Medical indications for PET/MRI

Nuclear medicine provides necessary informations in a situations where traditional diagnostic tools are insufficient to make a diagnosis. Depending on the tracers used, it is possible to provide a lot of valuable informations that may be important from the point of view of further treatment of many serious diseases by using the simultaneous full-body examination using two positron emission tomography (PET) and magnetic resonance modalities. PET / MRI is widely perceived as the examination by choice for imaging different kinds of tumors by connection of information on morphology, function and metabolism. The MR and PET hybrid offers the possibility of fuller imaging and a better understanding of many diseases. Current research and development of new radiotracers can raise even more the importance of research using this hybrid device. In the brain, detailed MR structural information combined with the image of PET metabolic activity help in early detection of the disease, precise planning of surgical intervention and allow effective post-treatment control. In the musculoskeletal system, the combination of MR and PET data allows an in-depth assessment of soft tissues and bone marrow. In the torso area, PET images provide detailed information on the metabolism of the thoracic and abdominal organs, while MR images complement the picture with additional functional and structural data. In addition, MR data can be used to correct motion artifacts in PET images, which significantly improves the quality of imaging.

Application of PET/MR examination

  • detection and assessment of malignancy of tumors based on their metabolic activity and MR image
  • detection of brain tumors of small diameter, eg metastases from lung cancer (diameter ~ 5 mm) – higher diagnostic sensitivity from CT or PET-CT,
  • imaging of head and neck tumors, eg cancer of the tongue, mouth, larynx,
  • diagnostics of lung diseases, including: lung tumors and their metastases, sensitivity comparable to PET-CT,
  • diagnosis and assessment of mediastinal tumors
  • diagnosis of pleural mesothelioma,
  • qualitative assessment and malignancy of breast tumors, imaging and assessment of axillary lymph nodes,
  • assessment of the degree of inflammatory changes in the course of sarcoidosis,
  • epigastric tumors showing increased glucose metabolism,
  • detection of tumors of the lower abdomen, among others: liver – hepatocellular cancer, bile ducts, metastases to the liver,
  • bile duct tumors – gall bladder tumor, bile ducts,
  • pancreatic cancer,
  • stomach, small intestine and other – stomach tumors, gastrointestinal stromal tumors,
  • large intestine – glucose metabolism increases in most colorectal cancers,
  • urinary system – prostate cancer diagnostics
  • diagnostics, assessment of the severity and recurrence of gynecological cancer in women in the pelvic region: ovarian cancer, endometrial cancer, cervical cancer,
  • musculoskeletal cancers: assessment of the severity of the disease, diagnosis of metastases / recurrence, assessment of response to treatment,
  • malignant melanoma – the test enables the detection of metastases (most often subcutaneous, to the bones, liver and brain) and to assess the effectiveness of chemotherapy,
  • lymphomas and other hematological diseases – assessment of the severity of the disease, recurrence, selection of the right treatment method and assessment of the response to treatment,
  • searching for an outbreak of primary cancer,
  • inflammatory diseases such as inflammation of large vessels
  • location of inflammatory foci,
  • diagnostics of neurodegenerative diseases, dementias – eg Alzheimer’s disease, differential diagnosis of fronto-temporal dementia (FTD) and Alzheimer’s disease (AD),
  • location of epileptic foci and diagnostics of glucose hypometabolism disorders during interictal periods,
  • assessment of myocardial viability.
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Contraindications for PET MR test and special precautions

  • pregnancy (for this reason, patients of childbearing age (ie from the first menstruation to the year after the last menstruation) are asked to perform a pregnancy test (can be purchased at the pharmacy) 1 day before the test and show the test result in the laboratory on the day of the examination. It is necessary to signing a statement that the patient who is applying for the test is not pregnant. In the case of breastfeeding, it is advisable to stop feeding for 24 hours after giving the radiotracer),
  • presence inside the body of metallic foreign bodies / implants / prostheses / stimulants, etc.