Local Time : 13:36 CET

NH 12 - The increasing clinical impact of MR/PET

Friday, March 3, 16:00 - 17:30 Room: B Session Type: New Horizons Session Topics: Nuclear Medicine, Molecular Imaging, Hybrid imaging Digital Evaluation: Open Digital Evaluation for this Session Moderator: L. Umutlu (Essen/DE) Add session to my schedule In your schedule (remove)

A-487

Chairman's introduction

L. Umutlu; Essen/DE
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Learning Objectives

1. To understand the increasing clinical impact of MR/PET in diverse application fields.
2. To understand the benefits of MR/PET over PET/CT in paediatric and head and neck imaging.
3. To become familiar with indications for MR/PET in cardiac and musculoskeletal imaging.

Abstract

Within the past 5 years, simultaneous PET/MRI has been successful introduced into clinical oncologic imaging. It has demonstrated its strength and superiority, particularly in application fields that require high soft tissue contrast imaging such as head and neck cancers or cardiac imaging, questioning the need and or benefit for PET/CT imaging in particular clinical investigations. Apart from its high soft tissue contrast, the interchange from CT to MRI for morphological correlation facilitates another favourable topic, by means of the reduction of the applied ionizing radiation. The applied amount of ionizing radiation can be reduced to 1/3 of the amount in full-dose diagnostic PET/CTs. This is of particular interest for paediatric imaging as well as in the setting for therapy monitoring, when repetitive scans are required.

A-488

MR/PET in paediatric oncology?

P. D. Humphries; London/UK

Learning Objectives

1. To understand the gain of using MRI instead of CT together with PET.
2. To become familiar with current application fields in paediatric imaging.
3. To give an insight into future application fields.

Abstract

Advances in paediatric oncology over the past decades have led to a much improved success rate in the treatment of children with cancer, with some tumours having a 5-year survival over 90%. This success increases the relevance of diagnostic radiation exposure, given the greater radiosensitivity of children and, therefore, increased chance of inducing a second malignancy following treatment. Imaging modalities that can reduce ionising exposure are, therefore, very attractive for paediatric imaging. MRI has been a preferred method of imaging childhood tumours for some time, owing to excellent soft tissue depiction, lack of ionising radiation and the ability to derive “functional” data from DWI and spectroscopy, for example. PET imaging is well established for some paediatric tumours, notably FDG-PET in lymphoma, but is also gaining traction in other cancers, such as sarcomas and choline-PET for CNS neoplasms. Given the above considerations a hybrid platform of PET-MRI is particularly relevant for paediatric oncology, with the potential for future multi-parametric tumour modelling allowing evaluation at both at staging and therapy response assessment.

A-489

MR/PET in cardiac imaging?

M. Dewey; Berlin/DE
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no recording
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Learning Objectives

1. To understand the gain of using hybrid MR/PET in cardiac imaging.
2. To become familiar with current application fields in cardiac imaging.
3. To give an insight into the clinical impact and potential future applications of MR/PET in cardiac imaging.

Abstract

MR/PET is the new kid on the block, enabling hybrid imaging of anatomy and function. I will summarise the new horizons of MR/PET for providing clinical impact in patients with known or suspected cardiac diseases. For this purpose, we will discuss myocardial area-at-risk definition, differentiation of cardiac tumours (from thrombus) and assessment of myocarditis by MR/PET. Finally, technical challenges and potential solutions will be discussed together with patients’ experience of the examination.

A-490

MR/PET in head and neck imaging?

M. Becker; Geneva/CH

Learning Objectives

1. To understand the gain of using MRI instead of CT together with PET.
2. To become familiar with current application fields in head and neck imaging.
3. To give an insight into the clinical impact of MR/PET in head and neck imaging.

Abstract

PET/CT and MRI with diffusion-weighted imaging (DWI) are complementary techniques for the assessment and staging of head and neck tumours. This lecture focuses on clinical applications of MR/PET in head and neck tumors with special emphasis on multiparametric imaging using high-resolution morphological MRI, DWI and perfusion imaging. First, advantages of using MRI instead of CT in head and neck oncology are summarized and current evidence regarding clinical feasibility, image quality, optimized imaging protocols and quantification with MRI-based attenuation algorithms and with DWI in the head and neck is reviewed. Then the current state of knowledge regarding the diagnostic performance of MR/PET in head and neck cancer is discussed and typical tumour manifestations are presented. The appearance of primary and recurrent squamous cell cancers, lymph node metastases and distant metastases on MR/PET, as well as the value of multiparametric imaging are summarized. The variable appearance of functional phenomena mimicking disease, as well as potential pitfalls of image interpretation due to morphological or functional post-treatment changes are addressed. Illustrative cases of concordant and discrepant multiparametric evaluations are discussed, as well as the dilemma how to deal with discrepant multiparametric data in clinical routine.

A-491

MR/PET in musculoskeletal imaging?

G. Andreisek; Münsterlingen/CH

Learning Objectives

1. To understand the gain of using hybrid MR/PET in MSK imaging.
2. To become familiar with current application fields in MSK imaging.
3. To give an insight into the clinical impact and potential future applications of MR/PET in musculoskeletal imaging.

Abstract

Hybrid MR/pet is an increasing and fast-growing topic in musculoskeletal research. This talk will highlight current applications in the field of musculoskeletal imaging and gives an insight into potential future applications of MR/PET in musculoskeletal imaging. Therefore, a short introduction is provided about the necessity for MR/PET in certain musculoskeletal pathologies. After that, the current gold standard imaging modalities and their limitations are reviewed, and then potential advantages of MR/PET are discussed. Examples for clinical applications are provided as well as a review of the corresponding literature. The audience should get an impression what is clinically available, what is “evidence-based” and what applications are currently purely reserved for research.

Panel discussion: Are we ready to fully integrate MR/PET into clinical diagnostic work-up?

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(no abstract)