Abstract:
Multimodality imaging has made great strides in the imaging evaluation of patients with a variety of diseases. Positron emission tomography (PET) combined with magnetic resonance imaging (MRI) is a hybrid technology which has recently gained interest as a potential cancer imaging tool. PET/MRI combines the unique features of MRI including excellent soft tissue contrast, diffusion-weighted imaging, dynamic cAontrast-enhanced imaging, fMRI and other specialized sequences as well as MR spectroscopy with the quantitative physiologic information that is provided by PET. Most evidence for the potential clinical utility of PET/MRI is based on studies performed with side-by-side comparison or software-fused MRI and PET images. Data on distinctive utility of hybrid PET/MRI are rapidly emerging. There are potential competitive advantages of PET/MRI over other molecular imaging modalities due to its lower ionizing radiation dose. These initial data convey that PET/MRI is promising in neurooncology and head & neck cancer applications as well as neoplasms in the abdomen and pelvis. The pediatric and young adult oncology population requiring frequent follow-up studies as well as pregnant woman might benefit from PET/MRI due to its lower ionizing radiation dose. This research dissertation reviews available literature to explain initial experience in illustrated cases done with simultaneous PET/MRI and discuss its potential for several clinical applications in oncology and other aspects. This has become more important as the role of PET/MRI in cancer management provides more accurate measurements of size and position of tumors. Also, the research dissertation reviews new tracers that can be involved by different radiotracers to evaluate other processes in cancer diseases.
Conclusion:
PET/MRI is one of the most exciting developments in imaging in recent years. There is a promising new technology with early studies suggesting that it may have a role in most aspects of oncology, neurology and cardiac imaging for this modality to develop, although widely accepted clinical indications remain to be defined. Although some studies have not shown a clear advantage over PET/CT, there is some evidence that it will have an advantage in selected body sites such as the head and neck, liver, and the pelvis. PET/MRI shows promise for multiple clinical applications through the combination of the improved soft tissue contrast of MRI with lower radiation dose, and the potential for better correlation of PET findings to anatomy given the simultaneous acquisition. Another benefit will be logistical by allowing selected patients to undergo a comprehensive one-stop examination rather than separate studies. The growing use of novel tracers and functional MRI parameters offers great potential benefit; this is especially evident in research but there are also various clinical applications in which optimal molecular information might be acquired, guiding the management of patients. Although only very few studies on optimization of protocols and workflow have been published so far, initial data on possible clinical application of hybrid PET/MRI are emerging with interesting and promising results. PET/MRI protocols have the potential to improve patient care by reducing radiation dose, reducing hospital visits, and shows great potential advantages for tumor detection and monitoring with potentially providing new and more specific/sensitive markers for disease assessment.
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