title: Hybrid imaging of the bowel using PET/MR enterography: Feasibility and first results.
abstract: OBJECTIVE
  To implement a protocol for PET/MR enterography for a multimodal assessment of intestinal pathologies.
  
  
  METHODS
  19 patients with bowel malignancies, Crohn's disease or fever of unknown origin (male: n=14, female: n=5, age: 57±13years) underwent PET/MR enterography with either [(18)F]FDG (n=10) or [(68)Ga]-DOTATOC (n=9) using an integrated scanner. For small bowel distension a contrast solution (1500 cm(3) of mannitol and locust bean gum) was ingested. The following sequences were acquired: (a) coronal TrueFISP; (b) coronal T2w HASTE; (c) coronal dynamic T1w VIBE; (d) axial and coronal T1w FLASH post gadolinium. All datasets were reviewed by two readers with regard to co-registration of anatomical structures based on a 3-point ordinal scale as well as overall image quality using a 4-point ordinal scale. Furthermore, visualization of intestinal and extra-intestinal pathologies was assessed.
  
  
  RESULTS
  PET/MR enterography was well tolerated by all patients. High overall MR image quality was achieved (mean score: 3.2±0.6) with good co-registration of PET and MRI (mean scores: 2.6 to 3.0). PET/MR enterography allowed for an excellent visualization of both intestinal as well as extra-intestinal pathologies.
  
  
  CONCLUSIONS
  PET/MR enterography is technically feasible and offers good co-registration of bowel structures. This novel method enables a multimodal assessment of bowel lesions in malignant and inflammatory disease.
authors.affiliation: Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147 Essen, Germany. Electronic address: karsten.beiderwellen@uk-essen.de.
authors.forename: Karsten
authors.initials: K
authors.lastname: Beiderwellen
authors.affiliation: Department of Radiology, School of Medicine and Public Health, University of Wisconsin, E3/366 Clinical Science Center, 600 Highland Avenue, Madison, WI 53792-3252, United States.
authors.forename: Sonja
authors.initials: S
authors.lastname: Kinner
authors.affiliation: Clinic for Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147 Essen, Germany.
authors.forename: Benedikt
authors.initials: B
authors.lastname: Gomez
authors.affiliation: Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147 Essen, Germany.
authors.forename: Lukas
authors.initials: L
authors.lastname: Lenga
authors.affiliation: Clinic for Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147 Essen, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Bellendorf
authors.affiliation: Department of Diagnostic and Interventional Radiology, University of Dusseldorf, Moorenstraße 5, 40225 Dusseldorf, Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Heusch
authors.affiliation: Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147 Essen, Germany.
authors.forename: Lale
authors.initials: L
authors.lastname: Umutlu
authors.affiliation: Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, University of Duisburg-Essen, Am Deimelsberg 34a, 45276 Essen, Germany.
authors.forename: Jost
authors.initials: J
authors.lastname: Langhorst
authors.affiliation: Division of Gastroenterology and Metabolic Diseases, Kliniken Essen-Sued, University of Duisburg-Essen, Propsteistraße 2, 45239 Essen, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Ruenzi
authors.affiliation: Division of Gastroenterology and Hepatology, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147 Essen, Germany.
authors.forename: Guido
authors.initials: G
authors.lastname: Gerken
authors.affiliation: Clinic for Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147 Essen, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Bockisch
authors.affiliation: Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147 Essen, Germany.
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Lauenstein
mesh_terms: D003287:Contrast Media; D005240:Feasibility Studies; D005260:Female; D019788:Fluorodeoxyglucose F18; D005710:Gallium Radioisotopes; D006801:Humans; D007089:Image Enhancement; D007410:Intestinal Diseases / Q000000981:diagnostic imaging* / Q000473:pathology*; D007422:Intestines / Q000000981:diagnostic imaging / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D015282:Octreotide / Q000031:analogs & derivatives; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals
chemical_list: D003287:Contrast Media; D005710:Gallium Radioisotopes; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D015282:Octreotide; C106246:Edotreotide
keywords: Large bowel; PET/MR; Small bowel