Project Summary/Abstract We propose the clinical translation and validation of an innovative “radiofrequency (RF) penetrable” dedicated positron emission tomography (PET) insert technology that can be placed within any stand- alone magnetic resonance imaging (MRI) system for acquiring simultaneous PET/MRI data. For this proposal the Stanford team will work with industry partner “PETcoil” to address technical developments required for translational studies, ensure industry level standardization of end user software and technology, and acquire first in-patient simultaneous PET/MRI data using this novel PET insert. PET/MRI exhibits some attractive features. First, combined PET/MRI is uniquely capable of providing excellent anatomical soft tissue contrast and multi-parameter information in a single a scan and, as a result, PET/MR is now commonly used for characterizing disease in regions such as the brain, head and neck, breast, liver and pelvis. Second, MRI does not introduce ionization radiation in a PET/MR study. This significant reduction of radiation dose makes PET/MRI an attractive modality for pediatric patients and those requiring recurring PET studies. Third, PET/MR imaging can occur simultaneously, unlike sequential PET/CT, resulting in temporal in addition to spatial correlation of PET with MR data. Despite these attractive features, the adoption of PET/MRI has been slow since its introduction in 2011. One main reason for this slow adoption is the high cost of procuring an integrated PET/MRI system, which is about $5M for the machine and another $1.5–2M for required room renovations to host the machine. The resulting cost (~$6-7M) is simply not affordable for most institutions. Furthermore, the permanently integrated PET/MR system designs offered by vendors such as GE and Siemens yield sub-optimal spatial resolution and sensitivity performance for the PET system component, especially for neurological imaging applications. The proposed brain-dedicated PET ring offers higher photon sensitivity and spatial resolution, and can be inserted into any existing MR system; thus a user only needs to procure the insert, and MR system modifications or room renovations are not required, reducing the entry costs roughly 10- fold. We have realized a 1st generation brain dedicated PET insert for simultaneous PET/MR and are completing a 2nd generation version, both with a spatial resolution of 2.7x2.7x2.7 mm3 and the latter achieving a photon sensitivity of >6%. In addition, this insert approach is “RF penetrable,” an important and novel concept enabling collection of PET/MR data using the MR system’s built-in body coil for RF transmission through the PET ring insert into the patient, and only a RF receiver coil resides inside the insert, thus facilitating the lower cost insert concept for achieving PET/MR. We will translate and validate the 2nd generation brain PET insert and work with our industry partner to standardize our data processing workflow. If successful, this project will enable more widespread dissemination/accessibility of PET/MRI.

Project Narrative We propose the clinical translation and validation of an innovative “radiofrequency (RF) penetrable” positron emission tomography (PET) insert technology that can be placed within any stand-alone magnetic resonance imaging (MRI) system for acquiring simultaneous PET/MRI data using the MR system’s built-in body coil for RF transmission. If successful, the results of this project will enable more widespread dissemination of and accessibility to simultaneous PET/MR imaging through the availability of this lower cost, novel PET insert technology alternative to the high cost permanently integrated PET/MR systems that are currently deployed in the field.