Molecular imaging in oncology: the acceptance of PET/CT and the emergence of MR/PET imaging

Schiepers, Christiaan; Dahlbom, Magnus

doi:10.1007/s00330-010-2033-y

Cited by 29 publications

(12 citation statements)

References 59 publications

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“…INITIATED BY THE success story of hybrid imaging by combining positron emission tomography (PET) and computed tomography (CT) in PET/CT, researchers have pursued the technically challenging but diagnostically attractive idea of integrating PET and MR imaging in one single system . Such PET/MR hybrid imaging modality has potential diagnostic advantages in cases where MR outperforms CT (i.e., increased soft tissue contrast and reduced radiation dose) with clinical potential in oncology, neurology, cardiology and monitoring of early therapeutic success . Integration of MR and PET, however, is technically demanding; standard PET detectors could not be placed in the isocenter of an MRI scanner because of their scintillation crystal blocks read out by photomultiplier tubes (PMT), which are highly susceptible to magnetic fields .…”

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confidence: 99%

Integrated PET/MR

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2013

Magnetic Resonance Imaging

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Integrated whole-body PET/MR hybrid imaging combines excellent soft tissue contrast and various functional imaging parameters provided by MR with high sensitivity and quantification of radiotracer metabolism provided by positron emission tomography (PET). While clinical evaluation now is under way, integrated PET/MR demands for new technologies and innovative solutions, currently subject to interdisciplinary research. Attenuation correction of human soft tissues and of hardware components has to be MR-based to maintain quantification of PET imaging because computed tomography (CT) attenuation information is missing. This brings up the question of how to provide bone information with MR imaging. The limited field-of-view in MR imaging leads to truncations in body imaging and MR-based attenuation correction. Another research field is the implementation of motion correction technologies to correct for breathing and cardiac motion in view of the relatively long PET data acquisition times. Initial clinical applications of integrated PET/MR in oncology, neurology, pediatric oncology, and cardiovascular disease are highlighted. The hybrid imaging workflow here has to be tailored to the clinical indication to maximize diagnostic information while minimizing acquisition time. PET/MR introduces new artifacts that need special observation and innovative solutions for correction. Finally, the rising need for appropriate phantoms and standardization efforts in PET/MR hybrid imaging is discussed.

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confidence: 99%

Integrated PET/MR

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2013

Magnetic Resonance Imaging

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“…Noninvasive hybrid PET/CT is a valuable diagnostic tool by virtue of its combining metabolic and anatomic information in vivo (17). Encouraging results have been reported on the usefulness of radiolabeled-choline PET/CT in prostate cancer (18,19).…”

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Repeatability of Quantitative ¹⁸F-Fluoromethylcholine PET/CT Studies in Prostate Cancer

et al. 2015

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Repeatable quantification is essential when using 18 F-fluoromethylcholine PET/CT to monitor treatment response in prostate cancer. It has been shown that SUV normalized to the area under the blood activity concentration curve (SUV AUC ) provides a better correlation with full kinetic analysis than does standard SUV. However, the precision of SUV AUC is not known yet. The purpose of this study was to assess the repeatability of various semiquantitative 18 F-fluoromethylcholine parameters in prostate cancer. Methods: Twelve patients (mean age ± SD, 64 ± 8 y) with metastasized prostate cancer underwent two sets of 18 F-fluoromethylcholine PET/CT scans, on consecutive days. Each set consisted of a 30-min dynamic PET/CT scan of the chest after intravenous administration of 200 MBq of 18 F-fluoromethylcholine, followed by a whole-body PET/CT scan at 40 min. The dynamic scan was used to derive the area under the blood activity concentration curve. Lesion uptake was derived from the whole-body scan using various types of volumes of interest: maximum, peak, and mean. Each of these parameters was normalized to injected activity per body weight, area under the blood activity concentration curve, and blood concentration itself at 40 min, resulting in several types of SUVs: SUV, SUV AUC , and SUV TBR . The test-retest repeatability of these metrics, as well as metabolic tumor volume (MTV) and total uptake of choline in the lesion, were studied. The level of agreement between testretest data and reliability was assessed using Bland-Altman plots, repeatability coefficients, and intraclass correlation coefficients (ICCs). Results: A total of 67 choline-avid metastases were identified: 44 bone lesions and 23 lymph node lesions. In the case of SUV max , the repeatability coefficients for SUV, SUV AUC , and SUV TBR were 26% (ICC, 0.95), 31% (ICC, 0.95), and 46% (ICC, 0.89), respectively. Similar values were obtained for SUV peak and SUV mean . The repeatability of SUV AUC was comparable to that of SUV max , SUV peak , and SUV mean. Tissue type and tumor localization did not affect repeatability. An MTV of less than 4.2 cm 3 had larger variability than larger volumes (repeatability coefficient, 45% vs. 29%; P 5 0.048). The repeatability coefficient did not significantly differ between lesions with SUV peak above or below the median value of 8.3 (19% vs. 28%; P 5 0.264). Conclusion: The repeatability of SUV AUC was comparable to that of standard SUV. The repeatability coefficients of various semiquantitative 18 F-fluoromethylcholine parameters (SUV, MTV, and total uptake in the lesion) were approximately 35%. Larger differences are likely to represent treatment effects. Prost ate cancer is the second most common cancer in men worldwide and was the third most diagnosed malignancy in Europe in 2012, with 92,000 deaths (1,2). This androgen-dependent neoplasm is characterized by a good initial response to antihormonal therapy and an unpredictable latent castration-resistant status (3). At the beginning of this decennium, molecular prof...

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“…Imaging technology and computer hardware and software recently developed very quickly in this field; for example, magnetic resonance imaging (MRI) and positron-emission tomography (PET) offer a whole spectrum of technologies increased by the possibility of combined approaches [46]. Other innovative approaches such as ultrasound and electromagnetic imaging or (nano)sensors increase the number of opportunities for high-resolution imaging and are efficient and inexpensive alternatives for existing technology.…”

Section: Anatomical Modelsmentioning

confidence: 98%

Future of Medicine: Models in Predictive Diagnostics and Personalized Medicine

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Zazzu

Sudbrak

et al. 2013

Advances in Biochemical Engineering/Biotechnology

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Molecular medicine is undergoing fundamental changes driving the whole area towards a revolution in modern medicine. The breakthrough was generated the fast-developing technologies in molecular biology since the first draft sequence of the human genome was published. The technological advances enabled the analysis of biological samples from cells and organs to whole organisms in a depth that was not possible before. These technologies are increasingly implemented in the medical and health care system to study diseases and refine diagnostics. As a consequence, the understanding of diseases and the health status of an individual patient is now based on an enormous amount of data that can only be interpreted in the context of the body as a whole. Systems biology as a new field in the life sciences develops new approaches for data integration and interpretation. Systems medicine as a specialized aspect of systems biology combines in an interdisciplinary approach all expertise necessary to decipher the human body in all its complexity. This created new challenges in the area of information and communication technologies to provide the infrastructure and technology needed to cope with the data flood that will accompany the next generation of medicine. The new initiative 'IT Future of Medicine' aims at driving this development even further and integrates not only molecular data (especially genomic information), but also anatomical, physiological, environmental, and lifestyle data in a predictive model approach-the 'virtual patient'-that will allow the clinician or the general practitioner to predict and anticipate the optimal treatment for the individual patient. The application of the virtual patient model will allow truly personalized medicine.

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Molecular imaging in oncology: the acceptance of PET/CT and the emergence of MR/PET imaging

Cited by 29 publications

References 59 publications

Integrated PET/MR

Integrated PET/MR

Repeatability of Quantitative ¹⁸F-Fluoromethylcholine PET/CT Studies in Prostate Cancer

Future of Medicine: Models in Predictive Diagnostics and Personalized Medicine

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Molecular imaging in oncology: the acceptance of PET/CT and the emergence of MR/PET imaging

Cited by 29 publications

References 59 publications

Integrated PET/MR

Integrated PET/MR

Repeatability of Quantitative 18F-Fluoromethylcholine PET/CT Studies in Prostate Cancer

Future of Medicine: Models in Predictive Diagnostics and Personalized Medicine

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Repeatability of Quantitative ¹⁸F-Fluoromethylcholine PET/CT Studies in Prostate Cancer