E. Edmund Kim · Hyung-Jun Im Dong Soo Lee · Keon Wook Kang Atlas and Anatomy of PET/MRI, PET/CT and SPECT/CT 123 Atlas and Anatomy of PET/MRI, PET/CT and SPECT/CT Atlas and Anatomy of PET/MRI, PET/CT and SPECT/CT E. Edmund Kim, MD, MS Department of Radiological Sciences, School of Medicine, University of California at Irvine, Irvine, CA, USA Hyung-Jun Im, MD, PhD Department of Nuclear Medicine, Seoul National University, Seoul, Republic of Korea Dong Soo Lee, MD, PhD Department of Nuclear Medicine and Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, Republic of Korea Keon Wook Kang, MD, PhD Department of Nuclear Medicine and Cancer Research Institute, Seoul National University, Seoul, Republic of Korea E. Edmund Kim, MD, MS Hyung-Jun Im, MD, PhD Department of Radiological Sciences Department of Nuclear Medicine School of Medicine Seoul National University University of California at Irvine Seoul , Republic of Korea Irvine , CA , USA Keon Wook Kang, MD, PhD Dong Soo Lee, MD, PhD Department of Nuclear Medicine and Cancer Department of Nuclear Medicine and Department Research Institute of Molecular Medicine and Biopharmaceutical Seoul National University Sciences Seoul , Republic of Korea Seoul National University Seoul , Republic of Korea ISBN 978-3-319-28650-1 ISBN 978-3-319-28652-5 (eBook) DOI 10.1007/978-3-319-28652-5 Library of Congress Control Number: 2016935407 © Springer International Publishing Switzerland 2016 This work is subject to copyright. 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Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. Printed on acid-free paper This Springer imprint is published by Springer Nature The registered company is Springer International Publishing AG Switzerland Pref ace Since we published S ectional Anatomy: PET/CT and SPECT/CT in 2007, there has been a signifi cant increase in the use of hybrid imaging in clinical practice and also reports of higher sensitivity and specifi city than those of the single imaging modality, thus making the integrated approach a more accurate imaging test. The precise lesion localization within the anatomic context, which frequently is critical, may not be possible in PET or SPECT. It is not easy to consider three dimensions in our mind’s eye and view the relationship of the pathology with surrounding normal organs in axial, coro- nal, and sagittal imaging. With gradual improvement of instruments as well as software for attenuation corrections, we have used new PET/CT and SPECT/CT images and also added PET/MRI images. I n all hybrid imaging, a good workfl ow is paramount for cost-effectiveness in clinical prac- tice. Since data acquisition on emission systems can only be dynamic or static, the major varia- tions of imaging protocols are on the anatomic imaging side. This atlas intends to provide educational information on sectional anatomy and illustrate common pathologies for trainees and practitioners in the fi elds of nuclear medicine, radiology, oncology, neurology, cardiology, and general medicine. E. Edmund Kim, MD, MS Hyung-Jun Im, MD, PhD Dong Soo Lee, MD, PhD Keon Wook Kang, MD, PhD v Acknowledgments W e express our gratitude to all our colleagues at the Seoul National University Hospital as well as the University of Texas M.D. Anderson Cancer Center, and also sincere thanks to our wives and children who support our works. We appreciate Mr. Lee Klein and his assistants at Springer who helped in the creation of this book. vii Contents 1 Atlas and Anatomy of PET/MR ................................................................................... 1 1.1 Brain .................................................................................................................... 1 1.1.1 Case 1 ...................................................................................................... 1 1.1.2 Case 2 ...................................................................................................... 1 1.2 Head and Neck .................................................................................................... 22 1.2.1 Case 1 ...................................................................................................... 22 1.2.2 Case 2 ...................................................................................................... 28 1.3 Chest ................................................................................................................... 32 1.3.1 Case 1 ...................................................................................................... 32 1.3.2 Case 2 ...................................................................................................... 49 1.4 Abdomen ............................................................................................................. 54 1.4.1 Case 1 ...................................................................................................... 54 1.4.2 Case 2 ...................................................................................................... 58 1.4.3 Case 3 ...................................................................................................... 73 1.4.4 Case 4 ...................................................................................................... 73 1.4.5 Case 5 ...................................................................................................... 93 1.4.6 Case 6 ...................................................................................................... 101 1.4.7 Case 7 ...................................................................................................... 101 1.4.8 Case 8 ...................................................................................................... 108 1.5 Pelvis ................................................................................................................... 115 1.5.1 Case 1 ...................................................................................................... 115 1.5.2 Case 2 ...................................................................................................... 135 1.5.3 Case 3 ...................................................................................................... 135 1.6 Musculoskeletal System ...................................................................................... 164 1.6.1 Case 1 ...................................................................................................... 164 1.6.2 Case 2 ...................................................................................................... 164 1.6.3 Case 3 ...................................................................................................... 182 References .................................................................................................................... 196 2 Atlas and Anatomy of PET/CT .................................................................................... 199 2.1 FDG ..................................................................................................................... 199 2.1.1 Brain/Head and Neck .............................................................................. 199 2.1.2 Chest ....................................................................................................... 230 2.1.3 Abdomen ................................................................................................. 266 2.1.4 Others ...................................................................................................... 330 2.2 Non-FDG ............................................................................................................ 3 59 2.2.1 11C-Acetate ............................................................................................ 359 ix