Brain imaging of sequential acquisition using a flexible PET scanner and 3-T MRI: quantitative and qualitative assessment

Objective A mobile PET scanner termed flexible PET (fxPET) has been designed to fit existing MRI systems. The purpose of this study was to assess brain imaging with fxPET combined with 3-T MRI in comparison with conventional PET (cPET)/CT. Methods In this prospective study, 29 subjects with no visible lesions except for mild leukoaraiosis on whole brain imaging underwent 2-deoxy-2-[F-18]fluoro-D-glucose ([F-18]FDG) cPET/CT followed by fxPET and MRI. The registration differences between fxPET and MRI and between cPET and CT were compared by measuring spatial coordinates. Three-dimensional magnetization-prepared rapid acquisition gradient-echo T1-weighted imaging (T1WI) was acquired. We applied two methods of attenuation correction to the fxPET images: MR-based attenuation correction, which yielded fxPET(MRAC); and CT-based attenuation correction, which yielded fxPET(CTAC). The three PET datasets were co-registered to the T1WI. Following subcortical segmentation and cortical parcellation, volumes of interest were placed in each PET image to assess physiological accumulation in the brain. SUVmean was obtained and compared between the three datasets. We also visually evaluated image distortion and clarity of fxPET(MRAC). Results Mean misregistration of fxPET/MRI was < 3 mm for each margin. Mean registration differences were significantly larger for fxPET/MRI than for cPET/CT except for the superior margin. There were high correlations between the three PET datasets regarding SUVmean. On visual evaluation of image quality, the grade of distortion was comparable between fxPET(MRAC) and cPET, and the grade of clarity was acceptable but inferior for fxPET(MRAC) compared with cPET. Conclusions fxPET could successfully determine physiological [F-18]FDG uptake; however, improved image clarity is desirable. In this study, fxPET/MRI at 3-T was feasible for brain imaging.