Technology is fascinating because of its potential to offer solutions to our daily problems. Imaging technologies, however, face challenges from several factors such as speed, availability in clinical routine and even patient comfort. Some of these challenges have meant that in the last century positronemission tomography (PET) was a rarely applied technology in a clinical setting; it proved time-consuming and without the potential to provide important information about anatomy and therefore about, for example, therapy-induced side-effects like thrombosis or pneumonia.
However, by integrating the anatomical information derived from computed tomography (CT) with PET, we acquire much more diagnostic information than would be available by applying these components individually. This combination also overcomes some limitations of a pure PET exam by integrating CT data for PET attenuation correction, which significantly reduces examination time. Today PET/CT is recognized as an imaging technique which can answer clinically relevant questions in multiple scenarios such as lung cancer; it clearly improves patient care and also, indirectly, therapy outcome.
In its first days, magnetic resonance imaging (MRI) was recognized mainly for providing best soft tissue contrast. But it was already known that MRI could do more than providing detailed anatomical information about, for example, biochemical processes through the use of MR spectroscopy. With the inventions such as MR contrast-media, together with the refinement of sequence techniques, MRI is nowadays able to provide both qualitative and quantitative functional information about perfusion and diffusion, as well as motion, such as cardiac wall motion and ejection volume.
Further developments in therapy have, however, triggered new questions from clinicians. Multimodality MRI already plays an important role in understanding disease biology in daily routine. But to provide further, deeper insight into metabolism such as glucose consumption or amino acid synthesis and several functional aspects of tissue like oxygenation or receptor expression, PET is still the imaging modality of choice because of its intrinsic high sensitivity to the probes used within picomolar range.
Of course, some information derived from PET and MRI will be interdependent, ranging from complimentary to contradictory. Thanks to Biograph mMR, we can now combine MRI and PET into one easy-to-handle system and obtain understanding of aspects of the biology of diseases at a single point in time.
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