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Potential influence of Gadolinium contrast on image segmentation in MR-based attenuation correction with Dixon sequences in whole-body 18F-FDG PET/MR

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Magnetic Resonance Materials in Physics, Biology and Medicine Aims and scope Submit manuscript

Abstract

Objective

To evaluate the influence of Gadolinium contrast agent on image segmentation in magnetic resonance (MR)-based attenuation correction (AC) with four-segment dual-echo time Dixon-sequences in whole-body [18F]-fluorodeoxyglucose positron emission tomography (PET)/MR imaging, and to analyze the consecutive effect on standardized uptake value (SUV).

Materials and methods

Hybrid imaging with an integrated PET/MR system was performed in 30 oncological patients. AC was based on MR imaging with a Dixon sequence with subsequent automated image segmentation. AC maps (µmaps) were acquired and reconstructed prior to (µmap−gd) and after (µmap+gd) Gd-contrast agent application. For quantification purposes, the SUV of organs and tumors based on both µmaps were compared.

Results

Tissue classification based on µmap−gd was correct in 29/30 patients; based on µmap+gd, the brain was falsely classified as fat in 12/30 patients with significant underestimation of SUV. In all cancerous lesions, tissue segmentation was correct. All concordant µmaps−gd/+gd resulted in no significant difference in SUV.

Conclusion

In PET/MR, Gd-contrast agent potentially influences fat/water separation in Dixon-sequences of the head with above-average false tissue segmentation and an associated underestimation of SUV. Thus, MR-based AC should be acquired prior to Gd-contrast agent application. Additionally, integrating the MR-based AC maps into the reading-routine in PET/MR is recommended to avoid interpretation errors in cases where tissue segmentation fails.

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Authors and Affiliations

  1. Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany

    Verena Ruhlmann & Andreas Bockisch

  2. Department of Diagnostic and Interventional Radiology, Medical Faculty, University of Dusseldorf, 40225, Dusseldorf, Germany

    Philipp Heusch, Gerald Antoch & Christian Buchbender

  3. Department of Diagnostic and Interventional Radiology and Neuroradiology, University of Duisburg-Essen, 45147, Essen, Germany

    Hilmar Kühl, Karsten Beiderwellen & Michael Forsting

  4. Erwin L. Hahn Institute for MR Imaging, University of Duisburg-Essen, 45141, Essen, Germany

    Harald H. Quick

  5. High Field and Hybrid MR Imaging, University Hospital Essen, 45147, Essen, Germany

    Harald H. Quick

Authors
  1. Verena Ruhlmann
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  2. Philipp Heusch
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  3. Hilmar Kühl
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  4. Karsten Beiderwellen
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  5. Gerald Antoch
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  6. Michael Forsting
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  7. Andreas Bockisch
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  8. Christian Buchbender
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  9. Harald H. Quick
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Corresponding author

Correspondence to Verena Ruhlmann.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Ruhlmann, V., Heusch, P., Kühl, H. et al. Potential influence of Gadolinium contrast on image segmentation in MR-based attenuation correction with Dixon sequences in whole-body 18F-FDG PET/MR. Magn Reson Mater Phy 29, 301–308 (2016). https://doi.org/10.1007/s10334-015-0516-1

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  • DOI: https://doi.org/10.1007/s10334-015-0516-1

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