PET/MRI for Neurologic Applications

Targeted CE per ARRT’s Discipline, Category, and Subcategory classification:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Magnetic Resonance Imaging: 0.75
Patient Care: 0.25
Patient Interactions and Management: 0.25
Image Production: 0.25
Data Acquisition, Processing, and Storage: 0.25
Procedures: 0.25
Neurological: 0.25

Nuclear Medicine Technology: 1.00
Patient Care: 0.25
Patient Interactions and Management: 0.25
Image Production: 0.25
Instrumentation: 0.25
Procedures: 0.50
Endocrine and Oncology Procedures: 0.25
Other Imaging Procedures: 0.25

Registered Radiologist Assistant: 0.50
Procedures: 0.50
Neurological, Vascular, and Lymphatic Sections: 0.50

Outline

1. Introduction
2. Methodologic and Scientific Advantages
3. MRI-Based PET Motion Correction
   1. Partial-Volume Effect (PVE) Correction
   2. Image-Based Radiotracer AIF Estimation
   3. Technique Cross-Calibration and Validation
4. Advantages of Simultaneous PET/MRI in Clinical and Research Applications
   1. Brain Tumors
   2. Dementia/Neurodegeneration
   3. Stroke/Cerebrovascular Disorders
   4. Epilepsy
   5. Neurobiology of Brain Activation
   6. Translational Research
5. Conclusion

Objectives

Upon completion of this course, students will:

1. identify the indicators of changes in brain hemodynamics
2. recognize a common source of motion during neurologic PET imaging
3. identify the categories of uncooperative patients that can benefit from simultaneous PET/MRI
4. understand the factors that affect tissue activity concentration on PET images
5. recognize the brain structure most often affected by partial volume effects
6. identify the factor affecting the accuracy of PVE correction that is eliminated by simultaneous PET/MRI acquisition
7. identify the gold standard for determining the arterial input function
8. identify the gold standard for measuring cerebral blood flow
9. describe the performance of functional MRI using BOLD imaging sequences
10. explain the neurologic concept of the brain baseline state
11. indicate the MRI techniques being used to investigate brain connectivity
12. identify the PET tracer used to measure metabolism
13. describe the magnetic properties of gadolinium-based contrast agents
14. list the types of MR images suitable for GBCA enhancement
15. explain the semi-quantitative measurement cerebral blood flow
16. explain the semi-quantitative measurement cerebral blood volume
17. describe the magnetic properties of oxyhemoglobin and deoxyhemoglobin
18. list ways that MRI assesses brain anatomy
19. list the factors that affect contrast enhancement of MR images
20. identify the PET tracer used to evaluate cellular proliferation
21. identify the PET tracer used to evaluate tissue hypoxia
22. recognize the most aggressive and fatal brain tumor
23. understand barriers preventing the use of novel MRI techniques in the evaluation of cognitive impairment or suspected dementia
24. identify the PET tracer used to evaluate amyloid deposition
25. identify the gold standard for noninvasively identifying brain regions associated with ischemic stroke
26. list the categories of PET tracers that are most useful in the acute phase of ischemic stroke
27. indicate the time window during which patient are most likely to benefit from therapeutic interventions following ischemic stroke
28. list the benefits to patients from the use of integrated PET/MRI systems
29. describe the fastest-acting cells in the human body
30. indicate the physical half-life of the isotope carbon-11