New Trends and Advances of MRI and PET Hybrid Imaging in Diagnostics

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: closed (31 August 2024) | Viewed by 6977

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Guest Editor
Institute of Radiology, Department of Medicine—DIMED, University of Padua, 35128 Padua, Italy
Interests: MRI; PET; diagnostic imaging
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Special Issue Information

Dear Colleagues,

Imaging holds an irreplaceable role in the routinary clinical practice. Nowadays, almost every clinician for diagnosis needs imaging confirmation, and two techniques that in recent years have most experienced an enhancement of their diagnostic capabilities are MRI and PET. With these concepts in mind, many researchers are developing methodologies and applications to further improve the accuracy of imaging. Among the research fields, we have the applications of artificial intelligence, big data, radiomics, and texture analysis in medical images. Using these techniques, much more hidden information can be extracted from the images than via simple qualitative or semi-quantitative evaluation. This research topic is of paramount importance since the workloads in the radiology and nuclear medicine departments are increasing more and more. The standardization of the reporting systems in MRI and PET is another crucial issue, both for increasing the reliability of the reports and for accelerating clinical activity in radiology departments. Other advances are driven by new radiotracers and new hybrid techniques in nuclear medicine, such as PET/MRI. Anyway, these are only a few of the new trends that are shaping the imaging of tomorrow. The aim of this Special Issue is to highlight new techniques that can further improve the accuracy and the quality of medical imaging with MRI and PET, giving an aid not only to clinicians but also to radiologists. This Special Issue welcomes full research articles, case reports, and reviews focused on advances in MR and PET imaging.

Dr. Filippo Crimi’
Guest Editor

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Published Papers (5 papers)

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Editorial

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2 pages, 205 KiB  
Editorial
New Trends and Advances in MRI and PET Hybrid Imaging in Diagnostics
by Filippo Crimì, Chiara Zanon, Alberto Crimì, Giulio Cabrelle and Emilio Quaia
Diagnostics 2023, 13(18), 2936; https://doi.org/10.3390/diagnostics13182936 - 13 Sep 2023
Viewed by 1317
Abstract
Imaging holds an irreplaceable role in routine clinical practice [...] Full article
(This article belongs to the Special Issue New Trends and Advances of MRI and PET Hybrid Imaging in Diagnostics)

Research

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17 pages, 2260 KiB  
Article
From Phantoms to Patients: Improved Fusion and Voxel-Wise Analysis of Diffusion-Weighted Imaging and FDG-Positron Emission Tomography in Positron Emission Tomography/Magnetic Resonance Imaging for Combined Metabolic–Diffusivity Index (cDMI)
by Katharina Deininger, Patrick Korf, Leonard Lauber, Robert Grimm, Ralph Strecker, Jochen Steinacker, Catharina S. Lisson, Bernd M. Mühling, Gerlinde Schmidtke-Schrezenmeier, Volker Rasche, Tobias Speidel, Gerhard Glatting, Meinrad Beer, Ambros J. Beer and Wolfgang Thaiss
Diagnostics 2024, 14(16), 1787; https://doi.org/10.3390/diagnostics14161787 - 16 Aug 2024
Viewed by 684
Abstract
Hybrid positron emission tomography/magnetic resonance imaging (PET/MR) opens new possibilities in multimodal multiparametric (m2p) image analyses. But even the simultaneous acquisition of positron emission tomography (PET) and magnetic resonance imaging (MRI) does not guarantee perfect voxel-by-voxel co-registration due to organs and distortions, especially [...] Read more.
Hybrid positron emission tomography/magnetic resonance imaging (PET/MR) opens new possibilities in multimodal multiparametric (m2p) image analyses. But even the simultaneous acquisition of positron emission tomography (PET) and magnetic resonance imaging (MRI) does not guarantee perfect voxel-by-voxel co-registration due to organs and distortions, especially in diffusion-weighted imaging (DWI), which would be, however, crucial to derive biologically meaningful information. Thus, our aim was to optimize fusion and voxel-wise analyses of DWI and standardized uptake values (SUVs) using a novel software for m2p analyses. Using research software, we evaluated the precision of image co-registration and voxel-wise analyses including the rigid and elastic 3D registration of DWI and [18F]-Fluorodeoxyglucose (FDG)-PET from an integrated PET/MR system. We analyzed DWI distortions with a volume-preserving constraint in three different 3D-printed phantom models. A total of 12 PET/MR-DWI clinical datasets (bronchial carcinoma patients) were referenced to the T1 weighted-DIXON sequence. Back mapping of scatterplots and voxel-wise registration was performed and compared to the non-optimized datasets. Fusion was rated using a 5-point Likert scale. Using the 3D-elastic co-registration algorithm, geometric shapes were restored in phantom measurements; the measured ADC values did not change significantly (F = 1.12, p = 0.34). Reader assessment showed a significant improvement in fusion precision for DWI and morphological landmarks in the 3D-registered datasets (4.3 ± 0.2 vs. 4.6 ± 0.2, p = 0.009). Most pronounced differences were noted for the chest wall (p = 0.006), tumor (p = 0.007), and skin contour (p = 0.014). Co-registration increased the number of plausible ADC and SUV combinations by 25%. The volume-preserving elastic 3D registration of DWI significantly improved the precision of fusion with anatomical sequences in phantom and clinical datasets. The research software allowed for a voxel-wise analysis and visualization of [18F]FDG-PET/MR data as a “combined diffusivity–metabolic index” (cDMI). The clinical value of the optimized PET/MR biomarker can thus be tested in future PET/MR studies. Full article
(This article belongs to the Special Issue New Trends and Advances of MRI and PET Hybrid Imaging in Diagnostics)
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14 pages, 4330 KiB  
Article
Patlak Slope versus Standardized Uptake Value Image Quality in an Oncologic PET/CT Population: A Prospective Cross-Sectional Study
by Semra Ince, Richard Laforest, Malak Itani, Vikas Prasad, Saeed Ashrafinia, Anne M. Smith, Richard L. Wahl and Tyler J. Fraum
Diagnostics 2024, 14(9), 883; https://doi.org/10.3390/diagnostics14090883 - 24 Apr 2024
Cited by 1 | Viewed by 841
Abstract
Patlak slope (PS) images have the potential to improve lesion conspicuity compared with standardized uptake value (SUV) images but may be more artifact-prone. This study compared PS versus SUV image quality and hepatic tumor-to-background ratios (TBRs) at matched time points. Early and late [...] Read more.
Patlak slope (PS) images have the potential to improve lesion conspicuity compared with standardized uptake value (SUV) images but may be more artifact-prone. This study compared PS versus SUV image quality and hepatic tumor-to-background ratios (TBRs) at matched time points. Early and late SUV and PS images were reconstructed from dynamic positron emission tomography (PET) data. Two independent, blinded readers scored image quality metrics (a four-point Likert scale) and counted tracer-avid lesions. Hepatic lesions and parenchyma were segmented and quantitatively analyzed. Differences were assessed via the Wilcoxon signed-rank test (alpha, 0.05). Forty-three subjects were included. For overall quality and lesion detection, early PS images were significantly inferior to other reconstructions. For overall quality, late PS images (reader 1 [R1]: 3.95, reader 2 [R2]: 3.95) were similar (p > 0.05) to early SUV images (R1: 3.88, R2: 3.84) but slightly superior (p ≤ 0.002) to late SUV images (R1: 2.97, R2: 3.44). For lesion detection, late PS images were slightly inferior to late SUV images (R1 only) but slightly superior to early SUV images (both readers). PS-based TBRs were significantly higher than SUV-based TBRs at the early time point, with opposite findings at the late time point. In conclusion, late PS images are similar to early/late SUV images in image quality and lesion detection; the superiority of SUV versus PS hepatic TBRs is time-dependent. Full article
(This article belongs to the Special Issue New Trends and Advances of MRI and PET Hybrid Imaging in Diagnostics)
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11 pages, 3835 KiB  
Article
Additional Value of FDG-PET/MRI Complementary to Sentinel Lymphonodectomy for Minimal Invasive Lymph Node Staging in Patients with Endometrial Cancer: A Prospective Study
by Matthias Weissinger, Lidia Bala, Sara Yvonne Brucker, Stefan Kommoss, Sascha Hoffmann, Ferdinand Seith, Konstantin Nikolaou, Christian la Fougère, Christina Barbara Walter and Helmut Dittmann
Diagnostics 2024, 14(4), 376; https://doi.org/10.3390/diagnostics14040376 - 9 Feb 2024
Viewed by 1328
Abstract
Background: Lymph node metastases (LNM) are rare in early-stage endometrial cancer, but a diagnostic systematic lymphadenectomy (LNE) is often performed to achieve reliable N-staging. Therefore, this prospective study aimed to evaluate the benefit of [18F]-Fluorodeoxyglucose (FDG) PET/MRI complementary to SPECT/CT guided sentinel lymphonodectomy [...] Read more.
Background: Lymph node metastases (LNM) are rare in early-stage endometrial cancer, but a diagnostic systematic lymphadenectomy (LNE) is often performed to achieve reliable N-staging. Therefore, this prospective study aimed to evaluate the benefit of [18F]-Fluorodeoxyglucose (FDG) PET/MRI complementary to SPECT/CT guided sentinel lymphonodectomy (SLNE) for a less invasive N-staging Methods: 79 patients underwent a whole-body FDG-PET/MRI, SLN mapping with 99mTc-Nanocolloid SPECT/CT and indocyanine green (ICG) fluoroscopy followed by LNE which served as ground truth. Results: FDG-PET/MRI was highly specific in N-staging (97.2%) but revealed limited sensitivity (66.7%) due to missed micrometastases. In contrast, bilateral SLN mapping failed more often in patients with macrometastases. The combination of SLN mapping and FDG-PET/MRI increased the sensitivity from 66.7% to 77.8%. Additional SLN labeling with dye (ICG) revealed a complete SLN mapping in 80% (8/10) of patients with failed or incomplete SLN detection in SPECT/CT, reducing the need for diagnostic systematic LNE up to 87%. FDG-PET/MRI detected para-aortic LNM in three out of four cases and a liver metastasis. Conclusions: The combination of FDG-PET/MRI and SLNE can reduce the need for diagnostic systematic LNE by up to 87%. PET/MRI complements the SLN technique particularly in the detection of para-aortic LNM and occasional distant metastases. Full article
(This article belongs to the Special Issue New Trends and Advances of MRI and PET Hybrid Imaging in Diagnostics)
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Review

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28 pages, 1541 KiB  
Review
Current Trends and Applications of PET/MRI Hybrid Imaging in Neurodegenerative Diseases and Normal Aging
by Jonathan Lee, Jonathan Renslo, Kasen Wong, Thomas G. Clifford, Bryce D. Beutler, Paul E. Kim and Ali Gholamrezanezhad
Diagnostics 2024, 14(6), 585; https://doi.org/10.3390/diagnostics14060585 - 10 Mar 2024
Viewed by 2248
Abstract
Dementia is a significant global health issue that is exacerbated by an aging population. Imaging plays an established role in the evaluation of patients with neurocognitive disorders such as dementia. In current clinical practice, magnetic resonance imaging (MRI) and positron emission tomography (PET) [...] Read more.
Dementia is a significant global health issue that is exacerbated by an aging population. Imaging plays an established role in the evaluation of patients with neurocognitive disorders such as dementia. In current clinical practice, magnetic resonance imaging (MRI) and positron emission tomography (PET) are primary imaging modalities used separately but in concert to help diagnose and classify dementia. The clinical applications of PET/MRI hybrid imaging in dementia are an active area of research, particularly given the continued emergence of functional MRI (fMRI) and amyloid PET tracers. This narrative review provides a comprehensive overview of the rationale and current evidence for PET/MRI hybrid dementia imaging from 2018 to 2023. Hybrid imaging offers advantages in the accuracy of characterizing neurodegenerative disorders, and future research will need to address the cost of integrated PET/MRI systems compared to stand-alone scanners, the development of new biomarkers, and image correction techniques. Full article
(This article belongs to the Special Issue New Trends and Advances of MRI and PET Hybrid Imaging in Diagnostics)
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