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Research ArticleClinical Investigation

Hybrid PET/MRI of Intracranial Masses: Initial Experiences and Comparison to PET/CT

Andreas Boss, Sotirios Bisdas, Armin Kolb, Matthias Hofmann, Ulrike Ernemann, Claus D. Claussen, Christina Pfannenberg, Bernd J. Pichler, Matthias Reimold and Lars Stegger
Journal of Nuclear Medicine August 2010, 51 (8) 1198-1205; DOI: https://doi.org/10.2967/jnumed.110.074773
Andreas Boss
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Sotirios Bisdas
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Armin Kolb
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Matthias Hofmann
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Ulrike Ernemann
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Claus D. Claussen
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Christina Pfannenberg
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Bernd J. Pichler
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Matthias Reimold
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Lars Stegger
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Abstract

Simultaneous PET and MRI using new hybrid PET/MRI systems promises optimal spatial and temporal coregistration of structural, functional, and molecular image data. In a pilot study of 10 patients with intracranial masses, the feasibility of tumor assessment using a PET/MRI system comprising lutetium oxyorthosilicate scintillators coupled to avalanche photodiodes was evaluated, and quantification accuracy was compared with conventional PET/CT datasets. Methods: All measurements were performed with a hybrid PET/MRI scanner consisting of a conventional 3-T MRI scanner in combination with an inserted MRI-compatible PET system. Attenuation correction of PET/MR images was computed from MRI datasets. Diagnoses at the time of referral were low-grade astrocytoma (n = 2), suspicion of low-grade astrocytoma (n = 1), anaplastic astrocytoma (World Health Organization grade III; n = 1), glioblastoma (n = 2), atypical neurocytoma (n = 1), and meningioma (n = 3). In the glial tumors, 11C-methionine was used for PET; in the meningiomas, 68Ga-DOTATOC was administered. Tumor–to–gray matter and tumor–to–white matter ratios were calculated for gliomas, and tracer uptake of meningiomas was referenced to nasal mucosa. PET/MRI was performed directly after clinically indicated PET/CT examination. Results: In all patients, the PET datasets showed similar diagnostic image quality on the hybrid PET/MRI and the PET/CT studies; however, slight streak artifacts were visible in coronal and sagittal sections when using the higher intrinsic resolution of the PET/MRI insert. Prefiltering of images with a 4-mm gaussian filter at a resolution comparable to that of the PET/CT system virtually eliminated these artifacts. Although acquisition of the PET/MR images started at 30–60 min after PET/CT (20.4-min half-life of 11C) acquisition, the signal-to-noise ratio was good enough, thus underlining the high sensitivity of the PET insert, compared with whole-body PET systems. The computed tumor–to–reference tissue ratios exhibited an excellent accordance between the PET/MRI and PET/CT systems, with a Pearson correlation coefficient of 0.98. Mean paired relative error was 7.9% ± 12.2%. No significant artifacts or distortions were detected in the simultaneously acquired MR images using the PET/MRI scanner. Conclusion: Structural, functional, and molecular imaging in patients with brain tumors is feasible with diagnostic imaging quality using simultaneous hybrid PET/MR image acquisition.

  • PET/MRI
  • hybrid imaging
  • intracranial tumor
  • methionine
  • DOTATOC

Footnotes

  • ↵* Contributed equally to this work.

  • © 2010 by Society of Nuclear Medicine
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Journal of Nuclear Medicine: 51 (8)
Journal of Nuclear Medicine
Vol. 51, Issue 8
August 1, 2010
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Hybrid PET/MRI of Intracranial Masses: Initial Experiences and Comparison to PET/CT
Andreas Boss, Sotirios Bisdas, Armin Kolb, Matthias Hofmann, Ulrike Ernemann, Claus D. Claussen, Christina Pfannenberg, Bernd J. Pichler, Matthias Reimold, Lars Stegger
Journal of Nuclear Medicine Aug 2010, 51 (8) 1198-1205; DOI: 10.2967/jnumed.110.074773

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Hybrid PET/MRI of Intracranial Masses: Initial Experiences and Comparison to PET/CT
Andreas Boss, Sotirios Bisdas, Armin Kolb, Matthias Hofmann, Ulrike Ernemann, Claus D. Claussen, Christina Pfannenberg, Bernd J. Pichler, Matthias Reimold, Lars Stegger
Journal of Nuclear Medicine Aug 2010, 51 (8) 1198-1205; DOI: 10.2967/jnumed.110.074773
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