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Simultaneously acquired MR/PET images compared with sequential MR/PET and PET/CT: alignment quality.

Cornelia B Brendle1, Holger Schmidt, Sabrina Fleischer

  • 1Department of Radiology, Division of Diagnostic and Interventional Radiology, Eberhard-Karls University Tuebingen, Hoppe-Seyler-Str 3, 72076 Tuebingen, Germany.

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Simultaneous MR/PET imaging offers superior anatomic alignment for abdominal organs compared to retrospective fusion and PET/CT. Thoracic MR/PET alignment is best with expiratory or free-breathing techniques, not inspiratory breath-holds.

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Area of Science:

  • Medical Imaging
  • Radiology
  • Nuclear Medicine

Background:

  • Accurate anatomic alignment is crucial for multimodal imaging fusion.
  • Simultaneous and retrospective fusion techniques have varying degrees of spatial accuracy.
  • Optimizing imaging protocols is essential for reliable diagnostic interpretation.

Purpose of the Study:

  • To compare the anatomic alignment accuracy of simultaneous MR/PET, PET/CT, and retrospective MR/PET fusion in the abdomen and pelvis.
  • To evaluate the impact of different breathing, registration, and gating protocols on thoracic MR/PET alignment.

Main Methods:

  • Analysis of 28 abdominal and 7 thoracic patient datasets.
  • Comparison of misalignment in simultaneous MR/PET, PET/CT, and retrospective MR/PET fusion.
  • Evaluation of various breathing (inspiratory, expiratory, free-breathing), registration, and gating protocols for thoracic imaging.

Main Results:

  • Simultaneous MR/PET demonstrated significantly reduced misalignment in abdominal organs compared to retrospective fusion (5.8 mm vs 11.9 mm) and PET/CT for the urinary bladder (5.9 mm vs 11.0 mm).
  • Thoracic MR/PET with inspiratory breath-hold showed the greatest misalignment (24.5 mm).
  • No significant differences were found between other thoracic protocols (sequential, gated, different registrations).

Conclusions:

  • Simultaneous whole-body MR/PET provides more accurate alignment than retrospective fusion for abdominal organs and PET/CT for the urinary bladder.
  • Expiratory breath hold or free-breathing protocols yield better thoracic MR/PET alignment than inspiratory breath-hold.
  • The clinical significance of observed misalignments requires further investigation.