Skip to main content

Advertisement

Springer Nature Link
Log in

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

  • Original Article
  • Published:
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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

Explore related subjects

Discover the latest articles and news from researchers in related subjects, suggested using machine learning.

References

  1. Cuocolo A, Breatnach E. Multimodality imaging in Europe: a survey by the European Association of Nuclear Medicine (EANM) and the European Society of Radiology (ESR). Eur J Nucl Med Mol Imaging. 2010;37(1):163–7.

    Article  PubMed  Google Scholar 

  2. Rosenbaum J, Basu S, Beckerman S, Werner T, Torigian DA, Alavi A. Evaluation of diagnostic performance of (18)F-FDG-PET compared to CT in detecting potential causes of fever of unknown origin in an academic centre. Hell J Nucl Med. 2011;14(3):255–9.

    PubMed  Google Scholar 

  3. Schiepers C, Dahlbom M. Molecular imaging in oncology: the acceptance of PET/CT and the emergence of MR/PET imaging. Eur Radiol. 2011;21(3):548–54.

    Article  PubMed  Google Scholar 

  4. Blodgett TM, Meltzer CC, Townsend DW. PET/CT: form and function. Radiology. 2007;242(2):360–85.

    Article  PubMed  Google Scholar 

  5. Freudenberg LS, Rosenbaum SJ, Beyer T, Bockisch A, Antoch G. PET versus PET/CT dual-modality imaging in evaluation of lung cancer. Thorac Surg Clin. 2010;20(1):25–30.

    Article  PubMed  Google Scholar 

  6. Ell PJ. The contribution of PET/CT to improved patient management. Br J Radiol. 2006;79(937):32–6.

    Article  PubMed  CAS  Google Scholar 

  7. Rosenbaum SJ, Lind T, Antoch G, Bockisch A. False-positive FDG PET uptake – the role of PET/CT. Eur Radiol. 2006;16(5):1054–65.

    Article  PubMed  Google Scholar 

  8. Bockisch A, Freudenberg LS, Schmidt D, Kuwert T. Hybrid imaging by SPECT/CT and PET/CT: proven outcomes in cancer imaging. Semin Nucl Med. 2009;39(4):276–89.

    Article  PubMed  Google Scholar 

  9. Chawla SC, Federman N, Zhang D, Nagata K, Nuthakki S, McNitt-Gray M, et al. Estimated cumulative radiation dose from PET/CT in children with malignancies: a 5-year retrospective review. Pediatr Radiol. 2010;40(5):681–6.

    Article  PubMed  Google Scholar 

  10. Mattsson S, Söderberg M. Radiation dose management in CT, SPECT/CT and PET/CT techniques. Radiat Prot Dosimetry. 2011;147(1–2):13–21.

    Article  PubMed  Google Scholar 

  11. Judenhofer MS, Wehrl HF, Newport DF, Catana C, Siegel SB, Becker M, et al. Simultaneous PET-MRI: a new approach for functional and morphological imaging. Nat Med. 2008;14(4):459–65.

    Article  PubMed  CAS  Google Scholar 

  12. Pichler BJ, Judenhofer MS, Catana C, Walton JH, Kneilling M, Nutt RE, et al. Performance test of an LSO-APD detector in a 7-T MRI scanner for simultaneous PET/MRI. J Nucl Med. 2006;47(4):639–47.

    PubMed  Google Scholar 

  13. Hofmann M, Pichler B, Schölkopf B, Beyer T. Towards quantitative PET/MRI: a review of MR-based attenuation correction techniques. Eur J Nucl Med Mol Imaging. 2009;36 Suppl 1:S93–104.

    Article  PubMed  Google Scholar 

  14. Judenhofer MS, Catana C, Swann BK, Siegel SB, Jung W-I, Nutt RE, et al. PET/MR images acquired with a compact MR-compatible PET detector in a 7-T magnet. Radiology. 2007;244(3):807–14.

    Article  PubMed  Google Scholar 

  15. Catana C, Procissi D, Wu Y, Judenhofer MS, Qi J, Pichler BJ, et al. Simultaneous in vivo positron emission tomography and magnetic resonance imaging. Proc Natl Acad Sci U S A. 2008;105(10):3705–10.

    Article  PubMed  CAS  Google Scholar 

  16. Wehrl HF, Judenhofer MS, Wiehr S, Pichler BJ. Pre-clinical PET/MR: technological advances and new perspectives in biomedical research. Eur J Nucl Med Mol Imaging. 2009;36 Suppl 1:S56–68.

    Article  PubMed  Google Scholar 

  17. Boss A, Bisdas S, Kolb A, Hofmann M, Ernemann U, Claussen CD, et al. Hybrid PET/MRI of intracranial masses: initial experiences and comparison to PET/CT. J Nucl Med. 2010;51(8):1198–205.

    Article  PubMed  Google Scholar 

  18. Boss A, Stegger L, Bisdas S, Kolb A, Schwenzer N, Pfister M, et al. Feasibility of simultaneous PET/MR imaging in the head and upper neck area. Eur Radiol. 2011;21(7):1439–46.

    Article  PubMed  Google Scholar 

  19. Schlemmer H-PW, Pichler BJ, Schmand M, Burbar Z, Michel C, Ladebeck R, et al. Simultaneous MR/PET imaging of the human brain: feasibility study. Radiology. 2008;248(3):1028–35.

    Article  PubMed  Google Scholar 

  20. Delso G, Fürst S, Jakoby B, Ladebeck R, Ganter C, Nekolla SG, et al. Performance measurements of the Siemens mMR integrated whole-body PET/MR scanner. J Nucl Med. 2011;52(12):1914–22.

    Article  PubMed  Google Scholar 

  21. Zaidi H, Ojha N, Morich M, Griesmer J, Hu Z, Maniawski P, et al. Design and performance evaluation of a whole-body Ingenuity TF PET-MRI system. Phys Med Biol. 2011;56(10):3091–106.

    Article  PubMed  CAS  Google Scholar 

  22. Kumar S, Pandey AK, Sharma P, Malhotra A, Kumar R. Optimization of the CT acquisition protocol to reduce patient dose without compromising the diagnostic quality for PET-CT: a phantom study. Nucl Med Commun. 2012;33(2):164–70.

    Article  PubMed  Google Scholar 

  23. Funama Y, Awai K, Nakayama Y, Kakei K, Nagasue N, Shimamura M, et al. Radiation dose reduction without degradation of low-contrast detectability at abdominal multisection CT with a low-tube voltage technique: phantom study. Radiology. 2005;237(3):905–10.

    Article  PubMed  Google Scholar 

  24. Martinez-Möller A, Souvatzoglou M, Delso G, Bundschuh RA, Chefd’hotel C, Ziegler SI, et al. Tissue classification as a potential approach for attenuation correction in whole-body PET/MRI: evaluation with PET/CT data. J Nucl Med. 2009;50(4):520–6.

    Article  PubMed  Google Scholar 

  25. Eiber M, Martinez-Möller A, Souvatzoglou M, et al. Value of a Dixon-based MR/PET attenuation correction sequence for the localization and evaluation of PET-positive lesions. Eur J Nucl Med Mol Imaging. 2011;38(9):1691–701.

    Article  PubMed  Google Scholar 

  26. Hofmann M, Bezrukov I, Mantlik F, Aschoff P, Steinke F, Beyer T, et al. MRI-based attenuation correction for whole-body PET/MRI: quantitative evaluation of segmentation-and atlas-based methods. J Nucl Med. 2011;52(9):1392–9.

    Article  PubMed  Google Scholar 

  27. Matthies A, Hickeson M, Cuchiara A, Alavi A. Dual time point 18F-FDG PET for the evaluation of pulmonary nodules. J Nucl Med. 2002;43(7):871–5.

    PubMed  Google Scholar 

  28. Basu S, Kwee TC, Surti S, Akin EA, Yoo D, Alavi A. Fundamentals of PET and PET/CT imaging. Ann N Y Acad Sci. 2011;1228:1–18.

    Article  PubMed  CAS  Google Scholar 

  29. Zytoon AA, Murakami K, El-Kholy MR, El-Shorbagy E. Dual time point FDG-PET/CT imaging. Potential tool for diagnosis of breast cancer. Clin Radiol. 2008;63(11):1213–27.

    Article  PubMed  CAS  Google Scholar 

  30. Paquet N, Albert A, Foidart J, Hustinx R. Within-patient variability of (18)F-FDG: standardized uptake values in normal tissues. J Nucl Med. 2004;45(5):784–8.

    PubMed  CAS  Google Scholar 

  31. Lee JW, Kim S-K, Lee SM, Moon SH, Kim T-S. Detection of hepatic metastases using dual-time-point FDG PET/CT scans in patients with colorectal cancer. Mol Imaging Biol. 2011;13(3):565–72.

    Article  PubMed  Google Scholar 

  32. Drzezga A, Souvatzoglou M, Eiber M, Beer AJ, Furst S, Martinez-Möller A, et al. First clinical experience with integrated whole-body PET/MR: comparison to PET/CT in patients with oncologic diagnoses. J Nucl Med. 2012;53(6):845–55.

    Article  PubMed  Google Scholar 

  33. Boellaard R, O’Doherty MJ, Weber WA, Mottaghy FM, Lonsdale MN, Stroobants SG. FDG PET and PET/CT: EANM procedure guidelines for tumour PET imaging: Version 1.0. Eur J Nucl Med Mol Imaging. 2010;37(1):181–200.

    Article  PubMed  Google Scholar 

  34. Zhuang H, Pourdehnad M, Lambright ES, Yamamoto AJ, Lanuti M, Li P, et al. Dual time point 18F-FDG PET imaging for differentiating malignant from inflammatory processes. J Nucl Med. 2001;42(9):1412–7.

    PubMed  CAS  Google Scholar 

  35. Schwenzer NF, Schraml C, Müller M, Brendle C, Sauter A, Spengler W, et al. Pulmonary lesion assessment: comparison of whole-body hybrid MR/PET and PET/CT imaging – pilot study. Radiology. 2012;264(2):551–8.

    Article  PubMed  Google Scholar 

  36. Mantlik F, Hofmann M, Werner MK, Sauter A, Kupferschläger J, Schölkopf B, et al. The effect of patient positioning aids on PET quantification in PET/MR imaging. Eur J Nucl Med Mol Imaging. 2011;38(5):920–9.

    Article  PubMed  Google Scholar 

  37. Vriens D, Visser EP, Geus-Oei L-F, Oyen WJG. Methodological considerations in quantification of oncological FDG PET studies. Eur J Nucl Med Mol Imaging. 2009;37(7):1408–25.

    Article  PubMed  Google Scholar 

  38. Tellmann L, Quick HH, Bockisch A, Herzog H, Beyer T. The effect of MR surface coils on PET quantification in whole-body PET/MR: results from a pseudo-PET/MR phantom study. Med Phys. 2011;38(5):2795–805.

    Article  PubMed  CAS  Google Scholar 

  39. Delso G, Martinez-Möller A, Bundschuh RA, Ladebeck R, Candidus Y, Faul D, et al. Evaluation of the attenuation properties of MR equipment for its use in a whole-body PET/MR scanner. Phys Med Biol. 2010;55(15):4361–74.

    Article  PubMed  CAS  Google Scholar 

  40. MacDonald LR, Kohlmyer S, Liu C, Lewellen TK, Kinahan PE. Effects of MR surface coils on PET quantification. Med Phys. 2011;38(6):2948–56.

    Article  PubMed  Google Scholar 

Download references

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.

Author information

Authors and Affiliations

  1. Clinic of Nuclear Medicine, University Hospital Erlangen, Ulmenweg 18, 91054, Erlangen, Germany

    Marco Wiesmüller, Philipp Ritt, Daniela Schmidt, Michael Beck, Torsten Kuwert & Carl C. von Gall

  2. Institute of Medical Physics, Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Germany

    Harald H. Quick & Bharath Navalpakkam

  3. Institute of Radiology, University Hospital Erlangen, Erlangen, Germany

    Michael M. Lell & Michael Uder

  4. Laboratory for Pattern Recognition, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany

    Philipp Ritt

Authors
  1. Marco Wiesmüller
    View author publications

    You can also search for this author inPubMed Google Scholar

  2. Harald H. Quick
    View author publications

    You can also search for this author inPubMed Google Scholar

  3. Bharath Navalpakkam
    View author publications

    You can also search for this author inPubMed Google Scholar

  4. Michael M. Lell
    View author publications

    You can also search for this author inPubMed Google Scholar

  5. Michael Uder
    View author publications

    You can also search for this author inPubMed Google Scholar

  6. Philipp Ritt
    View author publications

    You can also search for this author inPubMed Google Scholar

  7. Daniela Schmidt
    View author publications

    You can also search for this author inPubMed Google Scholar

  8. Michael Beck
    View author publications

    You can also search for this author inPubMed Google Scholar

  9. Torsten Kuwert
    View author publications

    You can also search for this author inPubMed Google Scholar

  10. Carl C. von Gall
    View author publications

    You can also search for this author inPubMed Google Scholar

Corresponding author

Correspondence to Carl C. von Gall.

Rights and permissions

Reprints and permissions

About this article

Cite this article

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

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

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

Keywords