Combined PET/MRI: Multi-modality Multi-parametric Imaging Is Here

Bailey, Dale L.; Pichler, Bernd J.; Gückel, Brigitte; Barthel, Henryk; Beer, Ambros J.; Bremerich, Jens; Czernin, Johannes; Drzezga, Alexander; Franzius, Christiane; Goh, Vicky; Hartenbach, Markus; Iida, Hidehiro; Kjær, Andreas; Fougère, Christian la; Ladefoged, Claes Nøhr; Law, Ian; Nikolaou, Konstantin; Quick, Harald H.; Sabri, Osama; Schäfer, Jürgen; Schäfers, Michael; Wehrl, Hans F.; Beyer, Thomas

doi:10.1007/s11307-015-0886-9

Cited by 55 publications

(38 citation statements)

References 63 publications

(80 reference statements)

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“…Multi-parametric imaging (MPI) has been of interest since the adoption of standalone PET, CT, and MR imaging, but gained further attention following the availability of combined imaging systems [257]. Combined, or dual-modality imaging systems facilitate multi-faceted and complex evaluations of tumor phenotypes, thus, promising an improved characterization of lesions and pathophysiology [258].…”

Section: Multi-parametric Imaging (Mpi)mentioning

confidence: 99%

Hybrid Imaging: Instrumentation and Data Processing

et al. 2018

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State-of-the-art patient management frequently requires the use of non-invasive imaging methods to assess the anatomy, function or molecular-biological conditions of patients or study subjects. Such imaging methods can be singular, providing either anatomical or molecular information, or they can be combined, thus, providing "anato-metabolic" information. Hybrid imaging denotes image acquisitions on systems that physically combine complementary imaging modalities for an improved diagnostic accuracy and confidence as well as for increased patient comfort. The physical combination of formerly independent imaging modalities was driven by leading innovators in the field of clinical research and benefited from technological advances that permitted the operation of PET and MR in close physical proximity, for example. This review covers milestones of the development of various hybrid imaging systems for use in clinical practice and small-animal research. Special attention is given to technological advances that helped the adoption of hybrid imaging, as well as to introducing methodological concepts that benefit from the availability of complementary anatomical and biological information, such as new types of image reconstruction and data correction schemes. The ultimate goal of hybrid imaging is to provide useful, complementary and quantitative information during patient work-up. Hybrid imaging also opens the door to multi-parametric assessment of diseases, which will help us better understand the causes of various diseases that currently contribute to a large fraction of healthcare costs.

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Section: Multi-parametric Imaging (Mpi)mentioning

confidence: 99%

Hybrid Imaging: Instrumentation and Data Processing

et al. 2018

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“…Since the introduction of combined, whole-body PET/MRI users have searched for the key clinical application [1–4]. This search has been conducted mainly by single institutions (rather than networks or by pooling data), and evidence in favour of, or against, identifying a specific indication as a key application has been weak.…”

Section: Discussion: How To Move Pet/mri Into Clinical Routinementioning

confidence: 99%

“…The previous workshop suggested that PET/MRI with 2-deoxy-2-[ 18 F]fluoro-D-glucose (FDG) should not try to compete with or replace [ 18 F]FDG-PET/X-ray computed tomorgraphy (CT) in many oncological applications [1]. A role for [ 18 F]FDG-PET/MRI was envisaged in paediatric oncology and for patients of reproductive potential to minimise exposure to ionising radiation from the CT component of a PET/CT study.…”

Section: Introductionmentioning

confidence: 99%

Combined PET/MRI: from Status Quo to Status Go. Summary Report of the Fifth International Workshop on PET/MR Imaging; February 15–19, 2016; Tübingen, Germany

et al. 2016

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This article provides a collaborative perspective of the discussions and conclusions from the fifth international workshop of combined positron emission tomorgraphy (PET)/magnetic resonance imaging (MRI) that was held in Tübingen, Germany, from February 15 to 19, 2016. Specifically, we summarise the second part of the workshop made up of invited presentations from active researchers in the field of PET/MRI and associated fields augmented by round table discussions and dialogue boards with specific topics. This year, this included practical advice as to possible approaches to moving PET/MRI into clinical routine, the use of PET/MRI in brain receptor imaging, in assessing cardiovascular diseases, cancer, infection, and inflammatory diseases. To address perceived challenges still remaining to innovatively integrate PET and MRI system technologies, a dedicated round table session brought together key representatives from industry and academia who were engaged with either the conceptualisation or early adoption of hybrid PET/MRI systems. Discussions during the workshop highlighted that emerging unique applications of PET/MRI such as the ability to provide multi-parametric quantitative and visual information which will enable not only overall disease detection but also disease characterisation would eventually be regarded as compelling arguments for the adoption of PET/MR. However, as indicated by previous workshops, evidence in favour of this observation is only growing slowly, mainly due to the ongoing inability to pool data cohorts from independent trials as well as different systems and sites. The participants emphasised that moving from status quo to status go entails the need to adopt standardised imaging procedures and the readiness to act together prospectively across multiple PET/MRI sites and vendors.

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“…Clinical use of PET/MRI was thoroughly discussed at a workshop held this year in Tübingen, Germany [25]. While it was generally acknowledged that PET/MRI is not currently viable as a complete replacement for PET/CT, calls were made for its use in CT-guided PET/MR examinations of fields of view limited to potential pathology, ideally in diseases that receive obligatorily diagnostic workup by MRI.…”

mentioning

confidence: 99%

“…However, in oncology, the number of overlapping clinical indications for fluorodeoxyglucose (FDG) PET and MR imaging is quite limited, as stated by Weber in a recent editorial in the Journal of Nuclear Medicine [26]. Nevertheless, new tracers such as the radioactively labelled amino acids used for diagnosis of gliomas or PET radiopharmaceuticals tracing the expression of prostate-specific membrane antigen (PSMA) in prostate carcinomas potentially offer a better platform for PET/MR hybrid imaging, as emerging evidence on PET imaging in prostate cancer already indicates (see also [25,26]). …”

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confidence: 99%

PET/MRI and PET/CT: is there room for both at the top of the food chain?

Kuwert

Ritt

2015

Eur J Nucl Med Mol Imaging

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In this issue of the journal, Vrachimis and colleagues demonstrate that positron emission tomography combined with Xray computed tomography (PET/CT) outperforms PET combined with magnetic resonance imaging (PET/MRI) in restaging radioiodine-negative patients with biochemical relapse of differentiated thyroid carcinoma [1]. This comes as a surprise, at least to the uninitiated: In a world predominantly driven by material considerations, common sense would presume that diagnostic accuracy correlates with costs, and PET/ MRI indeed Boutperforms^PET considerably with regard to its demands on resources spent on acquisition and operation.A closer look at the data proffered by Vrachimis et al. reveals that the poorer performance of PET/MRI compared to PET/CT for this indication resides in its shortcomings in the ability to diagnose pulmonary metastases, a frequent occurrence in progressive thyroid carcinoma. MRI aficionados will argue that this problem may be overcome by using MRI sequences dedicated to lung imaging. This contingent may ultimately be correct, but such arguments are purely speculative at the moment, as empirical proof for the case of PET/MRI is lacking.A comprehensive review on the evidence reporting the use of PET/MRI in a clinical setting is beyond the scope of this editorial. However, a short appraisal of the hitherto published literature comparing the utility of PET/MRI and PET/CT can be attempted: At the time of this writing, 166 papers featuring the keyword combination BPET/MR PET/CT^currently reside in the Web of Science (ISI) Internet library. Of these, roughly 22 are original articles comparing the diagnostic performance of these two hybrid imaging modalities in oncology. Six report data from mixed groups of patients [2][3][4][5][6][7], with five finding an equivalence of diagnostic performance of the two hybrid imaging technologies and one a slight superiority of PET/MRI over PET/CT with regard to influence on further clinical management. None deals with thyroid cancer directly, allowing us to consider the new publication under discussion by Vrachimis et al. the first to study this neoplastic entity specifically. However, the utility of PET/MRI and PET/CT to detect and characterize small pulmonary nodules more generally has been previously investigated in three papers, with the data tipping the scales in favour of PET/CT [8][9][10]. The remaining 13 publications report some evidence that PET/ MRI is superior to PET/CT for characterizing primary tumours, e.g. primary bone tumours [11][12][13] or oesophageal carcinoma [14], but do not demonstrate significant advantages of whole-body MRI over whole-body PET/CT for N or M staging [15][16][17][18][19][20][21][22][23][24].The introduction of PET/MRI was heralded as a technological breakthrough, and many expected a subsequent clinical revolution, with the newer modality vying to supersede PET/CT atop the diagnostic food chain just as the Burmese python is supplanting the American alligator in the Florida Everglades. However, none of the above-mention...

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Combined PET/MRI: Multi-modality Multi-parametric Imaging Is Here

Cited by 55 publications

References 63 publications

Hybrid Imaging: Instrumentation and Data Processing

Hybrid Imaging: Instrumentation and Data Processing

Combined PET/MRI: from Status Quo to Status Go. Summary Report of the Fifth International Workshop on PET/MR Imaging; February 15–19, 2016; Tübingen, Germany

PET/MRI and PET/CT: is there room for both at the top of the food chain?

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