Clinical PET/MRI (Sep 21, 2022)_(0323885373)_(Academic Press)

Clinical PET/MR presents the state-of-the-art of PET/MR, guiding the reader from how to scan patients, how to read and report the studies, and how keep an eye on what is clinically relevant for a patient's care. Each chapter starts with the clinical scenario and then moves to pertinent imaging, addressing the need of a clinical PET/MR book written by world experts in both clinical and imaging fields. It discusses the clinical application of PET/MR in diverse subspecialties such as head and neck, neurology, cardiovascular, pediatrics, chest, bone, hematology, breast, hepatobiliary pancreatic, genitourinary, gynecology, and gastrointestinal tract. This book is a valuable resource for radiologists, oncologists and members of the biomedical field who need to learn more about clinical applications of PET/MR. Presents a description of robust acquisition protocols to teach readers how to scan PET/MR patients, from tracers to sequences Provides a clinical background section in each chapter to help readers focus on the real clinical issues that need to be addressed in the medical report Written by world authorities in the field in a didactic manner to describe the real status of imaging Cover Clinical PET/MRI Copyright Dedication Contributors 1. PET/MRI: technical and methodological aspects Introduction Integrated PET/MRI systems Traditional approaches to address challenges and enable opportunities Attenuation correction Head attenuation correction Whole-body attenuation correction Motion correction Head motion correction Respiratory motion correction Cardio-respiratory heart motion correction Bulk motion correction Image enhancement Deep learning approaches to address challenges and enable opportunities Attenuation correction Motion correction Image enhancement Conclusions References 2. Radiopharmaceuticals and contrast agents Introduction to PET radiopharmaceuticals and radionuclides Selected clinically-relevant PET radiopharmaceuticals 18F- fluorodeoxyglucose (FDG) Introduction and mechanism of uptake Indications/uses Patient preparation Dietary preparation Activity restriction Glucose levels and diabetes Environmental precautions Radiopharmaceutical administration and postinjection wait period Normal biodistribution Pitfalls 68Ga-DOTATATE, 64Cu-DOTATATE and 68Ga-DOTATOC Introduction and mechanism of uptake Indications/uses Patient preparation Radiopharmaceutical administration and image acquisition Normal biodistribution PET interpretation Pitfalls 18F-fluciclovine Introduction and mechanism of uptake Indications/uses Patient preparation Radiopharmaceutical administration and image acquisition Normal biodistribution PET interpretation Pitfalls 68Ga and 18F labeled Prostate-Specific Membrane Antigen (PSMA)-targeted radiopharmaceuticals Introduction and mechanism of uptake Indications/uses Patient preparation Radiopharmaceutical administration and image acquisition Normal biodistribution PET interpretation Pitfalls 18F-fluoride Introduction and mechanism of uptake Indications/uses Patient preparation Radiopharmaceutical administration and imaging acquisition Normal biodistribution PET interpretation Pitfalls 18F-fluorodopa Introduction and mechanism of uptake Indications/uses Patient preparation Radiopharmaceutical administration and image acquisition Normal biodistribution/PET interpretation Pitfalls 18F-fluoroestradiol (FES) Introduction and mechanism of uptake Indications/uses Patient preparation Radiopharmaceutical administration and image acquisition Normal biodistribution Pitfalls 68Ga- fibroblast activation protein inhibitor (FAPI) Introduction and mechanism of uptake Indications/uses Patient preparation Radiopharmaceutical administration and image acquisition Normal biodistribution Pitfalls 11C-choline and 18F-choline Introduction and mechanism of uptake Indications/uses Patient preparation Radiopharmaceutical administration and image acquisition Normal biodistribution Pitfalls Other PET radiopharmaceuticals Common clinically-utilized MRI contrast agents Gadolinium-based contrast agents Safety A practical classification of GBCAs References 3. Head and neck imaging Introduction Current role of imaging in patients with known or suspected head and neck cancer Computed tomography Magnetic resonance imaging Ultrasound Positron emission tomography/computed tomography PET/MRI in head and neck cancer PET/MRI versus PET/CT PET/MRI protocol in head and neck cancer Evaluation of tumor extent Workup for carcinoma of unknown primary Lymph node evaluation Follow-up after treatment Tumors other than squamous cell carcinomas in the head and neck region Evaluation of distant metastases and secondary cancers Pitfalls of PET/MRI Future directions of PET/MRI in the head and neck Conclusion References 4. Neurologic imaging Introduction Protocols Sequences PET and radiopharmaceuticals Neurodegenerative disorders Current standard of care imaging PET/MRI in neurodegenerative disorders Brain tumors Current standard of care imaging PET/MRI in brain tumors Epilepsy Current standard of care imaging PET/MRI in epilepsy Acknowledgments References 5. Cardiovascular imaging Introduction Detection of coronary artery disease Keypoints Assessment of tissue viability and infarct size Key points Assessment of inflammatory response to acute ischemic injury Keypoints Myocarditis Keypoints Assessment of cardiac amyloidosis Keypoints Sarcoidosis Key points Assessment of cardiac fibrosis Keypoints Technical challenges of cardiac PET/MR Summary Acknowledgments References 6. Pediatrics imaging Introduction Imaging protocol Patient preparation Radiotracer PET/MRI protocol MRI contrast agent Lymphomas Clinical background Diagnosis 18F-FDG-PET/MRI Ewing sarcoma Clinical background Diagnosis 18F-FDG-PET/MRI Osteosarcoma Clinical background Diagnosis 18F-FDG-PET MRI Conventional osteosarcoma Telangiectatic osteosarcoma Juxtacortical osteosarcoma Parosteal osteosarcoma Periosteal osteosarcoma High-grade surface osteosarcoma Initial staging Treatment monitoring Soft tissue sarcomas Clinical background Diagnosis Rhabdomyosarcoma (RMS) Embryonal RMS Alveolar RMS Pleomorphic RMS Synovial sarcoma Desmoplastic small round blue cell tumor (DSRCT) Fibrosarcoma Epithelioid sarcoma Alveolar soft part sarcoma Liposarcoma Soft tissue Ewing sarcoma Malignant peripheral nerve sheath tumors Clinical background Diagnosis Criteria for MPNST Local staging Whole-body staging Future developments Neuroblastoma Clinical background Diagnosis and staging Criteria 123I-MIBG versus 18F-FDG Future directions Other adrenal gland tumors Neuroendocrine tumors Clinical background Diagnosis and staging Gastro-entero-pancreatic NETs (GEP-NETs) Lung and thymic carcinoid tumor Paraganglioma and pheochromocytoma Germ cell tumors Clinical background Tumor detection Treatment monitoring Follow-up imaging after completion of therapy Renal tumors Clinical background Diagnosis and 18F-FDG PET/MRI Malignant liver tumors Clinical background Diagnosis Hepatoblastoma Conventional HCC Fibrolamellar HCC 18F-FDG-PET/MRI PRE-treatment EXTent of tumor (PRETEXT) Langerhans cell histiocytosis Clinical background Diagnosis and staging MRI findings 18F-FDG PET/MRI Summary and conclusion Acknowledgments References 7. Thoracic imaging Clinical management of malignancies of the chest Lung cancer Pulmonary metastases PET/MRI of malignancies of the chest Technical considerations and protocols Current clinical PET/MRI aspects Newest developments and outlook References 8. Musculoskeletal imaging Primary bone and soft tissue malignancies Staging Monitoring treatment response and recurrence detection Prognosis Primary bone and soft tissue lesions Metastatic disease to the skeleton 18F FDG PET/MRI Non 18F-FDG tracers 68Ga-DOTATATE, 68Ga-DOTATOC, and 68Ga-DOTANOC Nononcological indications Osteoarthritis Rheumatoid arthritis Osteomyelitis References 9. Hematologic imaging Introduction PET/MRI protocols overview Lymphoma Histology and clinical background Current imaging state of the art Lymphoma staging Treatment response assessment in lymphoma PET/MRI in lymphoma: current status Myeloma Histology and clinical background Current imaging state of the art and staging Myeloma treatment response assessment PET/MRI in myeloma: current status Novel PET tracers in blood cancers Summary References 10. Breast imaging Introduction Breast PET/MRI acquisition technique Acquisition protocol Breast 18F-FDG PET/MRI Whole-body 18F-FDG PET/MRI Tracers Imaging Breast cancer staging Breast cancer diagnosis (benign vs. malignant) Tumor characterization Neoadjuvant chemotherapy (response assessment and early prediction of treatment response) Future perspectives: radiomics and artificial intelligence Pitfalls and strengths Acknowledgments References 11. Hepatobiliary and pancreatic imaging Introduction Protocols Sequences Radiopharmaceuticals Primary hepatic malignancies Hepatocellular carcinoma Current standard of care imaging PET/MRI in hepatocellular carcinoma Cholangiocarcinoma Current standard of care imaging PET/MRI in cholangiocarcinoma Pancreatic cancer Pancreatic adenocarcinoma Current standard of care imaging PET/MRI in pancreatic adenocarcinoma Pancreatic neuroendocrine tumor Novel and alternative radiotracers PET/MRI in pancreatic neuroendocrine tumors Liver metastases Current standard of care imaging PET/MRI in the diagnosis of liver metastases Miscellaneous pancreaticobiliary malignancies References 12. Genitourinary imaging Introduction PET/MRI protocol Adrenal masses Clinical overview Utility of PET/MRI Renal cell carcinoma Clinical overview Utility of PET/MRI Urothelial cancer Clinical overview Utility of PET/MRI Prostate cancer Clinical overview Utility of PET/MRI Conclusion References 13. Gynecologic imaging Introduction PET/MRI protocol Uterine cervical cancer Clinical overview PET/MRI for initial staging PET/MRI for other clinical indications Uterine endometrial cancer Clinical overview PET/MRI for initial staging PET/MRI for prognosis Ovarian cancer Clinical overview PET/MRI for initial staging PET/MRI for other clinical indications Vaginal cancer Clinical overview Utility of PET/MRI Vulvar cancer Clinical overview Utility of PET/MRI Summary References 14. Gastrointestinal imaging Introduction Acquisition protocols GI malignancies Inflammatory bowel disease Esophageal cancer Clinical overview Current imaging modalities PET/MRI in esophageal cancer Staging PET/MRI-derived imaging biomarkers Summary Gastric cancer Clinical overview PET/MRI in gastric cancer Summary Colorectal cancer Clinical overview PET/MRI in colorectal cancer Summary Anal cancer Clinical overview PET/MRI in anal cancer Inflammatory bowel disease Overview Current imaging modalities Crohn disease Clinical overview PET/MRI in Crohn disease Ulcerative colitis Clinical overview PET/MRI in ulcerative colitis Summary References 15. Radiomics and artificial intelligence Introduction PET/MRI radiomics in brain tumors Definition of WHO grade in patients with newly diagnosed gliomas Determination of the IDH genotype and 1p/19q codeletion status in patients with newly diagnosed gliomas Determination of the MGMT promoter methylation status Prediction of progression-free survival (PFS) and overall survival (OS) Differentiation between tumor progression and pseudoprogression Differentiation between treatment-related changes and local tumor recurrence in patients with brain metastases PET/MRI radiomics in breast cancer Prediction of axillary or sentinel lymph node metastasis Prediction of neoadjuvant chemotherapy response Differentiation between benign and malignant lesion Additional purposes PET/MRI radiomics in pancreatic neuroendocrine tumors Definition of PanNETs characteristics, tumor behavior, and aggressiveness Prediction of treatment response PET/MRI radiomics in prostate cancer Prostate cancer detection Prostate cancer grading Prediction of extraprostatic extension Metastases detection and prediction Treatment monitoring Prediction of biochemical recurrence Artificial intelligence for attenuation correction in PET/MR images Types of convolutional neural networks Attenuation correction from diagnostic MR sequences Attenuation correction from dedicated MR sequences GANs for attenuation correction Conclusions References Index