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Integrated whole body MR/PET: where are we?

Yoo HJ, Lee JS, Lee JM - Korean J Radiol (2015)

Bottom Line: This review provides an overview of the technical background of combined MR/PET systems, a discussion of the potential advantages and technical challenges of hybrid MR/PET instrumentation, as well as collection of possible solutions.Various early clinical applications of integrated MR/PET are also addressed.Finally, the workflow issues of integrated MR/PET, including maximizing diagnostic information while minimizing acquisition time are discussed.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Seoul National University Hospital, Seoul 110-744, Korea.

ABSTRACT
Whole body integrated magnetic resonance imaging (MR)/positron emission tomography (PET) imaging systems have recently become available for clinical use and are currently being used to explore whether the combined anatomic and functional capabilities of MR imaging and the metabolic information of PET provide new insight into disease phenotypes and biology, and provide a better assessment of oncologic diseases at a lower radiation dose than a CT. This review provides an overview of the technical background of combined MR/PET systems, a discussion of the potential advantages and technical challenges of hybrid MR/PET instrumentation, as well as collection of possible solutions. Various early clinical applications of integrated MR/PET are also addressed. Finally, the workflow issues of integrated MR/PET, including maximizing diagnostic information while minimizing acquisition time are discussed.

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63-year-old male had pancreatic mass.A. Axial CT image showed 2.5-cm, low-attenuated mass with heterogeneous enhancement (arrow) in pancreas tail, which was indeterminate finding. B. Axial, post-contrast, T1-weighted image demonstrated conglomerated cystic mass (arrow) with septal enhancement. C. MR cholangiopancreaticography also showed conglomerated cystic mass (arrow) in pancreas tail. D. ADC map showed no diffusion restriction in mass (arrow). E. Fused FDG-MR/PET image showed no FDG uptake in mass (arrow). Anatomical MR images (B, C) were helpful for characterizing mass, and functional images (D, E) suggested that mass was benign lesion. Mass was resected and confirmed as serous cystadenoma. ADC = apparent diffusion coefficient, FDG = fluorodeoxyglucose, MR/PET = magnetic resonance imaging/positron emission tomography
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Figure 4: 63-year-old male had pancreatic mass.A. Axial CT image showed 2.5-cm, low-attenuated mass with heterogeneous enhancement (arrow) in pancreas tail, which was indeterminate finding. B. Axial, post-contrast, T1-weighted image demonstrated conglomerated cystic mass (arrow) with septal enhancement. C. MR cholangiopancreaticography also showed conglomerated cystic mass (arrow) in pancreas tail. D. ADC map showed no diffusion restriction in mass (arrow). E. Fused FDG-MR/PET image showed no FDG uptake in mass (arrow). Anatomical MR images (B, C) were helpful for characterizing mass, and functional images (D, E) suggested that mass was benign lesion. Mass was resected and confirmed as serous cystadenoma. ADC = apparent diffusion coefficient, FDG = fluorodeoxyglucose, MR/PET = magnetic resonance imaging/positron emission tomography

Mentions: The assessment of the exact tumor localization, tumor invasion into adjacent organs, and neurovascular structures (T-staging) relies primarily on the information provided by the high spatial resolution of MR imaging. Therefore, integrated MR/PET may be superior to PET/CT for all tumors in which MR imaging is known to be superior to CT due to its high soft-tissue contrast, including brain tumors (58), head and neck cancer (59, 60, 61), gynecologic and intra-abdominal tumors (Fig. 4) (5, 12, 20, 62, 63, 64, 65), and soft-tissue sarcomas (16, 66).


Integrated whole body MR/PET: where are we?

Yoo HJ, Lee JS, Lee JM - Korean J Radiol (2015)

63-year-old male had pancreatic mass.A. Axial CT image showed 2.5-cm, low-attenuated mass with heterogeneous enhancement (arrow) in pancreas tail, which was indeterminate finding. B. Axial, post-contrast, T1-weighted image demonstrated conglomerated cystic mass (arrow) with septal enhancement. C. MR cholangiopancreaticography also showed conglomerated cystic mass (arrow) in pancreas tail. D. ADC map showed no diffusion restriction in mass (arrow). E. Fused FDG-MR/PET image showed no FDG uptake in mass (arrow). Anatomical MR images (B, C) were helpful for characterizing mass, and functional images (D, E) suggested that mass was benign lesion. Mass was resected and confirmed as serous cystadenoma. ADC = apparent diffusion coefficient, FDG = fluorodeoxyglucose, MR/PET = magnetic resonance imaging/positron emission tomography
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4296276&req=5

Figure 4: 63-year-old male had pancreatic mass.A. Axial CT image showed 2.5-cm, low-attenuated mass with heterogeneous enhancement (arrow) in pancreas tail, which was indeterminate finding. B. Axial, post-contrast, T1-weighted image demonstrated conglomerated cystic mass (arrow) with septal enhancement. C. MR cholangiopancreaticography also showed conglomerated cystic mass (arrow) in pancreas tail. D. ADC map showed no diffusion restriction in mass (arrow). E. Fused FDG-MR/PET image showed no FDG uptake in mass (arrow). Anatomical MR images (B, C) were helpful for characterizing mass, and functional images (D, E) suggested that mass was benign lesion. Mass was resected and confirmed as serous cystadenoma. ADC = apparent diffusion coefficient, FDG = fluorodeoxyglucose, MR/PET = magnetic resonance imaging/positron emission tomography
Mentions: The assessment of the exact tumor localization, tumor invasion into adjacent organs, and neurovascular structures (T-staging) relies primarily on the information provided by the high spatial resolution of MR imaging. Therefore, integrated MR/PET may be superior to PET/CT for all tumors in which MR imaging is known to be superior to CT due to its high soft-tissue contrast, including brain tumors (58), head and neck cancer (59, 60, 61), gynecologic and intra-abdominal tumors (Fig. 4) (5, 12, 20, 62, 63, 64, 65), and soft-tissue sarcomas (16, 66).

Bottom Line: This review provides an overview of the technical background of combined MR/PET systems, a discussion of the potential advantages and technical challenges of hybrid MR/PET instrumentation, as well as collection of possible solutions.Various early clinical applications of integrated MR/PET are also addressed.Finally, the workflow issues of integrated MR/PET, including maximizing diagnostic information while minimizing acquisition time are discussed.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Seoul National University Hospital, Seoul 110-744, Korea.

ABSTRACT
Whole body integrated magnetic resonance imaging (MR)/positron emission tomography (PET) imaging systems have recently become available for clinical use and are currently being used to explore whether the combined anatomic and functional capabilities of MR imaging and the metabolic information of PET provide new insight into disease phenotypes and biology, and provide a better assessment of oncologic diseases at a lower radiation dose than a CT. This review provides an overview of the technical background of combined MR/PET systems, a discussion of the potential advantages and technical challenges of hybrid MR/PET instrumentation, as well as collection of possible solutions. Various early clinical applications of integrated MR/PET are also addressed. Finally, the workflow issues of integrated MR/PET, including maximizing diagnostic information while minimizing acquisition time are discussed.

Show MeSH
Related in: MedlinePlus