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The effect of high count rates on cardiac perfusion quantification in a simultaneous PET-MR system using a cardiac perfusion phantom

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      PET-MRI is under investigation as a new strategy for quantitative myocardial perfusion imaging. Consideration is required as to the maximum scanner count rate in order to limit dead-time losses resulting from administered activity in the scanner field of view during the first pass of the radiotracer.


      We performed a decaying-source experiment to investigate the high count-rate performance of a PET-MR system (Siemens mMR) over the expected range of activities during a clinical study. We also performed imaging of a cardiac perfusion phantom, which provides an experimental simulation of clinical transit of a simultaneous radiotracer (phantom injected activities range 252 to 997 MBq) and gadolinium-based contrast agent (GBCA). Time-activity and time-intensity curves of the aorta and myocardium compartments from PET and MR images were determined, and quantification of perfusion was then performed using a standard cardiac kinetic model. The decaying-source experiment showed a maximum noise equivalent count rate (NECR max) of 286 kcps at a singles rate of 47.1 Mcps. NECR was maintained within 5% (NECR 95%) of the NECR max with a singles rate of 34.1 Mcps, corresponding to 310 MBq in the phantom. Count-rate performance was degraded above the singles rate of 64.9 Mcps due to the number of detection events impacting the quantitative accuracy of reconstructed images. A 10% bias in image activity concentration was observed between singles rates of 78.2 and 82.9 Mcps. Perfusion phantom experiments showed that image-based activity concentration and quantified values of perfusion were affected by count losses when the total singles rate was greater than 64.9 Mcps. This occurred during the peak arterial input function (AIF) phase of imaging for injected activities to the phantom of 600 MBq and greater.


      Care should be taken to avoid high count-rate losses in simultaneous PET-MRI studies. Based on our results in phantoms, bias in reconstructed images should be avoided by adhering to a singles rate lower than 64.9 Mcps on the mMR system. Quantification of perfusion values using singles rates higher than 64.9 Mcps on this system may be compromised and should be avoided.

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      Performance measurements of the Siemens mMR integrated whole-body PET/MR scanner.

      The recently released Biograph mMR is the first commercially available integrated whole-body PET/MR scanner. There are considerable advantages to integrating both modalities in a single scanner that enables truly simultaneous acquisition. However, there are also concerns about the possible degradation of both PET and MR performance in an integrated system. This paper evaluates the performance of the Biograph mMR during independent and simultaneous acquisition of PET and morphologic MR data. The NEMA NU 2-2007 protocol was followed for studying the PET performance. The following measurements were performed: spatial resolution; scatter fraction, count losses, and randoms; sensitivity; accuracy of the correction for count losses and randoms; and image quality. The quality control manual of the American College of Radiology was followed for studying the MR performance. The following measurements were performed: geometric accuracy, spatial resolution, low-contrast detectability, signal-to-noise ratio, static field (B(0)) homogeneity, radiofrequency field (B(1)) homogeneity, and radiofrequency noise. An average spatial resolution of 4.3 mm in full width at half maximum was measured at 1 cm offset from the center of the field of view. The system sensitivity was 15.0 kcps/MBq along the center of the scanner. The scatter fraction was 37.9%, and the peak noise-equivalent count rate was 184 kcps at 23.1 kBq/mL. The maximum absolute value of the relative count rate error due to dead-time losses and randoms was 5.5%. The average residual error in scatter and attenuation correction was 12.1%. All MR parameters were within the tolerances defined by the American College of Radiology. B(0) inhomogeneities below 1 ppm were measured in a 120-mm radius. B(1) homogeneity and signal-to-noise ratio were equivalent to those of a standard MR scanner. No radiofrequency interference was detected. These results compare favorably with other state-of-the-art PET/CT and PET/MR scanners, indicating that the integration of the PET detectors in the MR scanner and their operation within the magnetic field do not have a perceptible impact on the overall performance. The MR subsystem performs essentially like a standalone system. However, further work is necessary to evaluate the more advanced MR applications, such as functional imaging and spectroscopy.
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        Development of a universal dual-bolus injection scheme for the quantitative assessment of myocardial perfusion cardiovascular magnetic resonance

        Background The dual-bolus protocol enables accurate quantification of myocardial blood flow (MBF) by first-pass perfusion cardiovascular magnetic resonance (CMR). However, despite the advantages and increasing demand for the dual-bolus method for accurate quantification of MBF, thus far, it has not been widely used in the field of quantitative perfusion CMR. The main reasons for this are that the setup for the dual-bolus method is complex and requires a state-of-the-art injector and there is also a lack of post processing software. As a solution to one of these problems, we have devised a universal dual-bolus injection scheme for use in a clinical setting. The purpose of this study is to show the setup and feasibility of the universal dual-bolus injection scheme. Methods The universal dual-bolus injection scheme was tested using multiple combinations of different contrast agents, contrast agent dose, power injectors, perfusion sequences, and CMR scanners. This included 3 different contrast agents (Gd-DO3A-butrol, Gd-DTPA and Gd-DOTA), 4 different doses (0.025 mmol/kg, 0.05 mmol/kg, 0.075 mmol/kg and 0.1 mmol/kg), 2 different types of injectors (with and without "pause" function), 5 different sequences (turbo field echo (TFE), balanced TFE, k-space and time (k-t) accelerated TFE, k-t accelerated balanced TFE, turbo fast low-angle shot) and 3 different CMR scanners from 2 different manufacturers. The relation between the time width of dilute contrast agent bolus curve and cardiac output was obtained to determine the optimal predefined pause duration between dilute and neat contrast agent injection. Results 161 dual-bolus perfusion scans were performed. Three non-injector-related technical errors were observed (1.9%). No injector-related errors were observed. The dual-bolus scheme worked well in all the combinations of parameters if the optimal predefined pause was used. Linear regression analysis showed that the optimal duration for the predefined pause is 25s to separate the dilute and neat contrast agent bolus curves if 0.1 mmol/kg dose of Gd-DO3A-butrol is used. Conclusion The universal dual-bolus injection scheme does not require sophisticated double-head power injector function and is a feasible technique to obtain reasonable arterial input function curves for absolute MBF quantification.
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          PET-MRI: a review of challenges and solutions in the development of integrated multimodality imaging

           ,   (2015)
          The integration of positron emission tomography (PET) and magnetic resonance imaging (MRI) has been an ongoing research topic for the last 20 years. This paper gives an overview of the different developments and the technical problems associated with combining PET and MRI in one system. After explaining the different detector concepts for integrating PET-MRI and minimising interference the limitations and advantages of different solutions for the detector and system are described for preclinical and clinical imaging systems. The different integrated PET-MRI systems are described in detail. Besides detector concepts and system integration the challenges and proposed solutions for attenuation correction and the potential for motion correction and resolution recovery are also discussed in this topical review.

            Author and article information

            [1 ]ISNI 0000 0001 2322 6764, GRID grid.13097.3c, PET Imaging Centre, Division of Imaging Sciences and Biomedical Engineering, King’s College London, St. Thomas’ Hospital, ; London, UK
            [2 ]ISNI 0000 0004 0397 4222, GRID grid.467063.0, Department of Molecular Imaging, , Sidra Medical and Research Center, ; Al Luqta St, Doha, Qatar
            [3 ]Siemens Healthineers UK, Frimley, Camberley UK
            [4 ]GRID grid.420545.2, BHF Centre of Excellence, NIHR Biomedical Research Centre and Wellcome Trust and EPSRC Medical Engineering Centre at Guy’s and St. Thomas’ NHS Foundation Trust, ; London, UK
            [5 ]GRID grid.420545.2, Department of Cardiology, , Guy’s and St Thomas’ NHS Foundation Trust, ; London, UK
            ORCID:, +974 7044 7057 ,
            EJNMMI Phys
            EJNMMI Phys
            EJNMMI Physics
            Springer International Publishing (Cham )
            11 December 2017
            11 December 2017
            December 2017
            : 4
            29230607 5725400 199 10.1186/s40658-017-0199-y
            © The Author(s). 2017

            Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

            Funded by: Wellcome Trust (GB)
            Award ID: WT 088641/Z/09/Z
            Funded by: British Heart Foundation (GB)
            Award ID: RE/08/003
            Award Recipient :
            Original Research
            Custom metadata
            © The Author(s) 2017

            pet-mr, cardiac pet, dead time, perfusion


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