Synergy in Neuroimaging: PET-CT and MRI Fusion for Enhanced Characterization of Brain Pathology

Background: Accurate diagnosis and understanding of brain disorders are crucial for the best treatment. While multimodal neuroimaging is essential, it has its limitations. Conventional computed tomography (CT) and magnetic resonance imaging (MRI) provide detailed anatomical information but lack molecular insights, while 18F-fluorodeoxyglucose-positron emission tomography (FDG PET) offers metabolic data but often has limited spatial resolution.

Objective: This study aimed to assess the potential of combining 18F-FDG PET with MRI to characterize brain disorders compared to standard imaging methods.

Methods: Fifty patients suspected of having brain tumors underwent 18F-FDG PET-CT and then MRI (including 3D fluid-attenuated inversion recovery (FLAIR)) after CT scans revealed suspicious lesions. The images were combined and PET-MRI findings were compared to the initial CT interpretations.

Results: The combination of PET-MRI significantly improved diagnostic accuracy in 20 out of the 50 patients (40%). Importantly, it identified and characterized brain lesions missed by CT in two patients (4%). In patients with known dementia or epilepsy, PET-MRI revealed specific metabolic patterns in affected brain areas.

Conclusion: 18F-FDG PET-MRI fusion shows greater sensitivity and specificity than standard imaging techniques for various brain disorders. It provides valuable insights into structural and functional abnormalities, potentially leading to improved diagnosis, treatment planning, and patient outcomes.