Multimodal imaging utilising integrated MR-PET for human brain tumour assessment.
OBJECTIVE
The development of integrated magnetic resonance (MR)-positron emission tomography (PET) hybrid imaging opens up new horizons for imaging in neuro-oncology. In cerebral gliomas the definition of tumour extent may be difficult to ascertain using standard MR imaging (MRI) only. The differentiation of post-therapeutic scar tissue, tumour rests and tumour recurrence is challenging. The relationship to structures such as the pyramidal tract to the tumour mass influences the therapeutic neurosurgical approach.


METHODS
The diagnostic information may be enriched by sophisticated MR techniques such as diffusion tensor imaging (DTI), multiple-volume proton MR spectroscopic imaging (MRSI) and functional MRI (fMRI). Metabolic imaging with PET, especially using amino acid tracers such as (18)F-fluoroethyl-L-tyrosine (FET) or (11)C-L-methionine (MET) will indicate tumour extent and response to treatment.


RESULTS
The new technologies comprising MR-PET hybrid systems have the advantage of providing comprehensive answers by a one-stop-job of 40-50 min. The combined approach provides data of different modalities using the same iso-centre, resulting in optimal spatial and temporal realignment. All images are acquired exactly under the same physiological conditions.


CONCLUSIONS
We describe the imaging protocol in detail and provide patient examples for the different imaging modalities such as FET-PET, standard structural imaging (T1-weighted, T2-weighted, T1-weighted contrast agent enhanced), DTI, MRSI and fMRI.


CONCLUSIONS
Hybrid MR-PET opens up new horizons in neuroimaging. Hybrid MR-PET allows brain tumour assessment in one stop. Hybrid MR-PET allows simultaneous acquisition of structural, functional and molecular images.
Institute of Neuroscience and Medicine 4, INM 4, Forschungszentrum Jülich, 52428, Jülich, Germany. i.neuner@fz-juelich.de
Irene
I
Neuner
Joachim B
JB
Kaffanke
Karl-Josef
KJ
Langen
Elena Rota
ER
Kops
Lutz
L
Tellmann
Gabriele
G
Stoffels
Christoph
C
Weirich
Christian
C
Filss
Jürgen
J
Scheins
Hans
H
Herzog
N Jon
NJ
Shah
D000328:Adult; D001254:Astrocytoma / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D001706:Biopsy; D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D005910:Glioma / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D016012:Poisson Distribution; D049268:Positron-Emission Tomography / Q000295:instrumentation / Q000379:methods*; D019275:Radiopharmaceuticals
D003287:Contrast Media; D019275:Radiopharmaceuticals