ve bölgesel görüntülemelere göre uygun endikasyonların belirlenmesi ve görüntüleme protokollerinin optimizasyonu gereklidir. Anahtar Kelimeler: Onkoloji, PET/MR, PET/BT During December 2015 and February 2017, 1243 PET/MR images had been taken in Gazi Medical Faculty Nuclear Medicine Department. From those; 306 of them were whole body imaging and 937 of them were regional imaging. Most commonly taken regional imaging areas are brain (neurology-neurooncology), abdomen and breast. When we look at the most common PET/MRI indications: lung nodules and cancers, gastrointestinal cancers and breast cancers detected. There are several clinical case examples on the article. Our experiences showed that; simultaneous PET/MR imaging tolerated better by patients due to shorter duration. In pediatric patients because of lower ionizing radiation exposure PET/MRI can be chosen. In primary/metastatic brain tumors, abdominopelvic tumors and soft tissue sarcomas PET/ MRI is better than PET/CT due to high resolution in those areas. Also multiparametric MR usage with non FDG tracers could bring specific approaches to patients. Clinically, for efficent use of PET/MRI, proper indications has to be made according to whole and regional body imaging and protocols need to optimized for imaging.

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Combined PET/MR: The Real Work Has Just Started. Summary Report of the Third International Workshop on PET/MR Imaging; February 17–21, 2014, Tübingen, Germany

Cited by 55 publications

References 74 publications

Reproducibility of MRI Dixon-Based Attenuation Correction in Combined PET/MR with Applications for Lean Body Mass Estimation

Reproducibility of MRI Dixon-Based Attenuation Correction in Combined PET/MR with Applications for Lean Body Mass Estimation

[18F]FDG-PET/CT and MRI for initial pelvic lymph node staging in patients with cervical carcinoma: The potential usefulness of [18F]FDG-PET/MRI

Gazi Medical Faculty Nuclear Medicine Department’s Experiences for Usage of PET/MRI Between December 2015-February 2017: Clinical Examples of First 1000 Cases

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