Combined PET/MR: The Real Work Has Just Started. Summary Report of the Third International Workshop on PET/MR Imaging; February 17-21, 2014, Tübingen, Germany

D L Bailey, G Antoch, P Bartenstein, H Barthel, A J Beer, S Bisdas, D A Bluemke, R Boellaard, C D Claussen, C Franzius, M Hacker, H Hricak, C la Fougère, B Gückel, S G Nekolla, B J Pichler, S Purz, H H Quick, O Sabri, B Sattler, J Schäfer, H Schmidt, J van den Hoff, S Voss, W Weber, H F Wehrl, T Beyer, D L Bailey, G Antoch, P Bartenstein, H Barthel, A J Beer, S Bisdas, D A Bluemke, R Boellaard, C D Claussen, C Franzius, M Hacker, H Hricak, C la Fougère, B Gückel, S G Nekolla, B J Pichler, S Purz, H H Quick, O Sabri, B Sattler, J Schäfer, H Schmidt, J van den Hoff, S Voss, W Weber, H F Wehrl, T Beyer

Abstract

This paper summarises the proceedings and discussions at the third annual workshop held in Tübingen, Germany, dedicated to the advancement of the technical, scientific and clinical applications of combined PET/MRI systems in humans. Two days of basic scientific and technical instructions with "hands-on" tutorials were followed by 3 days of invited presentations from active researchers in this and associated fields augmented by round-table discussions and dialogue boards with specific themes. These included the use of PET/MRI in paediatric oncology and in adult neurology, oncology and cardiology, the development of multi-parametric analyses, and efforts to standardise PET/MRI examinations to allow pooling of data for evaluating the technology. A poll taken on the final day demonstrated that over 50 % of those present felt that while PET/MRI technology underwent an inevitable slump after its much-anticipated initial launch, it was now entering a period of slow, progressive development, with new key applications emerging. In particular, researchers are focusing on exploiting the complementary nature of the physiological (PET) and biochemical (MRI/MRS) data within the morphological framework (MRI) that these devices can provide. Much of the discussion was summed up on the final day when one speaker commented on the state of PET/MRI: "the real work has just started".

Figures

Fig. 1
Fig. 1
Illustration of the concept of multi-parametric imaging providing multiple layers of information that can be combined (or extracted) into probability maps (based on machine learning), image-based representations of selected information or other information. sFCM spatially constrained fuzzy c-means, SVM support vector machine (with support of Dr. Gatidis, Tübingen).
Fig. 2
Fig. 2
The IEC 61675–1 standard body-phantom: a For imaging, the phantom can be filled with fluid and tracer. Examples of inhomogeneous MR excitation in water (b) and inhomogeneous PET-tracer distribution in oil-based substances (c) in the described phantom are shown in the images on the right.
Fig. 3
Fig. 3
Current recommended applications of PET/MRI in paediatric oncology. Note that separate chest CT (all indications) may be omitted if MRI clearly demonstrates pulmonary manifestations and if allowed by protocol (*if required by protocol or in the case of inconclusive MRI).
Fig. 4
Fig. 4
An example of psoriatic arteritis imaged with simultaneous [18F]FDG-PET/MRI: a MRI, b fused PET and MR, and c PET.

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