1
|
Shi J, Li D, Chen M, Fu Y, Peng S, Zhang Q, Liang J, Lu Q, Lu J, Ai S, Wang F, Qiu X, Guo H. The Value of 68Ga-PSMA PET/MRI for Classifying Patients with PI-RADS 3 Lesions on Multiparametric MRI: A Prospective Single-Center Study. J Nucl Med 2024; 65:555-559. [PMID: 38485278 DOI: 10.2967/jnumed.123.266742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 01/23/2024] [Indexed: 04/04/2024] Open
Abstract
Prostate Imaging Reporting and Data System (PI-RADS) category 3 lesions remain a diagnostic challenge for detecting clinically significant prostate cancer (csPCa). This article evaluates the added value of 68Ga-labeled prostate-specific membrane antigen-11 (68Ga-PSMA) PET/MRI in classifying PI-RADS 3 lesions to avoid unnecessary biopsies. Methods: Sixty biopsy-naïve men with PI-RADS 3 lesions on multiparametric MRI were prospectively enrolled between February 2020 and October 2022. In all, 56 participants underwent 68Ga-PSMA PET/MRI and prostate systematic biopsy. 68Ga-PSMA PET/MRI was independently evaluated and reported by the 5-level PRIMARY score developed within the PRIMARY trial. Receiver-operating-characteristic curve analysis was used to estimate the diagnostic performance. Results: csPCa was detected in 8 of 56 patients (14.3%). The proportion of patients with csPCa and a PRIMARY score of 1, 2, 3, 4, and 5 was 0% (0/12), 0% (0/13), 6.3% (1/16), 38.5% (5/13), and 100% (2/2), respectively. The estimated area under the curve of the PRIMARY score was 0.91 (95% CI, 0.817-0.999). For a PRIMARY score of 4-5 versus a PRIMARY score of 1-3, the sensitivity, specificity, positive predictive value, and negative predictive value were 87.5%, 83.3%, 46.7%, and 97.5%, respectively. With a PRIMARY score of at least 4 to make a biopsy decision in men with PI-RADS 3 lesions, 40 of 48 patients (83.3%) could avoid unnecessary biopsies, at the expense of missing 1 of 8 (12.5%) csPCa cases. Conclusion: 68Ga-PSMA PET/MRI has great potential to classify patients with PI-RADS 3 lesions and help avoid unnecessary biopsies.
Collapse
Affiliation(s)
- Jingyan Shi
- Department of Urology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Danyan Li
- Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Mengxia Chen
- Department of Urology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Yao Fu
- Department of Pathology, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing, China; and
| | - Shan Peng
- Department of Pathology, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing, China; and
| | - Qing Zhang
- Department of Urology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Jing Liang
- Department of Urology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Qun Lu
- Department of Urology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Jiaming Lu
- Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Shuyue Ai
- Department of Nuclear Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Feng Wang
- Department of Nuclear Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Xuefeng Qiu
- Department of Urology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China;
| | - Hongqian Guo
- Department of Urology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China;
| |
Collapse
|
2
|
Cox CPW, Brabander T, Vegt E, de Lussanet de la Sablonière QG, Graven LH, Verburg FA, Segbers M. Reduction of [ 68Ga]Ga-DOTA-TATE injected activity for digital PET/MR in comparison with analogue PET/CT. EJNMMI Phys 2024; 11:27. [PMID: 38488989 DOI: 10.1186/s40658-024-00629-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 03/06/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND New digital detectors and block-sequential regularized expectation maximization (BSREM) reconstruction algorithm improve positron emission tomography (PET)/magnetic resonance (MR) image quality. The impact on image quality may differ from analogue PET/computed tomography (CT) protocol. The aim of this study is to determine the potential reduction of injected [68Ga]Ga-DOTA-TATE activity for digital PET/MR with BSREM reconstruction while maintaining at least equal image quality compared to the current analogue PET/CT protocol. METHODS NEMA IQ phantom data and 25 patients scheduled for a diagnostic PET/MR were included. According to our current protocol, 1.5 MBq [68Ga]Ga-DOTA-TATE per kilogram (kg) was injected. After 60 min, scans were acquired with 3 (≤ 70 kg) or 4 (> 70 kg) minutes per bedposition. PET/MR scans were reconstructed using BSREM and factors β 150, 300, 450 and 600. List mode data with reduced counts were reconstructed to simulate scans with 17%, 33%, 50% and 67% activity reduction. Image quality was measured quantitatively for PET/CT and PET/MR phantom and patient data. Experienced nuclear medicine physicians performed visual image quality scoring and lesion counting in the PET/MR patient data. RESULTS Phantom analysis resulted in a possible injected activity reduction of 50% with factor β = 600. Quantitative analysis of patient images revealed a possible injected activity reduction of 67% with factor β = 600. Both with equal or improved image quality as compared to PET/CT. However, based on visual scoring a maximum activity reduction of 33% with factor β = 450 was acceptable, which was further limited by lesion detectability analysis to an injected activity reduction of 17% with factor β = 450. CONCLUSION A digital [68Ga]Ga-DOTA-TATE PET/MR together with BSREM using factor β = 450 result in 17% injected activity reduction with quantitative values at least similar to analogue PET/CT, without compromising on PET/MR visual image quality and lesion detectability.
Collapse
Affiliation(s)
- Christina P W Cox
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Postbus 2040, 3000 CA, Rotterdam, The Netherlands.
| | - Tessa Brabander
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Postbus 2040, 3000 CA, Rotterdam, The Netherlands
| | - Erik Vegt
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Postbus 2040, 3000 CA, Rotterdam, The Netherlands
| | - Quido G de Lussanet de la Sablonière
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Postbus 2040, 3000 CA, Rotterdam, The Netherlands
| | - Laura H Graven
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Postbus 2040, 3000 CA, Rotterdam, The Netherlands
| | - Frederik A Verburg
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Postbus 2040, 3000 CA, Rotterdam, The Netherlands
| | - Marcel Segbers
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Postbus 2040, 3000 CA, Rotterdam, The Netherlands
| |
Collapse
|
3
|
Zhang M, Yang W, Yuan Y, Liu Z, Yue X, Cao X, Han B. Diagnostic potential of [ 18F]FDG PET/MRI in non-small cell lung cancer lymph node metastasis: a meta-analysis. Jpn J Radiol 2024; 42:87-95. [PMID: 37566187 DOI: 10.1007/s11604-023-01477-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 07/21/2023] [Indexed: 08/12/2023]
Abstract
PURPOSE This meta-analysis evaluated the diagnostic accuracy and diagnostic value of [18F]FDG PET/MRI for mediastinal lymph node staging of NSCLC. METHODS Relevant articles in PubMed, Embase, Web of Science, and the Cochrane Library were searched until January 2023. Research evaluating [18F]FDG PET/MRI for mediastinal lymph node staging of NSCLC was included. Pooled estimates of sensitivity, specificity, PLR, and NLR were calculated by the "Stata" software. RESULTS Nine researches were included, containing 618 patients. The pooled sensitivity of [18F]FDG PET/MRI for detecting mediastinal lymph node staging of NSCLC was 0.82 (0.70-0.90), and the pooled specificity was 0.88 (0.82-0.93). PLR and NLR were 7.38 (4.73-11.52) and 0.20 (0.11-0.36), respectively. The AUC value of this imaging modality was 0.92 (0.90-0.94). The post-test probability for [18F]FDG PET/MRI might rise to 88% when the pre-test probability was set at 50%. CONCLUSIONS We considered [18F]FDG PET/MRI as an effective imaging tool with relatively high specificity and sensitivity. It has great potential to be used in the clinical management of patients in NSCLC who are amenable to early surgery. More studies with large sample sizes in the same direction are needed in future to obtain more reliable evidence-based support.
Collapse
Affiliation(s)
- Min Zhang
- The First Clinical Medical College, Lanzhou University, Lanzhou, 730000, Gansu Province, China
- Department of Thoracic Surgery, The First Hospital of Lanzhou University, Lanzhou, 730000, Gansu Province, China
| | - Wenwen Yang
- The First Clinical Medical College, Lanzhou University, Lanzhou, 730000, Gansu Province, China
- Department of Thoracic Surgery, The First Hospital of Lanzhou University, Lanzhou, 730000, Gansu Province, China
| | - Yuhang Yuan
- The First Clinical Medical College, Lanzhou University, Lanzhou, 730000, Gansu Province, China
- Department of Thoracic Surgery, The First Hospital of Lanzhou University, Lanzhou, 730000, Gansu Province, China
| | - Zhikang Liu
- The First Clinical Medical College, Lanzhou University, Lanzhou, 730000, Gansu Province, China
- Department of Thoracic Surgery, The First Hospital of Lanzhou University, Lanzhou, 730000, Gansu Province, China
| | - Xiaolei Yue
- The First Clinical Medical College, Lanzhou University, Lanzhou, 730000, Gansu Province, China
| | - Xiong Cao
- Department of Thoracic Surgery, The First Hospital of Lanzhou University, Lanzhou, 730000, Gansu Province, China
- Gansu Province International Cooperation Base for Research and Application of Key Technology of Thoracic Surgery, The First Hospital of Lanzhou University, Lanzhou, 730000, Gansu Province, China
| | - Biao Han
- Department of Thoracic Surgery, The First Hospital of Lanzhou University, Lanzhou, 730000, Gansu Province, China.
- Gansu Province International Cooperation Base for Research and Application of Key Technology of Thoracic Surgery, The First Hospital of Lanzhou University, Lanzhou, 730000, Gansu Province, China.
| |
Collapse
|
4
|
Fu Y, Ruan W, Sun X, Hu F, Lan X, Liu F. Added value of regional 18F-FDG PET/MRI-assisted whole-body 18F-FDG PET/CT in malignant ascites with unknown primary origin. Eur J Hybrid Imaging 2023; 7:22. [PMID: 38044389 PMCID: PMC10694118 DOI: 10.1186/s41824-023-00179-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 09/12/2023] [Indexed: 12/05/2023] Open
Abstract
BACKGROUND Comparing to PET/CT, integrative PET/MRI imaging provides superior soft tissue resolution. This study aims to evaluate the added value of regional delayed 18F-FDG PET/MRI-assisted whole-body 18F-FDG PET/CT in diagnosing malignant ascites patients. RESULTS The final diagnosis included 22 patients with ovarian cancer (n = 11), peritoneal cancer (n = 3), colon cancer (n = 2), liver cancer (n = 2), pancreatic cancer (n = 2), gastric cancer (n = 1), and fallopian tube cancer (n = 1). The diagnosis of the primary tumor using whole-body PET/CT was correct in 11 cases. Regional PET/MRI-assisted whole-body PET/CT diagnosis was correct in 18 cases, including 6 more cases of ovarian cancer and 1 more case of fallopian tube cancer. Among 4 cases that were not diagnosed correctly, 1 case had the primary tumor outside of the PET/MRI scan area, 2 cases were peritoneal cancer, and 1 case was colon cancer. The diagnostic accuracy of regional PET/MRI-assisted whole-body PET/CT was higher than PET/CT alone (81.8% vs. 50.0%, κ 2 = 5.14, p = 0.023). The primary tumor conspicuity score of PET/MRI was higher than PET/CT (3.67 ± 0.66 vs. 2.76 ± 0.94, P < 0.01). In the same scan area, more metastases were detected in PET/MRI than in PET/CT (156 vs. 86 in total, and 7.43 ± 5.17 vs. 4.10 ± 1.92 per patient, t = 3.89, P < 0.01). Lesion-to-background ratio in PET/MRI was higher than that in PET/CT (10.76 ± 5.16 vs. 6.56 ± 3.45, t = 13.02, P < 0.01). CONCLUSION Comparing to whole-body PET/CT alone, additional delayed regional PET/MRI with high soft tissue resolution is helpful in diagnosing the location of the primary tumor and identifying more metastases in patients with malignant ascites. Yet larger sample size in multicenter and prospective clinical researches is still needed.
Collapse
Affiliation(s)
- Yiru Fu
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, China
- Hubei Key Laboratory of Molecular Imaging, Wuhan, 430022, Hubei, China
| | - Weiwei Ruan
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, China
- Hubei Key Laboratory of Molecular Imaging, Wuhan, 430022, Hubei, China
| | - Xun Sun
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, China
- Hubei Key Laboratory of Molecular Imaging, Wuhan, 430022, Hubei, China
- Key Laboratory of Biological Targeted Therapy of the Ministry of Education, Wuhan, 430022, China
| | - Fan Hu
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, China
- Hubei Key Laboratory of Molecular Imaging, Wuhan, 430022, Hubei, China
- Key Laboratory of Biological Targeted Therapy of the Ministry of Education, Wuhan, 430022, China
| | - Xiaoli Lan
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, China.
- Hubei Key Laboratory of Molecular Imaging, Wuhan, 430022, Hubei, China.
- Key Laboratory of Biological Targeted Therapy of the Ministry of Education, Wuhan, 430022, China.
| | - Fang Liu
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, China.
- Hubei Key Laboratory of Molecular Imaging, Wuhan, 430022, Hubei, China.
- Key Laboratory of Biological Targeted Therapy of the Ministry of Education, Wuhan, 430022, China.
| |
Collapse
|
5
|
Becker M, de Vito C, Dulguerov N, Zaidi H. PET/MR Imaging in Head and Neck Cancer. Magn Reson Imaging Clin N Am 2023; 31:539-564. [PMID: 37741640 DOI: 10.1016/j.mric.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/25/2023]
Abstract
Head and neck squamous cell carcinoma (HNSCC) can either be examined with hybrid PET/MR imaging systems or sequentially, using PET/CT and MR imaging. Regardless of the acquisition technique, the superiority of MR imaging compared to CT lies in its potential to interrogate tumor and surrounding tissues with different sequences, including perfusion and diffusion. For this reason, PET/MR imaging is preferable for the detection and assessment of locoregional residual/recurrent HNSCC after therapy. In addition, MR imaging interpretation is facilitated when combined with PET. Nevertheless, distant metastases and distant second primary tumors are detected equally well with PET/MR imaging and PET/CT.
Collapse
Affiliation(s)
- Minerva Becker
- Diagnostic Department, Division of Radiology, Unit of Head and Neck and Maxillofacial Radiology, Geneva University Hospitals, University of Geneva, Rue Gabrielle-Perret-Gentil 4, Geneva 14 1211, Switzerland.
| | - Claudio de Vito
- Diagnostic Department, Division of Clinical Pathology, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, Geneva 14 1211, Switzerland
| | - Nicolas Dulguerov
- Department of Clinical Neurosciences, Clinic of Otorhinolaryngology, Head and Neck Surgery, Unit of Cervicofacial Surgery, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, Geneva 14 1211, Switzerland
| | - Habib Zaidi
- Diagnostic Department, Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospitals, University of Geneva, Rue Gabrielle-Perret-Gentil 4, Geneva 14 1211, Switzerland; Geneva University Neurocenter, University of Geneva, Geneva, Switzerland; Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, Netherlands; Department of Nuclear Medicine, University of Southern Denmark, Odense, Denmark
| |
Collapse
|
6
|
Jannusch K, Morawitz J, Schweiger B, Weiss D, Schimmöller L, Minko P, Herrmann K, Fendler WP, Quick HH, Antoch G, Umutlu L, Kirchner J, Bruckmann NM. [ 18F]FDG PET/MRI in children suffering from lymphoma: does MRI contrast media make a difference? Eur Radiol 2023; 33:8366-8375. [PMID: 37338559 PMCID: PMC10598113 DOI: 10.1007/s00330-023-09840-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 03/07/2023] [Accepted: 04/14/2023] [Indexed: 06/21/2023]
Abstract
OBJECTIVES Evaluate the influence of an MRI contrast agent application on primary and follow-up staging in pediatric patients with newly diagnosed lymphoma using [18F]FDG PET/MRI to avoid adverse effects and save time and costs during examination. METHODS A total of 105 [18F]FDG PET/MRI datasets were included for data evaluation. Two different reading protocols were analyzed by two experienced readers in consensus, including for PET/MRI-1 reading protocol unenhanced T2w and/or T1w imaging, diffusion-weighted imaging (DWI), and [18F]FDG PET imaging and for PET/MRI-2 reading protocol an additional T1w post contrast imaging. Patient-based and region-based evaluation according to the revised International Pediatric Non-Hodgkin's Lymphoma (NHL) Staging System (IPNHLSS) was performed, and a modified standard of reference was applied comprising histopathology and previous and follow-up cross-sectional imaging. Differences in staging accuracy were assessed using the Wilcoxon and McNemar tests. RESULTS In patient-based analysis, PET/MRI-1 and PET/MRI-2 both determined a correct IPNHLSS tumor stage in 90/105 (86%) exams. Region-based analysis correctly identified 119/127 (94%) lymphoma-affected regions. Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy for PET/MRI-1 and PET/MRI-2 were 94%, 97%, 90%, 99%, 97%, respectively. There were no significant differences between PET/MRI-1 and PET/MRI-2. CONCLUSIONS The use of MRI contrast agents in [18F]FDG PET/MRI examinations has no beneficial effect in primary and follow-up staging of pediatric lymphoma patients. Therefore, switching to a contrast agent-free [18F]FDG PET/MRI protocol should be considered in all pediatric lymphoma patients. CLINICAL RELEVANCE STATEMENT This study gives a scientific baseline switching to a contrast agent-free [18F]FDG PET/MRI staging in pediatric lymphoma patients. This could avoid side effects of contrast agents and saves time and costs by a faster staging protocol for pediatric patients. KEY POINTS • No additional diagnostic benefit of MRI contrast agents at [18F]FDG PET/MRI examinations of pediatric lymphoma primary and follow-up staging • Highly accurate primary and follow-up staging of pediatric lymphoma patients at MRI contrast-free [18F]FDG PET/MRI.
Collapse
Affiliation(s)
- Kai Jannusch
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Moorenstrasse 5, 40225, Dusseldorf, Germany
| | - Janna Morawitz
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Moorenstrasse 5, 40225, Dusseldorf, Germany
| | - Bernd Schweiger
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, 45147, Essen, Germany
| | - Daniel Weiss
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Moorenstrasse 5, 40225, Dusseldorf, Germany
| | - Lars Schimmöller
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Moorenstrasse 5, 40225, Dusseldorf, Germany
| | - Peter Minko
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Moorenstrasse 5, 40225, Dusseldorf, Germany
| | - Ken Herrmann
- Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, 45147, Essen, Germany
| | - Wolfgang P Fendler
- Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, 45147, Essen, Germany
| | - Harald H Quick
- High-Field and Hybrid MR Imaging, University Hospital Essen, University Duisburg-Essen, 45147, Essen, Germany
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, 45141, Essen, Germany
| | - Gerald Antoch
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Moorenstrasse 5, 40225, Dusseldorf, Germany
| | - Lale Umutlu
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, 45147, Essen, Germany
| | - Julian Kirchner
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Moorenstrasse 5, 40225, Dusseldorf, Germany.
| | - Nils-Martin Bruckmann
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Moorenstrasse 5, 40225, Dusseldorf, Germany
| |
Collapse
|
7
|
Prakken NHJ, Besson FL, Borra RJH, Büther F, Buechel RR, Catana C, Chiti A, Dierckx RAJO, Dweck MR, Erba PA, Glaudemans AWJM, Gormsen LC, Hristova I, Koole M, Kwee TC, Mottaghy FM, Polycarpou I, Prokop M, Stegger L, Tsoumpas C, Slart RHJA. PET/MRI in practice: a clinical centre survey endorsed by the European Association of Nuclear Medicine (EANM) and the EANM Forschungs GmbH (EARL). Eur J Nucl Med Mol Imaging 2023; 50:2927-2934. [PMID: 37378857 DOI: 10.1007/s00259-023-06308-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Affiliation(s)
- Niek H J Prakken
- Medical Imaging Centre, Departments of Nuclear Medicine and Molecular Imaging, Radiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Florent L Besson
- Commissariat À L'énergie Atomique Et Aux Énergies Alternatives (CEA), Centre National de La Recherche Scientifique (CNRS), InsermBioMaps, Orsay, France
- Department of Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Le Kremlin-Bicêtre, France
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Ronald J H Borra
- Medical Imaging Centre, Departments of Nuclear Medicine and Molecular Imaging, Radiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Florian Büther
- Department of Nuclear Medicine, University Hospital Münster, Munster, Germany
| | - Ronny R Buechel
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland
| | - Ciprian Catana
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and , Harvard Medical School, Boston, MA, USA
| | - Arturo Chiti
- Department of Nuclear Medicine, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Rudi A J O Dierckx
- Medical Imaging Centre, Departments of Nuclear Medicine and Molecular Imaging, Radiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Marc R Dweck
- British Heart Foundation Centre for Cardiovascular Science, Edinburgh Heart Centre, University of Edinburgh, Chancellors Building, Little France Crescent, Edinburgh, UK
| | - Paola A Erba
- Medical Imaging Centre, Departments of Nuclear Medicine and Molecular Imaging, Radiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Department of Medicine and Surgery, University of Milan Bicocca, and Nuclear Medicine Unit ASST Ospedale Papa Giovanni XXIII, Bergamo, Italy
| | - Andor W J M Glaudemans
- Medical Imaging Centre, Departments of Nuclear Medicine and Molecular Imaging, Radiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Lars C Gormsen
- Department of Nuclear Medicine & PET Centre, Aarhus University Hospital, Aarhus N, Denmark
| | - Ivalina Hristova
- European Association of Nuclear Medicine Research Ltd. (EARL), Vienna, Austria
| | - Michel Koole
- Department of Imaging and Pathology, Nuclear Medicine and Molecular Imaging, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Thomas C Kwee
- Medical Imaging Centre, Departments of Nuclear Medicine and Molecular Imaging, Radiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Felix M Mottaghy
- Department of Nuclear Medicine, University Hospital Aachen, RWTH Aachen University, Aachen, Germany
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, MUMC+), Maastricht, The Netherlands
| | - Irene Polycarpou
- Department of Health Sciences, European University Cyprus, Nicosia, Cyprus
| | - Mathias Prokop
- Medical Imaging Centre, Departments of Nuclear Medicine and Molecular Imaging, Radiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Lars Stegger
- Department of Nuclear Medicine, University Hospital Münster, Munster, Germany
| | - Charalampos Tsoumpas
- Medical Imaging Centre, Departments of Nuclear Medicine and Molecular Imaging, Radiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Riemer H J A Slart
- Medical Imaging Centre, Departments of Nuclear Medicine and Molecular Imaging, Radiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
- Biomedical Photonic Imaging Group, Faculty of Science and Technology, University of Twente, Enschede, The Netherlands.
| |
Collapse
|
8
|
Hayat H, Wang R, Sun A, Mallett CL, Nigam S, Redman N, Bunn D, Gjelaj E, Talebloo N, Alessio A, Moore A, Zinn K, Wei GW, Fan J, Wang P. Deep learning-enabled quantification of simultaneous PET/MRI for cell transplantation monitoring. iScience 2023; 26:107083. [PMID: 37416468 PMCID: PMC10319838 DOI: 10.1016/j.isci.2023.107083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 02/10/2023] [Accepted: 06/06/2023] [Indexed: 07/08/2023] Open
Abstract
Current methods of in vivo imaging islet cell transplants for diabetes using magnetic resonance imaging (MRI) are limited by their low sensitivity. Simultaneous positron emission tomography (PET)/MRI has greater sensitivity and ability to visualize cell metabolism. However, this dual-modality tool currently faces two major challenges for monitoring cells. Primarily, the dynamic conditions of PET such as signal decay and spatiotemporal change in radioactivity prevent accurate quantification of the transplanted cell number. In addition, selection bias from different radiologists renders human error in segmentation. This calls for the development of artificial intelligence algorithms for the automated analysis of PET/MRI of cell transplantations. Here, we combined K-means++ for segmentation with a convolutional neural network to predict radioactivity in cell-transplanted mouse models. This study provides a tool combining machine learning with a deep learning algorithm for monitoring islet cell transplantation through PET/MRI. It also unlocks a dynamic approach to automated segmentation and quantification of radioactivity in PET/MRI.
Collapse
Affiliation(s)
- Hasaan Hayat
- Precision Health Program, Michigan State University, 766 Service Road, Rm. 2020, East Lansing, MI 48823, USA
- Department of Radiology, College of Human Medicine, Michigan State University, East Lansing, MI, USA
- College of Human Medicine, Michigan State University, East Lansing, MI, USA
| | - Rui Wang
- Department of Mathematics, College of Natural Science, Michigan State University, East Lansing, MI, USA
| | - Aixia Sun
- Precision Health Program, Michigan State University, 766 Service Road, Rm. 2020, East Lansing, MI 48823, USA
- Department of Radiology, College of Human Medicine, Michigan State University, East Lansing, MI, USA
| | - Christiane L. Mallett
- Department of Radiology, College of Human Medicine, Michigan State University, East Lansing, MI, USA
- Institute for Quantitative Health Science and Engineering, Department of Biomedical Engineering, Michigan State University, East Lansing, MI, USA
| | - Saumya Nigam
- Precision Health Program, Michigan State University, 766 Service Road, Rm. 2020, East Lansing, MI 48823, USA
- Department of Radiology, College of Human Medicine, Michigan State University, East Lansing, MI, USA
| | - Nathan Redman
- Institute for Quantitative Health Science and Engineering, Department of Biomedical Engineering, Michigan State University, East Lansing, MI, USA
- Department of Biomedical Engineering, College of Engineering, Michigan State University, East Lansing, MI, USA
| | - Demarcus Bunn
- Institute for Quantitative Health Science and Engineering, Department of Biomedical Engineering, Michigan State University, East Lansing, MI, USA
- Department of Biomedical Engineering, College of Engineering, Michigan State University, East Lansing, MI, USA
| | - Elvira Gjelaj
- Precision Health Program, Michigan State University, 766 Service Road, Rm. 2020, East Lansing, MI 48823, USA
- Lyman Briggs College, Michigan State University, East Lansing, MI, USA
| | - Nazanin Talebloo
- Precision Health Program, Michigan State University, 766 Service Road, Rm. 2020, East Lansing, MI 48823, USA
- Department of Chemistry, College of Natural Science, Michigan State University, East Lansing, MI, USA
| | - Adam Alessio
- Department of Radiology, College of Human Medicine, Michigan State University, East Lansing, MI, USA
- Institute for Quantitative Health Science and Engineering, Department of Biomedical Engineering, Michigan State University, East Lansing, MI, USA
- Department of Biomedical Engineering, College of Engineering, Michigan State University, East Lansing, MI, USA
- Departments of Computational Mathematics, Science, and Engineering (CMSE), College of Natural Science, Michigan State University, East Lansing, MI, USA
| | - Anna Moore
- Precision Health Program, Michigan State University, 766 Service Road, Rm. 2020, East Lansing, MI 48823, USA
- Department of Radiology, College of Human Medicine, Michigan State University, East Lansing, MI, USA
| | - Kurt Zinn
- Department of Radiology, College of Human Medicine, Michigan State University, East Lansing, MI, USA
- Institute for Quantitative Health Science and Engineering, Department of Biomedical Engineering, Michigan State University, East Lansing, MI, USA
| | - Guo-Wei Wei
- Department of Mathematics, College of Natural Science, Michigan State University, East Lansing, MI, USA
- Departments of Computational Mathematics, Science, and Engineering (CMSE), College of Natural Science, Michigan State University, East Lansing, MI, USA
- Department of Electrical and Computer Engineering, College of Engineering, Michigan State University, East Lansing, MI, USA
| | - Jinda Fan
- Department of Radiology, College of Human Medicine, Michigan State University, East Lansing, MI, USA
- Institute for Quantitative Health Science and Engineering, Department of Biomedical Engineering, Michigan State University, East Lansing, MI, USA
- Department of Chemistry, College of Natural Science, Michigan State University, East Lansing, MI, USA
| | - Ping Wang
- Precision Health Program, Michigan State University, 766 Service Road, Rm. 2020, East Lansing, MI 48823, USA
- Department of Radiology, College of Human Medicine, Michigan State University, East Lansing, MI, USA
| |
Collapse
|
9
|
Hamdi M, Ying C, An H, Laforest R. An automatic pipeline for PET/MRI attenuation correction validation in the brain. RESEARCH SQUARE 2023:rs.3.rs-2842317. [PMID: 37292630 PMCID: PMC10246257 DOI: 10.21203/rs.3.rs-2842317/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose PET/MRI quantitative accuracy for neurological applications is challenging due to accuracy of the PET attenuation correction. In this work, we proposed and evaluated an automatic pipeline for assessing the quantitative accuracy of four different MRI = based attenuation correction (PET MRAC) approaches. Methods The proposed pipeline consists of a synthetic lesion insertion tool and the FreeSurfer neuroimaging analysis framework. The synthetic lesion insertion tool is used to insert simulated spherical, and brain regions of interest (ROI) into the PET projection space and reconstructed with four different PET MRAC techniques, while FreeSurfer is used to generate brain ROIs from T1 weighted MRI image. Using a cohort of 11 patients' brain PET dataset, the quantitative accuracy of four MRAC(s), which are: DIXON AC, DIXONbone AC, UTE AC, and Deep learning trained with DIXON AC, named DL-DIXON AC, were compared to the PET-based CT attenuation correction (PET CTAC). MRAC to CTAC activity bias in spherical lesions and brain ROIs were reconstructed with and without background activity and compared to the original PET images. Results The proposed pipeline provides accurate and consistent results for inserted spherical lesions and brain ROIs inserted with and without considering the background activity and following the same MRAC to CTAC pattern as the original brain PET images. As expected, the DIXON AC showed the highest bias; the second was for the UTE, then the DIXONBone, and the DL-DIXON with the lowest bias. For simulated ROIs inserted in the background activity, DIXON showed a -4.65% MRAC to CTAC bias, 0.06% for the DIXONbone, -1.70% for the UTE, and - 0.23% for the DL-DIXON. For lesion ROIs inserted without background activity, DIXON showed a -5.21%, -1% for the DIXONbone, -2.55% for the UTE, and - 0.52 for the DL-DIXON. For MRAC to CTAC bias calculated using the same 16 FreeSurfer brain ROIs in the original brain PET reconstructed images, a 6.87% was observed for the DIXON, -1.83% for DIXON bone, -3.01% for the UTE, and - 0.17% for the DL-DIXON. Conclusion The proposed pipeline provides accurate and consistent results for synthetic spherical lesions and brain ROIs inserted with and without considering the background activity; hence a new attenuation correction approach can be evaluated without using measured PET emission data.
Collapse
Affiliation(s)
- Mahdjoub Hamdi
- Washington University In St Louis: Washington University in St Louis
| | - Chunwei Ying
- Washington University in St Louis School of Medicine Mallinckrodt Institute of Radiology
| | - Hongyu An
- Washington University in St Louis School of Medicine Mallinckrodt Institute of Radiology
| | - Richard Laforest
- Washington University in St Louis School of Medicine Mallinckrodt Institute of Radiology
| |
Collapse
|
10
|
Westphal K, Eiber M, Henninger M, Scheidhauer K, Beer AJ, Thaiss W, Rischpler C. Diagnostic significance of MRI versus CT using identical PET data in patients with recurrent differentiated thyroid cancer: A PET/MRI study. Medicine (Baltimore) 2023; 102:e33533. [PMID: 37083773 PMCID: PMC10118350 DOI: 10.1097/md.0000000000033533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 03/24/2023] [Indexed: 04/22/2023] Open
Abstract
In this retrospective study we compared magnet resonance imaging (MRI) and computed tomography (CT) each combined with identical 2-deoxy-2-[18F] fluoro-D-glucose or 2-[18F] F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) data in patients with recurrent differentiated thyroid cancer (DTC). In total 42 patients with DTC were examined. All patients underwent FDG PET/MRI and CT, the latter originating from one of the following examinations: I-131 single photon emission computed tomography/CT (32/42), low dose FDG PET/CT (5/42) or diagnostic FDG PET/CT (5/42). Two readers assessed FDG PET/MRI as well as FDG PET/CT, with the latter CT coming from one of the above examinations performed at a maximum temporal interval of 5 days from PET/MRI. Local recurrence, cervical lymph node - and pulmonary metastases were assessed in a consensus read. Lesions rated with a high malignancy score (score 4 or 5) were further analyzed. Every malignant lesion was verified if it was identified by one of both or by both modalities. In 20 of 42 patients altogether 100 malignant lesions were present. In 11/20 patients in total 15 local recurrences (15 in MRI/ 9 in CT: 9 CT/MRI, 6 MRI only, 0 CT only; P = .04) were found with a statistically significant better performance of MRI. Regarding lymph node metastases, in total 13 lesions (12 in MRI/ 8 in CT: 7 CT/MRI, 5 MRI only, 1 CT only; P = .22) in 8/20 patients were found with no significant difference between both modalities. Furthermore, in 9/20 patients in total 72 lung lesions (40 in MRI/ 63 in CT: 31 CT/MRI, 9 MRI only, 32 CT only; P = .001) were found with a statistically significant better performance of CT. In 33/42 patients follow up was available and supported the observations. In patients with recurrent DTC, PET/MRI showed superiority compared to PET/CT in evaluation of the neck region. PET/MRI was inferior to PET/CT in evaluation of the lung. PET/MRI in combination with a low dose CT of the lung may thus represent the ideal staging tool in patients with recurrent DTC.
Collapse
Affiliation(s)
- Korbinian Westphal
- Department of Nuclear Medicine, Klinikum Rechts Der Isar, Technical University Munich, Munich, Germany
| | - Matthias Eiber
- Department of Nuclear Medicine, Klinikum Rechts Der Isar, Technical University Munich, Munich, Germany
| | - Martin Henninger
- Department of Nuclear Medicine, Klinikum Rechts Der Isar, Technical University Munich, Munich, Germany
| | - Klemens Scheidhauer
- Department of Nuclear Medicine, Klinikum Rechts Der Isar, Technical University Munich, Munich, Germany
| | - Ambros J. Beer
- Department of Nuclear Medicine, Klinikum Rechts Der Isar, Technical University Munich, Munich, Germany
- Department of Nuclear Medicine, Ulm University Hospital, Ulm, Germany
| | - Wolfgang Thaiss
- Department of Nuclear Medicine, Ulm University Hospital, Ulm, Germany
- Department of Radiology, Ulm University Hospital, Ulm, Germany
| | - Christoph Rischpler
- Department of Nuclear Medicine, Klinikum Rechts Der Isar, Technical University Munich, Munich, Germany
- Clinic for Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Department of Nuclear Medicine, Klinikum Stuttgart, Stuttgart, Germany
| |
Collapse
|
11
|
Senders ML, Calcagno C, Tawakol A, Nahrendorf M, Mulder WJM, Fayad ZA. PET/MR imaging of inflammation in atherosclerosis. Nat Biomed Eng 2023; 7:202-220. [PMID: 36522465 DOI: 10.1038/s41551-022-00970-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 10/25/2022] [Indexed: 12/23/2022]
Abstract
Myocardial infarction, stroke, mental disorders, neurodegenerative processes, autoimmune diseases, cancer and the human immunodeficiency virus impact the haematopoietic system, which through immunity and inflammation may aggravate pre-existing atherosclerosis. The interplay between the haematopoietic system and its modulation of atherosclerosis has been studied by imaging the cardiovascular system and the activation of haematopoietic organs via scanners integrating positron emission tomography and resonance imaging (PET/MRI). In this Perspective, we review the applicability of integrated whole-body PET/MRI for the study of immune-mediated phenomena associated with haematopoietic activity and cardiovascular disease, and discuss the translational opportunities and challenges of the technology.
Collapse
Affiliation(s)
- Max L Senders
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Biomedical Engineering and Physics, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | - Claudia Calcagno
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ahmed Tawakol
- Cardiology Division and Cardiovascular Imaging Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Matthias Nahrendorf
- Center for Systems Biology and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Willem J M Mulder
- Department of Biomedical Engineering and Physics, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands.
- Department of Internal Medicine, Radboud Institute of Molecular Life Sciences (RIMLS) and Radboud Center for Infectious Diseases (RCI), Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands.
- Laboratory of Chemical Biology, Department of Biochemical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands.
| | - Zahi A Fayad
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| |
Collapse
|
12
|
A novel superparamagnetic iron oxide nanoparticles-based SPECT/MRI dual-modality probe for tumor imaging. J Radioanal Nucl Chem 2023. [DOI: 10.1007/s10967-022-08741-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
|
13
|
Nakajima S, Fushimi Y, Hinoda T, Sakata A, Okuchi S, Arakawa Y, Ishimori T, Nakamoto Y. Brain imaging of sequential acquisition using a flexible PET scanner and 3-T MRI: quantitative and qualitative assessment. Ann Nucl Med 2022; 37:209-218. [PMID: 36585566 DOI: 10.1007/s12149-022-01817-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 12/23/2022] [Indexed: 01/01/2023]
Abstract
OBJECTIVE A mobile PET scanner termed flexible PET (fxPET) has been designed to fit existing MRI systems. The purpose of this study was to assess brain imaging with fxPET combined with 3-T MRI in comparison with conventional PET (cPET)/CT. METHODS In this prospective study, 29 subjects with no visible lesions except for mild leukoaraiosis on whole brain imaging underwent 2-deoxy-2-[18F]fluoro-D-glucose ([18F]FDG) cPET/CT followed by fxPET and MRI. The registration differences between fxPET and MRI and between cPET and CT were compared by measuring spatial coordinates. Three-dimensional magnetization-prepared rapid acquisition gradient-echo T1-weighted imaging (T1WI) was acquired. We applied two methods of attenuation correction to the fxPET images: MR-based attenuation correction, which yielded fxPETMRAC; and CT-based attenuation correction, which yielded fxPETCTAC. The three PET datasets were co-registered to the T1WI. Following subcortical segmentation and cortical parcellation, volumes of interest were placed in each PET image to assess physiological accumulation in the brain. SUVmean was obtained and compared between the three datasets. We also visually evaluated image distortion and clarity of fxPETMRAC. RESULTS Mean misregistration of fxPET/MRI was < 3 mm for each margin. Mean registration differences were significantly larger for fxPET/MRI than for cPET/CT except for the superior margin. There were high correlations between the three PET datasets regarding SUVmean. On visual evaluation of image quality, the grade of distortion was comparable between fxPETMRAC and cPET, and the grade of clarity was acceptable but inferior for fxPETMRAC compared with cPET. CONCLUSIONS fxPET could successfully determine physiological [18F]FDG uptake; however, improved image clarity is desirable. In this study, fxPET/MRI at 3-T was feasible for brain imaging.
Collapse
Affiliation(s)
- Satoshi Nakajima
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Yasutaka Fushimi
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
| | - Takuya Hinoda
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Akihiko Sakata
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Sachi Okuchi
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Yoshiki Arakawa
- Department of Neurosurgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takayoshi Ishimori
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Yuji Nakamoto
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| |
Collapse
|
14
|
Pollard AC, de la Cerda J, Schuler FW, Kingsley CV, Gammon ST, Pagel MD. Evaluations of the performances of PET and MRI in a simultaneous PET/MRI instrument for pre-clinical imaging. EJNMMI Phys 2022; 9:70. [PMID: 36209262 PMCID: PMC9547760 DOI: 10.1186/s40658-022-00483-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 08/08/2022] [Indexed: 11/15/2022] Open
Abstract
Background PET/MRI is an attractive imaging modality due to the complementary nature of MRI and PET. Obtaining high quality small animal PET/MRI results is key for the translation of novel PET/MRI agents and techniques to the radiology clinic. To obtain high quality imaging results, a hybrid PET/MRI system requires additional considerations beyond the standard issues with separate PET and MRI systems. In particular, researchers must understand how their PET system affects the MR acquisitions and vice versa. Depending on the application, some of these effects may substantially influence image quality. Therefore, the goal of this report is to provide guidance, recommendations, and practical experiments for implementing and using a small animal PET/MRI instrument. Results Various PET and MR image quality parameters were tested with their respective modality alone and in the presence of both systems to determine how the combination of PET/MRI affects image quality. Corrections and calibrations were developed for many of these effects. While not all image characteristics were affected, some characteristics such as PET quantification, PET SNR, PET spatial resolution, PET partial volume effects, and MRI SNR were altered by the presence of both systems. Conclusions A full exploration of a new PET/MRI system before performing small animal PET/MRI studies is beneficial and necessary to ensure that the new instrument can produce highly accurate and precise PET/MR images. Supplementary Information The online version contains supplementary material available at 10.1186/s40658-022-00483-x.
Collapse
Affiliation(s)
- Alyssa C Pollard
- Department of Chemistry, Rice University, Houston, TX, USA.,Department of Cancer Systems Imaging, MD Anderson Cancer Center, Houston, TX, USA
| | - Jorge de la Cerda
- Department of Cancer Systems Imaging, MD Anderson Cancer Center, Houston, TX, USA
| | - F William Schuler
- Department of Cancer Systems Imaging, MD Anderson Cancer Center, Houston, TX, USA
| | - Charles V Kingsley
- Department of Imaging Physics, MD Anderson Cancer Center, Houston, TX, USA
| | - Seth T Gammon
- Department of Cancer Systems Imaging, MD Anderson Cancer Center, Houston, TX, USA
| | - Mark D Pagel
- Department of Cancer Systems Imaging, MD Anderson Cancer Center, Houston, TX, USA.
| |
Collapse
|
15
|
PET/MR imaging in gynecologic cancer: tips for differentiating normal gynecologic anatomy and benign pathology versus cancer. Abdom Radiol (NY) 2022; 47:3189-3204. [PMID: 34687323 DOI: 10.1007/s00261-021-03264-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 08/24/2021] [Accepted: 08/25/2021] [Indexed: 01/18/2023]
Abstract
Positron emission tomography/magnetic resonance imaging (PET/MR) is used in the pre-treatment and surveillance settings to evaluate women with gynecologic malignancies, including uterine, cervical, vaginal and vulvar cancers. PET/MR combines the excellent spatial and contrast resolution of MR imaging for gynecologic tissues, with the functional metabolic information of PET, to aid in a more accurate assessment of local disease extent and distant metastatic disease. In this review, the optimal protocol and utility of whole-body PET/MR imaging in patients with gynecologic malignancies will be discussed, with an emphasis on the advantages of PET/MR over PET/CT and how to differentiate normal or benign gynecologic tissues from cancer in the pelvis.
Collapse
|
16
|
Tang W, He F, Liu Y, Duan Y. MATR: Multimodal Medical Image Fusion via Multiscale Adaptive Transformer. IEEE TRANSACTIONS ON IMAGE PROCESSING : A PUBLICATION OF THE IEEE SIGNAL PROCESSING SOCIETY 2022; 31:5134-5149. [PMID: 35901003 DOI: 10.1109/tip.2022.3193288] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Owing to the limitations of imaging sensors, it is challenging to obtain a medical image that simultaneously contains functional metabolic information and structural tissue details. Multimodal medical image fusion, an effective way to merge the complementary information in different modalities, has become a significant technique to facilitate clinical diagnosis and surgical navigation. With powerful feature representation ability, deep learning (DL)-based methods have improved such fusion results but still have not achieved satisfactory performance. Specifically, existing DL-based methods generally depend on convolutional operations, which can well extract local patterns but have limited capability in preserving global context information. To compensate for this defect and achieve accurate fusion, we propose a novel unsupervised method to fuse multimodal medical images via a multiscale adaptive Transformer termed MATR. In the proposed method, instead of directly employing vanilla convolution, we introduce an adaptive convolution for adaptively modulating the convolutional kernel based on the global complementary context. To further model long-range dependencies, an adaptive Transformer is employed to enhance the global semantic extraction capability. Our network architecture is designed in a multiscale fashion so that useful multimodal information can be adequately acquired from the perspective of different scales. Moreover, an objective function composed of a structural loss and a region mutual information loss is devised to construct constraints for information preservation at both the structural-level and the feature-level. Extensive experiments on a mainstream database demonstrate that the proposed method outperforms other representative and state-of-the-art methods in terms of both visual quality and quantitative evaluation. We also extend the proposed method to address other biomedical image fusion issues, and the pleasing fusion results illustrate that MATR has good generalization capability. The code of the proposed method is available at https://github.com/tthinking/MATR.
Collapse
|
17
|
Rischpler C, Seifert R. Combined PET and MRI for the masses! : At least for the cardiac ones. J Nucl Cardiol 2022; 29:1518-1519. [PMID: 34935109 PMCID: PMC9351608 DOI: 10.1007/s12350-021-02881-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 10/31/2021] [Indexed: 11/15/2022]
Affiliation(s)
- Christoph Rischpler
- Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
| | - Robert Seifert
- Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| |
Collapse
|
18
|
He H, Zhang X, Du L, Ye M, Lu Y, Xue J, Wu J, Shuai X. Molecular imaging nanoprobes for theranostic applications. Adv Drug Deliv Rev 2022; 186:114320. [PMID: 35526664 DOI: 10.1016/j.addr.2022.114320] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 04/11/2022] [Accepted: 04/30/2022] [Indexed: 12/13/2022]
Abstract
As a non-invasive imaging monitoring method, molecular imaging can provide the location and expression level of disease signature biomolecules in vivo, leading to early diagnosis of relevant diseases, improved treatment strategies, and accurate assessment of treating efficacy. In recent years, a variety of nanosized imaging probes have been developed and intensively investigated in fundamental/translational research and clinical practice. Meanwhile, as an interdisciplinary discipline, this field combines many subjects of chemistry, medicine, biology, radiology, and material science, etc. The successful molecular imaging not only requires advanced imaging equipment, but also the synthesis of efficient imaging probes. However, limited summary has been reported for recent advances of nanoprobes. In this paper, we summarized the recent progress of three common and main types of nanosized molecular imaging probes, including ultrasound (US) imaging nanoprobes, magnetic resonance imaging (MRI) nanoprobes, and computed tomography (CT) imaging nanoprobes. The applications of molecular imaging nanoprobes were discussed in details. Finally, we provided an outlook on the development of next generation molecular imaging nanoprobes.
Collapse
Affiliation(s)
- Haozhe He
- Nanomedicine Research Center, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China; Department of Pediatrics, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen 518107, China
| | - Xindan Zhang
- Beijing Laboratory of Biomedical Materials, Beijing University of Chemical Technology, Beijing 100029, China
| | - Lihua Du
- PCFM Lab of Ministry of Education, School of Materials Science and Engineering, Sun Yat-Sen University, Guangzhou 510260, China
| | - Minwen Ye
- Beijing Laboratory of Biomedical Materials, Beijing University of Chemical Technology, Beijing 100029, China
| | - Yonglai Lu
- Beijing Laboratory of Biomedical Materials, Beijing University of Chemical Technology, Beijing 100029, China
| | - Jiajia Xue
- Beijing Laboratory of Biomedical Materials, Beijing University of Chemical Technology, Beijing 100029, China.
| | - Jun Wu
- PCFM Lab of Ministry of Education, School of Biomedical Engineering, Sun Yat-sen University, Shenzhen 518107, China.
| | - Xintao Shuai
- Nanomedicine Research Center, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China; PCFM Lab of Ministry of Education, School of Materials Science and Engineering, Sun Yat-Sen University, Guangzhou 510260, China.
| |
Collapse
|
19
|
Power JW, Dempsey PJ, Yates A, Fenlon H, Mulsow J, Shields C, Cronin CG. Peritoneal malignancy: anatomy, pathophysiology and an update on modern day imaging. Br J Radiol 2022; 95:20210217. [PMID: 34826229 PMCID: PMC9153709 DOI: 10.1259/bjr.20210217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
With increasing subspecialised experience in radical cytoreductive surgery and intra-abdominal chemotherapy for peritoneal malignancy, outcomes have improved significantly in selected patients. The surgery and the treatment regimens are radical and therefore correct patient selection is critical. The radiologist plays a central role in this process by estimating, as precisely as possible, the pre-treatment disease burden. Because of the nature of the disease process, accurate staging is not an easy task. Tumour deposits may be very small and in locations where they are very difficult to detect. It must be acknowledged that no form of modern day imaging has the capability of detecting the smallest peritoneal nodules, which may only be visible to direct inspection or histopathological evaluation. Nonetheless, it behoves the radiologist to be as exact and precise as possible in the reporting of this disease process. This is both to select patients who are likely to benefit from radical treatment, and just as importantly, to identify patients who are unlikely to achieve adequate cytoreductive outcomes. In this review, we outline the patterns of spread of disease and the anatomic basis for this, as well as the essential aspects of reporting abdominal studies in this patient group. We provide an evidence-based update on the relative strengths and limitations of our available multimodality imaging techniques namely CT, MRI and positron emission tomography/CT.
Collapse
Affiliation(s)
- Jack W Power
- University College Dublin (UCD) School of Medicine, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Philip J Dempsey
- University College Dublin (UCD) School of Medicine, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Andrew Yates
- University College Dublin (UCD) School of Medicine, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Helen Fenlon
- University College Dublin (UCD) School of Medicine, Mater Misericordiae University Hospital, Dublin, Ireland
| | | | - Conor Shields
- University College Dublin (UCD) School of Medicine, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Carmel G Cronin
- University College Dublin (UCD) School of Medicine, Mater Misericordiae University Hospital, Dublin, Ireland
| |
Collapse
|
20
|
Xing H, Ding H, Hou B, Hao Z, Hu Y, Zhu W, Liang S, Feng F, Li F, Zhao Y, Huo L. The Performance Comparison of 18F-FDG PET/MRI and 18F-FDG PET/CT for the Identification of Pancreatic Neoplasms. Mol Imaging Biol 2022; 24:489-497. [PMID: 35332447 DOI: 10.1007/s11307-021-01687-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 10/17/2021] [Accepted: 11/23/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE To determine the optimal imaging tool for clinical evaluation of pancreatic neoplasm by comparing the performance of 18F-FDG PET/MRI and PET/CT. PROCEDURES Patients with suspected pancreatic neoplasms underwent PET/MRI and PET/CT in the same day prior to resection or endoscopic ultrasound-guided fine-needle aspiration. Histology served as the golden standard of lesion classification. Visual assessment on lesion type and lesion malignancy via PET/MRI and PET/CT images was compared. Standard uptake values (SUVs) of PET images from the two scanners were measured and their correlations were further evaluated. RESULTS Thirty-nine patients were included for the final analysis. In visual assessment, we found MRI achieved better performance than CT in differentiating solid and cystic neoplasms, with accuracy of 100% vs. 87%, respectively. In visual malignancy diagnosis, the accuracy of PET/CT was 92.3% for overall lesions and 90.9% for cysts, while the accuracy of PET/MRI was 92.3% and 86.4%, respectively. Besides, semi-quantitative analysis achieved better specificity than visual assessment for both hybrid modalities (100% vs. 87.5% for PET/CT; 100% vs. 81.5% for PET/MR). Furthermore, strong correlation of SUV was found between PET/CT and PET/MRI, with Pearson's correlation coefficients > 0.82. CONCLUSIONS In this study, we found PET/MRI and PET/CT, both using 18F-FDG as tracer, had comparable overall performance in identification of pancreatic neoplasms. Interestingly, for patients who had suspected pancreatic neoplasm but invisible FDG uptake, PET/MRI had shown exceptionally better performance, probably because MR images could detect tiny abnormal structures to improve diagnosis.
Collapse
Affiliation(s)
- Haiqun Xing
- Department of Nuclear Medicine, Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Center for Rare Diseases Research, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, 1 Shuaifuyuan, Beijing, 100730, Dongcheng District, China
| | - Haiyan Ding
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, 100084, China
| | - Bo Hou
- Departments of Radiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Zhixin Hao
- Department of Nuclear Medicine, Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Center for Rare Diseases Research, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, 1 Shuaifuyuan, Beijing, 100730, Dongcheng District, China
| | - Ya Hu
- Department of General Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Wenjia Zhu
- Department of Nuclear Medicine, Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Center for Rare Diseases Research, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, 1 Shuaifuyuan, Beijing, 100730, Dongcheng District, China
| | - Sayuan Liang
- PET/MR Modality, GE Healthcare China, Beijing, 100176, China
| | - Feng Feng
- Departments of Radiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Fang Li
- Department of Nuclear Medicine, Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Center for Rare Diseases Research, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, 1 Shuaifuyuan, Beijing, 100730, Dongcheng District, China
| | - Yupei Zhao
- Department of General Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Li Huo
- Department of Nuclear Medicine, Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Center for Rare Diseases Research, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, 1 Shuaifuyuan, Beijing, 100730, Dongcheng District, China.
| |
Collapse
|
21
|
Tanaka A, Sekine T, Ter Voert EEGW, Zeimpekis KG, Delso G, de Galiza Barbosa F, Warnock G, Kumita SI, Veit Haibach P, Huellner M. Reproducibility of Standardized Uptake Values Including Volume Metrics Between TOF-PET-MR and TOF-PET-CT. Front Med (Lausanne) 2022; 9:796085. [PMID: 35308500 PMCID: PMC8924656 DOI: 10.3389/fmed.2022.796085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 02/07/2022] [Indexed: 11/30/2022] Open
Abstract
Purpose To investigate the reproducibility of tracer uptake measurements, including volume metrics, such as metabolic tumor volume (MTV) and tumor lesion glycolysis (TLG) obtained by TOF-PET-CT and TOF-PET-MR. Materials and Methods Eighty consecutive patients with different oncologic diagnoses underwent TOF-PET-CT (Discovery 690; GE Healthcare) and TOF-PET-MR (SIGNA PET-MR; GE Healthcare) on the same day with single dose−18F-FDG injection. The scan order, PET-CT following or followed by PET-MR, was randomly assigned. A spherical volume of interest (VOI) of 30 mm was placed on the liver in accordance with the PERCIST criteria. For liver, the maximum and mean standard uptake value for body weight (SUV) and lean body mass (SUL) were obtained. For tumor delineation, VOI with a threshold of 40 and 50% of SUVmax was used (VOI40 and VOI50). The SUVmax, SUVmean, SUVpeak, MTV and TLG were calculated. The measurements were compared between the two scanners. Results In total, 80 tumor lesions from 35 patients were evaluated. There was no statistical difference observed in liver regions, whereas in tumor lesions, SUVmax, SUV mean, and SUVpeak of PET-MR were significantly underestimated (p < 0.001) in both VOI40 and VOI50. Among volume metrics, there was no statistical difference observed except TLG on VOI50 (p = 0.03). Correlation between PET-CT and PET-MR of each metrics were calculated. There was a moderate correlation of the liver SUV and SUL metrics (r = 0.63–0.78). In tumor lesions, SUVmax and SUVmean had a stronger correlation with underestimation in PET-MR on VOI 40 (SUVmax and SUVmean; r = 0.92 and 0.91 with slope = 0.71 and 0.72, respectively). In the evaluation of MTV and TLG, the stronger correlations were observed both on VOI40 (MTV and TLG; r = 0.75 and 0.92) and VOI50 (MTV and TLG; r = 0.88 and 0.95) between PET-CT and PET-MR. Conclusion PET metrics on TOF-PET-MR showed a good correlation with that of TOF-PET-CT. SUVmax and SUVpeak of tumor lesions were underestimated by 16% on PET-MRI. MTV with % threshold can be regarded as identical volumetric markers for both TOF-PET-CT and TOF-PET-MR.
Collapse
Affiliation(s)
- Aruki Tanaka
- Department of Radiology, Nippon Medical School Hospital, Tokyo, Japan
| | - Tetsuro Sekine
- Department of Radiology, Nippon Medical School Hospital, Tokyo, Japan.,Department of Radiology, Nippon Medical School Musashi Kosugi Hospital, Kanagawa, Japan.,Departments of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Edwin E G W Ter Voert
- Departments of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Konstantinos G Zeimpekis
- Departments of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland.,Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | | | - Felipe de Galiza Barbosa
- Departments of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Geoffrey Warnock
- Departments of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland.,PMOD Technologies Ltd., Zurich, Switzerland
| | | | - Patrick Veit Haibach
- Departments of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland.,Toronto Joint Department Medical Imaging, University Health Network, Sinai Health System, Women's College Hospital, Toronto, ON, Canada.,Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
| | - Martin Huellner
- Departments of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| |
Collapse
|
22
|
Akram MSH, Obata T, Nishikido F, Yamaya T. Study on the RF transparency of electrically floating and ground PET inserts in a 3T clinical MRI system. Med Phys 2022; 49:2965-2978. [PMID: 35271749 DOI: 10.1002/mp.15588] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 01/17/2022] [Accepted: 02/22/2022] [Indexed: 11/10/2022] Open
Abstract
PURPOSE The positron emission tomography (PET) insert for a magnetic resonance imaging (MRI) system that implements the radiofrequency (RF) built-in body coil of the MRI system as a transmitter is designed to be RF-transparent, as the coil resides outside the RF-shielded PET ring. This approach reduces the design complexities (e.g., large PET ring diameter) related to implementing a transmit coil inside the PET ring. However, achieving the required field transmission into the imaging region of interest (ROI) becomes challenging because of the RF shield of the PET insert. In this study, a modularly RF-shielded PET insert is used to investigate the RF transparency considering two electrical configurations of the RF shield, namely the electrical floating and ground configurations. The purpose is to find the differences, advantages and disadvantages of these two configurations. METHODS Eight copper-shielded PET detector modules (intermodular gap: 3 mm) were oriented cylindrically with an inner-diameter of 234 mm. Each PET module included four-layer LYSO scintillation crystal blocks and front-end readout electronics. RF-shielded twisted-pair cables were used to connect the front-end electronics with the power sources and PET data acquisition systems located outside the MRI room. In the ground configuration, both the detector and cable shields were connected to the RF ground of the MRI system. In the floating configuration, only the RF shields of the PET modules were isolated from the RF ground. Experiments were conducted using two cylindrical homogeneous phantoms in a 3T clinical MRI system, in which the built-in body RF coil (a cylindrical volume coil of diameter 700 mm and length 540 mm) was implemented as a transceiver. RESULTS For both PET configurations, the RF and MR imaging performances were lower than those for the MRI-only case, and the MRI-system provided SAR values that were almost double. The RF homogeneity and field strength, and the SNR of the MR images were mostly higher for the floating PET configuration than they were for the ground PET configuration. However, for a shorter axial FOV of 125 mm, both configurations offered almost the same performance with high RF homogeneities (e.g., 76 ± 10%). Moreover, for both PET configurations, 56 ± 6% larger RF pulse amplitudes were required for MR imaging purposes. The increased power is mostly absorbed in the conductive shields in the form of shielding RF eddy currents; as a result, the SAR values only in the phantoms were estimated to be close to the MRI-only values. CONCLUSIONS The floating PET configuration showed higher RF transparency under all experimental setups. For a relatively short axial FOV of 125 mm, the ground configuration also performed well which indicated that an RF-penetrable PET insert with the conventional design (e.g., the ground configuration) might also become possible. However, some design modifications (e.g., a wider intermodular gap and using the RF receiver coil inside the PET insert) should improve the RF performance to the level of the MRI-only case. This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
- Md Shahadat Hossain Akram
- Department of Advanced Nuclear Medicine Sciences, Institute of Quantum Medical Science in the National Institutes for Quantum and Radiological Science and Technology (QST), 263-8555 Chiba, Inage, Anagawa 4-9-1, Japan
| | - Takayuki Obata
- Department of Applied MRI Research, National Institute of Radiological Sciences in the National Institutes for Quantum and Radiological Science and Technology (NIRS-QST), 263-8555 Chiba, Inage, Anagawa 4-9-1, Japan
| | - Fumihiko Nishikido
- Department of Advanced Nuclear Medicine Sciences, Institute of Quantum Medical Science in the National Institutes for Quantum and Radiological Science and Technology (QST), 263-8555 Chiba, Inage, Anagawa 4-9-1, Japan
| | - Taiga Yamaya
- Department of Advanced Nuclear Medicine Sciences, Institute of Quantum Medical Science in the National Institutes for Quantum and Radiological Science and Technology (QST), 263-8555 Chiba, Inage, Anagawa 4-9-1, Japan
| |
Collapse
|
23
|
Daldrup-Link HE, Theruvath AJ, Baratto L, Hawk KE. One-stop local and whole-body staging of children with cancer. Pediatr Radiol 2022; 52:391-400. [PMID: 33929564 PMCID: PMC10874282 DOI: 10.1007/s00247-021-05076-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 02/04/2021] [Accepted: 03/30/2021] [Indexed: 12/19/2022]
Abstract
Accurate staging and re-staging of cancer in children is crucial for patient management. Currently, children with a newly diagnosed cancer must undergo a series of imaging tests, which are stressful, time-consuming, partially redundant, expensive, and can require repetitive anesthesia. New approaches for pediatric cancer staging can evaluate the primary tumor and metastases in a single session. However, traditional one-stop imaging tests, such as CT and positron emission tomography (PET)/CT, are associated with considerable radiation exposure. This is particularly concerning for children because they are more sensitive to ionizing radiation than adults and they live long enough to experience secondary cancers later in life. In this review article we discuss child-tailored imaging tests for tumor detection and therapy response assessment - tests that can be obtained with substantially reduced radiation exposure compared to traditional CT and PET/CT scans. This includes diffusion-weighted imaging (DWI)/MRI and integrated [F-18]2-fluoro-2-deoxyglucose (18F-FDG) PET/MRI scans. While several investigators have compared the value of DWI/MRI and 18F-FDG PET/MRI for staging pediatric cancer, the value of these novel imaging technologies for cancer therapy monitoring has received surprisingly little attention. In this article, we share our experiences and review existing literature on this subject.
Collapse
Affiliation(s)
- Heike E Daldrup-Link
- Department of Radiology, Molecular Imaging Program at Stanford (MIPS), Lucile Packard Children's Hospital, Stanford University, 725 Welch Road, Room 1665, Stanford, CA, 94305-5614, USA.
- Department of Pediatrics, Stanford University, Stanford, CA, USA.
- Cancer Imaging and Early Detection Program, Stanford Cancer Institute, Stanford, CA, USA.
| | - Ashok J Theruvath
- Department of Radiology, Molecular Imaging Program at Stanford (MIPS), Lucile Packard Children's Hospital, Stanford University, 725 Welch Road, Room 1665, Stanford, CA, 94305-5614, USA
- Cancer Imaging and Early Detection Program, Stanford Cancer Institute, Stanford, CA, USA
| | - Lucia Baratto
- Department of Radiology, Molecular Imaging Program at Stanford (MIPS), Lucile Packard Children's Hospital, Stanford University, 725 Welch Road, Room 1665, Stanford, CA, 94305-5614, USA
- Cancer Imaging and Early Detection Program, Stanford Cancer Institute, Stanford, CA, USA
| | - Kristina Elizabeth Hawk
- Department of Radiology, Molecular Imaging Program at Stanford (MIPS), Lucile Packard Children's Hospital, Stanford University, 725 Welch Road, Room 1665, Stanford, CA, 94305-5614, USA
- Cancer Imaging and Early Detection Program, Stanford Cancer Institute, Stanford, CA, USA
| |
Collapse
|
24
|
Wei X, Zhao H, Huang G, Liu J, He W, Huang Q. ES-MION-Based Dual-Modality PET/MRI Probes for Acidic Tumor Microenvironment Imaging. ACS OMEGA 2022; 7:3442-3451. [PMID: 35128253 PMCID: PMC8811892 DOI: 10.1021/acsomega.1c05815] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 12/31/2021] [Indexed: 06/14/2023]
Abstract
Among all characteristics of the tumor microenvironment (TME), which are caused by abnormal proliferation of solid tumors, extracellular acidity is an important indicator for malignancy grading. pH-low insertion peptides (pHLIPs) are adopted to discern the acidic TME. To date, different imaging agents including fluorescent, positron emission tomography (PET), single photon emission computed tomography (SPECT), and magnetic resonance (MR) contrast agents with pHLIPs to target the acidic TME have been used to image various tumor models successfully. In this article, a PET/MRI dual-modality probe, based on extremely small magnetic iron oxide nanoparticles (ES-MIONs) with pHLIPs as a targeting unit, was proposed for the first time. In the phantom study, the probe showed relatively high r 1 relaxivity (r 1 = 1.03 mM-1 s-1), indicating that it could be used as a T1-weighted MR contrast agent. The 68Ga-radiolabeled probe was further studied in vitro and in vivo to evaluate pHLIP targeting efficacy and feasibility for PET/MRI. PET with intratumoral injection and T1-weighted MRI with intravenous injection both showed pHLIP-specific delivery of the probe. Therefore, we successfully designed and developed a radiolabeled ES-MION-based dual-modality PET/MRI agent to target the acidic tumor microenvironment. Although the accumulation of the probe in tumors with intravenous injection was not high enough to exhibit signals in the PET imaging study, our study still provides further insights into the ES-MION-based PET/MRI strategy.
Collapse
Affiliation(s)
- Xiuyan Wei
- Medical
Chemistry and Bioinformatics Center, College of Basic Medical Sciences, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Haitao Zhao
- Department
of Nuclear Medicine, Institute of Clinical Nuclear Medicine, Renji
Hospital, School of Medicine, Shanghai Jiao
Tong University, Shanghai 200127, China
| | - Gang Huang
- Shanghai
Key Laboratory of Molecular Imaging, Shanghai
University of Medicine and Health Sciences, Shanghai 201318, China
| | - Jianhua Liu
- Medical
Chemistry and Bioinformatics Center, College of Basic Medical Sciences, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Weina He
- Medical
Chemistry and Bioinformatics Center, College of Basic Medical Sciences, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Qingqing Huang
- Shanghai
Key Laboratory of Molecular Imaging, Shanghai
University of Medicine and Health Sciences, Shanghai 201318, China
| |
Collapse
|
25
|
Bogdanovic B, Solari EL, Villagran Asiares A, McIntosh L, van Marwick S, Schachoff S, Nekolla SG. PET/MR Technology: Advancement and Challenges. Semin Nucl Med 2021; 52:340-355. [PMID: 34969520 DOI: 10.1053/j.semnuclmed.2021.11.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 11/25/2021] [Accepted: 11/29/2021] [Indexed: 01/07/2023]
Abstract
When this article was written, it coincided with the 11th anniversary of the installation of our PET/MR device in Munich. In fact, this was the first fully integrated device to be in clinical use. During this time, we have observed many interesting behaviors, to put it kindly. However, it is more critical that in this process, our understanding of the system also improved - including the advantages and limitations from a technical, logistical, and medical perspective. The last decade of PET/MRI research has certainly been characterized by most sites looking for a "key application." There were many ideas in this context and before and after the devices became available, some of which were based on the earlier work with integrating data from single devices. These involved validating classical PET methods with MRI (eg, perfusion or oncology diagnostics). More important, however, were the scenarios where intermodal synergies could be expected. In this review, we look back on this decade-long journey, at the challenges overcome and those still to come.
Collapse
Affiliation(s)
- Borjana Bogdanovic
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Esteban Lucas Solari
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Alberto Villagran Asiares
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Lachlan McIntosh
- Department of Physical Sciences, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Sandra van Marwick
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Sylvia Schachoff
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Stephan G Nekolla
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany.
| |
Collapse
|
26
|
Young JD, Jauregui-Osoro M, Wong WL, Cooper MS, Cook G, Barrington SF, Ma MT, Blower PJ, Aboagye EO. An overview of nuclear medicine research in the UK and the landscape for clinical adoption. Nucl Med Commun 2021; 42:1301-1312. [PMID: 34284442 PMCID: PMC8584216 DOI: 10.1097/mnm.0000000000001461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 06/21/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND OBJECTIVES Nuclear medicine contributes greatly to the clinical management of patients and experimental medicine. This report aims to (1) outline the current landscape of nuclear medicine research in the UK, including current facilities and recent or ongoing clinical studies and (2) provide information about the available pathways for clinical adoption and NHS funding (commissioning) of radiopharmaceuticals. METHODS Evidence was obtained through database searches for UK-based nuclear medicine clinical studies and by conducting a questionnaire-based survey of UK radiopharmaceutical production facilities. A recent history of clinical commissioning, either through recommendations from the National Institute for Health and Care Excellence (NICE) or through NHS specialised services commissioning, was compiled from publicly available documents and policies. RESULTS The collected data highlighted the UK's active nuclear medicine research community and recent investment in new facilities and upgrades. All commissioning routes favour radiopharmaceuticals that have marketing authorisation and since 2017 there has been a requirement to demonstrate both clinical and cost-effectiveness. Whilst radiopharmaceuticals for molecular radiotherapy are well suited to these commissioning pathways, diagnostic radiotracers have not historically been assessed in this manner. CONCLUSIONS We hope that by collating this information we will provide stimulus for future discussion and consensus statements around this topic.
Collapse
Affiliation(s)
- Jennifer D. Young
- Department of Imaging Chemistry and Biology, School of Biomedical Engineering and Imaging Sciences, King’s College London
- National Cancer Imaging Translational Accelerator, Cancer Research UK
| | - Maite Jauregui-Osoro
- National Cancer Imaging Translational Accelerator, Cancer Research UK
- Department of Surgery & Cancer, Division of Cancer, Imperial College London, London
| | - Wai-Lup Wong
- Department of Nuclear Medicine, Mount Vernon Cancer Centre, Mount Vernon Hospital, Northwood
| | - Margaret S. Cooper
- Department of Imaging Chemistry and Biology, School of Biomedical Engineering and Imaging Sciences, King’s College London
| | - Gary Cook
- Department of Imaging Chemistry and Biology, School of Biomedical Engineering and Imaging Sciences, King’s College London
- National Cancer Imaging Translational Accelerator, Cancer Research UK
- King’s College London and Guy’s and St Thomas’ PET Centre, King’s College London, King’s Health Partners, London, UK
| | - Sally F. Barrington
- Department of Imaging Chemistry and Biology, School of Biomedical Engineering and Imaging Sciences, King’s College London
- King’s College London and Guy’s and St Thomas’ PET Centre, King’s College London, King’s Health Partners, London, UK
| | - Michelle T. Ma
- Department of Imaging Chemistry and Biology, School of Biomedical Engineering and Imaging Sciences, King’s College London
- National Cancer Imaging Translational Accelerator, Cancer Research UK
| | - Philip J. Blower
- Department of Imaging Chemistry and Biology, School of Biomedical Engineering and Imaging Sciences, King’s College London
- National Cancer Imaging Translational Accelerator, Cancer Research UK
| | - Eric O. Aboagye
- National Cancer Imaging Translational Accelerator, Cancer Research UK
- Department of Surgery & Cancer, Division of Cancer, Imperial College London, London
| |
Collapse
|
27
|
Watanabe M, Kawai-Miyake K, Fushimi Y, Ishimori T, Nakajima A, Yoshimura M, Kikuchi M, Ohno K, Nakamoto Y. Application of a Flexible PET Scanner Combined with 3 T MRI Using Non-local Means Reconstruction: Qualitative and Quantitative Comparison with Whole-Body PET/CT. Mol Imaging Biol 2021; 24:167-176. [PMID: 34642900 DOI: 10.1007/s11307-021-01651-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 07/21/2021] [Accepted: 09/01/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE Flexible positron emission tomography (fxPET) employing a non-local means reconstruction algorithm was designed to fit existing magnetic resonance imaging (MRI) systems. We aimed to compare the qualitative and quantitative performance of fxPET among fxPET with MR-based attenuation correction (MRAC), fxPET with CT-based attenuation correction (CTAC) using CT as a part of WB PET/CT, and whole-body (WB) PET/CT. PROCEDURES Sixteen patients with suspected head and neck cancer underwent 2-deoxy-2-[18F]fluoro-D-glucose WB PET/CT scans, followed by fxPET and 3 T MRI scans. Phantom data were compared among the three datasets. For registration accuracy, we measured the distance between the center of the tumor determined by fxPET and that in MRI. We compared image quality, detection rates, and quantitative values including maximal standardized uptake value (SUVmax), metabolic tumor volume (MTV), total lesion glycolysis (TLG), and tumor-to-muscle ratio (TMR) among the three datasets. RESULTS The phantom data in fxPET, except the percent contrast recoveries of 17-mm and 22-mm hot spheres, were inferior to those in WB PET/CT. The mean registration accuracy was 4.4 mm between fxPET using MRAC and MRI. The image quality was comparable between two fxPET datasets, but significantly inferior to WB PET/CT (p < 0.0001). In contrast, detection rates were comparable among the three datasets. SUVmax was significantly higher, and MTV and TLG were significantly lower in the two fxPET datasets compared with the WB PET/CT dataset (p < 0.005). There were no significant differences in SUVmax, MTV, and TLG between the two fxPET datasets or in TMR among the three datasets. All quantitative values had significantly positive correlations. CONCLUSIONS Compared with WB PET/CT, the phantom data and image quality were inferior in fxPET. However, the results of the detection rates and quantitative values suggested the clinical feasibility of fxPET.
Collapse
Affiliation(s)
- Masao Watanabe
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.,Department of Radiology, Kobe City Medical Center General Hospital, 2-1-1 Minatojima Minamimachi, Chuo-ku, Kobe, 650-0047, Japan
| | - Kanae Kawai-Miyake
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Yasutaka Fushimi
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Takayoshi Ishimori
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Aya Nakajima
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Michio Yoshimura
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Masahiro Kikuchi
- Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Kazuko Ohno
- Department of Radiological Technology, Kyoto College of Medical Science, 1-3 Imakita, Oyamahigashi-cho, Sonobe-cho, Nantan, Kyoto, 622-0041, Japan
| | - Yuji Nakamoto
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
| |
Collapse
|
28
|
Hamdi M, Natsuaki Y, Wangerin KA, An H, St James S, Kinahan PE, Sunderland JJ, Larson PEZ, Hope TA, Laforest R. Evaluation of attenuation correction in PET/MRI with synthetic lesion insertion. J Med Imaging (Bellingham) 2021; 8:056001. [PMID: 34568511 DOI: 10.1117/1.jmi.8.5.056001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 09/02/2021] [Indexed: 11/14/2022] Open
Abstract
Purpose: One major challenge facing simultaneous positron emission tomography (PET)/ magnetic resonance imaging (MRI) is PET attenuation correction (AC) measurement and evaluation of its accuracy. There is a crucial need for the evaluation of current and emergent PET AC methodologies in terms of absolute quantitative accuracy in the reconstructed PET images. Approach: To address this need, we developed and evaluated a lesion insertion tool for PET/MRI that will facilitate this evaluation process. This tool was developed for the Biograph mMR and evaluated using phantom and patient data. Contrast recovery coefficients (CRC) from the NEMA IEC phantom of synthesized lesions were compared to measurements. In addition, SUV biases of lesions inserted in human brain and pelvis images were assessed from PET images reconstructed with MRI-based AC (MRAC) and CT-based AC (CTAC). Results: For cross-comparison PET/MRI scanners AC evaluation, we demonstrated that the developed lesion insertion tool can be harmonized with the GE-SIGNA lesion insertion tool. About < 3 % CRC curves difference between simulation and measurement was achieved. An average of 1.6% between harmonized simulated CRC curves obtained with mMR and SIGNA lesion insertion tools was achieved. A range of - 5 % to 12% MRAC to CTAC SUV bias was respectively achieved in the vicinity and inside bone tissues in patient images in two anatomical regions, the brain, and pelvis. Conclusions: A lesion insertion tool was developed for the Biograph mMR PET/MRI scanner and harmonized with the SIGNA PET/MRI lesion insertion tool. These tools will allow for an accurate evaluation of different PET/MRI AC approaches and permit exploration of subtle attenuation correction differences across systems.
Collapse
Affiliation(s)
- Mahdjoub Hamdi
- Washington University in St. Louis, Mallinckrodt Institute of Radiology, St. Louis, Missouri, United States
| | - Yutaka Natsuaki
- University of California San Francisco, Department of Radiation Oncology, San Francisco, California, United States
| | | | - Hongyu An
- Washington University in St. Louis, Mallinckrodt Institute of Radiology, St. Louis, Missouri, United States
| | - Sarah St James
- University of California San Francisco, Department of Radiation Oncology, San Francisco, California, United States
| | - Paul E Kinahan
- University of Washington Seattle, Seattle, Washington, United States
| | - John J Sunderland
- University of Iowa, Carver College of Medicine, Department of Radiology, Iowa City, Iowa, United States
| | - Peder E Z Larson
- University of California San Francisco, Department of Radiology and Biomedical Imaging, San Francisco, California, United States
| | - Thomas A Hope
- University of California San Francisco, Department of Radiology and Biomedical Imaging, San Francisco, California, United States
| | - Richard Laforest
- Washington University in St. Louis, Mallinckrodt Institute of Radiology, St. Louis, Missouri, United States
| |
Collapse
|
29
|
Araz M, Nak D, Soydal Ç, Peker E, Erden İ, Küçük NÖ. Detectability of 18F-choline PET/MR in primary hyperparathyroidism. Eur Arch Otorhinolaryngol 2021; 279:2583-2589. [PMID: 34495350 DOI: 10.1007/s00405-021-07046-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 08/15/2021] [Indexed: 12/31/2022]
Abstract
PURPOSE We aimed to evaluate the power of 18F-fluorocholine (FCH) positron emission tomography/magnetic resonance (PET/MR) imaging in unlocalized primary hyperparathyroidism. METHODS Thirty-four patients were included. In 17/34 patients, PET/MR was performed immediately after a negative 18F-FCH PET/CT. Sensitivity, specificity, positive and negative predictive values were calculated for MR only (blinded to PET data) and PET only (blinded to MR data) findings. RESULTS 18F-FCH PET/MR was positive in 26/34 (76%) patients. PET/MR was also positive in 12/17 (71%) patients with a negative PET/CT. Among 11/34 (32%) patients where 18F-FCH PET-only and MR-only results were discordant, MR was false positive in 7/11 patients (3/7 of the lesions were not 18F-FCH avid and in 4/7 of them PET and MRI pointed different locations. Postoperative histopathology revealed that 18F-FCH-positive ones were true positives). Sensitivity, specificity, PPV, NPV and accuracy of neck MR evaluated blinded to PET data were 80%, 50%, 70%, 64% and 68%, respectively, and all were calculated as 100% for PET/MR. CONCLUSION 18F-FCH PET/MR is very effective in preoperative localization of parathyroid adenomas even if 18F-FCH PET/CT is negative. Neck MR alone is insufficient in detecting parathyroid adenomas but PET/MR combination helps in precise localisation.
Collapse
Affiliation(s)
- Mine Araz
- Nuclear Medicine Department, Cebeci Hospital, Ankara University Medical Faculty, Ankara, Turkey.
| | - Demet Nak
- Nuclear Medicine Department, Cebeci Hospital, Ankara University Medical Faculty, Ankara, Turkey
| | - Çiğdem Soydal
- Nuclear Medicine Department, Cebeci Hospital, Ankara University Medical Faculty, Ankara, Turkey
| | - Elif Peker
- Radiology Department, Ankara University Medical School, Ankara, Turkey
| | - İlhan Erden
- Radiology Department, Ankara University Medical School, Ankara, Turkey
| | - N Özlem Küçük
- Nuclear Medicine Department, Cebeci Hospital, Ankara University Medical Faculty, Ankara, Turkey
| |
Collapse
|
30
|
Brancato V, Borrelli P, Alfano V, Picardi M, Mascalchi M, Nicolai E, Salvatore M, Aiello M. The impact of MR-based attenuation correction in spinal cord FDG-PET/MR imaging for neurological studies. Med Phys 2021; 48:5924-5934. [PMID: 34369590 PMCID: PMC9293017 DOI: 10.1002/mp.15149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 05/30/2021] [Accepted: 07/24/2021] [Indexed: 11/21/2022] Open
Abstract
Purpose Positron emission tomography (PET) attenuation correction (AC) in positron emission tomography‐magnetic resonance (PET/MR) scanners constitutes a critical and barely explored issue in spinal cord investigation, mainly due to the limitations in accounting for highly attenuating bone structures which surround the spinal canal. Our study aims at evaluating the clinical suitability of MR‐driven AC (MRAC) for 18‐fluorodeoxy‐glucose positron emission tomography (18F‐FDG‐PET) in spinal cord. Methods Thirty‐six patients, undergoing positron emission tomography‐computed tomography (PET/CT) and PET/MR in the same session for oncological examination, were retrospectively analyzed. For each patient, raw PET data from PET/MR scanner were reconstructed with 4‐ and 5‐class MRAC maps, generated by hybrid PET/MR system (PET_MRAC4 and PET_MRAC5, respectively, where PET_MRAC is PET images reconstructed using MR‐based attenuation correction map), and an AC map derived from CT data after a custom co‐registration pipeline (PET_rCTAC, where PET_rCTAC is PET images reconstructed using CT‐based attenuation correction map), which served as reference. Mean PET standardized uptake values (SUVm) were extracted from the three reconstructed PET images by regions of interest (ROIs) identified on T2‐weighted MRI, in the spinal cord, lumbar cerebrospinal fluid (CSF), and vertebral marrow at five levels (C2, C5, T6, T12, and L3). SUVm values from PET_MRAC4 and PET_MRAC5 were compared with each other and with the reference by means of paired t‐test, and correlated using Pearson's correlation (r) to assess their consistency. Cohen's d was calculated to assess the magnitude of differences between PET images. Results SUVmvalues from PET_MRAC4 were lower than those from PET_MRAC5 in almost all analyzed ROIs, with a mean difference ranging from 0.03 to 0.26 (statistically significant in the vertebral marrow at C2 and C5, spinal cord at T6 and T2, and CSF at L3). This was also confirmed by the effect size, with highest values at low spinal levels (d = 0.45 at T12 in spinal cord, d = 0.95 at L3 in CSF). SUVm values from PET_MRAC4 and PET_MRAC5 showed a very good correlation (0.81 < r < 0.97, p < 0.05) in all spinal ROIs. Underestimation of SUVm between PET_MRAC4 and PET_rCTAC was observed at each level, with a mean difference ranging from 0.02 to 0.32 (statistically significant in the vertebral marrow at C2 and T6, and CSF at L3). Although PET_MRAC5 underestimates PET_rCTAC (mean difference ranging from 0.02 to 0.3), an overall decrease in effect size could be observed for PET_MRAC5, mainly at lower spinal levels (T12, L3). SUVm from both PET_MRAC4 and PET_MRAC5 methods showed r value from good to very good with respect to PET_rCTAC (0.67 < r < 0.9 and 0.73 < r < 0.94, p < 0.05, respectively). Conclusions Our results showed that neglecting bones in AC can underestimate the FDG uptake measurement of the spinal cord. The inclusion of bones in MRAC is far from negligible and improves the AC in spinal cord, mainly at low spinal levels. Therefore, care must be taken in the spinal canal region, and the use of AC map reconstruction methods accounting for bone structures could be beneficial.
Collapse
Affiliation(s)
| | | | | | - Marco Picardi
- Department of Clinical Medicine and Surgery, Federico II University Medical School, Naples, Italy
| | - Mario Mascalchi
- «Mario Serio» Department of Experimental and Clinical Biomedical Sciences, University of Florence, Italy
| | | | | | | |
Collapse
|
31
|
PET/MRI for Staging the Axilla in Breast Cancer: Current Evidence and the Rationale for SNB vs. PET/MRI Trials. Cancers (Basel) 2021; 13:cancers13143571. [PMID: 34298781 PMCID: PMC8303241 DOI: 10.3390/cancers13143571] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 07/05/2021] [Accepted: 07/12/2021] [Indexed: 01/03/2023] Open
Abstract
Simple Summary PET/MRI is a relatively new, hybrid imaging tool that allows practitioners to obtain both a local and systemic staging in breast cancer patients in a single exam. To date, the available evidence is not sufficient to determine the role of PET/MRI in breast cancer management. The aims of this paper are to provide an overview of the current literature on PET/MRI in breast cancer, and to illustrate two ongoing trials aimed at defining the eventual role of PET/MRI in axillary staging in two different settings: patients with early breast cancer and patients with positive axillary nodes that are candidates for primary systemic therapy. In both cases, findings from PET/MRI will be compared with the final pathology and could be helpful to better tailor axillary surgery in the future. Abstract Axillary surgery in breast cancer (BC) is no longer a therapeutic procedure but has become a purely staging procedure. The progressive improvement in imaging techniques has paved the way to the hypothesis that prognostic information on nodal status deriving from surgery could be obtained with an accurate diagnostic exam. Positron emission tomography/magnetic resonance imaging (PET/MRI) is a relatively new imaging tool and its role in breast cancer patients is still under investigation. We reviewed the available literature on PET/MRI in BC patients. This overview showed that PET/MRI yields a high diagnostic performance for the primary tumor and distant lesions of liver, brain and bone. In particular, the results of PET/MRI in staging the axilla are promising. This provided the rationale for two prospective comparative trials between axillary surgery and PET/MRI that could lead to a further de-escalation of surgical treatment of BC. • SNB vs. PET/MRI 1 trial compares PET/MRI and axillary surgery in staging the axilla of BC patients undergoing primary systemic therapy (PST). • SNB vs. PET/MRI 2 trial compares PET/MRI and sentinel node biopsy (SNB) in staging the axilla of early BC patients who are candidates for upfront surgery. Finally, these ongoing studies will help clarify the role of PET/MRI in BC and establish whether it represents a useful diagnostic tool that could guide, or ideally replace, axillary surgery in the future.
Collapse
|
32
|
Zhu Y, Bilgel M, Gao Y, Rousset OG, Resnick SM, Wong DF, Rahmim A. Deconvolution-based partial volume correction of PET images with parallel level set regularization. Phys Med Biol 2021; 66. [PMID: 34157707 DOI: 10.1088/1361-6560/ac0d8f] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 06/22/2021] [Indexed: 11/11/2022]
Abstract
The partial volume effect (PVE), caused by the limited spatial resolution of positron emission tomography (PET), degrades images both qualitatively and quantitatively. Anatomical information provided by magnetic resonance (MR) images has the potential to play an important role in partial volume correction (PVC) methods. Post-reconstruction MR-guided PVC methods typically use segmented MR tissue maps, and further, assume that PET activity distribution is uniform in each region, imposing considerable constraints through anatomical guidance. In this work, we present a post-reconstruction PVC method based on deconvolution with parallel level set (PLS) regularization. We frame the problem as an iterative deconvolution task with PLS regularization that incorporates anatomical information without requiring MR segmentation or assuming uniformity of PET distributions within regions. An efficient algorithm for non-smooth optimization of the objective function (invoking split Bregman framework) is developed so that the proposed method can be feasibly applied to 3D images and produces sharper images compared to PLS method with smooth optimization. The proposed method was evaluated together with several other PVC methods using both realistic simulation experiments based on the BrainWeb phantom as well asin vivohuman data. Our proposed method showed enhanced quantitative performance when realistic MR guidance was provided. Further, the proposed method is able to reduce image noise while preserving structure details onin vivohuman data, and shows the potential to better differentiate amyloid positive and amyloid negative scans. Overall, our results demonstrate promise to provide superior performance in clinical imaging scenarios.
Collapse
Affiliation(s)
- Yansong Zhu
- Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD, United States of America.,Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD, United States of America.,Department of Physics & Astronomy, University of British Columbia, Vancouver, BC, Canada
| | - Murat Bilgel
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, MD, United States of America
| | - Yuanyuan Gao
- School of Biomedical Engineering, Southern Medical University, Guangzhou, People's Republic of China
| | - Olivier G Rousset
- Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD, United States of America
| | - Susan M Resnick
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, MD, United States of America
| | - Dean F Wong
- Mallinckrodt Institute of Radiology, Washington University in St. Louis, St. Louis, MO, United States of America
| | - Arman Rahmim
- Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD, United States of America.,Department of Physics & Astronomy, University of British Columbia, Vancouver, BC, Canada
| |
Collapse
|
33
|
Bal H, Kiser JW, Conti M, Bowen SL. Comparison of maximum likelihood and conventional PET scatter scaling methods for 18 F-FDG and 68 Ga-DOTATATE PET/CT. Med Phys 2021; 48:4218-4228. [PMID: 34013586 DOI: 10.1002/mp.14988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 03/17/2021] [Accepted: 05/05/2021] [Indexed: 11/10/2022] Open
Abstract
PURPOSE We aim to quantify differences between a new maximum likelihood (ML) background scaling (MLBS) algorithm and two conventional scatter scaling methods for clinical PET/CT. A common source of reduced image quantification with conventional scatter corrections is attributed to erroneous scaling of the initial scatter estimate to match acquired scattered events in the sinogram. MLBS may have performance advantages over conventional methods by using all available data intersecting the subject. METHODS A retrospective analysis was performed on subjects injected with 18 F-FDG (N = 71) and 68 Ga-DOTATATE (N = 11) and imaged using time-of-flight (TOF) PET/CT. The scatter distribution was estimated with single scatter simulation approaches. Conventional scaling algorithms included (a) tail fitted background scaling (TFBS), which scales the scatter to "tails" outside the emission support, and (b) absolute scatter correction (ABS), which utilizes the simulated scatter distribution with no scaling applied. MLBS consisted of an alternating iterative reconstruction with a TOF-based ML activity image update allowing negative values (NEG-ML) and nested loop ML scatter scaling estimation. Scatter corrections were compared using reconstructed images as follows: (a) normalized relative difference images were generated and used for voxel-wise analysis, (b) liver and suspected lesion ROIs were drawn to compute mean SUVs, and (c) a qualitative analysis of overall diagnostic image quality, impact of artifacts, and lesion conspicuity was performed. Absolute quantification and normalized relative differences were also assessed with an 18 F-FDG phantom study. RESULTS For human subjects 18 F-FDG data, Bland-Altman plots demonstrated that the largest normalized voxel-wise differences were observed close to the lower limit (SUV = 1.0). MLBS reconstructions trended towards higher scatter fractions compared to TFBS and ABS images, with median voxel differences across all subjects for TFBS-MLBS measured at 1.7% and 7.6% for 18 F-FDG and 68 Ga-DOTATATE, respectively. For mean SUV analysis, there was a high degree of correlation between the scatter corrections. For 18 F-FDG, ABS scatter correction reconstructions trended towards higher liver mean SUVs relative to MLBS. The qualitative image analysis revealed no significant differences between TFBS and MLBS image reconstructions. For a uniformly filled relatively large 37 cm diameter phantom, MLBS produced the lowest bias in absolute quantification, while normalized voxel-wise differences showed a trend in scatter correction performance consistent with the human subjects study. CONCLUSIONS For 18 F-FDG, MLBS is at least a valid substitute to TFBS, providing reconstructed image performance comparable to TFBS in most subjects but exhibiting quantitative differences in cases where TFBS is typically prone to inaccuracies (e.g., due to patient motion and CT-based attenuation map truncation). Particularly for low contrast regions, quantification differs for ABS compared to MLBS and TFBS, and caution should be taken when utilizing ABS for decision-making based on quantitative metrics.
Collapse
Affiliation(s)
- Harshali Bal
- Siemens Medical Solutions USA, Inc, Knoxville, TN, USA
| | | | | | - Spencer L Bowen
- Fralin Biomedical Research Institute at VTC, Roanoke, VA, USA
| |
Collapse
|
34
|
Gong J, Liu H, Bao Z, Bian L, Li X, Meng Y. Relative clinical utility of simultaneous 18F-fluorodeoxyglucose PET/MRI and PET/CT for preoperative cervical cancer diagnosis. J Int Med Res 2021; 49:3000605211019190. [PMID: 34162259 PMCID: PMC8236793 DOI: 10.1177/03000605211019190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Objective To investigate the utility of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/magnetic resonance imaging (PET/MRI) for the preoperative diagnosis of cervical cancer. Methods We retrospectively analyzed 114 patients who were diagnosed with cervical cancer and underwent PET/MRI (n = 59) or PET/computed tomography (PET/CT) (n = 65) before surgery. The maximal standardized uptake value (SUVmax) and mean SUV (SUVmean) were determined for regions of interest in the resultant radiographic images. Results Relative to PET/CT, 18F-FDG PET/MRI exhibited higher specificity and sensitivity in defining the primary tumor bounds and higher sensitivity for detection of bladder involvement. The SUVmax and SUVmean of PET/MRI were remarkably higher than those of PET/CT as a means of detecting primary tumors, bladder involvement, and the lymph node status. However, no significant differences in these values were detected when comparing the two imaging approaches as a means of detecting vaginal involvement or para-aortic lymph node metastasis. Conclusions These outcomes may demonstrate the capability of 18F-FDG PET/MRI to clarify preoperative cervical cancer diagnoses in the context of unclear PET/CT findings. However, studies directly comparing SUVs in different lesion types from patients who have undergone both PET/MRI and PET/CT scans are essential to validate and expand upon these findings.
Collapse
Affiliation(s)
- Jing Gong
- Department of Obstetrics and Gynecology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Honghong Liu
- Department of Nuclear Medicine, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Zhaoliang Bao
- Department of Obstetrics and Gynecology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Lihua Bian
- Department of Obstetrics and Gynecology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Xiuzhen Li
- Department of Obstetrics and Gynecology, People's Hospital of Shuangluan District, Chengde City, Hebei Province, China
| | - Yuanguang Meng
- Department of Obstetrics and Gynecology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| |
Collapse
|
35
|
Wang S, Zhu H, Ding J, Wang F, Meng X, Ding L, Zhang Y, Li N, Yao S, Sheng X, Yang Z. Positron Emission Tomography Imaging of Programmed Death 1 Expression in Cancer Patients Using 124I-Labeled Toripalimab: A Pilot Clinical Translation Study. Clin Nucl Med 2021; 46:382-388. [PMID: 33512952 DOI: 10.1097/rlu.0000000000003520] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
PURPOSE Although anti-programmed cell death molecule-1 (PD-1)/PD-1 ligand therapy has achieved remarkable success in oncology field, the low response rate and lack of accurate prognostic biomarker identifying benefiting patients remain unresolved challenges. This study developed a PD-1 targeting radiotracer 124I-labeled toripalimab (124I-JS001) for clinical PET imaging and evaluated its biodistribution, safety, and dosimetry in human. METHODS Patients with melanoma or urologic cancer confirmed by pathology were enrolled. 124I-JS001 PET/CT and PET/MR were performed with or without coinjection of 5 mg unlabeled JS001, and 18F-FDG PET was undertaken within 1 week. RESULTS Eight melanoma and 3 urologic cancer patients were enrolled. No adverse events were noticed during the whole examination after the injection of 124I-JS001 and an acceptable dosimetry of 0.236 mSv/MBq was found. 124I-JS001 PET/CT showed high uptake in spleen and liver and slight uptake in bone marrow and lung. All primary and metastatic tumor lesions in 11 patients demonstrated different levels of uptake of 124I-JS001 with SUVmax ranging from 0.2 to 4.7. With coinjection of unlabeled JS001, the uptake in spleen was reduced significantly (P < 0.05), whereas tumor uptake and tumor background ratio increased significantly (P < 0.05). Four patients undertook regional 124I-JS001 PET/MR. All tumor lesions were detected effectively with abnormal MR signal on PET/MR, whereas PET/MR detected liver lesions more sensitively than PET/CT. CONCLUSIONS The first-in-human study demonstrated 124I-JS001 was a safe tracer for PET with acceptable dosimetry, and the PET/CT results showed a favorable biodistribution. PET/MR could detect liver lesions more sensitively than PET/CT.
Collapse
Affiliation(s)
- Shujing Wang
- From the Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Beijing
| | - Hua Zhu
- From the Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Beijing
| | - Jin Ding
- From the Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Beijing
| | - Feng Wang
- From the Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Beijing
| | - Xiangxi Meng
- From the Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Beijing
| | - Lixin Ding
- From the Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Beijing
| | - Yan Zhang
- From the Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Beijing
| | - Nan Li
- From the Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Beijing
| | - Sheng Yao
- Shanghai Junshi Biosciences Co Ltd, Shanghai
| | - Xinan Sheng
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Renal Cancer and Melanoma, Peking University Cancer Hospital & Institute, Beijing, China
| | - Zhi Yang
- From the Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Beijing
| |
Collapse
|
36
|
Maurer T, Gesterkamp H, Nguyen N, Westenfelder K, Gschwend JE, Budäus L, Rauscher I, Vag T, Weber W, Eiber M. [68Ga-PSMA-11 PET/mpMRI for local detection of primary prostate cancer in men with a negative prior biopsy]. Aktuelle Urol 2021; 52:143-148. [PMID: 32854128 DOI: 10.1055/a-1198-2305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION AND OBJECTIVE Multiparametric MRI (mpMRI) represents the current gold standard for the detection of primary prostate cancer (PC) after a negative biopsy. PSMA PET imaging has been introduced in the diagnostic work-up of PC with high accuracy, but is currently mainly utilised in the setting of biochemical recurrence. This study aimed to determine the efficacy of combined 68Ga-PSMA-11 PET/mpMRI imaging to detect PC in patients with previously negative prostate biopsies. METHODS A total of 57 patients who had undergone at least one prior negative prostate biopsy were included in this retrospective analysis. All patients underwent 68Ga-PSMA-11 PET/mpMRI imaging of the prostate. mpMRI was evaluated according to the PIRADS classification system and 68Ga-PSMA-11 PET was rated on a 5-point Likert scale (1: PC highly unlikely; 2: PC unlikely; 3: presence of PC is equivocal; 4: PC likely; 5: PC highly likely). All patients received a systematic random biopsy as well as a targeted transrectal biopsy of lesions suspicious on imaging. Imaging and histological biopsy outcomes were compared on a per-patient basis. RESULTS In the histological analysis, 35/57 (61.4 %) patients harboured PC lesions. In patients with biopsy-proven PC, 21/35 (60.0 %) had a PI-RADS 4 or 5 lesion on mpMRI and 28 /35 (80.0 %) had a PET rating of 4 or 5. Combined 68Ga-PSMA-11 PET/mpMRI missed only one patient with a Gleason score (GS) 7a tumour (rating of 1 or 2 in both PET and mpMRI). Limitations include the retrospective analysis as well as possible false negative biopsy results even in a fusion biopsy setting. CONCLUSION In this initial analysis, the combined 68Ga-PSMA-11 PET/mpMRI proved to be a valuable imaging tool to guide prostate biopsies for the detection of PC in patients with a negative prior biopsy. In this approach, 68Ga-PSMA-11 PET and mpMRI show partially complementary findings that enhance the detection of PC lesions.
Collapse
Affiliation(s)
- Tobias Maurer
- Urologische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München
- Martini-Klinik und Klinik und Poliklinik für Urologie, Universität Hamburg-Eppendorf
| | - Hannah Gesterkamp
- Urologische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München
| | - Noemi Nguyen
- Urologische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München
| | - Kay Westenfelder
- Urologische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München
| | - Jürgen E. Gschwend
- Urologische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München
| | - Lars Budäus
- Martini-Klinik und Klinik und Poliklinik für Urologie, Universität Hamburg-Eppendorf
| | - Isabel Rauscher
- Nuklearmedizinische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München
| | - Tibor Vag
- Nuklearmedizinische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München
| | - Wolfgang Weber
- Nuklearmedizinische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München
| | - Matthias Eiber
- Nuklearmedizinische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München
| |
Collapse
|
37
|
Suzuki M, Fushimi Y, Okada T, Hinoda T, Nakamoto R, Arakawa Y, Sawamoto N, Togashi K, Nakamoto Y. Quantitative and qualitative evaluation of sequential PET/MRI using a newly developed mobile PET system for brain imaging. Jpn J Radiol 2021; 39:669-680. [PMID: 33641056 DOI: 10.1007/s11604-021-01105-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 02/15/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE To evaluate the clinical feasibility of a newly developed mobile PET system with MR-compatibility (flexible PET; fxPET), compared with conventional PET (cPET)/CT for brain imaging. METHODS Twenty-one patients underwent cPET/CT with subsequent fxPET/MRI using 18F-FDG. As qualitative evaluation, we visually rated image quality of MR and PET images using a four-point scoring system. We evaluated overall image quality for MR, while we evaluated overall image quality, sharpness and lesion contrast. As quantitative evaluation, we compared registration accuracy between two modalities [(fxPET and MRI) and (cPET and CT)] measuring spatial coordinates. We also examined the accuracy of regional 18F-FDG uptake. RESULTS All acquired images were of diagnostic quality and the number of detected lesions did not differ significantly between fxPET/MR and cPET/CT. Mean misregistration was significantly larger with fxPET/MRI than with cPET/CT. SUVmax and SUVmean for fxPET and cPET showed high correlations in the lesions (R = 0.84, 0.79; P < 0.001, P = 0.002, respectively). In normal structures, we also showed high correlations of SUVmax (R = 0.85, 0.87; P < 0.001, P < 0.001, respectively) and SUVmean (R = 0.83, 0.87; P < 0.001, P < 0.001, respectively) in bilateral caudate nuclei and a moderate correlation of SUVmax (R = 0.65) and SUVmean (R = 0.63) in vermis. CONCLUSIONS The fxPET/MRI system showed image quality within the diagnostic range, registration accuracy below 3 mm and regional 18F-FDG uptake highly correlated with that of cPET/CT.
Collapse
Affiliation(s)
- Mizue Suzuki
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Yasutaka Fushimi
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
| | - Tomohisa Okada
- Human Brain Research Center, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Takuya Hinoda
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Ryusuke Nakamoto
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Yoshiki Arakawa
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Nobukatsu Sawamoto
- Department of Human Health Sciences, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Kaori Togashi
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Yuji Nakamoto
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| |
Collapse
|
38
|
Kebir S, Rauschenbach L, Weber M, Lazaridis L, Schmidt T, Keyvani K, Schäfer N, Milia A, Umutlu L, Pierscianek D, Stuschke M, Forsting M, Sure U, Kleinschnitz C, Antoch G, Colletti PM, Rubello D, Herrmann K, Herrlinger U, Scheffler B, Bundschuh RA, Glas M. Machine learning-based differentiation between multiple sclerosis and glioma WHO II°-IV° using O-(2-[18F] fluoroethyl)-L-tyrosine positron emission tomography. J Neurooncol 2021; 152:325-332. [PMID: 33502678 DOI: 10.1007/s11060-021-03701-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 01/13/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION This study aimed to test the diagnostic significance of FET-PET imaging combined with machine learning for the differentiation between multiple sclerosis (MS) and glioma II°-IV°. METHODS Our database was screened for patients in whom FET-PET imaging was performed for the diagnostic workup of newly diagnosed lesions evident on MRI and suggestive of glioma. Among those, we identified patients with histologically confirmed glioma II°-IV°, and those who later turned out to have MS. For each group, tumor-to-brain ratio (TBR) derived features of FET were determined. A support vector machine (SVM) based machine learning algorithm was constructed to enhance classification ability, and Receiver Operating Characteristic (ROC) analysis with area under the curve (AUC) metric served to ascertain model performance. RESULTS A total of 41 patients met selection criteria, including seven patients with MS and 34 patients with glioma. TBR values were significantly higher in the glioma group (TBRmax glioma vs. MS: p = 0.002; TBRmean glioma vs. MS: p = 0.014). In a subgroup analysis, TBR values significantly differentiated between MS and glioblastoma (TBRmax glioblastoma vs. MS: p = 0.0003, TBRmean glioblastoma vs. MS: p = 0.0003) and between MS and oligodendroglioma (ODG) (TBRmax ODG vs. MS: p = 0.003; TBRmean ODG vs. MS: p = 0.01). The ability to differentiate between MS and glioma II°-IV° increased from 0.79 using standard TBR analysis to 0.94 using a SVM based machine learning algorithm. CONCLUSIONS FET-PET imaging may help differentiate MS from glioma II°-IV° and SVM based machine learning approaches can enhance classification performance.
Collapse
Affiliation(s)
- Sied Kebir
- Division of Clinical Neurooncology, Department of Neurology, University Hospital Essen, University Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany.,West German Cancer Center (WTZ), German Cancer Consortium (DKTK), University Hospital Essen, University Duisburg-Essen, Partner Site University Hospital Essen, Essen, Germany.,DKFZ Division of Translational Neurooncology at the West German Cancer Center (WTZ), German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
| | - Laurèl Rauschenbach
- DKFZ Division of Translational Neurooncology at the West German Cancer Center (WTZ), German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany.,Department of Neurosurgery and Spine Surgery, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Manuel Weber
- Department of Nuclear Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Lazaros Lazaridis
- Division of Clinical Neurooncology, Department of Neurology, University Hospital Essen, University Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany.,West German Cancer Center (WTZ), German Cancer Consortium (DKTK), University Hospital Essen, University Duisburg-Essen, Partner Site University Hospital Essen, Essen, Germany.,DKFZ Division of Translational Neurooncology at the West German Cancer Center (WTZ), German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
| | - Teresa Schmidt
- Division of Clinical Neurooncology, Department of Neurology, University Hospital Essen, University Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany.,West German Cancer Center (WTZ), German Cancer Consortium (DKTK), University Hospital Essen, University Duisburg-Essen, Partner Site University Hospital Essen, Essen, Germany
| | - Kathy Keyvani
- Institute of Neuropathology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Niklas Schäfer
- Division of Clinical Neurooncology, Department of Neurology, University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Asma Milia
- Department of Pulmonology and Cardiology, Petrus Hospital Academic Teaching, Wuppertal, Germany
| | - Lale Umutlu
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Daniela Pierscianek
- Department of Neurosurgery and Spine Surgery, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Martin Stuschke
- Department of Radiotherapy, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Michael Forsting
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Ulrich Sure
- Department of Neurosurgery and Spine Surgery, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Christoph Kleinschnitz
- Department of Neurology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Gerald Antoch
- Department of Diagnostic and Interventional Radiology, University Hospital Düsseldorf, University of Düsseldorf, Düsseldorf, Germany
| | - Patrick M Colletti
- Department of Radiology, University of Southern California, Los Angeles, USA
| | - Domenico Rubello
- Department of Nuclear Medicine, Radiology, Neuroradiology, Clinical Pathology, S. Maria Della Misericordia Hospital, Rovigo, Italy
| | - Ken Herrmann
- Department of Nuclear Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Ulrich Herrlinger
- Division of Clinical Neurooncology, Department of Neurology, University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Björn Scheffler
- West German Cancer Center (WTZ), German Cancer Consortium (DKTK), University Hospital Essen, University Duisburg-Essen, Partner Site University Hospital Essen, Essen, Germany.,DKFZ Division of Translational Neurooncology at the West German Cancer Center (WTZ), German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
| | - Ralph A Bundschuh
- Department of Nuclear Medicine, University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Martin Glas
- Division of Clinical Neurooncology, Department of Neurology, University Hospital Essen, University Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany. .,West German Cancer Center (WTZ), German Cancer Consortium (DKTK), University Hospital Essen, University Duisburg-Essen, Partner Site University Hospital Essen, Essen, Germany. .,DKFZ Division of Translational Neurooncology at the West German Cancer Center (WTZ), German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany. .,Division of Clinical Neurooncology, Department of Neurology, University Hospital Bonn, University of Bonn, Bonn, Germany.
| |
Collapse
|
39
|
Direct comparisons of left ventricular volume and function by simultaneous cardiac magnetic resonance imaging and gated 13N-ammonia positron emission tomography. Nucl Med Commun 2021; 41:383-388. [PMID: 31939899 DOI: 10.1097/mnm.0000000000001149] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Hybrid PET/MRI is useful for the simultaneous evaluation of both -ammonia PET and MRI data. The aim of the current study was to compare the accuracy of gated -ammonia PET with MRI for the measurement of left ventricular volumes and function in patients with coronary artery disease (CAD), using simultaneous acquisitions on a hybrid PET/MRI system. METHODS Fifty-one consecutive patients with suspected CAD who underwent -ammonia PET/MRI were enrolled in this study. End-diastolic volume (EDV), end-systolic volume (ESV), and left ventricular ejection fraction (LVEF) were simultaneously evaluated using both gated -ammonia PET and cine MRI. Regional wall motion was visually scored on a 4-point scale using a 17-segment model for both methods. RESULTS The correlations between each EDV (R = 0.99, P < 0.001), ESV (R = 0.98, P < 0.001), and LVEF (R = 0.99, P = 0.001) measured by gated -ammmonia and MRI were very high. These high correlations were also observed in postmyocardial infarction patients. Furthermore, the regional wall motion scores determined on gated -ammonia PET and MRI showed an agreement of 89.0% with a kappa value of 0.82 ± 0.02. CONCLUSION EDV, ESV, LVEF, and regional wall motion measured by gated -ammonia PET were highly correlated with those measured by MRI.
Collapse
|
40
|
Fowler AM, Kumar M, Bancroft LH, Salem K, Johnson JM, Karow J, Perlman SB, Bradshaw TJ, Hurley SA, McMillan AB, Strigel RM. Measuring Glucose Uptake in Primary Invasive Breast Cancer Using Simultaneous Time-of-Flight Breast PET/MRI: A Method Comparison Study with Prone PET/CT. Radiol Imaging Cancer 2021; 3:e200091. [PMID: 33575660 PMCID: PMC7850238 DOI: 10.1148/rycan.2021200091] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 09/24/2020] [Accepted: 10/28/2020] [Indexed: 12/26/2022]
Abstract
Purpose To compare the measurement of glucose uptake in primary invasive breast cancer using simultaneous, time-of-flight breast PET/MRI with prone time-of-flight PET/CT. Materials and Methods In this prospective study, women with biopsy-proven invasive breast cancer undergoing preoperative breast MRI from 2016 to 2018 were eligible. Participants who had fasted underwent prone PET/CT of the breasts approximately 60 minutes after injection of 370 MBq (10 mCi) fluorine 18 fluorodeoxyglucose (18F-FDG) followed by prone PET/MRI using standard clinical breast MRI sequences performed simultaneously with PET acquisition. Volumes of interest were drawn for tumors and contralateral normal breast fibroglandular tissue to calculate standardized uptake values (SUVs). Spearman correlation, Wilcoxon signed ranked test, Mann-Whitney test, and Bland-Altman analyses were performed. Results Twenty-three women (mean age, 50 years; range, 33-70 years) were included. Correlation between tumor uptake values measured with PET/MRI and PET/CT was strong (r s = 0.95-0.98). No difference existed between modalities for tumor maximum SUV (SUVmax) normalized to normal breast tissue SUVmean (normSUVmax) (P = .58). The least amount of measurement bias was observed with normSUVmax, +3.86% (95% limits of agreement: -28.92, +36.64). Conclusion These results demonstrate measurement agreement between PET/CT, the current reference standard for tumor glucose uptake quantification, and simultaneous time-of-flight breast 18F-FDG PET/MRI.Keywords: Breast, Comparative Studies, PET/CT, PET/MR Supplemental material is available for this article. © RSNA, 2021See also the commentary by Mankoff and Surti in this issue.
Collapse
Affiliation(s)
- Amy M. Fowler
- From the Departments of Radiology (A.M.F., M.K., L.H.B., K.S., J.M.J., J.K., S.B.P., T.J.B., S.A.H., A.B.M., R.M.S.) and Medical Physics (A.M.F., R.M.S.), University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792-3252; and University of Wisconsin Carbone Cancer Center, Madison, Wis (A.M.F., R.M.S.)
| | - Manoj Kumar
- From the Departments of Radiology (A.M.F., M.K., L.H.B., K.S., J.M.J., J.K., S.B.P., T.J.B., S.A.H., A.B.M., R.M.S.) and Medical Physics (A.M.F., R.M.S.), University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792-3252; and University of Wisconsin Carbone Cancer Center, Madison, Wis (A.M.F., R.M.S.)
| | - Leah Henze Bancroft
- From the Departments of Radiology (A.M.F., M.K., L.H.B., K.S., J.M.J., J.K., S.B.P., T.J.B., S.A.H., A.B.M., R.M.S.) and Medical Physics (A.M.F., R.M.S.), University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792-3252; and University of Wisconsin Carbone Cancer Center, Madison, Wis (A.M.F., R.M.S.)
| | - Kelley Salem
- From the Departments of Radiology (A.M.F., M.K., L.H.B., K.S., J.M.J., J.K., S.B.P., T.J.B., S.A.H., A.B.M., R.M.S.) and Medical Physics (A.M.F., R.M.S.), University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792-3252; and University of Wisconsin Carbone Cancer Center, Madison, Wis (A.M.F., R.M.S.)
| | - Jacob M. Johnson
- From the Departments of Radiology (A.M.F., M.K., L.H.B., K.S., J.M.J., J.K., S.B.P., T.J.B., S.A.H., A.B.M., R.M.S.) and Medical Physics (A.M.F., R.M.S.), University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792-3252; and University of Wisconsin Carbone Cancer Center, Madison, Wis (A.M.F., R.M.S.)
| | | | - Scott B. Perlman
- From the Departments of Radiology (A.M.F., M.K., L.H.B., K.S., J.M.J., J.K., S.B.P., T.J.B., S.A.H., A.B.M., R.M.S.) and Medical Physics (A.M.F., R.M.S.), University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792-3252; and University of Wisconsin Carbone Cancer Center, Madison, Wis (A.M.F., R.M.S.)
| | - Tyler J. Bradshaw
- From the Departments of Radiology (A.M.F., M.K., L.H.B., K.S., J.M.J., J.K., S.B.P., T.J.B., S.A.H., A.B.M., R.M.S.) and Medical Physics (A.M.F., R.M.S.), University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792-3252; and University of Wisconsin Carbone Cancer Center, Madison, Wis (A.M.F., R.M.S.)
| | - Samuel A. Hurley
- From the Departments of Radiology (A.M.F., M.K., L.H.B., K.S., J.M.J., J.K., S.B.P., T.J.B., S.A.H., A.B.M., R.M.S.) and Medical Physics (A.M.F., R.M.S.), University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792-3252; and University of Wisconsin Carbone Cancer Center, Madison, Wis (A.M.F., R.M.S.)
| | - Alan B. McMillan
- From the Departments of Radiology (A.M.F., M.K., L.H.B., K.S., J.M.J., J.K., S.B.P., T.J.B., S.A.H., A.B.M., R.M.S.) and Medical Physics (A.M.F., R.M.S.), University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792-3252; and University of Wisconsin Carbone Cancer Center, Madison, Wis (A.M.F., R.M.S.)
| | - Roberta M. Strigel
- From the Departments of Radiology (A.M.F., M.K., L.H.B., K.S., J.M.J., J.K., S.B.P., T.J.B., S.A.H., A.B.M., R.M.S.) and Medical Physics (A.M.F., R.M.S.), University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792-3252; and University of Wisconsin Carbone Cancer Center, Madison, Wis (A.M.F., R.M.S.)
| |
Collapse
|
41
|
Gsell W, Molinos C, Correcher C, Belderbos S, Wouters J, Junge S, Heidenreich M, Velde GV, Rezaei A, Nuyts J, Cawthorne C, Cleeren F, Nannan L, Deroose CM, Himmelreich U, Gonzalez AJ. Characterization of a preclinical PET insert in a 7 tesla MRI scanner: beyond NEMA testing. Phys Med Biol 2020; 65:245016. [PMID: 32590380 DOI: 10.1088/1361-6560/aba08c] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
This study evaluates the performance of the Bruker positron emission tomograph (PET) insert combined with a BioSpec 70/30 USR magnetic resonance imaging (MRI) scanner using the manufacturer acceptance protocol and the NEMA NU 4-2008 for small animal PET. The PET insert is made of 3 rings of 8 monolithic LYSO crystals (50 × 50 × 10 mm3) coupled to silicon photomultipliers (SiPM) arrays, conferring an axial and transaxial FOV of 15 cm and 8 cm. The MRI performance was evaluated with and without the insert for the following radiofrequency noise, magnetic field homogeneity and image quality. For the PET performance, we extended the NEMA protocol featuring system sensitivity, count rates, spatial resolution and image quality to homogeneity and accuracy for quantification using several MRI sequences (RARE, FLASH, EPI and UTE). The PET insert does not show any adverse effect on the MRI performances. The MR field homogeneity is well preserved (Diameter Spherical Volume, for 20 mm of 1.98 ± 4.78 without and -0.96 ± 5.16 Hz with the PET insert). The PET insert has no major effect on the radiofrequency field. The signal-to-noise ratio measurements also do not show major differences. Image ghosting is well within the manufacturer specifications (<2.5%) and no RF noise is visible. Maximum sensitivity of the PET insert is 11.0% at the center of the FOV even with simultaneous acquisition of EPI and RARE. PET MLEM resolution is 0.87 mm (FWHM) at 5 mm off-center of the FOV and 0.97 mm at 25 mm radial offset. The peaks for true/noise equivalent count rates are 410/240 and 628/486 kcps for the rat and mouse phantoms, and are reached at 30.34/22.85 and 27.94/22.58 MBq. PET image quality is minimally altered by the different MRI sequences. The Bruker PET insert shows no adverse effect on the MRI performance and demonstrated a high sensitivity, sub-millimeter resolution and good image quality even during simultaneous MRI acquisition.
Collapse
Affiliation(s)
- Willy Gsell
- Biomedical MRI, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
42
|
Catana C. A Stepping-Stone to Fully Integrated Whole-Body PET/MRI. J Nucl Med 2020; 61:236S-237S. [PMID: 33293443 DOI: 10.2967/jnumed.120.252239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 08/11/2020] [Indexed: 11/16/2022] Open
Affiliation(s)
- Ciprian Catana
- Massachusetts General Hospital and Harvard Medical School, Charlestown, Massachusetts
| |
Collapse
|
43
|
Qualitative and Quantitative Assessment of Nonlocal Means Reconstruction Algorithm in a Flexible PET Scanner. AJR Am J Roentgenol 2020; 216:486-493. [PMID: 33236947 DOI: 10.2214/ajr.19.22245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE. Flexible PET (fxPET) was designed to fit existing MRI systems. The newly modified nonlocal means (NLM) algorithm is combined with the 3D dynamic row-action maximum likelihood algorithm (DRAMA). We investigated qualitative and quantitative acceptability of fxPET images reconstructed by modified NLM compared with whole-body (WB) PET/CT images and conventional 3D DRAMA reconstruction alone. MATERIALS AND METHODS. Fifty-nine patients with known or suspected malignancies underwent WB PET/CT scanning approximately 1 hour after the injection of 18F-FDG, after which they underwent fxPET scanning. Two readers rated the quality of fxPET images by consensus. Detection rate (the proportion of lesions found on PET), maximal standardized uptake value (SUVmax), metabolic tumor volume (MTV), total lesion glycolysis (TLG), tumor-to-normal liver ratio (TNR), and background liver signal-to-noise ratio (SNR) were compared among the three datasets. RESULTS. Higher image quality was obtained by modified NLM reconstruction than by conventional reconstruction without statistical significance. The detection rate was comparable among three datasets. SUVmax was significantly higher, and MTV and TLG were significantly lower in the modified NLM dataset (p < 0.002) than in the other two datasets, with significantly positive correlations (p < 0.001; Spearman rank correlation coefficient, 0.87-0.99). The TNRs in modified NLM images were significantly larger than in the other datasets (p < 0.05). The background SNRs in modified NLM images were comparable with those in WB PET/CT images, and significantly higher than in the conventional fxPET images (p < 0.005). CONCLUSION. The modified NLM algorithm was clinically acceptable, yielding higher TNR and background SNR compared with conventional reconstruction. Image quality and the lesion detection rate were comparable in this population.
Collapse
|
44
|
Öztürk H. PET/MRI: The future of cancer restaging. Cancer Treat Res Commun 2020; 25:100250. [PMID: 33276287 DOI: 10.1016/j.ctarc.2020.100250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 10/27/2020] [Accepted: 11/20/2020] [Indexed: 11/26/2022]
Abstract
The re-staging of cancer is one of the main oncological problems faced in the present day. Restaging can lead to the emergence of surgical therapy alternatives for a down-staged cancer, or to the consideration of secondary or tertiary chemotherapies for an up-staged cancer. That said, with the application of one of the surgical, radiotheraphy(RT) or chemotherapy(CT) protocols, complications may occur, and restaging becomes difficult. Another difficulty may be encountered in explaining to the patient that additional therapy protocols may be needed after an accurate restaging. After surgery, RT or CT, renal, hepatic and bone marrow reserves may severely be decreased, and since the primary therapy protocol may reduce significantly the patient's performance status, "accurate restaging" is the most important problem to be resolved when planning further therapy.
Collapse
Affiliation(s)
- Hakan Öztürk
- Department of Urology, Medicalpark Izmir Hospital, Yeni Girne Boulevard 1825 St. No: 12, 35350, Karsiyaka-Izmir, Turkey.
| |
Collapse
|
45
|
Guo R, Xu P, Cheng S, Lin M, Zhong H, Li W, Huang H, Ouyang B, Yi H, Chen J, Lin X, Shi K, Zhao W, Li B. Comparison of Nasopharyngeal MR, 18 F-FDG PET/CT, and 18 F-FDG PET/MR for Local Detection of Natural Killer/T-Cell Lymphoma, Nasal Type. Front Oncol 2020; 10:576409. [PMID: 33178609 PMCID: PMC7591820 DOI: 10.3389/fonc.2020.576409] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 09/18/2020] [Indexed: 12/11/2022] Open
Abstract
Objectives The present study aims to compare the diagnostic efficacy of MR, 18F-FDG PET/CT, and 18F-FDG PET/MR for the local detection of early-stage extranodal natural killer/T-cell lymphoma, nasal type (ENKTL). Patients and Methods Thirty-six patients with histologically proven early-stage ENKTL were enrolled from a phase 2 study (Cohort A). Eight nasopharyngeal anatomical regions from each patient were imaged using 18F-FDG PET/CT and MR. A further nine patients were prospectively enrolled from a multicenter, phase 3 study; these patients underwent 18F-FDG PET/CT and PET/MR after a single 18F-FDG injection (Cohort B). Region-based sensitivity and specificity were calculated. The standardized uptake values (SUV) obtained from PET/CT and PET/MR were compared, and the relationship between the SUV and apparent diffusion coefficients (ADC) of PET/MR were analyzed. Results In Cohort A, of the 288 anatomic regions, 86 demonstrated lymphoma involvement. All lesions were detected by 18F-FDG PET/CT, while only 70 were detected by MR. 18F-FDG PET/CT exhibited a higher sensitivity than MR (100% vs. 81.4%, χ2 = 17.641, P < 0.001) for local detection of malignancies. The specificity of 18F-FDG PET/CT and MR were 98.5 and 97.5%, respectively (χ2 = 0.510, P = 0.475). The accuracy of 18F-FDG PET/CT was 99.0% and the accuracy of MR was 92.7% (χ2 = 14.087, P < 0.001). In Cohort B, 72 anatomical regions were analyzed. PET/CT and PET/MR have a sensitivity of 100% and a specificity of 92.5%. The two methods were consistent (κ = 0.833, P < 0.001). There was a significant correlation between PET/MR SUVmax and PET/CT SUVmax (r = 0.711, P < 0.001), and SUVmean (r = 0.685, P < 0.001). No correlation was observed between the SUV and the ADC. Conclusion In early-stage ENKTL, nasopharyngeal MR showed a lower sensitivity and a similar specificity when compared with 18F-FDG PET/CT. PET/MR showed similar performance compared with PET/CT.
Collapse
Affiliation(s)
- Rui Guo
- Department of Nuclear Medicine, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Pengpeng Xu
- State Key Laboratory of Medical Genomics, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Shu Cheng
- State Key Laboratory of Medical Genomics, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Mu Lin
- Siemens Healthcare, Beijing, China
| | - Huijuan Zhong
- State Key Laboratory of Medical Genomics, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Weixia Li
- Department of Radiology, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Hengye Huang
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Bingsheng Ouyang
- Department of Pathology, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Hongmei Yi
- Department of Pathology, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jiayi Chen
- Department of Radiation, Rui Jin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaozhu Lin
- Department of Nuclear Medicine, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Kuangyu Shi
- Department of Nuclear Medicine, University Hospital Bern, Bern, Switzerland.,Faculty of Informatics, Technical University of Munich, Munich, Germany
| | - Weili Zhao
- State Key Laboratory of Medical Genomics, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Biao Li
- Department of Nuclear Medicine, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| |
Collapse
|
46
|
Vairavan R, Abdullah O, Retnasamy PB, Sauli Z, Shahimin MM, Retnasamy V. A Brief Review on Breast Carcinoma and Deliberation on Current Non Invasive Imaging Techniques for Detection. Curr Med Imaging 2020; 15:85-121. [PMID: 31975658 DOI: 10.2174/1573405613666170912115617] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 08/27/2017] [Accepted: 08/29/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND Breast carcinoma is a life threatening disease that accounts for 25.1% of all carcinoma among women worldwide. Early detection of the disease enhances the chance for survival. DISCUSSION This paper presents comprehensive report on breast carcinoma disease and its modalities available for detection and diagnosis, as it delves into the screening and detection modalities with special focus placed on the non-invasive techniques and its recent advancement work done, as well as a proposal on a novel method for the application of early breast carcinoma detection. CONCLUSION This paper aims to serve as a foundation guidance for the reader to attain bird's eye understanding on breast carcinoma disease and its current non-invasive modalities.
Collapse
Affiliation(s)
- Rajendaran Vairavan
- School of Microelectronic Engineering, Universiti Malaysia Perlis, Pauh Putra Campus, 02600 Arau, Perlis, Malaysia
| | - Othman Abdullah
- Hospital Sultan Abdul Halim, 08000 Sg. Petani, Kedah, Malaysia
| | | | - Zaliman Sauli
- School of Microelectronic Engineering, Universiti Malaysia Perlis, Pauh Putra Campus, 02600 Arau, Perlis, Malaysia
| | - Mukhzeer Mohamad Shahimin
- Department of Electrical and Electronic Engineering, Faculty of Engineering, National Defence University of Malaysia (UPNM), Kem Sungai Besi, 57000 Kuala Lumpur, Malaysia
| | - Vithyacharan Retnasamy
- School of Microelectronic Engineering, Universiti Malaysia Perlis, Pauh Putra Campus, 02600 Arau, Perlis, Malaysia
| |
Collapse
|
47
|
Aizaz M, Moonen RPM, van der Pol JAJ, Prieto C, Botnar RM, Kooi ME. PET/MRI of atherosclerosis. Cardiovasc Diagn Ther 2020; 10:1120-1139. [PMID: 32968664 DOI: 10.21037/cdt.2020.02.09] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Myocardial infarction and stroke are the most prevalent global causes of death. Each year 15 million people worldwide die due to myocardial infarction or stroke. Rupture of a vulnerable atherosclerotic plaque is the main underlying cause of stroke and myocardial infarction. Key features of a vulnerable plaque are inflammation, a large lipid-rich necrotic core (LRNC) with a thin or ruptured overlying fibrous cap, and intraplaque hemorrhage (IPH). Noninvasive imaging of these features could have a role in risk stratification of myocardial infarction and stroke and can potentially be utilized for treatment guidance and monitoring. The recent development of hybrid PET/MRI combining the superior soft tissue contrast of MRI with the opportunity to visualize specific plaque features using various radioactive tracers, paves the way for comprehensive plaque imaging. In this review, the use of hybrid PET/MRI for atherosclerotic plaque imaging in carotid and coronary arteries is discussed. The pros and cons of different hybrid PET/MRI systems are reviewed. The challenges in the development of PET/MRI and potential solutions are described. An overview of PET and MRI acquisition techniques for imaging of atherosclerosis including motion correction is provided, followed by a summary of vessel wall imaging PET/MRI studies in patients with carotid and coronary artery disease. Finally, the future of imaging of atherosclerosis with PET/MRI is discussed.
Collapse
Affiliation(s)
- Mueez Aizaz
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.,CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
| | - Rik P M Moonen
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.,CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
| | - Jochem A J van der Pol
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Claudia Prieto
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK.,Escuela de Ingenieria, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - René M Botnar
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK.,Escuela de Ingenieria, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - M Eline Kooi
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.,CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
| |
Collapse
|
48
|
Yang J, Zhang G, Chang W, Chi Z, Shang Q, Wu M, Pan T, Huang L, Jiang H. Photoacoustic imaging of hemodynamic changes in forearm skeletal muscle during cuff occlusion. BIOMEDICAL OPTICS EXPRESS 2020; 11:4560-4570. [PMID: 32923064 PMCID: PMC7449729 DOI: 10.1364/boe.392221] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 06/30/2020] [Accepted: 07/01/2020] [Indexed: 05/20/2023]
Abstract
Characterizations of circulatory and metabolic function in skeletal muscle are of great importance in clinical settings. Here in this study, we investigate the utility of photoacoustic tomography (PAT) to monitor the hemodynamic changes in forearm skeletal muscle during cuff occlusion. We show high quality photoacoustic (PA) images of human forearm in comparison with ultrasound images. Besides, we track the hemodynamic changes in the forearm during cuff occlusion cross-validated with near-infrared spectroscopy. Our study suggests that PAT, as a new tool, could be applied to common diseases affecting skeletal muscle in the future.
Collapse
Affiliation(s)
- Jinge Yang
- School of Optoelectric Engineering, Chongqing University of Posts and Telecommunications, Chongqing 400065, China
| | - Guang Zhang
- School of Electronic Science and Engineering (National Exemplary School of Microelectronics), University of Electronic Science and Technology of China, Chengdu 611731, China
- Center for Information in Medicine, University of Electronic and Technology of China, Chengdu 611731, China
| | - Wu Chang
- School of Electronic Science and Engineering (National Exemplary School of Microelectronics), University of Electronic Science and Technology of China, Chengdu 611731, China
- Center for Information in Medicine, University of Electronic and Technology of China, Chengdu 611731, China
| | - Zihui Chi
- School of Optoelectric Engineering, Chongqing University of Posts and Telecommunications, Chongqing 400065, China
| | - Qiquan Shang
- School of Electronic Science and Engineering (National Exemplary School of Microelectronics), University of Electronic Science and Technology of China, Chengdu 611731, China
- Center for Information in Medicine, University of Electronic and Technology of China, Chengdu 611731, China
| | - Man Wu
- School of Electronic Science and Engineering (National Exemplary School of Microelectronics), University of Electronic Science and Technology of China, Chengdu 611731, China
- Center for Information in Medicine, University of Electronic and Technology of China, Chengdu 611731, China
| | - Teng Pan
- School of Electronic Science and Engineering (National Exemplary School of Microelectronics), University of Electronic Science and Technology of China, Chengdu 611731, China
- Center for Information in Medicine, University of Electronic and Technology of China, Chengdu 611731, China
| | - Lin Huang
- School of Electronic Science and Engineering (National Exemplary School of Microelectronics), University of Electronic Science and Technology of China, Chengdu 611731, China
- Center for Information in Medicine, University of Electronic and Technology of China, Chengdu 611731, China
| | - Huabei Jiang
- Department of Medical Engineering, University of South Florida, Tampa 33620, USA
| |
Collapse
|
49
|
Abstract
Although fluorodeoxyglucose PET/MR imaging is a promising new modality, there is not yet enough data to support its routine use for staging or surveillance of children with lymphoma. PET/MR imaging protocols are still under development, and its availability globally is limited. The cost-benefit of using PET/MR imaging has not yet been established, especially because annual post-treatment surveillance imaging with fluorodeoxyglucose PET is not necessary in most patients with lymphoma. Further research into the use of PET/MR imaging in pediatric oncology patients is needed with continued collaborations among institutions.
Collapse
|
50
|
Gratz M, Ruhlmann V, Umutlu L, Fenchel M, Hong I, Quick HH. Impact of respiratory motion correction on lesion visibility and quantification in thoracic PET/MR imaging. PLoS One 2020; 15:e0233209. [PMID: 32497135 PMCID: PMC7272064 DOI: 10.1371/journal.pone.0233209] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 04/30/2020] [Indexed: 01/04/2023] Open
Abstract
The impact of a method for MR-based respiratory motion correction of PET data on lesion visibility and quantification in patients with oncologic findings in the lung was evaluated. Twenty patients with one or more lesions in the lung were included. Hybrid imaging was performed on an integrated PET/MR system using 18F-FDG as radiotracer. The standard thoracic imaging protocol was extended by a free-breathing self-gated acquisition of MR data for motion modelling. PET data was acquired simultaneously in list-mode for 5-10 mins. One experienced radiologist and one experienced nuclear medicine specialist evaluated and compared the post-processed data in consensus regarding lesion visibility (scores 1-4, 4 being best), image noise levels (scores 1-3, 3 being lowest noise), SUVmean and SUVmax. Motion-corrected (MoCo) images were additionally compared with gated images. Non-motion-corrected free-breathing data served as standard of reference in this study. Motion correction generally improved lesion visibility (3.19 ± 0.63) and noise ratings (2.95 ± 0.22) compared to uncorrected (2.81 ± 0.66 and 2.95 ± 0.22, respectively) or gated PET data (2.47 ± 0.93 and 1.30 ± 0.47, respectively). Furthermore, SUVs (mean and max) were compared for all methods to estimate their respective impact on the quantification. Deviations of SUVmax were smallest between the uncorrected and the MoCo lesion data (average increase of 9.1% of MoCo SUVs), while SUVmean agreed best for gated and MoCo reconstructions (MoCo SUVs increased by 1.2%). The studied method for MR-based respiratory motion correction of PET data combines increased lesion sharpness and improved lesion activity quantification with high signal-to-noise ratio in a clinical setting. In particular, the detection of small lesions in moving organs such as the lung and liver may thus be facilitated. These advantages justify the extension of the PET/MR imaging protocol by 5-10 minutes for motion correction.
Collapse
Affiliation(s)
- Marcel Gratz
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, University of Duisburg Essen, Essen, Germany
- High Field and Hybrid MR Imaging, University of Duisburg-Essen, Essen, Germany
| | - Verena Ruhlmann
- Department of Nuclear Medicine, University Hospital Essen, Essen, Germany
| | - Lale Umutlu
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
| | | | - Inki Hong
- Siemens Medical Solutions Inc, Knoxville, Tennessee, United States of America
| | - Harald H. Quick
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, University of Duisburg Essen, Essen, Germany
- High Field and Hybrid MR Imaging, University of Duisburg-Essen, Essen, Germany
| |
Collapse
|