Quantitative accuracy of preclinical in ovo PET/MRI: influence of attenuation and quantification methods

Aim: The combination of positron emission tomography (PET) and magnetic resonance imaging (MRI) provides an innovation leap in the use of fertilized chicken eggs (in ovo model) in preclinical imaging as PET/MRI enables the investigation of the chick embryonal organ-specific distribution of PET-tracers. However, hybrid PET/MRI inheres technical challenges in quantitative in ovo PET such as attenuation correction (AC) for the object as well as for additional hardware parts present in the PET field-of-view, which potentially contribute to quantification biases in the PET images if not accounted for. This study aimed to investigate the influence of the different sources of attenuation on in ovo PET/MRI and assess the accuracy of MR-based AC for in ovo experiments.

Method: An in-house made chicken egg phantom was used to investigate the magnitude of self-attenuation and the influence of the MRI hardware on the PET signal. The phantom was placed in a preclinical PET/MRI system and PET acquisitions were performed without, and after subsequently adding the different hardware parts to the setup. Reconstructions were performed without any AC for the different setups and with subsequently incorporating the hardware parts into the AC. In addition, in ovo imaging was performed using [¹⁸F]FDG and [⁶⁸Ga]Ga-Pentixafor, and PET data was reconstructed with the different AC combinations. Quantitative accuracy was assessed for the phantom and the in ovo measurements.

Results: In general, not accounting for the self-attenuation of the egg and the hardware parts caused an underestimation of the PET signal of around 49% within the egg. Accounting for all sources of attenuation allowed a proper quantification with global offsets of 2% from the true activity. Quantification based on % injected dose per cc (%ID/cc) was similar for the in ovo measurements, regardless of whether hardware parts were included in AC or not, when the injected activity was extracted from the PET images. However, substantial quantification biases were found when the self-attenuation of the egg was not taken into account.

Conclusion: Self-attenuation of the egg and PET signal attenuation within the hardware parts of the MRI substantially influence quantitative accuracy in in ovo measurements. However, when compensating for the self-attenuation of the egg by a respective AC, a reliable quantification using %ID/cc can be performed even if not accounting for the attenuation of the hardware parts.