MR-PET für die Medizinische Bildgebung

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In response to the DFG call for a PET-MR scanning system, the “Leipzig Combined PET-MRI” (LEipzig X combined PET-MRT, LEXPERT) initiative seeks funding. LEXPERT assembles an interdisciplinary consortium of internationally renowned PET and MRI imaging researchers from the Depts. of Nuclear Medicine (NUK), Diagnostic and Interventional Radiology (RAD), Neuroradiology (NEU), Pediatric Radiology (PED), and Cognitive Neurology at the University Hospital Leipzig, the Dept. of Neurology at the Max Planck Institute for Human Cognitive and Brain Sciences (MPI), the Dept. of Diagnostic and Interventional Radiology at the University Leipzig / Heart Center Leipzig (HZL), and the Fraunhofer Institute for Cell Therapy and Immu-nology Leipzig (IZI). As such, we can draw from a broad PET and MR imaging expertise to ad-dress a wide spectrum of research topics ranging from preclinical animal models to clinical ap-plications in immunology, neurosurgery, pediatrics, neuropsychiatry, oncology and cardiology. For many research questions, combining functional and morphological imaging information as obtained by sequential PET, fMRI and/or MRI has already been established as a standard procedure since sufficient precision of coregistration can be obtained with software-based co-registration algorithms. However, when a finding in one imaging modality (e.g. PET) must be directly related to a certain (e.g. functional) state as defined by the other modality (e.g. fMRI), simultaneous PET-MR imaging becomes crucial. Therefore, we and others believe in the unique potential of combined PET-MRI to substantially advance the medical imaging repertoire avail-able for basic and clinical research. LEXPERT will focus on those scientific questions, for which simultaneous acquisition of the respective imaging data is key to improve diagnostics. Brain studies to be performed with the new combined imaging technique comprise basic re-search applications aiming at (i) establishing a “multimodal brain state neuroimaging“ with simul-taneous EEG, fMRI, and PET measurements and (ii) quantitative validation of BOLD fMRI con-trast by comparative perfusion PET. Preclinical large animal and clinical testing is planned for (iii) measuring the neurotransmitter / brain state effects of nicotine on addiction and dementia, (iv) investigating mood-affecting hormonal changes on serotonergic and general brain function, (v) verifying the stroke-MR concept currently in clinical routine in acute stage, (vi) improving the understanding, imaging and treatment of the ischemic penumbra in acute stroke, (vii) simulta-neously tracing stem cells and monitoring their treatment effects in stroke, as well as for (viii) simultaneously assessing cerebral metabolism and circulation in aneurysmal subarachnoid hemorrhage. In the area of tumor imaging, cervical cancer will be investigated as a model for the estab-lishment of combined whole-body PET-MRI to improve primary or recurrence tumor staging as well as therapy monitoring. This model was chosen to be the first in a simultaneous design based on the extreme challenge tumor-staging of cervical cancer poses in terms of spatial co-registration that is often limited in conventional sequential imaging design. We predict that pro-gress achieved for cervical cancer can then be transferred to other tumor entities. Further we aim to investigate the diagnostic potential of combined PET-MRI and the degree of anesthesia and radiation burden reduction for children suffering from Hodgkin’s disease, bone malignan-cies, and Ewing sarcoma (as compared to sequential whole-body PET-CT and MR imaging). In cardiac research, combined PET-MRI will be applied to (i) simultaneously image coronary artery morphology and inflammation to identify patients with vulnerable plaques at an early stage of disease, (ii) improve diagnosis of myocarditis, and to (iii) verify the concept of measur-ing myocardial perfusion versus the PET gold standard. The scientific expertise of LEXPERT is met with full commitment of the Leipzig University Hospital and the Medical Faculty of the Leipzig University to maximize the clinical impact of the PET-MR scanner in Leipzig. The first milestones of setting up the infrastructure required to in-stall a combined PET-MRI system have already been achieved. There is a clear financial com-mitment of the University Hospital Leipzig / Medical Faculty of the Leipzig University to cover follow-up expenditures, and additional funding will be secured from partners of the PET and MRI scanner, as well as image processing software and radiotracer manufacturing industry. To optimize the utilization of a combined PET-MRI system, a straight-forward user concept has been developed, which will allow access to “internal” and “external” scientists interested in this field and foster international collaboration. We are convinced that LEXPERT does not only meet all scientific and infrastructural prereq-uisites to successfully run a combined PET-MRI system, but that we have jointly developed a unique and ambitious research agenda to secure further cutting edge methodological develop-ment, solid scientific validation studies and clinical testing, and the exploration of compelling innovative applications of the simultaneous PET-MRI technique.