Hybrid imaging in Crohn's disease: from SPECT/CT to PET/MR and new image interpretation criteria

Abstract

block as selectively as possible the pathological mechanisms responsible for the disease.New specific targeted therapies are being developed for several immune mediated diseases. Several clinical trials are being performed to assess the efficacy and safety of this approach. all of them, however, rely largely on the clinical assessment of the patients to evaluate the effect of treatment. an objective and reliable method to visualize directly the immune process underlying the individual disease would be valuable; specific diagnostic tests, furthermore, may allow the selection of patients to be treated. i nflammatory diseases are a heterogeneous class of diseases characterized by chronic inflammation of the target organ, often relapsing, invalidating and requiring life-long treatment. The so-called "aseptic chronic inflammatory diseases" include: autoimmune diseases, graft rejection, sarcoidosis, vasculitis, atherosclerosis and some degenerative diseases. in these patients, it is very important to try and achieve specific immunosuppression to extinguish the immune process with the aim of halting the disease, preventing or delaying complications and avoiding disease relapse, reducing to a minimum side effect by using specific immune therapies that

Comparison of White Blood Cell Scintigraphy, FDG PET/CT and MRI in Suspected Diabetic Foot Infection: Results of a Large Retrospective Multicenter Study

“…The recent availability of PET/MRI may gain an important role in defining the different complications of the diabetic foot in the near future and it will hopefully solve these challenging clinical scenarios [43][44][45].…”

State of the art of 18F-FDG PET/CT application in inflammation and infection: a guide for image acquisition and interpretation

“…From the available data in literature emerged that [ 18 F]FDG PET/MR can be indicated in some clinical indications in infection and inflammation, such as: - Diagnosis of limbic encephalitis [ 238 ]; - Diagnosis and follow-up of SI, [ 13 ]; - Diagnosis of CS, [ 239 , 240 ]; - Diagnosis of LVV, [ 60 , 241 ]; - Diagnosis of RF, [ 128 ]. - Evaluation of CD, [ 242 – 244 ]. …”

“… In case of CD, [18F]FDG PET/MRI allows precise localization of the inflamed intestinal loop and permites the differential diagnosis between fibrotic stenosis and inflammatory stenosis. Co-acquisition also enables more accurate spatial and temporal matching of MR anatomy with PET data, reducing miss-registration artifacts due to motion and peristalsis [ 242 , 243 ]. Attention should be paid to understand non-specific activity in transit in bowel lumen.…”

Initial Experience With Low-Dose 18F-Fluorodeoxyglucose Positron Emission Tomography/Magnetic Resonance Imaging With Deep Learning Enhancement

“…12 Although simultaneous PET/MR imaging has the potential to provide both excellent anatomic and functional information for disease assessment, the radiation exposure from the radiotracer remains a concern. 13 Although several image postprocessing strategies have been implemented to reduce radiotracer dose, such as image filtering, 14 singular value thresholding, 15 and model based iterative reconstruction, 16 the current standard-of-care image reconstruction algorithms continue to suffer from significant disadvantages, such as artifacts, pixilation, and noise. Hence, radiation exposure from the radiotracer remains a substantial factor.…”

“…Quantitative biomarkers of PET/MR have also been demonstrated to differentiate between purely fibrotic strictures from mixed or inflammatory strictures, where a hybrid biomarker incorporating both MR and PET information performs better for stricture evaluation than either modality alone 12 . Although simultaneous PET/MR imaging has the potential to provide both excellent anatomic and functional information for disease assessment, the radiation exposure from the radiotracer remains a concern 13 …”