PET/MRI Clinical Research

UCSF participated in the initial FDA clinical trial used to obtain FDA approval for the first time-of-flight PET/MRI in 2014.  Since the installation of the machine, researchers at UCSF have been working on numerous applications leveraging the capabilities of the new technology.  The UCSF Radiopharmaceutical Facility can produce over 30 radiotracers that can be applied in PET/MRI research.  A few example research applications are listed below:

Imaging of Neuroendocrine Tumors

We have been evaluating the utility of Ga-68 DOTA-TOC PET/MRI for the staging of patients with neuroendocrine tumor (of note Ga-68 DOTA-TOC is not FDA approved).  We have imaged over 100 patients using DOTA-TOC PET/CT at UCSF under and Investigational New Drug approval from the FDA.  We have imaged over 15 patients with neuroendocrine tumor using PET/MRI, and using this technology we have been able to provide gold standard imaging of the liver while providing whole body staging for metastatic disease.  The removal of a contrast enhanced CT from the PET/CT study decreases patient radiation dose by over 50%, which is an important issue in this patient population.  Please follow this link to view a video about DOTA-TOC PET/MRI.

Prostate Cancer Staging

Imaging plays an important role in staging of patients with prostate cancer.  At UCSF, we have helped to develop multiparametric MRI as a robust imaging modality for imaging primary tumors in order to determine biopsy and surgical management (Kurhanewicz lab).  One limitation in initial staging of prostate cancer is the limited detection of nodal metastasis, which is particularly important in patients with high-risk disease.  Using agents such as C11 and F18 choline as well as Ga-68 labeled PSMA, we can use combined PET and MRI to provide staging of the primary tumor while imaging for metastatic disease in the same study.

Novel Pulse Sequences and Post-Processing for Attenuation Correction

One of the main limitations of PET/MRI is related to attenuation correction.  In the setting of PET/CT attenuation correction is easily implemented as the CT images can be converted to attenuation maps.  MRI on the other hand does not image density and so an attenuation map cannot be simply created.  This issue can lead to errors in quantitative uptake measurements on PET/MRI.  Therefore we are working on both MRI pulse sequence development and post-processing approaches to create accurate attenuation correction maps in the setting of PET/MRI.

Information for researchers wanting to use the PET/MRI.

 

Journal Publications

  1. Kluijfhout WP, Pasternak JD, Gosnell JE, Shen WT, Duh QY, Vriens MR, de Keizer B, Hope TA, Glastonbury CM, Pampaloni MH, Suh I. 18F Fluorocholine PET/MR Imaging in Patients with Primary Hyperparathyroidism and Inconclusive Conventional Imaging: A Prospective Pilot Study. Radiology. 2017 Jan 25:160768. doi: 10.1148/radiol.2016160768.

  2. Leynes AP, Yang J, Shanbhag DD, Kaushik SS, Seo Y, Hope TA, Wiesinger F, Larson PE. Hybrid ZTE/Dixon MR-based Attenuation Correction for Quantitative Uptake Estimation of Pelvic Lesions in PET/MRI. Med Phys. 2017 Jan 23. doi: 10.1002/mp.12122.

  3. Yang J, Khalighi M, Hope TA, Ordovas K, Seo Y. Technical Note: Fast respiratory motion estimation using sorted singles without unlist processing: A feasibility study. Med Phys. 2017 Jan 18. doi: 10.1002/mp.12115.

  4. Barajas RF, Pampaloni MH, Clarke JL, Seo Y, Savic D, Hawkins RA, Behr SC, Chang SM, Berger M, Dillion WP, Cha S. Assessing biological response to bevacizumab using 18F-fluoromisonidazole PET/MR imaging in a Patient with Recurrent Anaplastic Astrocytoma. Case Rep Radiol. 2015;2015:731361.

  5. Hope TA, Pampaloni MH, Nakakura E, VanBrocklin H, Slater J, Jivan S, Aparici CM, Yee J, Bergsland E. Simultaneous 68Ga-DOTA-TOC PET/MRI with gadoxetate disodium in patients with neuroendocrine tumor. Abdom Imaging. 2015 Mar 28.

  6. Burris NS, Johnson KM, Larson PE, Hope MD, Nagle SK, Behr SC, Hope TA. Detection of Small Pulmonary Nodules with Ultrashort Echo Time Sequences in Oncology Patients by Using a PET/MR System. Radiology. 2015 Jul 2:150489.

  7. Hope TA, Verdin EJ, Bergsland EK, Ohliger MA, Corvera CU, Nakakura EK. Correcting for respiratory motion in liver PET/MRI: preliminary evaluation of the utility of bellows and navigated hepatobiliary phase imaging. EJNMMI Physics. 2015:2(1):21.

Conference Presentations

  1. Behr S, Nardo L, Hawkins R, Hope T, Ravanfar V, Verdin E, Savic D, Seo Y. Ultrafast PET acquisition using solid-state photomultiplier-based PET camera under a strong magnetic field. Presented at the Radiological Society of North America Annual Meeting, Chicago, IL, 2014.
  2. Huang SY, Shrestha U, Seo Y. The effect of magnetic field on positron range and spatial resolution in an integrated whole-body time-of-flight PET/MRI system. Presented at the IEEE Nuclear Science Symposium and Medical Imaging Conference, Seattle, WA, 2014.
  3. Seo Y, Ravanfar V, Kohli L, Behr S. Feasibility assessment of quantitative PET studies using a high-sensitivity PET based on solid-state photomultiplier photodetectors in a strong magnetic field. Presented at the World Molecular Imaging Congress, Seoul, Korea, 2014.
  4. Hope TA, Pampaloni MH, Nakakura EK, VanBrocklin H, Slater J, Jivan S, Aparici CM, Yee J, Bergsland EK.  Evaluation of DOTA-TOC PET/MRI combined with gadoxetate enhanced MRI for the evaluation of neuroendocrine tumors. Third Theranostics World Congress on Ga-68 and Radiopeptide Therapy, March 2015.
  5. Hope TA, Aparici CM, Nakakura E, VanBrocklin H, Pampaloni MH, Slater J, Jivan S, Yee J, and Bergsland EK. Utility of combined Ga-68 DOTA-TOC PET and Eovist MRI utilizing PET/MRI. ISMRM, May 2015.
  6. Hope TA, Verdin E, Behr S, Ohliger MA, Nakakura E, Corvera CU. Benefits of dedicated hepatic imaging using simultaneous PET/MRI. SNMMI, June 2015.
  7. Huang SY, Shrestha U, Seo Y. The effect of magnetic field on positron range and spatial resolution in an integrated whole-body time-of-flight PET/MRI system. Presented at the IEEE Nuclear Science Symposium and Medical Imaging Conference, Seattle, WA, 2014.
  8. Yang J, Tohme M, Behr S, Jian Y, Hope T, Larson P, Vigneron D, Majumdar S, Seo Y. Impact of atlas-CT-based bone anatomy compensation on MRAC for brain PET imaging in a time-of-flight PET/MRI system. Presented at the 4th Conference on PET/MR and SPECT/MR, La Biodola, Isola d’Elba, Italy, 2015.
  9. Savic D, Seo Y, Hawkins R, Cha S, Pampaloni M, Majumdar S, Barajas R. Noninvasive image-based quantification of 18F-fluoromisonidazole (FMISO) uptake using PET/MRI. Presented at the International Society of Magnetic Resonance in Medicine Annual Meeting, Toronto, Canada, 2015.
  10. Seo Y, Hawkins R, Christine CW, Larson P, Bankiewicz K. In vivo quantitative PET/MR imaging of gene expression in Parkinson’s Disease. Presented at the Society of Nuclear Medicine and Molecular Imaging Annual Meeting, Baltimore, MD, 2015.
  11. Yang J, Tohme M, Jian Y, Deller T, Jansen F, Behr S, Vigneron D, Majumdar S, Seo Y. Quantitative evaluation of atlas-based MR attenuation correction for brain PET imaging using a time-of-flight PET/MRI system: A direct comparison with CT-based attenuation correction. Presented at the Society of Nuclear Medicine and Molecular Imaging Annual Meeting, Baltimore, MD, 2015.
  12. Yang J, Jian Y, Tohme M, Jenkins N, Behr S, Hope T, Larson P, Vigneron D, Majumdar S, Seo Y. Quantitative evaluation of bone-anatomy compensation methods for MR-based attenuation correction for brain PET imaging in a time-of-flight PET/MRI system. Presented at the World Molecular Imaging Congress, Honolulu, HI, 2015.
  13. Savic D, Mazur CM, Venkatachari AK, Pedoia V, Seo Y, Franc BL, Majumdar S. 18F sodium fluoride uptake on PET/MRI is associated with pain and cartilage degeneration in knee osteoarthritis. Presented at the World Molecular Imaging Congress, Honolulu, HI, 2015.
  14. Mazur CM, Savic D, Pedoia V, Venkatachari AK, Seo Y, Franc BL, Majumdar S. Cartilage-bone interactions in osteoarthritis: A PET/MR study using T1rho dispersion. Presented at the World Molecular Imaging Congress, Honolulu, HI, 2015.

Lead Researchers

Spencer Behr, MD
Professor
Director, Fellowship Programs
Associate Director, Precision Imaging of Cancer and Therapy
Professor Clinical Radiology