Whole-Body PET/MRI: The Future in Oncological Imaging

Positron emission tomography (PET) facilitates the evaluation of molecular aspects and metabolic alterations that are fundamental in detecting of malignancies, characterization of tumor stage and assessment of therapeutical response, and tumor recurrence. The main advantage of PET is its high sensitivity in identifying of areas of cancerous involvement at an early stage. In general, the accelerated radiotracer activity occurs before anatomical structure changes. The main difficulty with PET is the lack of an anatomical reference frame. Magnetic resonance imaging (MRI) is an excellent morphological imaging modality with a high anatomical resolution. Whole-body MRI produce large amounts of image data, resulting in the possibility of overlooking subtle pathological findings. The fusion of PET with MRI can compensate for their disadvantages and therefore offers several advantages in comparison to PET or MRI alone. The combination of these two excellent diagnostic imaging modalities into a single scanner improves the diagnostic accuracy by facilitating the accurate registration of molecular aspects and metabolic alterations of the diseases with exact correlation to anatomical findings and morphological information. Whole-body PET/MRI is a very promising diagnostic modality for oncological imaging and for use in cancer screening in the decades to come due to the considerably lower radiation exposure in contrast to PET/CT and the high soft tissue resolution of MRI.

[1]  R L Wahl,et al.  Pitfalls in oncologic diagnosis with FDG PET imaging: physiologic and benign variants. , 1999, Radiographics : a review publication of the Radiological Society of North America, Inc.

[2]  R. Goei,et al.  Interobserver variability and accuracy of computed tomographic assessment of nodal status in lung cancer. , 1994, The Annals of thoracic surgery.

[3]  L. Blomqvist,et al.  Whole-body imaging with MRI or PET/CT: the future for single-modality imaging in oncology? , 2003, JAMA.

[4]  M. Schwaiger,et al.  Neoadjuvant Therapy of Esophageal Squamous Cell Carcinoma: Response Evaluation by Positron Emission Tomography , 2001, Annals of surgery.

[5]  R. Semelka,et al.  Imaging of benign and malignant focal liver lesions. , 2001, Magnetic resonance imaging clinics of North America.

[6]  J. Debatin,et al.  Whole-body dual-modality PET/CT and whole-body MRI for tumor staging in oncology. , 2003, JAMA.

[7]  E. Melhem,et al.  A comparison of whole-body turboSTIR MR imaging and planar 99mTc-methylene diphosphonate scintigraphy in the examination of patients with suspected skeletal metastases. , 1997, AJR. American journal of roentgenology.

[8]  S. Eustace,et al.  Whole-body turbo short tau inversion recovery MR imaging using a moving tabletop. , 2002, AJR. American journal of roentgenology.

[9]  E. Melhem,et al.  Whole body turbo STIR MRI in unknown primary tumor detection , 1998, Journal of magnetic resonance imaging : JMRI.

[10]  E. Rummeny,et al.  Assessment of the extent of metastases of gastrointestinal carcinoid tumors using whole-body PET, CT, MRI, PET/CT and PET/MRI. , 2006, European journal of medical research.

[11]  K. Johnson,et al.  Total-body MR imaging in as little as 18 seconds. , 1997, Radiology.

[12]  S. Nekolla,et al.  PET/CT: Fundamental principles , 2004 .

[13]  D W. Townsend,et al.  Combined PET/CT Imaging in Oncology. Impact on Patient Management. , 2000, Clinical positron imaging : official journal of the Institute for Clinical P.E.T.

[14]  G. Laub,et al.  Breath-hold MR imaging of focal liver lesions: comparison of fast and ultrafast techniques , 2004, European Radiology.

[15]  M D Seemann,et al.  Whole-body imaging with PET/MRI. , 2004, European journal of medical research.

[16]  J. Debatin,et al.  Whole-body MRI using a rolling table platform for the detection of bone metastases , 2002, European Radiology.

[17]  J. Debatin,et al.  Whole-body MR imaging in 30 seconds with real-time true FISP and a continuously rolling table platform: feasibility study. , 2001, Radiology.

[18]  K. Scheidhauer,et al.  FDG PET and other imaging modalities in the primary diagnosis of suspicious breast lesions , 2004, European Journal of Nuclear Medicine and Molecular Imaging.

[19]  H. Biersack,et al.  FDG-PET in monitoring therapy of breast cancer , 2004, European Journal of Nuclear Medicine and Molecular Imaging.

[20]  E. Imhoff,et al.  Comparison of whole-body MRI with automatic moving table technique and bone scintigraphy for screening for bone metastases in patients with breast cancer , 2004, European Radiology.

[21]  M. Seemann,et al.  Human PET/CT scanners: feasibility for oncological in vivo imaging in mice. , 2004, European journal of medical research.

[22]  G. V. von Schulthess,et al.  Staging of non-small-cell lung cancer with integrated positron-emission tomography and computed tomography. , 2003, The New England journal of medicine.

[23]  Whole-body turbo STIR MR imaging: controversies and avenues for development , 2003, European Radiology.

[24]  R Weissleder,et al.  Molecular imaging. , 2009, Radiology.