Innovations in multimodality imaging devices · From 2-D to 5-D multimodality imaging 5-D PET/CT 2-D projections 3-D CT 4-D CT 4-D PET 3-D PET Zaidi H. Navigating beyond the 6th dimension:

Hôpitaux

Universitaires

Genève

Innovations in multimodality

imaging devices

Habib Zaidi1,2,3

1Geneva University Hospital, Geneva, Switzerland 2University of Groningen, Groningen, Nethelands 3University of Southern Denmark, Odense, Denmark

Email: habib.zaidi@hcuge.ch

Web: http://pinlab.hcuge.ch

3rd Global Forum on Medical Devices, 10-12 May 2017

Convergence of multiple image-capture techniques, basic cell/molecular

biology, chemistry, medicine, pharmacology, medical physics,

biomathematics, and bioinformatics into a new imaging paradigm

Anatomic Physiologic Metabolic Molecular

PET/SPECT

x-ray CT

MRI

ultrasound

optical imaging

Molecular Imaging: Interdisciplinary!

From 2-D to 5-D multimodality imaging

5-D PET/CT

2-D projections

3-D CT

4-D CT

4-D PET

3-D PET

Zaidi H. Navigating beyond the 6th dimension: A challenge in the era of multi-parametric molecular imaging (2009) EJNMMI 36: 1025-28

Navigating beyond the 5th dimension …

Beyond pretty images …

Early references to emission/transmission imaging

Mayneord WV (1952) The radiology of the human body with radioactive isotopes. Br J Radiol 25: 517-525 Kuhl DE, J Hale, WL Eaton (1966) Transmission scanning: A useful adjunct to conventional emission scanning for accurately keying isotope deposition to radiographic anatomy. Radiology 87: 278-284 Anger HO, J McRae (1968) Transmission scintiphotography. J Nucl Med 9: 267-269 Sorenson JA, RC Briggs, JR Cameron (1969) 99mTc Point Source for Transmission Scanning. J Nucl Med 10: 252-253 Tothill P, JM Galt (1971) Quantitative profile scanning for the measurement of organ radioactivity. Phys Med Biol 16: 625-634 Budinger TF, GT Gullberg (1974) Three-dimensional reconstruction in nuclear medicine emission imaging. IEEE Trans Nucl Sci 21: 2-20

Description of a Simultaneous Emission-Transmission CT System Hasegawa BH et al SPIE Vol 1231 Medical Imaging IV Image Formation (1990)

UCSF Emission/Transmission CT (1993)

HPGe detector

LN2 cryostat

X-ray tube

Correlated Image

CT

X-Ray CT Radionuclide Emission

SPECT

Computer

Courtesy Dr Bruce Hasegawa

1951-2008

Anatomy

(CT)

Fusion

(SPECT/CT)

+

=

Function

(SPECT)

Scout Spiral CT PET PET/CT

Principles of PET/CT

Trimodality m PET/m SPECT/m CT

FLEX Triumph™ Tri-modality system

LabPET ™ - Gamma Medica

LabPETTM ~1 mm

Benefits of combined PET/MRI

Direct and accurate registration of molecular PET signal with high

resolution MR anatomy

Better soft tissue contrast than CT

No radiation dose

Anatomically-guided reconstruction of PET data

Improved quantification of PET data

Time correlation of PET and MRI or MRS signal

Interventional, therapeutic studies

Dual-labeled agents (64Cu, Gd)

Dual-agent molecular imaging/cell tracking

Reduced positron range – improvements in the in-plane spatial

resolution (high b+ energy)

Potential designs of combined PET-MRI

Full integration

Sequential (Tandem/docked)

PET insert within MRI

Zaidi and Del Guerra (2011) Med Phys

Commercially available PET-MRI scanners

GE SIGNA PET/MR

Patient Transfer Table Top (PTTP) PET/CT MRI

Clinical whole-body PET/MRI

SIGNA PET/MR

GEMINI TF PET/MR Biograph mMR

Summary

PET/MR is producing challenges in terms of software/hardware

development but also plenty of opportunities.

MR sequences is the key for providing answers to a number of

issues.

Existing approaches previously developed in PET/CT multimodality

imaging may be explored within the PET/MR field.

New software developments are necessary to efficiently explore the

multitude of information that may be available from PET/MR.

Presently available multimodality imaging systems:

PET/CT, SPECT/CT, PET/SPECT, PET/SPECT/CT, PET/MRI,

PET/Optical

From PET/CT … to PET-MR

Will PET/MRI replace PET/CT?

Zaidi and Mawlawi Med Phys 34: 1525-1528 (2007)

Clinical applications of PET-MRI

Still the bottleneck of PET-MRI …