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Whole-body PET/MRI of Pediatric Patients: The Details That Matter
Published on: December 19, 2017
Optimized workflow and imaging protocols for whole-body oncologic PET/MRI
Shirou Ishii1, Takamitsu Hara2, Takeyuki Nanbu2
1Department of Radiology, Fukushima Medical University, 1, Hikarigaoka, Fukushima, Fukushima, Japan. shirou@fmu.ac.jp.
Abstract:
Although PET/MRI has the advantages of a simultaneous acquisition of PET and MRI, high soft-tissue contrast of the MRI images, and reduction of radiation exposure, its low profitability and long acquisition time are significant problems in clinical settings. Thus, MRI protocols that meet oncological purposes need to be used in order to reduce examination time while securing detectability. Currently, half-Fourier acquisition single-shot turbo spin echo and 3D-T1 volumetric interpolated breath-hold examination may be the most commonly used sequences for whole-body imaging due to their shorter acquisition time and higher diagnostic accuracy. Although there have been several reports that adding diffusion weighted image (DWI) to PET/MRI protocol has had no effect on tumor detection to date, in cases of liver, kidney, bladder, and prostate cancer, the use of DWI may be beneficial in detecting lesions. Another possible option is to scan each region with different MRI sequences instead of scanning the whole body using one sequence continuously. We herein report a workflow and imaging protocols for whole-body oncologic PET/MRI using an integrated system in the clinical routine, designed for the detection, for example by cancer screening, of metastatic lesions, in order to help future users optimize their workflow and imaging protocols.
Insights
Optimizing whole-body PET/MRI protocols is crucial for clinical oncology. This study presents a workflow and imaging strategies to reduce scan times while maintaining diagnostic accuracy for detecting metastatic lesions.
Area of Science:
- Medical Imaging
- Oncology
- Radiology
Background:
- Positron Emission Tomography/Magnetic Resonance Imaging (PET/MRI) offers simultaneous acquisition, high soft-tissue contrast, and reduced radiation exposure.
- Clinical adoption of PET/MRI is hindered by low profitability and long examination times.
- Optimized MRI protocols are needed to enhance efficiency in oncologic imaging.
Purpose of the Study:
- To report a workflow and imaging protocols for whole-body oncologic PET/MRI.
- To address the challenges of long acquisition times and low profitability in clinical PET/MRI settings.
- To aid future users in optimizing their workflow and imaging protocols for cancer screening and metastatic lesion detection.
Main Methods:
- Evaluation of commonly used MRI sequences for whole-body imaging, including half-Fourier acquisition single-shot turbo spin echo and 3D-T1 volumetric interpolated breath-hold examination.
- Consideration of the utility of diffusion-weighted imaging (DWI) for specific cancers like liver, kidney, bladder, and prostate.
- Exploration of regional scanning with different MRI sequences as an alternative to continuous whole-body scanning.
Main Results:
- Identified specific MRI sequences (half-Fourier acquisition single-shot turbo spin echo, 3D-T1 volumetric interpolated breath-hold examination) as efficient for whole-body oncologic imaging.
- Highlighted the potential benefit of DWI in detecting lesions in certain abdominal and pelvic cancers.
- Proposed a workflow and protocol strategy for integrated, whole-body oncologic PET/MRI.
Conclusions:
- Optimized MRI protocols are essential for efficient whole-body oncologic PET/MRI.
- Strategic selection of MRI sequences and potential inclusion of DWI can improve lesion detection and reduce examination time.
- The presented workflow and protocols aim to facilitate clinical routine use and improve the utility of PET/MRI in cancer management.
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