Imaging of Bone in the Head and Neck Region, is There More Than CT?

Purpose Of Review: The objective of this review is to document the advances in non-ionising imaging alternatives to CT for the head and neck.

Recent Findings: The main alternative to CT for imaging bone of the head and neck region is MRI, particularly techniques which incorporate gradient echo imaging (Black Bone technique) and ultra-short or zero-echo time imaging. Since these techniques can provide high resolution isometric voxels, they can be used to provide multi-planar reformats and, following post processing, 3D reconstructed images of the craniofacial skeleton.

Reproducibility of Standardized Uptake Values Including Volume Metrics Between TOF-PET-MR and TOF-PET-CT.

Purpose: To investigate the reproducibility of tracer uptake measurements, including volume metrics, such as metabolic tumor volume (MTV) and tumor lesion glycolysis (TLG) obtained by TOF-PET-CT and TOF-PET-MR.

Materials And Methods: Eighty consecutive patients with different oncologic diagnoses underwent TOF-PET-CT (Discovery 690; GE Healthcare) and TOF-PET-MR (SIGNA PET-MR; GE Healthcare) on the same day with single dose-18F-FDG injection. The scan order, PET-CT following or followed by PET-MR, was randomly assigned.

Improving the robustness of MOLLI T1 maps with a dedicated motion correction algorithm.

Myocardial tissue T1 constitutes a reliable indicator of several heart diseases related to extracellular changes (e.g. edema, fibrosis) as well as fat, iron and amyloid content.

How to Design AI-Driven Clinical Trials in Nuclear Medicine.

Artificial intelligence (AI) is an overarching term for a multitude of technologies which are currently being discussed and introduced in several areas of medicine and in medical imaging specifically. There is, however, limited literature and information about how AI techniques can be integrated into the design of clinical imaging trials. This article will present several aspects of AI being used in trials today and how imaging departments and especially nuclear medicine departments can prepare themselves to be at the forefront of AI-driven clinical trials.

Zero Echo Time MRAC on FDG-PET/MR Maintains Diagnostic Accuracy for Alzheimer's Disease; A Simulation Study Combining ADNI-Data.

Aim: Attenuation correction using zero-echo time (ZTE) - magnetic resonance imaging (MRI) (ZTE-MRAC) has become one of the standard methods for brain-positron emission tomography (PET) on commercial PET/MR scanners. Although the accuracy of the net tracer-uptake quantification based on ZTE-MRAC has been validated, that of the diagnosis for dementia has not yet been clarified, especially in terms of automated statistical analysis. The aim of this study was to clarify the impact of ZTE-MRAC on the diagnosis of Alzheimer's disease (AD) by performing simulation study.

Three-dimensional magnetic resonance imaging ultrashort echo-time cones for assessing lung density in pediatric patients.

Background: MRI of lung parenchyma is challenging because of the rapid decay of signal by susceptibility effects of aerated lung on routine fast spin-echo sequences.

Objective: To assess lung signal intensity in children on ultrashort echo-time sequences in comparison to a fast spin-echo technique.

Materials And Methods: We conducted a retrospective study of lung MRI obtained in 30 patients (median age 5 years, range 2 months to 18 years) including 15 with normal lungs and 15 with cystic fibrosis.

Automated 3D MRI rendering of the craniofacial skeleton: using ZTE to drive the segmentation of black bone and FIESTA-C images.

Purpose: Automated bone segmentation from MRI datasets would have a profound impact on clinical utility, particularly in the craniofacial skeleton where complex anatomy is coupled with radiosensitive organs. Techniques such as gradient echo black bone (GRE-BB) and short echo time (UTE, ZTE) have shown potential in this quest. The objectives of this study were to ascertain (1) whether the high-contrast of zero echo time (ZTE) could drive segmentation of high-resolution GRE-BB data to enhance 3D-output and (2) if these techniques could be extrapolated to ZTE driven segmentation of a routinely used non bone-specific sequence (FIESTA-C).

Enhancing Distraction Osteogenesis With Carbon Fiber Reinforced Polyether Ether Ketone Bone Pins and a Three-Dimensional Printed Transfer Device to Permit Artifact-Free Three-Dimensional Magnetic Resonance Imaging.

Objectives: To: (1) design an artifact-free 3D-printed MR-safe temporary transfer device, (2) engineer bone-pins from carbon fiber reinforced polyether ether ketone (CFR-PEEK), (3) evaluate the imaging artifacts of CFR-PEEK, and (4) confirm the osteointegration potential of CFR-PEEK, thus enhancing 3D-planning of bony advancements in hemifacial microsomia using sequential magnetic resonance imaging (MRI).

Study Design: Engineered CRF-PEEK bone pins and a 3D printed ex-fix device were implanted into a sheep head and imaged with MRI and computed tomography . The osseointegration and bony compatibility potential of CFR-PEEK was assessed with scanning electron microscopy images of MC3T3 preosteoblast cells on the surface of the material.

Automated Segmentation of the Craniofacial Skeleton With "Black Bone" Magnetic Resonance Imaging.

Three-dimensional (3D) imaging of the craniofacial skeleton is integral in managing a wide range of bony pathologies. The authors have previously demonstrated the potential of "Black Bone" MRI (BB) as a non-ionizing alternative to CT. However, even in experienced hands 3D rendering of BB datasets can be challenging and time consuming.

The impact of atlas-based MR attenuation correction on the diagnosis of FDG-PET/MR for Alzheimer's diseases- A simulation study combining multi-center data and ADNI-data.

Background: The purpose of this study was to assess the impact of vendor-provided atlas-based MRAC on FDG PET/MR for the evaluation of Alzheimer's disease (AD) by using simulated images.

Methods: We recruited 47 patients, from two institutions, who underwent PET/CT and PET/MR (GE SIGNA) examination for oncological staging. From the PET raw data acquired on PET/MR, two FDG-PET series were generated, using vendor-provided MRAC (atlas-based) and CTAC.

Ga-PSMA-11 dose reduction for dedicated pelvic imaging with simultaneous PET/MR using TOF BSREM reconstructions.

Objectives: When increasing the PET acquisition time to match the longer MRI protocol in simultaneous PET/MR, the injected PET tracer dose can possibly be lowered to reduce radiation exposure. Moreover, applying new commercially available time-of-flight (TOF) block sequential regularized expectation maximization (BSREM)-based reconstruction algorithms could allow for further dose reductions. The purpose of this study was to find the minimal dose of the tracer targeting the prostate specific membrane antigen (Ga-PSMA-11) for a dedicated 15-min pelvic PET/MR scan that still matches the image quality of a reference 3-min scan at 100% (150 MBq) dose.

PET image reconstruction using physical and mathematical modelling for time of flight PET-MR scanners in the STIR library.

This work demonstrates how computational and physical modelling of the positron emission tomography (PET) image acquisition process for a state-of-the-art integrated PET and magnetic resonance imaging (PET-MR) system can produce images comparable to the manufacturer. The GE SIGNA PET/MR scanner is manufactured by General Electric and has time-of-flight (TOF) capabilities of about 390 ps. All software development took place in the Software for Tomographic Image Reconstruction (STIR: http://stir.

ZTE MR-based attenuation correction in brain FDG-PET/MR: performance in patients with cognitive impairment.

Objective: One of the main challenges of integrated PET/MR is to achieve an accurate PET attenuation correction (AC), especially in brain acquisition. Here, we evaluated an AC method based on zero echo time (ZTE) MRI, comparing it with the single-atlas AC method and CT-based AC, set as reference.

Methods: Fifty patients (70 ± 11 years old, 28 men) underwent FDG-PET/MR examination (SIGNA PET/MR 3.

Role of intravoxel incoherent motion parameters in gastroesophageal cancer: relationship with 18F-FDG-positron emission tomography, computed tomography perfusion and magnetic resonance perfusion imaging parameters.

Background: Identification of pretherapeutic predictive markers in gastro-esophageal cancer is essential for individual-oriented treatment. This study evaluated the relationship of multimodality parameters derived from intravoxel incoherent motion method (IVIM), 18F-FDG-positron emission tomography (PET), computed tomography (CT) perfusion and dynamic contrast enhanced magnetic resonance imaging (MRI) in patients with gastro-esophageal cancer and investigated their histopathological correlation.

Methods: Thirty-one consecutive patients (28 males; median age 63.

A Quantitative Evaluation of Joint Activity and Attenuation Reconstruction in TOF PET/MR Brain Imaging.

Time-of-flight (TOF) PET data provide an effective means for attenuation correction (AC) when no (or incomplete or inaccurate) attenuation information is available. Since MR scanners provide little information on photon attenuation of different tissue types, AC in hybrid PET/MR scanners has always been challenging. In this contribution, we aim at validating the activity reconstructions of the maximum-likelihood ordered-subsets activity and attenuation (OSAA) reconstruction algorithm on a patient brain data set.

Black bone MRI with 3D reconstruction for the detection of skull fractures in children with suspected abusive head trauma.

Purpose: The purpose of this study was to determine the accuracy of "black bone" (BB) MRI for the detection of skull fractures in children with potential abusive head trauma.

Methods: A total of 34 pediatric patients were evaluated for potential abusive head trauma. All patients had both a non-contrast head CT (HCT) with multiplanar reformatted images and 3D volumetric reformatted images where available (gold standard) for fracture diagnosis and BB of the head with multiplanar reformatted images and 3D volumetric images.

Value of PET/MRI for assessing tumor resectability in NSCLC-intra-individual comparison with PET/CT.

Objective: The purpose of this study was to compare the diagnostic accuracy of positron emission tomography (PET)/MRI with PET/CT for determining tumor resectability of non-small cell lung cancer (NSCLC).

Methods: Sequential trimodality PET/CT/MRI was performed in 36 patients referred with the clinical question of resectability assessment in NSCLC. PET/CT and PET/MR images including weighted sequence (-Dixon) and respiration gated weighted sequence (-Propeller) were evaluated for resectability-defining factors; longest diameter of the tumor, minimal tumor distance to the carina, mediastinal invasion, invasion of the carina, pleural infiltration, pericardial infiltration, diaphragm infiltration, presence of additional nodules.

Quantitative performance and optimal regularization parameter in block sequential regularized expectation maximization reconstructions in clinical Ga-PSMA PET/MR.

Background: In contrast to ordered subset expectation maximization (OSEM), block sequential regularized expectation maximization (BSREM) positron emission tomography (PET) reconstruction algorithms can run until full convergence while controlling image quality and noise. Recent studies with BSREM and F-FDG PET reported higher signal-to-noise ratios and higher standardized uptake values (SUV). In this study, we investigate the optimal regularization parameter (β) for clinical Ga-PSMA PET/MR reconstructions in the pelvic region applying time-of-flight (TOF) BSREM in comparison to TOF OSEM.

Improving PET/MR brain quantitation with template-enhanced ZTE.

Purpose: The impact of MR-based attenuation correction on PET quantitation accuracy is an ongoing cause of concern for advanced brain research with PET/MR. The purpose of this study was to evaluate a new, template-enhanced zero-echo-time attenuation correction method for PET/MR scanners.

Methods: 30 subjects underwent a clinically-indicated F-FDG-PET/CT, followed by PET/MR on a GE SIGNA PET/MR.

Feasibility of F-FDG Dose Reductions in Breast Cancer PET/MRI.

The goal of this study was to determine the level of clinically acceptable F-FDG dose reduction in time-of-flight PET/MRI in patients with breast cancer. Twenty-six consecutive women with histologically proven breast cancer were analyzed (median age, 51 y; range, 34-83 y). Simulated dose-reduced PET images were generated by unlisting the list-mode data on PET/MRI.

WITHDRAWN: Evaluation of multifunctional imaging parameters in gastro-oesophageal cancer using F-18-FDG-PET/CT with integrated perfusion CT.

Ahead of Print article withdrawn by publisher.

Pulmonary nodule detection in oncological patients - Value of respiratory-triggered, periodically rotated overlapping parallel T2-weighted imaging evaluated with PET/CT-MR.

Purpose: To prospectively evaluate the detection and conspicuity of pulmonary nodules in an oncological population, using a tri-modality PET/CT-MR protocol including a respiration-gated T2-PROPELLER sequence for possible integration into a simultaneous PET/MR protocol.

Methods: 149 patients referred for staging of malignancy were prospectively enrolled in this single-center study. Imaging was performed on a tri-modality PET/CT-MR setup and was comprised of PET/CT and 3T-MR imaging with 3D dual-echo GRE pulse sequence (Dixon) and an axial respiration-gated T2-weighted PROPELLER (T2-P) sequence.

Reduction of F-FDG Dose in Clinical PET/MR Imaging by Using Silicon Photomultiplier Detectors.

Purpose To determine the level of clinically acceptable reduction in injected fluorine 18 (F) fluorodeoxyglucose (FDG) dose in time-of-flight (TOF)-positron emission tomography(PET)/magnetic resonance (MR) imaging by using silicon photomultiplier (SiPM) detectors compared with TOF-PET/computed tomography (CT) using Lu1.8Y0.2SiO(Ce), or LYSO, detectors in patients with different body mass indexes (BMIs).

Local resectability assessment of head and neck cancer: Positron emission tomography/MRI versus positron emission tomography/CT.

Background: The purpose of this study was to compare the diagnostic accuracy of positron emission tomography (PET)/MRI with PET/CT for local resectability of head and neck cancer.

Methods: Sequential contrast-enhanced PET/CT-MRI was performed in 58 patients referred for the staging or restaging of head and neck cancer. Tumors were assessed with PET/CT and PET/MRI for the presence of resectability-defining factors: T4b status (mediastinal invasion, invasion of the prevertebral space, and vascular encasement), and another 8 findings that would imply obstacles for surgical cure (invasion of the laryngeal cartilage, invasion of the preepiglottic fat pad, perineural spread, orbital invasion, bone infiltration, skull base invasion, dural infiltration, and invasion of the brachial plexus).

Clinical evaluation of TOF versus non-TOF on PET artifacts in simultaneous PET/MR: a dual centre experience.

Purpose: Our objective was to determine clinically the value of time-of-flight (TOF) information in reducing PET artifacts and improving PET image quality and accuracy in simultaneous TOF PET/MR scanning.

Methods: A total 65 patients who underwent a comparative scan in a simultaneous TOF PET/MR scanner were included. TOF and non-TOF PET images were reconstructed, clinically examined, compared and scored.