Hurdles for PET/MR

PET/MR has been poised on the cutting edge of imaging for a few years, but the hybrid modality still faces a number of challenges keeping it from widespread use in clinical practice.

Among the top read stories in molecular imaging in the past month was a review published in the Journal of Nuclear Medicine which argued that the wide availability of PET/CT and its lower price tag make it hard to justify the cost of PET/MR in most cases.

“The real problem that PET/MR imaging has to overcome in its competition with PET/CT is the need to demonstrate at least some degree of superiority in the evidence-based world of medicine, in which PET/CT dominates because of its wider distribution and lower cost and because medical staff are more skilled in its use,” wrote Luigi Mansi, MD, professor of nuclear medicine at Seconda Second University of Naples, Italy, and Andrea Ciarmiello, MD, researcher of nuclear medicine at Sant’Andrea Hospital La Spezia in Italy.

There’s also a learning curve standing between PET/MR and clinical practice, with healthcare professionals being more familiar with PET/CT and having less of an understanding of the advantages of morphostructural or functional MR data.

“Either nuclear physicians or radiologists have to better understand the significance of the pathophysiologic information that can be acquired by MR imaging,” wrote Mansi and Ciarmiello. “Without waiting for new experts who are able to evaluate the entire diagnostic content of fused PET/MR images, nuclear physicians need to educate themselves more widely and in greater depth not only on the morphostructural information provided by PET/MR imaging but also on the entire spectrum of functional information that can be gained.”

Still, the potential of PET/MR is undeniable. Pediatric patients and those with inflammatory disease or chronic conditions requiring repeat imaging can benefit from the reduced exposure to ionizing radiation allowed by PET/MR. The hybrid modality could become the standard imaging technique for head and neck cancers and offer a deeper level of tumor characterization.

It’s this potential that will allow PET/MR to overcome the challenges it currently faces in gaining a foothold in clinical practice.

For more on PET/MR, please read “MRI’s Expanding Frontiers: Scanning More, Scanning Faster” in a recent issue of Health Imaging.

-Evan Godt
Editor – Health Imaging