Clinically Valuable Quality Control for PET/MRI Systems:Consensus Recommendation From the HYBRID Consortium

International audienceQuality control (QC) of medical imaging devices is essential to ensure their proper function and to gain accurate and quantitative results. Therefore, several international bodies have published QC guidelines and recommendations for a wide range of imaging modalities to ensure adequate performance of the systems. Hybrid imaging systems such as positron emission tomography/computed tomography (PET/CT) or PET/magnetic resonance imaging (PET/MRI), in particular, present additional challenges caused by differences between the combined modalities. However, despite the increasing use of this hybrid imaging modality in recent years, there are no dedicated QC recommendations for PET/MRI. Therefore, this work aims at collecting information on QC procedures across a European PET/MRI network, presenting quality assurance procedures implemented by PET/MRI vendors and achieving a consensus on PET/MRI QC procedures across imaging centers. Users of PET/MRI systems at partner sites involved in the HYBRID consortium were surveyed about local frequencies of QC procedures for PET/MRI. Although all sites indicated that they perform vendor-specific daily QC procedures, significant variations across the centers were observed for other QC tests and testing frequencies. Likewise, variations in available recommendations and guidelines and the QC procedures implemented by vendors were found. Based on the available information and our clinical expertise within this consortium, we were able to propose a minimum set of PET/MRI QC recommendations including the daily QC, cross-calibration tests, and an image quality (IQ) assessment for PET and coil checks and MR image quality tests for MRI. Together with regular checks of the PET-MRI alignment, proper PET/MRI performance can be ensured

[¹⁸F]Florbetapir PET/MR imaging to assess demyelination in multiple sclerosis

none15PurposeWe evaluated myelin changes throughout the central nervous system in Multiple Sclerosis (MS) patients by using hybrid [18F]florbetapir PET-MR imaging.MethodsWe included 18 relapsing-remitting MS patients and 12 healthy controls. Each subject performed a hybrid [18F]florbetapir PET-MR and both a clinical and cognitive assessment. [18F]florbetapir binding was measured as distribution volume ratio (DVR), through the Logan graphical reference method and the supervised cluster analysis to extract a reference region, and standard uptake value (SUV) in the 70–90 min interval after injection. The two quantification approaches were compared. We also evaluated changes in the measures derived from diffusion tensor imaging and arterial spin labeling.Results[18F]florbetapir DVRs decreased from normal-appearing white matter to the centre of T2 lesion (P < 0.001), correlated with fractional anisotropy and with mean, axial and radial diffusivity within T2 lesions (coeff. = −0.15, P < 0.001, coeff. = −0.12, P < 0.001 and coeff. = −0.16, P < 0.001, respectively). Cerebral blood flow was reduced in white matter damaged areas compared to white matter in healthy controls (−10.9%, P = 0.005). SUV70–90 and DVR are equally able to discriminate between intact and damaged myelin (area under the curve 0.76 and 0.66, respectively; P = 0.26).ConclusionOur findings demonstrate that [18F]florbetapir PET imaging can measure in-vivo myelin damage in patients with MS. Demyelination in MS is not restricted to lesions detected through conventional MRI but also involves the normal appearing white matter. Although longitudinal studies are needed, [18F]florbetapir PET imaging may have a role in clinical settings in the management of MS patients.noneCarotenuto, Antonio; Giordano, Beniamino; Dervenoulas, George; Wilson, Heather; Veronese, Mattia; Chappell, Zachary; Polychronis, Sotirios; Pagano, Gennaro; Mackewn, Jane; Turkheimer, Federico E; Williams, Steven C R; Hammers, Alexander; Silber, Eli; Brex, Peter; Politis, MariosCarotenuto, Antonio; Giordano, Beniamino; Dervenoulas, George; Wilson, Heather; Veronese, Mattia; Chappell, Zachary; Polychronis, Sotirios; Pagano, Gennaro; Mackewn, Jane; Turkheimer, Federico E; Williams, Steven C R; Hammers, Alexander; Silber, Eli; Brex, Peter; Politis, Mario

Simultaneous PET–MR acquisition and MR-derived motion fields for correction of non-rigid motion in PET

Positron emission tomography (PET) provides an accurate measurement of radiotracer concentration in vivo, but performance can be limited by subject motion which degrades spatial resolution and quantitative accuracy. This effect may become a limiting factor for PET studies in the body as PET scanner technology improves. In this work, we propose a new approach to address this problem by employing motion information from images measured simultaneously using a magnetic resonance (MR) scanner. The approach is demonstrated using an MR-compatible PET scanner and PET-MR acquisition with a purpose-designed phantom capable of non-rigid deformations. Measured, simultaneously acquired MR data were used to correct for motion in PET, and results were compared with those obtained using motion information from PET images alone. Motion artefacts were significantly reduced and the PET image quality and quantification was significantly improved by the use of MR motion fields, whilst the use of PET-only motion information was less successful. Combined PET-MR acquisitions potentially allow PET motion compensation in whole-body acquisitions without prolonging PET acquisition time or increasing radiation dose. This, to the best of our knowledge, is the first study to demonstrate that simultaneously acquired MR data can be used to estimate and correct for the effects of non-rigid motion in PET