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Review
. 2021 Nov 30;13(23):6019.
doi: 10.3390/cancers13236019.

Adapting Imaging Protocols for PET-CT and PET-MRI for Immunotherapy Monitoring

Bettina Beuthien-Baumann  1 , Christos Sachpekidis  2 , Regula Gnirs  1 , Oliver Sedlaczek  1   3
Affiliations
Review

Adapting Imaging Protocols for PET-CT and PET-MRI for Immunotherapy Monitoring

Bettina Beuthien-Baumann et al. Cancers (Basel). .

Abstract

Hybrid imaging with positron emission tomography (PET) in combination with computer tomography (CT) is a well-established diagnostic tool in oncological staging and restaging. The combination of PET with magnetic resonance imaging (MRI) as a clinical scanner was introduced approximately 10 years ago. Although MRI provides superb soft tissue contrast and functional information without the radiation exposure of CT, PET-MRI is not as widely introduced in oncologic imaging as PET-CT. One reason for this hesitancy lies in the relatively long acquisition times for a PET-MRI scan, if the full diagnostic potential of MRI is exploited. In this review, we discuss the possible advantages of combined imaging protocols of PET-CT and PET-MRI, within the context of staging and restaging of patients under immunotherapy, in order to achieve "multi-hybrid imaging" in one single patient visit.

Keywords: PET-CT; PET-MRI; immunotherapy.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Components of a “multi-hybrid-imaging” oncological protocol combining PET-CT and PET-MRI with one single application of the radiopharmaceutical. The examination protocol would begin with an initial whole-body PET-CT lasting between 10 and 20 min (right side of the figure) followed by PET-MRI. PET-MRI can be performed with a fast whole-body acquisition completed within less than 30 min (upper part of the image depicting the PET-MRI protocol—blue background). To significantly take advantage of the MR-component, local PET-MRI imaging of defined body regions lasting approximately 20 min (middle part of the image depicting the PET-MRI protocol—green background) can be added. Finally, the PET-MRI examination can be further expanded with the generation of DWI of the body trunk with a minimum acquisition time of 13 min (lower part of the image depicting the PET-MRI protocol—yellow background).
Figure 2
Figure 2
Example of respiratory motion correction in PET-MRI. (A) CT: Development of a semi-solid formation post-immunotherapy at the right hilum. (B) 18F-FDG-PET with PET/CT (upper left) und PET-MRI (upper right): With MRI-based motion correction (moco), a higher SUVpeak is calculated (lower left), compared to static reconstruction (lower right).
Figure 3
Figure 3
Preferred imaging modality for the characterization of immune-related side effects (PET refers to 18F-FDG-PET).
See this image and copyright information in PMC

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