Abstract
Whole-body PET/MR imaging has the potential to supplement or even replace combined PET/CT imaging in selected clinical indications. In view of the lack of separate standard transmission sources in combined PET/MR imaging systems, attenuation correction (AC) of the PET data is performed using the available MR images. Given the novelty of MR-based AC (MR-AC), related image distortions and subsequent methodological pitfalls need to be recognized. Here, we review the most common artifacts observed in routine PET/MR imaging following MR-AC in either sequential or fully integrated system designs.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Kuhl DE, Edwards RQ. Image separation radioisotope scanning. Radiology. 1963;80:653–61.
Phelps ME. Emission computed tomography. Semin Nucl Med. 1977;7:337–65.
Huang SC, Hoffman EJ, Phelps ME, et al. Quantitation in positron emission computed tomography: 2. Effects of inaccurate attenuation correction. J Comput Assist Tomogr. 1979;3:804–14.
Townsend DW. Multimodality imaging of structure and function. Phys Med Biol. 2008;53:R1–39.
Beyer T, Townsend DW, Brun T, Kinahan P, Charron M, Roddy R, Jerin J, Young J, Nutt R, Byars LG. A combined PET/CT scanner for clinical oncology. J Nucl Med. 2000;41:1369–79.
Beyer T, Townsend DW, Czernin J, Freudenberg LS. The future of hybrid imaging-part 2: PET/CT. Insights Imaging. 2011;2:225–34.
Czernin J, Allen-Auerbach M, Schelbert HR. Improvements in cancer staging with PET/CT: literature-based evidence as of September 2006. J Nucl Med. 2007;48:78S–88.
von Schulthess GK. Cost considerations regarding an integrated CT-PET system. Eur Radiol. 2000;10:S377–80.
Kinahan PE, Hasegawa BH, Beyer T. X-ray-based attenuation correction for positron emission tomography/computed tomography scanners. Semin Nucl Med. 2003;33:166–79.
Pichler BJ, Wehrl HF, Judenhofer MS. Latest advances in molecular imaging instrumentation. J Nucl Med. 2008;49:5S–23.
Beyer T, Freudenberg LS, Czernin J, et al. The future of hybrid imaging-part 3: PET/MR, small-animal imaging and beyond. Insights Imaging. 2011;2:235–46.
Kalemis A, Delattre BM, Heinzer S. Sequential whole-body PET/MR scanner: concept, clinical use, and optimisation after two years in the clinic. The manufacturer’s perspective. Magn Reson Mater Phys. 2013;26:5–23.
Delso G, Fürst S, Jakoby B, Ladebeck R, Ganter C, Nekolla SG, Schwaiger M, Ziegler SI. Performance measurements of the Siemens mMR integrated whole-body PET/MR scanner. J Nucl Med. 2011;52(12):1914–22.
Martinez-Möller A, Souvatzoglou M, Delso G, et al. Tissue classification as a potential approach for attenuation correction in whole-body PET/MRI: evaluation with PET/CT data. J Nucl Med. 2009;50:520–6.
Bezrukov I, Mantlik F, Schmidt H, Schölkopf B, Pichler BJ. MR-Based PET attenuation correction for PET/MR imaging. Semin Nucl Med. 2013;43:45–59.
Schulz V, Torres-Espallardo I, Renisch S, et al. Automatic, three-segment, MR-based attenuation correction for whole-body PET/MR data. Eur J Nucl Med Mol Imaging. 2010;38:138–52.
Eiber M, Martinez-Möller A, Souvatzoglou M, et al. Value of a Dixon-based MR/PET attenuation correction sequence for the localization and evaluation of PET-positive lesions. Eur J Nucl Med Mol Imaging. 2011;38:1691–701.
Beyer T. Technical artifacts in PET/CT imaging. In: Shreve P, Townsend DW, editors. Clinical PET-CT in radiology. New York: Springer; 2011. p. 47–60. Chapter 5.
Keller SH, Holm S, Hansen AE, Sattler B, Andersen F, Klausen TL, Højgaard L, Kjær A, Beyer T. Image artifacts from MR-based attenuation correction in clinical, whole-body PET/MRI. Magn Reson Mater Phys. 2013;26:173–81.
Goerres GW, Kamel E, Seifert B, Burger C, Buck A, Hany TF, Von Schulthess GK. Accuracy of image coregistration of pulmonary lesions in patients with non-small cell lung cancer using an integrated PET/CT system. J Nucl Med. 2002;43(11):1469–75.
Beyer T, Antoch G, Müller S, Egelhof T, Freudenberg L, Debatin J, Bockisch A. Acquisition protocol considerations for combined PET/CT imaging. J Nucl Med. 2004;45:25S–35.
Delso G, Martinez-Möller A, Bundschuh RA, Nekolla SG, Ziegler SI. The effect of limited MR field of view in MR/PET attenuation correction. Med Phys. 2010;37:2804–12.
Nuyts J, Dupont P, Stroobants S, Benninck R, Mortelmans L, Suetens P. Simultaneous maximum a posteriori reconstruction of attenuation and activity distributions from emission sinograms. IEEE Trans Med Imaging. 1999;18:393–403.
Nuyts J, Bal G, Kehren F, Fenchel M, Michel C, Watson C. Completion of a truncated attenuation image from the attenuated PET emission data. IEEE Trans Med Imaging. 2013;32:237–46.
Jezzard P. The physical basis of spatial distortions in magnetic resonance images, handbook of medical imaging. San Diego: Academic; 2000. p. 425–38.
Blumhagen JO, Ladebeck R, Fenchel M, Scheffler K. MR-based field-of-view extension in MR/PET: B(0) homogenization using gradient enhancement (HUGE). Magn Reson Med. 2012. doi:10.1002/mrm.24555. Epub ahead of print.
Schwenzer NF, Schraml C, Müller M, Brendle C, Sauter A, Spengler W, Pfannenberg AC, Claussen CD, Schmidt H. Pulmonary lesion assessment: comparison of whole-body hybrid MR/PET and PET/CT imaging–pilot study. Radiology. 2012;264:551–8.
Klausen TL, Keller SH, Olesen OV, Aznar M, Andersen FL. Innovations in PET/CT. Q J Nucl Med Mol Imaging. 2012;56:268–79.
Catana C, Benner T, van der Kouwe A, Byars L, Hamm M, Chonde DB, Michel CJ, El Fakhri G, Schmand M, Sorensen AG. MRI-assisted PET motion correction for neurologic studies in an integrated MR-PET scanner. J Nucl Med. 2011;52:154–61.
Ullisch MG, Scheins JJ, Weirich C, Rota Kops E, Celik A, Tellmann L, Stöcker T, Herzog H, Shah NJ. MR-based PET motion correction procedure for simultaneous MR-PET neuroimaging of human brain. PLoS One. 2012;7:e48149.
Dikaios N, Izquierdo-Garcia D, Graves MJ, Mani V, Fayad ZA, Fryer TD. MRI-based motion correction of thoracic PET: initial comparison of acquisition protocols and correction strategies suitable for simultaneous PET/MRI systems. Eur Radiol. 2012;22:439–46.
Robson MD, Bydder GM. Clinical ultrashort echo time imaging of bone and other connective tissues. NMR Biomed. 2006;19:765–80.
Andersen FL, Ladefoged CN, Beyer T, Keller SH, Hansen AE, Højgaard L, Kjær A, Law I, Holm S.Combined PET/MR imaging in neurology: MR-based attenuation correction implies a strong spatial bias when ignoring bone. Neuroimage. 2013;84C:206–16. doi:10.1016/j.neuroimage.2013.08.042 [Epub ahead of print].
Hitz S, Habekost C, Delso G, Souvatzoglou M, Grimmer T, Beer A, Fürst S, Ziegler S, Schwaiger M, Drzezga A. Evaluation of the qualitative performance of PET/MR versus PET/CT in patients with Alzheimer’s disease. J Nucl Med. 2012;53 Suppl 1:1932.
Catana C, van der Kouwe A, Benner T, Michel CJ, Hamm M, Fenchel M, Fischl B, Rosen B, Schmand M, Sorensen AG. Toward implementing an MRI-based PET attenuation-correction method for neurologic studies on the MR-PET brain prototype. J Nucl Med. 2010;51:1431–8.
Keereman V, Fierens Y, Broux T, De Deene Y, Lonneux M, Vandenberghe S. MRI-based attenuation correction for PET/MRI using ultrashort echo time sequences. J Nucl Med. 2010;51:812–18.
Berker Y, Franke J, Salomon A, Palmowski M, Donker HC, Temur Y, Mottaghy FM, Kuhl C, Izquierdo-Garcia D, Fayad ZA, Kiessling F, Schulz V. MRI-based attenuation correction for hybrid PET/MRI systems: a 4-class tissue segmentation technique using a combined ultrashort-echo-time/Dixon MRI sequence. J Nucl Med. 2012;53:796–804.
Johansson A, Karlsson M, Nyholm T. CT substitute derived from MRI sequences with ultrashort echo time. Med Phys. 2011;38:2708–14.
Hofmann M, Bezrukov I, Mantlik F, Aschoff P, Steinke F, Beyer T, Pichler BJ, Schoelkopf B. MRI-based attenuation correction for whole-body PET/MRI: quantitative evaluation of segmentation- and atlas-based methods. J Nucl Med. 2011;52:1392–9.
Samarin A, Burger C, Wollenweber SD, Crook DW, Burger IA, Schmid DT, von Schulthess GK, Kuhn FP. PET/MR imaging of bone lesions–implications for PET quantification from imperfect attenuation correction. Eur J Nucl Med Mol Imaging. 2012;39:1154–60.
Defrise M, Rezaei A, Nuyts J. Time-of-flight PET data determine the attenuation sinogram up to a constant. Phys Med Biol. 2012;57:885–99.
Ladefoged CN, Andersen FL, Keller SH, Löfgren J, Hansen AE, Holm S, Højgaard L, Beyer T. PET/MR imaging of the pelvis in the presence of endoprostheses: reducing image artifacts and increasing accuracy through inpainting. Eur J Nucl Med Mol Imaging. 2013;40(4):594–601.
Lois C, Bezrukov I, Schmidt H, Schwenzer N, Werner MK, Kupferschläger J, Beyer T. Effect of MR contrast agents on quantitative accuracy of PET in combined whole-body PET/MR imaging. Eur J Nucl Med Mol Imaging. 2012;39:1756–66.
BischofDelaloye A, Carrió I, Cuocolo A, Knapp W, Gourtsoyiannis N, McCall I, Reiser M, Silberman B. White paper of the European Association of Nuclear Medicine (EANM) and the European Society of Radiology (ESR) on multimodality imaging. Eur J Nucl Med Mol Imaging. 2007;34:1147–51.
Gourtsoyiannis N, McCall I, Reiser M, Silberman B, BischofDelaloye A, Carrió I, Cuocolo A, Knapp W. White paper of the European Society of Radiology (ESR) and the European Association of Nuclear Medicine (EANM) on multimodality imaging. Eur Radiol. 2007;17:1926–30.
Sattler B, Jochimsen T, Barthel H, Sommerfeld K, Stumpp P, Hoffmann KT, Gutberlet M, Villringer A, Kahn T, Sabri O. Physical and organizational provision for installation, regulatory requirements and implementation of a simultaneous hybrid PET/MR-imaging system in an integrated research and clinical setting. Magn Reson Mater Phys. 2013;26:159–71.
Boellaard R, O’Doherty MJ, Weber WA, Mottaghy FM, Lonsdale MN, Stroobants SG, Oyen WJ, Kotzerke J, Hoekstra OS, Pruim J, Marsden PK, Tatsch K, Hoekstra CJ, Visser EP, Arends B, Verzijlbergen FJ, Zijlstra JM, Comans EF, Lammertsma AA, Paans AM, Willemsen AT, Beyer T, Bockisch A, Schaefer-Prokop C, Delbeke D, Baum RP, Chiti A, Krause BJ. FDG PET and PET/CT: EANM procedure guidelines for tumour PET imaging: version 1.0. Eur J Nucl Med Mol Imaging. 2010;37:181–200.
Olsen RV, Munk PL, Lee MJ, Janzen DL, MacKay AL, Xiang QS, Masri B. Metal artifact reduction sequence: early clinical applications. Radiographics. 2000;20:699–712.
Acknowledgments
We gratefully acknowledge contributions from A Kalemis, F DiLalla and B Delattre (Philips Healthcare), MJ Ribeiro (CEA/SHFJ Orsay, France), B Sattler (Leipzig, Germany), FL Andersen (Copenhagen, DK), and G Schramm (Dresden, Germany).
Further, we thank our colleagues from Copenhagen for helpful advice and support: J Löfgren, K Stahr, J Poulsen, M Federspiel, and C Ladefoged.
Conflict of Interest
None
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2014 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Keller, S.H., Hansen, A.E., Holm, S., Beyer, T. (2014). Image Distortions in Clinical PET/MR Imaging. In: Carrio, I., Ros, P. (eds) PET/MRI. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-40692-8_2
Download citation
DOI: https://doi.org/10.1007/978-3-642-40692-8_2
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-40691-1
Online ISBN: 978-3-642-40692-8
eBook Packages: MedicineMedicine (R0)