Development of a Methodological Framework for Integrated PET/MR Imaging of Neurodegeneration

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Currently, dedicated guidelines and frameworks are available for stand-alone brain imaging techniques, such as MRI and PET. Due to substantial differences in image data acquisition and processing, a direct translation of these single-modality guiding principles into integrated PET/MRI is not feasible. Acquiring brain PET and MRI data with integrated systems also allows the gathering of multimodality information at the same time - an opportunity which is of special interest to drug testing applications and which is not supported by separate imaging systems. Furthermore, newly developed brain PET tracers tend to be highly specific with regard to their target, which is advantageous for target characterisation, but can complicate the post-hoc coregistration to other imaging modalities due to the reduced anatomical information in the PET images. Therefore, dedicated frameworks/ guidelines are needed for the proper utilisation of integrated brain PET/MRI. Such documents are so far, however, not available, aside from the initial work by members of this initiative to (i) describe physical and organizational provisions for the implementation of integrated PET/MRI system, (ii) guide technologists on how to acquire brain PET/MRI scans, and (iii) investigate ways to control quality of integrated PET/MRI. In addition, a statement was recently published by the respective bodies regarding the training, experience, judgment skills, and competence that should be available in the USA to perform integrated brain PET/MRI in clinical routine. The members of this present initiative are convinced that integrated brain PET/MRI requires more work than that already done on harmonisation and alignment before it can reveal its full potential in brain imaging. Specifically, there is a great need for a methodological framework to guide physicians, technologists, physicists, as well as technicians who jointly desire to apply this new technology in patients with NDs.