title: Workflow and scan protocol considerations for integrated whole-body PET/MRI in oncology.
abstract: Integrated PET/MRI systems open exciting possibilities for clinical and research applications. However, compared with PET/CT, PET/MRI is a complex technique resulting in new problems and challenges, especially regarding workflow, scan protocols, and data analysis. This complexity applies in particular to examinations in oncology with partial- or whole-body coverage extending over several bed positions. Unlike diagnostic PET/CT, for which the clinical CT protocols can largely be copied from stand-alone CT, the design of a diagnostic MRI protocol for partial- or whole-body coverage is more complex and has to be adapted to the special requirements of PET/MRI to be both time-efficient and comprehensive. Here, we describe basic considerations concerning workflow, imaging protocols, and image analysis for whole-body PET/MRI in oncology, based on our experience with the first integrated PET/MRI scanner. The aim is to fully and optimally make use of the combined PET/MRI measurements in oncology, including identifying and reducing image artifacts as well as optimizing workflow beyond the mere fusion of 2 image datasets.
authors.affiliation: Department of Nuclear Medicine, Technische Universität München, Munich, Germany.
authors.forename: Axel
authors.initials: A
authors.lastname: Martinez-Möller
authors.forename: Matthias
authors.initials: M
authors.lastname: Eiber
authors.forename: Stephan G
authors.initials: SG
authors.lastname: Nekolla
authors.forename: Michael
authors.initials: M
authors.lastname: Souvatzoglou
authors.forename: Alexander
authors.initials: A
authors.lastname: Drzezga
authors.forename: Sibylle
authors.initials: S
authors.lastname: Ziegler
authors.forename: Ernst J
authors.initials: EJ
authors.lastname: Rummeny
authors.forename: Markus
authors.initials: M
authors.lastname: Schwaiger
authors.forename: Ambros J
authors.initials: AJ
authors.lastname: Beer
mesh_terms: D016477:Artifacts; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009367:Neoplasm Staging; D009369:Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D009934:Organization and Administration; D049268:Positron-Emission Tomography / Q000379:methods*; D018511:Systems Integration; D051598:Whole Body Imaging / Q000379:methods*; D057188:Workflow