Value of a Dixon-based MR/PET attenuation correction sequence for the localization and evaluation of PET-positive lesions

Matthias Eiber, Axel Martinez-Möller, Michael Souvatzoglou, Konstantin Holzapfel, Anja Pickhard, Dennys Löffelbein, Ivan Santi, Ernst J. Rummeny, Sibylle Ziegler, Markus Schwaiger, Stephan G. Nekolla, Ambros J. Beer

Research output: Contribution to journalArticlepeer-review

155 Scopus citations


Purpose In this study, the potential contribution of Dixon-based MR imaging with a rapid low-resolution breath-hold sequence, which is a technique used for MR-based attenuation correction (AC) for MR/positron emission tomography (PET), was evaluated for anatomical correlation of PET-positive lesions on a 3Tclinical scanner compared to low-dose CT. This technique is also used in a recently installed fully integrated whole-body MR/PET system. Methods Thirty-five patients routinely scheduled for oncological staging underwent 18F-fluorodeoxyglucose (FDG) PET/CT and a 2-point Dixon 3-D volumetric interpolated breath-hold examination (VIBE) T1-weighted MR sequence on the same day. Two PET data sets reconstructed using attenuation maps from low-dose CT (PET AC-CT) or simulated MR-based segmentation (PET AC-MR) were evaluated for focal PET-positive lesions. The certainty for the correlation with anatomical structures was judged in the low-dose CT and Dixon-based MRI on a 4-point scale (0-3). In addition, the standardized uptake values (SUVs) for PETAC-CT and PET AC-MR were compared. Results: Statistically, no significant difference could be found concerning anatomical localization for all 81 PET-positive lesions in low-dose CT compared to Dixonbased MR (mean 2.51±0.85 and 2.37±0.87, respectively; p=0.1909). CT tended to be superior for small lymph nodes, bone metastases and pulmonary nodules, while Dixon-based MR proved advantageous for soft tissue pathologies like head/neck tumours and liver metastases. For the PET AC-CT- and PET AC-MR-based SUVs (mean 6.36±4.47 and 6.31±4.52, respectively) a nearly complete concordance with a highly significant correlation was found (r=0.9975, p<0.0001). Conclusion: Dixon-based MR imaging for MR AC allows for anatomical allocation of PET-positive lesions similar to low-dose CT in conventional PET/CT. Thus, this approach appears to be useful for future MR/PET for body regions not fully covered by diagnostic MRI due to potential time constraints.

Original languageEnglish
Pages (from-to)1691-1701
Number of pages11
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Issue number9
StatePublished - Sep 2011


  • Attenuation correction
  • Dixon-based VIBE T1-weighted MR sequence
  • Localization
  • Low-dose CT
  • MR/PET


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