Growth of Hybrid Imaging

Bryan VanMeter

I am attending the European Congress of Radiology (ECR) this week in Vienna, Austria where there’s lots of interest around hybrid imaging.  Combining anatomical and molecular imaging started in earnest in 2001 with the introduction of the first fully integrated PET/CT systems.  Since then, PET/CT has seen significant adoption in oncology diagnosis and treatment assessment.  Additionally, the technology is seeing emerging applications in neurology and cardiology.  SPECT/CT introduced a few years after PET/CT has had a slower adoption, while PET/MR, which has been only commercially available for three years, is gaining substantial interest. It’s estimated that there are 60 PET/MR systems installed or scheduled to be installed world-wide.

At ECR 2015, GE Healthcare is introducing our entry into the PET/MR market with the SIGNA PET/MR, which pairs a 3.0T MR with the latest positron emission tomography (PET) technology.  Complementing this imaging modality introduction is GE Healthcare IT’s next generation server based AW platform, VS7, which contains a updated  volume viewer application with MR/PET functionality*  With an advanced visualization tool for volumetric visualization of fused MR anatomical images and PET active biochemistry, data can be visualized to help pinpoint areas of abnormal cell growth.

AW’s new volume viewer software may aid radiologists in some of the challenges associated with hybrid imaging, such as how morphological and functional imaging interact and how this interaction may lead to lower quality images caused by artifacts. “Body parts such as the gastrointestinal tract uptake may also focally take up FDG, which may be misinterpreted as a tumor.  This will be known to regular hybrid imagers but not to the general radiologist typically using it once in a while for oncology questions”, said Prof. Dr. Gerald Antoch, chair of radiology at Dusseldorf University Hospital, Germany.

Two other key points that will affect the growth of hybrid imaging brought up at today’s presentations and panel discussions, were reimbursement and the development of new molecular tracers.  It’s realistic to state that the future of hybrid imaging is heavily dependent on reimbursement, which in some European countries remains limited while in others is more liberal.   According to Thomas Beyer, Ph. D., from the Medical University of Vienna, there is no reimbursement for hybrid imaging in Austria, while there are two approved indications in Germany, and in Switzerland almost all indications are approved.  The second key driver that will affect the future of hybrid imaging and supporting AV applications is the availability of new and different molecular tracers.  It is anticipated that new tracers will be very specific, meaning high sensitivity within the targeted areas/regions with little non-targeted anatomical background signal.  It is anticipated these advances in tracers will be especially impactful for PET/MR applications, such as in the area of neurodegenerative disease.



* AW VS7 server platform and AW VS7 applications anticipated availability first half of 2015 in the U.S. and EU.  Products cannot be placed on the market or put into service until they have been made to comply with CE marking.   Not all applications will be regulatory approved or licensed in all countries.

1 “New breed of imagers can ensure hybrid techniques thrive in clinical routine”; Clinical Corner, March 4, 2015; European Society of Radiology

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