Anatomic evaluation of 3-dimensional ultrashort-echo-time bone maps for PET/MR attenuation correction

Ultrashort-echo-time (UTE) sequences have been proposed in the past for MR-based attenuation correction of PET data, because of their ability to image cortical bone. In the present work we assessed the limitations of dual-echo UTE imaging for bone segmentation in head and neck imaging. Sequentially acquired MR and PET/CT clinical data were used for this purpose. METHODS: Twenty patients referred for a clinical oncology examination were scanned using a trimodality setup. Among the MR sequences, a dual-echo UTE acquisition of the head was acquired and used to create tissue R2 maps. The different undesired structures present in these maps were identified by an experienced radiologist. Global and local measurements of the overlap between R2-based and CT-based bone masks were computed. RESULTS: UTE R2 maps displayed a nonfunctional relation with CT data. The obtained bone masks showed acceptable overlap with the corresponding CT data, in the case of the skull itself (e.g., 47% mismatch for the parietal region), with decreased performance in the base of the skull and in the neck (e.g., 78% for the maxillary region). Unwanted structures were detected, both anatomic (e.g., sternocleidomastoid, temporal, and masseter muscles) and artifactual (e.g., dental implants and air-tissue interfaces). CONCLUSION: It is indeed possible to estimate the anatomic location of bone tissue using UTE sequences. However, using pure parametric maps for attenuation correction may lead to bias close to certain anatomic structures and areas of high magnetic field inhomogeneity. More sophisticated approaches are necessary to compensate for these effects

Clinical evaluation of zero-echo-time MR imaging for the segmentation of the skull

MR-based attenuation correction is instrumental for integrated PET/MR imaging. It is generally achieved by segmenting MR images into a set of tissue classes with known attenuation properties (e.g., air, lung, bone, fat, soft tissue). Bone identification with MR imaging is, however, quite challenging, because of the low proton density and fast decay time of bone tissue. The clinical evaluation of a novel, recently published method for zero-echo-time (ZTE)-based MR bone depiction and segmentation in the head is presented here. METHODS: A new paradigm for MR imaging bone segmentation, based on proton density-weighted ZTE imaging, was disclosed earlier in 2014. In this study, we reviewed the bone maps obtained with this method on 15 clinical datasets acquired with a PET/CT/MR trimodality setup. The CT scans acquired for PET attenuation-correction purposes were used as reference for the evaluation. Quantitative measurements based on the Jaccard distance between ZTE and CT bone masks and qualitative scoring of anatomic accuracy by an experienced radiologist and nuclear medicine physician were performed. RESULTS: The average Jaccard distance between ZTE and CT bone masks evaluated over the entire head was 52% ± 6% (range, 38%-63%). When only the cranium was considered, the distance was 39% ± 4% (range, 32%-49%). These results surpass previously reported attempts with dual-echo ultrashort echo time, for which the Jaccard distance was in the 47%-79% range (parietal and nasal regions, respectively). Anatomically, the calvaria is consistently well segmented, with frequent but isolated voxel misclassifications. Air cavity walls and bone/fluid interfaces with high anatomic detail, such as the inner ear, remain a challenge. CONCLUSION: This is the first, to our knowledge, clinical evaluation of skull bone identification based on a ZTE sequence. The results suggest that proton density-weighted ZTE imaging is an efficient means of obtaining high-resolution maps of bone tissue with sufficient anatomic accuracy for, for example, PET attenuation correction