The highly anticipated 4th Chinese PET/MR academic symposium successfully took place in Rui** Hospital, Shanghai Jiao Tong University School of Medicine on May 9th -12th, which attracted more than 480 experts, researchers and practitioners from China and Europe (Fig. 1).

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Group photo of the main attending experts

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Since the first PET/MR was introduced into clinical use in China in 2012, there have been more than 80 PET/MR installations, and over 20 device orders pending as of April 2024. However, in fact, it has not enjoyed the same rapid adoption as PET/CT over the past decade, owing to its slower scanning speed and higher cost. Its clinical application value was once challenged by the more cost-effective pattern of PET/CT plus MR alone.

Building on the success of the 3rd PET/MR symposium [1], this meeting put a particular emphasis on the advantageous clinical applications, AI-assisted enhanced image quality and increased scan speed in PET/MR, and meanwhile showcased the powerful and versatile benefits that hybrid PET/MR brings to the diagnosis of diseases by preserving spatial and temporal consistency between these two imaging modalities. Attendees were treated to a series of compelling presentations, covering diverse topics, including a total of 33 keynote speeches, 21 oral presentations and 34 posters from 37 institutions nationwide in which oncology accounted for 37.7%, neurological diseases for 27.87%, cardiovascular diseases for 9.84%, animal imaging for 6.56%, technical aspects for 13.11%, and other subjects for 4.92%. In terms of radionuclide applications, [18F]FDG constituted 46% of the presentations. Notably, the usage of novel PET agents surpassed that of [18F]FDG, reaching 54%, encompassing agents such as 18F or 68Ga labelled FAPI, 18F or 68Ga labelled PSMA, [18F]FET, [18F]F-AV45, [11C]CFT and others.

This meeting finally highlighted that under the context of the widespread utilization of PET/CT, PET/MR has further refined the diagnostic capabilities of nuclear medicine. Both PET/CT and PET/MR possess distinct advantages in clinical applications. PET/MR, due to the low radiation dose, high soft tissue contrast of MR, and the benefits of multi-sequence and multi-parametric imaging, demonstrates greater efficacy in the diagnosis of brain tumors, neurodegenerative, cardiovascular and pediatric diseases, but not for the assessment of pulmonary and other tumors M staging. In the diagnosis of hepatobiliary, gastrointestinal, and musculoskeletal tumors, these two devices complement each other. Additionally, the continuous development of novel specific PET radiopharmaceutical probes is a crucial driving force in fully realizing the clinical application value of PET/MR.