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Comparison of lesion detection and quantitation of tracer uptake between PET from a simultaneously acquiring whole-body PET/MR hybrid scanner and PET from PET/CT

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

PET/MR hybrid scanners have recently been introduced, but not yet validated. The aim of this study was to compare the PET components of a PET/CT hybrid system and of a simultaneous whole-body PET/MR hybrid system with regard to reproducibility of lesion detection and quantitation of tracer uptake.

Methods

A total of 46 patients underwent a whole-body PET/CT scan 1 h after injection and an average of 88 min later a second scan using a hybrid PET/MR system. The radioactive tracers used were 18F-deoxyglucose (FDG), 18F-ethylcholine (FEC) and 68Ga-DOTATATE (Ga-DOTATATE). The PET images from PET/CT (PETCT) and from PET/MR (PETMR) were analysed for tracer-positive lesions. Regional tracer uptake in these foci was quantified using volumes of interest, and maximal and average standardized uptake values (SUVmax and SUVavg, respectively) were calculated.

Results

Of the 46 patients, 43 were eligible for comparison and statistical analysis. All lesions except one identified by PETCT were identified by PETMR (99.2 %). In 38 patients (88.4 %), the same number of foci were identified by PETCT and by PETMR. In four patients, more lesions were identified by PETMR than by PETCT, in one patient PETCT revealed an additional focus compared to PETMR. The mean SUVmax and SUVavg of all lesions determined by PETMR were by 21 % and 11 % lower, respectively, than the values determined by PETCT (p < 0.05), and a strong correlation between these variables was identified (Spearman rho 0.835; p < 0.01).

Conclusion

PET/MR showed equivalent performance in terms of qualitative lesion detection to PET/CT. The differences demonstrated in quantitation of tracer uptake between PETCT and PETMR were minor, but statistically significant. Nevertheless, a more detailed study of the quantitative accuracy of PETMR and the factors governing it is needed to ultimately assess its accuracy in measuring tissue tracer concentrations.

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Acknowledgments

We would like to thank the whole MR imaging team at IMP Erlangen as well as Ms. Andrea Mühl, our PET/MR technologist, for continuous and unfailing support. The mMR was provided by Siemens Healthcare to the Institute of Medical Physics of the FAU Erlangen-Nuremberg in the framework of a scientific cooperation. The data presented are part of a clinical trial of this device conducted by the Clinic of Nuclear Medicine and the Institute of Radiology.

Conflicts of interest

Michael Beck has no conflicts of interest.

Carl v. Gall is compensated for developing educational presentations on behalf of Siemens Healthcare.

Torsten Kuwert gives lectures on behalf of Siemens Healthcare and has a research cooperation in the field of SPECT/CT. He is the principal investigator of the clinical trial regarding the mMR installed at the IMP Erlangen without any financial compensation.

Michael Lell gives lectures on behalf of Siemens Healthcare and is compensated for developing educational presentations.

Harald H. Quick is head of the MR imaging section at the Institute of Medical Physics Erlangen. The PET/MR system used in this study and installed at the Institute of Medical Physics, Erlangen, was funded through a research cooperation between the University of Erlangen and Siemens Healthcare.

Philipp Ritt has no conflicts of interest.

Daniela Schmidt has no conflicts of interest.

Michael Uder gives lectures on behalf of Siemens Healthcare and is compensated for developing educational presentations for Siemens Healthcare. He has a research cooperation in the field of MRI.

Marco Wiesmüller has no conflicts of interest.

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Correspondence to Carl C. von Gall.

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Wiesmüller, M., Quick, H.H., Navalpakkam, B. et al. Comparison of lesion detection and quantitation of tracer uptake between PET from a simultaneously acquiring whole-body PET/MR hybrid scanner and PET from PET/CT. Eur J Nucl Med Mol Imaging 40, 12–21 (2013). https://doi.org/10.1007/s00259-012-2249-y

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  • DOI: https://doi.org/10.1007/s00259-012-2249-y

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