Brain imaging of sequential acquisition using a flexible PET scanner and 3-T MRI: quantitative and qualitative...

A mobile PET scanner termed flexible PET (fxPET) has been designed to fit existing MRI systems. The purpose of this study was to assess brain imaging with fxPET combined with 3-T MRI in comparison with conventional PET (cPET)/CT.

In this prospective study, 29 subjects with no visible lesions except for mild leukoaraiosis on whole brain imaging underwent 2-deoxy-2-[¹⁸F]fluoro-D-glucose ([¹⁸F]FDG) cPET/CT followed by fxPET and MRI. The registration differences between fxPET and MRI and between cPET and CT were compared by measuring spatial coordinates. Three-dimensional magnetization-prepared rapid acquisition gradient-echo T1-weighted imaging (T1WI) was acquired. We applied two methods of attenuation correction to the fxPET images: MR-based attenuation correction, which yielded fxPET_MRAC; and CT-based attenuation correction, which yielded fxPET_CTAC. The three PET datasets were co-registered to the T1WI. Following subcortical segmentation and cortical parcellation, volumes of interest were placed in each PET image to assess physiological accumulation in the brain. SUV_mean was obtained and compared between the three datasets. We also visually evaluated image distortion and clarity of fxPET_MRAC.

Mean misregistration of fxPET/MRI was < 3 mm for each margin. Mean registration differences were significantly larger for fxPET/MRI than for cPET/CT except for the superior margin. There were high correlations between the three PET datasets regarding SUV_mean. On visual evaluation of image quality, the grade of distortion was comparable between fxPET_MRAC and cPET, and the grade of clarity was acceptable but inferior for fxPET_MRAC compared with cPET.

fxPET could successfully determine physiological [¹⁸F]FDG uptake; however, improved image clarity is desirable. In this study, fxPET/MRI at 3-T was feasible for brain imaging.