A Practical Approach to Optimize Scan Protocol for Simultaneous Whole-Body Positron Emission Tomography/Magnetic Resonance Imaging in Cancer Staging

OBJECTIVE: The aim of the report is to present time efficient whole-body positron emission tomography/magnetic resonance imaging (PET/MRI) protocol evolved and tested for comprehensive evaluation of cancer patients. MATERIALS AND METHODS: Whole body as well as regional simultaneous PET and MRI was performed on Biograph mMR (Siemens, Erlangen, Germany) Simultaneous PET/MRI system in 4500 clinical cases of various cancers from 2013 to 2017 with an in-house designed imaging protocol to assess its utility. RESULTS: Using this protocol, the whole body is covered with optimized sequences (T1, T2, short tau inversion recovery, diffusion, and 3D volumetric interpolated breath-held) with PET which has been found adequate for complete metastatic workup in 30–45 min. With region-specific studies, it provides a comprehensive staging workup in an additional 10–15 min. The workflow offered additive advantages of effectively addressing incidentalomas besides being useful in terms of diagnostic utility. CONCLUSION: The proposed whole-body PET MRI imaging protocol used in a clinical setting is found acceptable and reasonably time efficient to optimally exploit the potentials of the technique in oncology.