Abstract
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Objectives: To demonstrate the feasibility of zero-echo-time (ZTE) MR imaging for jaw bones and to evaluate the quantitative performance of 2-[18F]-fluoro-2-deoxy-D-glucose (18F-FDG) PET/MRI with ZTE-based attenuation correction (ZTE-AC) compared with PET/CT and PET/MRI with Dixon-MR-based AC (MR-AC) in patients with oral cavity cancer (OCC).
Methods: Thirteen patients with OCC underwent a whole-body 18F-FDG PET/CT scan and a subsequent regional PET/MR scan with MR-AC and ZTE-AC in one day. The standardized uptake values (SUVs) were measured on PET/CT (SUVCT-AC), PET/MRI with MR-AC (SUVMR-AC), and with ZTE-AC (SUVZTE-AC). The SUVs were correlated and compared with each other.
Results: ZTE MR images minimized the effects of metal artifacts from dentures and ZTE-AC maps correctly delineated the jaw bones. SUVMR-AC and SUVZTE-AC showed significant positive correlations with SUVCT-AC (Pearson’s r = 0.95 and r = 0.98, respectively). The means ± SD of SUVCT-AC, SUVMR-AC and SUVZTE-AC were 12.8 ± 6.7, 12.8 ± 6.6, and 13.9 ± 7.1, respectively. SUVZTE-AC was significantly higher than SUVCT-AC (p < 0.05) whereas there was no significant difference between SUVCT-AC and SUVMR-AC or between SUVMR-AC and SUVZTE-AC.
Conclusions: The ZTE MR images clearly delineate the jaw bones while minimizing the effects of metal artifacts. The ZTE-AC method in 18F-FDG PET/MRI reduces the underestimation of tracer uptake by MR-AC errors of jaw bones and improves the quantitative performance in patients with OCC.
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