Beuthien-Baumann Bettina
Abteilung Radiologie, Deutsches Krebsforschungszentrum, Im Neuenheimer Feld 280, 69120, Heidelberg, Deutschland.
Radiologe. 2018 Mar;58(3):211-217. doi: 10.1007/s00117-018-0355-y.
CLINICAL/METHODICAL ISSUE: Magnet resonance imaging (MRI) is an excellent anatomical reference method for the combination with positron emission tomography (PET). But MRI does not produce data, which can be directly used for attenuation correction of PET data, potentially compromising quantitative accuracy of PET.
Hybrid-positron emission tomography/computed tomography (PET/CT) is an established standard diagnostic tool, particularly for staging and restaging in oncology. Attenuation correction of PET data is performed with a µMAP derived from low-dose-CT, considered as a robust method.
Using standardized MRI-sequences, tissue classes are segmented and attenuation maps are obtained, based on empirical density values. In addition, new reconstruction algorithms and the possibility to acquire PET and MRI simultaneously with MRI-based motion correction are available. These advances have improved image quality and quantitative accuracy of the PET-data in PET/MRI.
In numerous oncological studies PET/CT and PET/MR were rated as equal in their diagnostic performance. The combination of functional-metabolic PET and multiparametric MRI with excellent soft tissue contrast complement each other with regard to their diagnostic information in numerous tumor entities.
The standard diagnostic workup for lung cancer is currently still based on PET/CT. In numerous tumor entities, the combination of PET/MRI can provide additional diagnostic information.
临床/方法学问题:磁共振成像(MRI)是与正电子发射断层扫描(PET)相结合的出色解剖学参考方法。但MRI不产生可直接用于PET数据衰减校正的数据,这可能会影响PET的定量准确性。
正电子发射断层扫描/计算机断层扫描(PET/CT)是一种既定的标准诊断工具,尤其用于肿瘤学的分期和再分期。PET数据的衰减校正是用从低剂量CT得出的µMAP进行的,这被认为是一种可靠的方法。
使用标准化的MRI序列,基于经验密度值对组织类别进行分割并获得衰减图。此外,还有新的重建算法以及基于MRI运动校正同时采集PET和MRI的可能性。这些进展提高了PET/MRI中PET数据的图像质量和定量准确性。
在众多肿瘤学研究中,PET/CT和PET/MR在诊断性能方面被评为相当。功能性代谢PET与具有出色软组织对比度的多参数MRI相结合,在众多肿瘤实体的诊断信息方面相互补充。
目前肺癌的标准诊断检查仍基于PET/CT。在众多肿瘤实体中,PET/MRI的结合可提供额外的诊断信息。