PET/MR Based Attenuation Corrections of 18 F-FBPA PET for Boron Neutron Capture Therapy: Comparison with PET/CT-based Attenuation Correction

Tumor-to-normal ratio (T/N) measurement is crucial for patient eligibility to receive boron neutron capture therapy. This study aims to compare the difference in standard uptake value ratios on brain tumors and normal brains using PET/MR ZTE and atlas-based attenuation correction with the current standard PET/CT attenuation correction. Regarding the normal brain uptake, the difference was not significant between PET/CT and PET/MR attenuation correction methods. The T/N ratio of PET/CT-AC, PET/MR ZTE-AC and PET/MR AB-AC were 2.34 ± 0.95, 2.29 ± 0.88, and 2.19 ± 0.80, respectively. The T/N ratio comparison showed no significance using PET/CT-AC and PET/MR ZTE-AC. As for the PET/MRI AB-AC, significantly lower T/N ratio was observed (-5.18 ± 9.52%; p < 0.05). The T/N difference between ZTE-AC and AB-AC was also significant (4.71 ± 5.80%; p < 0.01). Our findings suggested PET/MET imaging using ZTE-AC provided superior quantification on FBPA-PET compared to atlas-based AC. Using ZTE-AC on FBPA-PET/MRI might be crucial for BNCT pre-treatment planning.