Validation of MR-Based Attenuation Correction of a Newly Released Whole-Body Simultaneous PET/MR System

Abstract

The aim of this study was to validate quantitative performance of a newly released simultaneous positron emission tomography (PET)/magnetic resonance imaging (MRI) scanner, by using MR-based attenuation correction (MRAC), both in phantom study and in patient study. PET/MRI image uniformities of a phantom under different hardware configurations were tested and compared. Thirty patients were examined with 2-deoxy-2-[ 18 F]fluoro-D-glucose ( 18 F-FDG) PET/computed tomography (CT) and subsequent PET/MRI. PET images from PET/MRI were corrected with MRAC (PET MR ), CT-based attenuation maps ( μ -maps, PET CT ), and segmented CT μ -maps (PET CTSeg ) derived from PET/CT. Standardized uptake values (SUVs) were compared among the 3 sets of PET in main organs (bone, liver and lung) and in 52 FDG-avid lesions, including soft-tissue lesions and bone lesions. The result showed that PET imaging uniformities of PET/MRI under different configurations were good (&lt;8.8%). The SUV differences among the 3 sets of PET varied with organs and lesion types. In detail, the mean relative differences of SUV between PET MR and PET CT were as follows: −18.8%, bone (SUV mean ); −8.0%, liver (SUV mean ); −12.2%, lung (SUV mean ); −18.1%, bone lesions (SUV mean ); −13.3%, bone lesions (SUV max ); −8.2%, soft-tissue lesions (SUV mean ); and −7.3%, soft-tissue lesions (SUV max ). The mean relative differences between PET MR and PET CTSeg were as follows: −19.0%, bone (SUV mean ); −3.5%, liver (SUV mean ); −3.3%, lung (SUV mean ); −19.3%, bone lesions (SUV mean ); −17.5%, bone lesions (SUV max ); −5.5%, soft-tissue lesions (SUV mean ); and −4.4%, soft-tissue lesions (SUV max ). The differences of SUV between PET MR and PET CT were larger than those between PET MR and PET CTSeg , in both soft tissue and soft-tissue lesions (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M1"><mml:mrow><mml:mi>P</mml:mi><mml:mo>&lt;</mml:mo><mml:mn>0.001</mml:mn></mml:mrow></mml:math>), but not in bone or bone lesions. In conclusion, MRAC in the newly released PET/MR system is accurate in most tissues, with SUV deviations being generally less than 10%, compared to PET/CT. In bone, however, underestimations can be substantial, which may be partially attributed to segmentation of the MR-based μ -maps.