Lemke A-J, Niehues S M, Amthauer H, Rohlfing T, Hosten N, Felix R
Campus Virchow-Klinikum, Klinik für Strahlenheilkunde, Charité, Universitätsmedizin Berlin.
Rofo. 2004 Dec;176(12):1811-8. doi: 10.1055/s-2004-813663.
To evaluate the feasibility and the clinical benefits of retrospective digital image fusion (PET, SPECT, CT and MRI).
In a prospective study, a total of 273 image fusions were performed and evaluated. The underlying image acquisitions (CT, MRI, SPECT and PET) were performed in a way appropriate for the respective clinical question and anatomical region. Image fusion was executed with a software program developed during this study. The results of the image fusion procedure were evaluated in terms of technical feasibility, clinical objective, and therapeutic impact.
The most frequent combinations of modalities were CT/PET (n = 156) and MRI/PET (n = 59), followed by MRI/SPECT (n = 28), CT/SPECT (n = 22) and CT/MRI (n = 8). The clinical questions included following regions (more than one region per case possible): neurocranium (n = 42), neck (n = 13), lung and mediastinum (n = 24), abdomen (n = 181), and pelvis (n = 65). In 92.6 % of all cases (n = 253), image fusion was technically successful. Image fusion was able to improve sensitivity and specificity of the single modality, or to add important diagnostic information. Image fusion was problematic in cases of different body positions between the two imaging modalities or different positions of mobile organs. In 37.9 % of the cases, image fusion added clinically relevant information compared to the single modality.
For clinical questions concerning liver, pancreas, rectum, neck, or neurocranium, image fusion is a reliable method suitable for routine clinical application. Organ motion still limits its feasibility and routine use in other areas (e. g., thorax).
评估回顾性数字图像融合（PET、SPECT、CT和MRI）的可行性及临床益处。
在一项前瞻性研究中，共进行并评估了273次图像融合。基础图像采集（CT、MRI、SPECT和PET）以适合各自临床问题和解剖区域的方式进行。图像融合通过本研究期间开发的软件程序执行。从技术可行性、临床目标和治疗影响方面评估图像融合程序的结果。
最常见的模态组合是CT/PET（n = 156）和MRI/PET（n = 59），其次是MRI/SPECT（n = 28）、CT/SPECT（n = 22）和CT/MRI（n = 8）。临床问题包括以下区域（每个病例可能有多个区域）：颅骨（n = 42）、颈部（n = 13）、肺和纵隔（n = 24）、腹部（n = 181）和骨盆（n = 65）。在所有病例的92.6%（n = 253）中，图像融合在技术上是成功的。图像融合能够提高单一模态的敏感性和特异性，或添加重要的诊断信息。在两种成像模态之间身体位置不同或移动器官位置不同的情况下，图像融合存在问题。与单一模态相比，在37.9%的病例中，图像融合添加了临床相关信息。
对于涉及肝脏、胰腺、直肠、颈部或颅骨的临床问题，图像融合是一种适用于常规临床应用的可靠方法。器官运动仍然限制了其在其他领域（如胸部）的可行性和常规使用。
