The Clinical Role of Fusion Imaging Using PET, CT, and MR Imaging

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Software-based image registration and fusion

Software image fusion can be challenging to perform on a routine basis in the clinical setting because it requires exceptional digital communication in medicine (DICOM) connectivity, compatibility between the scanning protocols used by various imaging modalities, and outstanding collaboration between various clinical departments. These challenges may be overcome by the use of combined PET/CT systems described in the following section, although software-based coregistration offers greater

Combined PET/CT Instrumentation

The historical development of multimodality imaging is marked by various significant technical and scientific accomplishments driven by an unprecedented collaboration between multidisciplinary groups of investigators. Even though the introduction of commercial PET/CT units in a clinical setting is a recent feature, the prospective benefits of correlative multimodality imaging have been well established since the early years of medical imaging. Many pioneering radiologic scientists and

Clinical role of correlative fusion imaging

The clinical role of correlative imaging encompasses a wide variety of applications. It is now performed routinely with commercially available radiopharmaceuticals to answer important clinical questions in oncology,72 cardiology,73 neurology, and psychiatry.74, 75 As discussed previously, much of the early image registration effort was restricted to intrasubject brain applications, where the confinement of compact brain tissues within the skull renders a rigid-body model a satisfactory

Advances in anatomically guided quantification of PET data

The primary motivation for multimodality imaging has been image fusion of functional and anatomic data to facilitate anatomic localization of functional abnormalities and to assist region-of-interest (ROI) definition for quantitative analysis. The anatomic information also can be useful for many other tasks, including attenuation compensation, transmission-based scatter modeling, motion detection, and correction, introducing a priori anatomic information into reconstruction of the PET emission

Summary and future prospects

This article has attempted to summarize important themes of ongoing advancements by providing an overview of current state-of-the art developments in software- and hardware-based multimodality imaging combining PET with other structural imaging modalities (PET/CT and PET/MR imaging). Clearly, multimodality imaging has changed drastically over the last 2 decades. The pace of change has accelerated rapidly in the last decade driven by the introduction and widespread acceptance of combined PET/CT

Acknowledgments

The authors would like to thank Dr C. Steiner for providing some of the clinical illustrations used in this manuscript.

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    This article originally appeared in PET Clinics 2008;3(3);275–91.

    This work was supported by grant SNSF 3100A0-116547 from the Swiss National Foundation.

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