PET/MR imaging of neoplastic and inflammatory lesions

PET/MR imaging of neoplastic and inflammatory lesions

PET/MR constitutes an innovative hybrid imaging technology that may take advantage of the best strengths of each parent technology and overcome some of their weakness when standing alone. Although investigation of PET/MR capabilities has just started, it seems likely that it will play an increasing role in oncologic and inflammatory imaging. At a fraction of the radiation burden of PET/CT, it is expected to provide a more accurate staging of most solid organ malignancies. We demonstrated that PET/MR improves staging in a heterogeneous population of cancer patients, leading to management change in up to 18% of cases, as compared to same-day PET/CT. We confirmed the improved staging performance of PET/MR versus PET/CT both in specific cancer populations, like breast and colorectal, and in evaluating specific targets of metastases, like bones in breast cancer. However, using PET/MR only for staging is reductive. In fact, the technology, coupling the synchronous acquisition of several metabolic-functional parameters from PET and MR, with an ideal spatiotemporal matching and a high soft tissue contrast morphologic layout, can investigate the histology and molecular biology of inflammation and cancers, predicting, for example, the phenotype of breast cancer patients, discriminating purely fibrotic strictures in Crohn disease and assessing for active inflammation, with higher accuracy, in Crohn disease.

Dissertation: http://hdl.handle.net/11370/b071a8d3-0018-4276-bbff-c885ccf736f8