PET/MR Imaging: Potential Clinical and Research Applications

Journal of Nuclear Medicine (JNM): Volume 55, Supplement 2 (June 2014)

Guest Editors:

Johannes Czernin, MD
David Townsend, PhD
Markus Schwaiger, MD

Introduction:

Several years ago, the Journal of Nuclear Medicine summarized the evidence for the usefulness of PET/CT in oncology 1. Since then, PET/CT has become a leading modality for diagnosing, staging, restaging and monitoring of cancer. More than 5000 clinical PET/CT centers are operational world-wide and more than 2 million patients have been studied in the US in 2013.

Recently, hybrid PET/MRI scanners have become available and have been placed in more than 50 centers around the world. This technology is attractive because it can provide anatomical and functional (MRI) as well as molecular information (PET). Both modalities play established diagnostic roles in a variety of diseases, which promises comprehensive PET/MRI examinations combining excellent tissue contrast, molecular targeting and reduced radiation exposure as compared to PET/CT. Whether these capabilities will result in improved management of patients with neurologic, cardiologic, metabolic and oncologic diseases is not defined yet. PET/MRI is a complex and challenging technology requiring cross-disciplinary competence and collaborations among physicians, physicists and technologists.

This supplement aims at updating physicians from various specialties and subspecialties on the current status of PET/MRI in research and the clinic. The contributors to this supplement were asked to describe their use of PET/MRI in research and the clinic and to delineate strengths and limitations of the approach.

The principles of PET/MRI imaging and its use in preclinical and translational research are described by Disselhorst et al (-) and Wehrl et al (-) from the Tuebingen group. Veit-Haibach et al. highlight the operational complexities of PET/MRI and propose efficient clinical imaging protocols (-). Potential clinical applications in neurology are reviewed by Drzezga and colleagues while pediatric applications are discussed by Purz and coworkers from the group in Leipzig (-). Ratib et al from the University of Geneva propose optimized protocols for cardiac imaging and describe initial cardiac applications (-).

Three contributions address the use of PET/MRI in oncology. Rauscher et al from the Munich group focus on the use of non FDG PET probes in conjunction with PET/MRI (-). Wolfgang Weber provides a critical appraisal and suggests that comparisons with PET/CT may not be the best initial approach to clinical PET/MRI research (-). Finally, Czernin et al summarize the available clinical evidence that demonstrates feasibility but no diagnostic superiority (-).

This supplement does not intend to provide any guidelines. Rather, it summarizes the rapidly growing experience of the author’s institutions and proposes protocols for research and clinical applications in neurology, pediatrics, cardiology and oncology.

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