Advanced Image Analysis Laboratory
Nuclear medicine studies can be particularly useful when they are digitally combined (fused)with anatomical images generated by computed tomography (CT) or magnetic resonance imaging (MRI). Boston Children's Hospital is one of the few pediatric nuclear medicine programs nationwide that is routinely capable of electronically fusing nuclear medicine studies with images obtained from CT or MRI. Since 1996, we have routinely applied image fusion to single photon emission tomography (SPECT), position emission tomography (PET), bone scans, rest-stress myocardial perfusion scintigraphy, MRI, and CT.
These enhanced 3D images are helpful to improve our diagnostic ability. For example, a neurologist can see the exact location in the brain where a seizure originated or an oncologist can determine which parts of a tumor are growing the fastest. Our work has been published and has been the topic of several presentations at national and international meetings.
At Children's, image fusion is used in:
- Neurology - To determine the exact location in the brain where a seizure originates
- Neuro-Oncology - To determine if a brain tumor is metabolically active or not following treatment
- Oncology - To diagnose and determine the extent of a tumor, guide biopsy and radiation oncology treatment, and provide more specific assessment of the effect of therapy
The following are examples of fused images
Example of a nuclear medicine brain SPECT (color) fused to an MRI (black and white) showing the region of the brain responsible for epileptic seizures.
A brain tumor seen on MRI and fused to a brain PET (18F-FDG), reveals that only a portion of the tumor mass is still actively growing after chemotherapy and radiation therapy.
The bone PET (18F-sodium fluoride) shows an area of stress in the lower back due to intense physical activity. The PET/CT fusion provides exquisite anatomical localization of the bone injury.
SPECT/MRI Fusion: A 123I-MIBG SPECT in a young patient with neuroblastoma is fused with and MRI showing that the lesion seen on the SPECT is located in the spine.
For more information and relevant publications:
- Habboush IH, Mitchell KD, Mulkern RV, Barnes PD, Treves ST. Registration and alignment of three-dimensional images: an interactive visual approach. Radiology 1996; 199(2):573-8.
- Treves ST, Mitchell KD, Habboush IH. Three dimensional image alignment, registration and fusion. Q J Nucl Med 1998; 42(2):83-92.