Quantitative and qualitative evaluation of sequential PET/MRI using a newly developed mobile PET system for brain imaging

Abstract

To evaluate the clinical feasibility of a newly developed mobile PET system with MR-compatibility (flexible PET; fxPET), compared with conventional PET (cPET)/CT for brain imaging. Twenty-one patients underwent cPET/CT with subsequent fxPET/MRI using 18F-FDG. As qualitative evaluation, we visually rated image quality of MR and PET images using a four-point scoring system. We evaluated overall image quality for MR, while we evaluated overall image quality, sharpness and lesion contrast. As quantitative evaluation, we compared registration accuracy between two modalities [(fxPET and MRI) and (cPET and CT)] measuring spatial coordinates. We also examined the accuracy of regional 18F-FDG uptake. All acquired images were of diagnostic quality and the number of detected lesions did not differ significantly between fxPET/MR and cPET/CT. Mean misregistration was significantly larger with fxPET/MRI than with cPET/CT. SUVmax and SUVmean for fxPET and cPET showed high correlations in the lesions (R\u2009=\u20090.84, 0.79; P\u2009<\u20090.001, P\u2009=\u20090.002, respectively). In normal structures, we also showed high correlations of SUVmax (R\u2009=\u20090.85, 0.87; P\u2009<\u20090.001, P\u2009<\u20090.001, respectively) and SUVmean (R\u2009=\u20090.83, 0.87; P\u2009<\u20090.001, P\u2009<\u20090.001, respectively) in bilateral caudate nuclei and a moderate correlation of SUVmax (R\u2009=\u20090.65) and SUVmean (R\u2009=\u20090.63) in vermis. The fxPET/MRI system showed image quality within the diagnostic range, registration accuracy below 3 mm and regional 18F-FDG uptake highly correlated with that of cPET/CT.