Lisa Fratt, Editor

Much of the pre-RSNA 2010 buzz focuses on the advent of PET/MR, with major vendors expected to launch this next advance in hybrid whole-body imaging at the conference.

Researchers around the globe are investigating the potential of PET/MR. Early work has focused on performance, says Osman Ratib, chair of radiology and head of nuclear medicine at University Hospital of Geneva in Switzerland. “We can say that the scanner provides adequate clinical information on the MR side and the PET side.” Early applications include early prostate, breast and head and neck cancers.

Some still question the utility of the system, which has not yet demonstrated additional value, he admits. The next step for researchers is to assess the clinical value of the hybrid system. PET/MR delivers two perfectly aligned studies that may provide improved tissue characterization, lesion identification and anatomical and functional extent of disease, explains Ratib, who is about to launch a prospective study to determine if hybrid imaging delivers better data than separately acquired scans. “We already have [anecdotal experience] to suggest this is the case,” he says.

As Ratib and other pioneers blaze new trails in hybrid MR imaging, standalone MRI also continues to demonstrate value.

Neuroradiology applications appear particularly promising. Researchers were able to determine with greater than 90 percent accuracy the time of stroke onset using MRI sequencing, offering the potential to extend effective treatment to 25 percent more patients admitted for strokes, according to a study published Nov. 2 in Radiology. And a recent study in published PLoS suggested MRI-detected lesions could predict dementia later in life. Both applications could open the door to earlier treatment and thus improve patient care.

At the same time, both clinical research and technical developments are propelling cardiac MR. High-dose dobutamine stress MRI (DS-MRI) can be used to accurately identify patients at high risk for cardiac death and heart attack, according to a study published Oct. 5 in the Journal of the American College of Cardiology. At the same time, new coils and ultrafast scanning techniques are boosting MRI’s speed and simplicity to make it more competitive with cardiac CT. Researchers capitalized on MRI in a study published in the October issue of American Journal of Roentgenology that suggested that some MRI sequences may provide a less invasive, safer and sufficiently accurate alternative to angiogram and CT for assessing great vessel stents.

And the modality is increasingly deployed in breast imaging. In fact, according to Health Imaging & IT’s Top Trends survey, the need to adopt breast MRI is propelling the market.

Finally, vendors are developing advanced coils for specific applications (think cardiac and neuro) as well as larger magnets. Medical College of Wisconsin recently installed an investigational ultra-high field 7T MRI scanner and plans to study early neurological and psychiatric disorders.

RSNA 2010 will prove exciting as hybrid whole-body PET/MR edges toward clinical practice and researchers share a host of other clinical developments.

Lisa Fratt
lfratt@healthimaging.com
Editor of Health Imaging & IT