Juan Parra-Robles¹, Helen Marshall¹, Ruth A Hartley², Christopher E Brightling², and Jim M Wild^1
1Unit of Academic Radiology, University of Sheffield, Sheffield, United Kingdom, ²Institute for Lung Health, University of Leicester, Leicester, United Kingdom

In this work, a new approach based on a fractional diffusion model is developed to allow for in-vivo estimation of the distributions of the microscopic length scales of acinar airways from ³He diffusion MRI data. This new technique is used to assess the acinar microstructure in asthma patients and the results are compared with CT densitometry and macroscopic ³He ventilation distributions.

Maxim Terekhov¹, Ursula Wolf², Klaus K Gast², Christian Hoffmann², Nina Bojadzic², Sergei Karpuk³, Christian Mrozik³, Christoph Düber², and Laura Maria Schreiber^1
1Section of Medical Physics, Department of Radiology, Johannes Gutenberg University Medical Center Mainz, Mainz, Germany, ²Department of Radiology, Johannes Gutenberg University Medical Center Mainz, Mainz, Germany, ³Institute of Physics, Johannes Gutenberg University Mainz, Mainz, Germany

Static and Dynamic Ventilation of lungs measured with hyperpolarized 3He-MRI are efficient tools to visualize and quantify the lung ventilation and intrapulmonary gas inflow. Ventilation measurements give information on both spatial and temporal distribution of gas in airways and parenchyma being of great importance for the diagnostics of airways obstruction diseases e.g. asthma and COPD. Measurements of static and dynamic lung ventilation with HP-3He-MRI were performed on bronchial asthma patients before and after bronchodilatation in order find out if the BD-effect can be detected using 3He-MRI and to correlate the variation of measured parameters with the spirometry tests.

Guilhem Jean Collier¹, Helen Marshall¹, and Jim Wild^1
1Academic Radiology, University of Sheffield, Sheffield, United Kingdom

In this work, dynamic acquisition of hyperpolarized ³He ventilation images was combined with phase contrast velocimetry sequences to assess airflow modulation due to the cardiac cycle during inspiration in healthy subjects. The results show opposite flow oscillations at the heartbeat frequency between the left lower lobe and all other lobes, suggesting that the movement of the heart is influencing the airflow pattern in the lungs.

Madhwesha Rama Rao¹, Neil J Stewart¹, Graham Norquay¹, and Jim M Wild^1
1Academic Unit of Radiology, University of Sheffield, Sheffield, South Yorkshire, United Kingdom

Hyperpolarized 129Xe has large range of chemical shift and can be used to study the human brain when 129Xe dissolved in the blood is transferred to white matter, grey matter and cerebral lipids. In this work we demonstrate in vivo human brain spectroscopy with dissolved 129Xe at 1.5T. In addition to peaks from grey and white matter, we detected peaks from 129Xe in red blood cells and lipids in the brain. We have established optimal topology for RF coils for 129Xe brain spectroscopy and developed a model for dissolved xenon blood uptake from the lungs to the brain.

Hooman Hamedani¹, Stephen Kadlecek¹, Masaru Ishii², Yi Xin¹, Hoora Shaghaghi¹, Biao Han¹, Sarmad Siddiqui¹, Milton Rossman¹, and Rahim R. Rizi^1
1University of Pennsylvania, Philadelphia, PA, United States, ²Johns Hopkins University, Merryland, United States

The hybrid multibreath ³He imaging technique has been previously used to measure regional lung parameters such as p_AO₂, specific ventilation (SV) and ADC measurements simultaneously. The combination of these three imaging measurements effectively probes the different aspects of lung disease in a manner analogous to current clinical measurements. The obtained measurements are highly correlated with conventional pulmonary tests (pulmonary function test, six-minute walk test, and the St. George’s Questionnaire). In this study, the p_AO₂, SV and ADC measurements acquired using the hybrid technique were assessed for their viability as markers for distinguishing between smokers and nonsmokers.

Haidong Li¹, Zhiying Zhang¹, Jianping Zhong¹, Weiwei Ruan¹, Zhao Li¹, Xianping Sun¹, and Xin Zhou^1
1Wuhan Institute of Physics and Mathematics,CAS, Wuhan, Hubei, China

We defined T1_total as a parameter to identify the total relaxation for the delivery of xenon gas to the brain, and the ventilation with 25-30% oxygen in the lung has shown the maximal HP xenon signal in the rat brain, which is valuable for in vivo brain applications

Sarmad Siddiqui¹, Mehrdad Pourfathi¹, Hooman Hamedani¹, Yi Xin¹, Hoora Shaghaghi¹, Stephen J. Kadlecek¹, and Rahim R. Rizi^1
1Radiology, University of Pennsylvania, Philadelphia, PA, United States

It has been previously demonstrated that hyperpolarized (HP) 3He MRI can be used to construct regional fractional ventilation maps by imaging HP signal build up, by delivering several HP breaths, each followed by a breath hold for image acquisition. More recently, it was shown [2] that a similar regional fractional ventilation map could be constructed by fitting the signal decay after only one inhalation of HP gas. In this study, we compare the regional fractional ventilation maps generated by both the ‘wash-in’ and ‘wash-out’ methods to determine the robustness of the ‘wash-out’ method compared to the ‘wash-in’ method.

James D Quirk¹, Jason C Woods², Alexander L Sukstanskii¹, Barbara A Lutey³, Mario Castro³, and Dmitriy A Yablonskiy^1
1Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, United States, ²Pediatrics and Radiology, Cincinnati Children's Hospital, Cincinnati, OH, United States, ³Pulmonary and Critical Care Medicine, Washington University School of Medicine, St. Louis, MO, United States

Pulmonary function in adults is known to decline with age. Using non-invasive diffusion MRI-based in vivo helium-3 lung morphometry, we studied 38 healthy subjects (ages 18-70) to determine the changes in lung microstructure at the alveolar level associated with this decline. We found that with increased age, there is a significant decrease in alveolar density, associated with both an increase in acinar duct lumen and acinar duct radius and a decrease in the alveolar depth. This establishes a baseline of age-dependent lung parameters for use in future studies to detect changes associated with pulmonary diseases.

Krista M. Dowhos^1,2, Matthew S. Fox³, Iain K. Ball³, Tao Li^3,4, Gowtham Gajawada^3,4, Jordan Wentzell⁴, Brenton DeBoef⁵, and Mitchell S. Albert^3,4
1Lakehead University, Thunder Bay, Ontario, Canada, ²Thunder Bay Regional Research Institute, Thunder Bay, Ontario, Canada, ³Thunder Bay Regional Research Institute, Ontario, Canada, ⁴Lakehead University, Ontario, Canada, ⁵Rhode Island University, Rhode Island, United States

The combination of hyperpolarized 129Xe MRI and Chemical Exchange Saturation Transfer (CEST), Hyper-CEST, can potentially enhance MR sensitivity by 108, making it a promising molecular imaging technique via MRI. In this study, we employ a Hyper-CEST pulse sequence at 3T, which uses pulsed saturation to lower SAR and provides an unprecedented 87% depletion in 129Xe(dissolved) signal. In addition, we used the same pulse sequence to demonstrate Hyper-CEST imaging, which may eventually allow for molecular imaging of inflammation sites in the body caused by diseases such as COPD and arthritis, due to the ability of PK11195 to target these pathologies.

Yoshiharu Ohno¹, Shinichiro Seki², Mizuho Nishio¹, Hisanobu Koyama², Takeshi Yoshikawa¹, Sumiaki Matsumoto¹, Nobukazu Aoyama³, Kota Aoyagi⁴, Hitoshi Yamagata⁵, Hideaki Kawamitsu³, and Kazuro Sugimura^2
1Advanced Biomedical Imaging Research Center, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan, ²Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan, ³Center for Radiology and Radiation Oncology, Kobe University Hospital, Kobe, Hyogo, Japan, ⁴MClinical Application Research Center, Toshiba Medical Systems Corporation, Otawara, Tochigi, Japan, ⁵Toshiba Medical Systems Corporation, Otawara, Tochigi, Japan

Clinical stage assessment is important for treatment in NSCLC patients. We hypothesized that whole-body MRI at 3T MR system, which is utilized multiple array coil with parallel imaging capability and Quick 3D sequence with DFS technique, has equal to or better potential for T, N and M factors and operability assessments in NSCLC patients than co-registered FDG-PET/MRI and integrated FDG-PET/CT. The purpose of this study was to directly compare the capability for clinical stage and operability assessments among whole-body MRI, co-registered FDG-PET/MRI and integrated FDG-PET/CT in NSCLC patients.

Soon Ho Yoon¹, Chanhee Lee², Jinil Park², JaeKyun Ryu², Jin Mo Goo¹, and Jang-Yeon Park^2
1Department of Radiology, Seoul National University College of Medicine, Seoul, Korea, ²Department of Biomedical Engineering, Konkuk University, Chung-ju, Korea

The purpose of our study was to investigate the technical feasibility of CODE(Concurrent Dephasing and Excitation) MRI in human lung. 1.3mm3 isotropic voxel 3D radial CODE imaging was performed in three healthy adult volunteers on 3.0 T MR system. An overall image quality of CODE was graded good to excellent. Pulmonary vessels were consistently traceable from central to subpleural area in whole lung. Thin bronchial walls were traceable from main bronchus to segmental bronchi with mild motion and streak artifacts on CODE. Lobar fissures were also identifiable. CODE MRI was techinally feasible in human lung on a clinical scanner.

Lan Lu^1,2, Shannon Donnola¹, Elliott C Dasenbrook³, David Weaver³, Michael W Konstan³, and Chris A Flask^1,4
1Department of Radiology, Case Western Reserve University, Cleveland, OH, United States, ²Department of Urology, Case Western Reserve University, Cleveland, OH, United States, ³Department of Pediatrics, Case Western Reserve University, Cleveland, OH, United States, ⁴Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, United States

We have previously developed a normalized T1 (nT1) method to sensitively and rapidly detect early-stage lung disease in cystic fibrosis (CF) patients. In this study, we aimed to determine the mechanism underlying observed nT1 changes in CF patients by direct comparison with pulmonary perfusion assessed by Arterial Spin Labeling. ASL and nT1 assessments in nine CF patients demonstrated significantly reduced mean nT1 and pulmonary perfusion in the upper lungs in comparison to healthy controls. A significant correlation (p <0.05) was also observed between nT1 and pulmonary perfusion. These results suggest that the nT1 technique is related to pulmonary perfusion.

Hongchen Wang¹, Catherine Sébrié¹, Jean-Pierre Ruaud¹, Geneviève Guillot¹, Khaoula Bouazizi-Verdier¹, Georges Willoquet¹, Xavier Maître¹, Luc Darrasse¹, and Ludovic de Rochefort^1
1Imagerie par Résonance Magnétique Médicale et Multi-Modalités (UMR8081) IR4M, CNRS, Univ. Paris-Sud, Orsay, France

Aerosol toxicology and drug delivery through the lungs require the development of methods to quantify particle deposition. The use of intrapulmonary-administered MRI contrast agent combined to lung-specific imaging sequences has been proposed and remains an active preclinical research topic. Various administration protocols and pulse sequences have been used, and more recently ultra-short echo (UTE) sequences that are more adapted for lung parenchyma imaging. Here, we present the use of 3D UTE implemented in a clinical scanner, performed pre- and post- administration of gadolinium-based aerosol delivery in spontaneously breathing healthy rats, thus mimicking chronic particle exposure or free-breathing drug delivery. The contrast-enhanced quantification method enabled us to follow up lung clearance and regional heterogeneity in the deposition.

Fabio Gibiino^1,2, Laura Sacolick³, Anne Menini⁴, Luigi Landini¹, and Florian Wiesinger^4
1University of Pisa, Pisa, PI, Italy, ²GE Global Research, Munich, Bavaria, Germany, ³GE Heathcare, Munich, Germany, ⁴GE Global Research, Munich, Germany

A 3D radial zero-TE sequence similar to the Rotating-Ultra-Fast-Sequence was implemented and optimized for high-resolution structural imaging of the lungs. The pulse-and-acquire sequence scheme achieves a nominal echo time equal to zero with repetition time of about one millisecond. The minimal gradient ramping kept the sequence free from eddy current artifacts. A prospective triggering on the respiration signal was used to avoid motion artifacts. The receive bandwidth was chosen to obtain the best compromise between resolution and signal-to-noise ratio. 3D datasets of the lung structures at ~0.9mm isotropic resolution were acquired on volunteers in ~9min scan time.

Yoshiharu Ohno¹, Shinichiro Seki², Mizuho Nishio¹, Hisanobu Koyama², Takeshi Yoshikawa¹, Sumiaki Matsumoto¹, Nobukazu Aoyama³, Yoshimori Kassai⁴, Masao Yui⁴, Hideaki Kawamitsu³, and Kazuro Sugimura^2
1Advanced Biomedical Imaging Research Center, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan, ²Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan, ³Center for Radiology and Radiation Oncology, Kobe University Hospital, Kobe, Hyogo, Japan, ⁴MRI Systems Development Department, Toshiba Medical Systems Corporation, Otawara, Tochigi, Japan

We hypothesize that Non CE-perfusion MRI based on fresh blood imaging (FBI) technique at 3T system can accurately assess regional perfusion difference, and predict postoperative lung function in NSCLC patients, when compared with perfusion scan (Q scan), thin-section MDCT and dynamic CE-perfusion MRI. The purpose of this study was to prospectively and directly compare capabilities of regional perfusion assessment and prediction of postoperative lung function in NSCLC patients among Q scan, thin-section CT, dynamic CE-perfusion MRI and non-CE-perfusion MRI.

Kathrin R Hemberger¹, Daniel Haddad¹, Peter M Jakob^1,2, and Felix A Breuer^1
1Magnetic Resonance Center Bavaria, Wuerzburg, Bavaria, Germany, ²Department of Experimental Physics 5, Wuerzburg, Germany

A T1-weighted oxygen-enhanced Twisted Projection Imaging sequence was used to assess several functional lung parameters in 3D during free breathing. Retrospective DC-gating to expiration and inspiration enables the assessment of changes in T2* and T1 due to increased concentration of oxygen in the breathing gas for each respiratory state as well as changes in spin density at different breathing states.

Laura Bell¹, Kang Wang², Alejandro Munoz Del Rio³, Thomas Grist^1,3, Sean Fain^1,3, and Scott Nagle^1,3
1Medical Physics, University of Wisconsin - Madison, Madison, Wisconsin, United States, ²Global MR Applications and Workflow, GE Healthcare, Wisconsin, United States, ³Radiology, University of Wisconsin - Madison, Wisconsin, United States

Quantification of pulmonary perfusion using T1-weighted contrast-enhanced MRI is challenging due to both the nonlinear relationship between signal intensity (SI) and contrast agent (CA) concentration, and the inherently low signal within the lung itself. We assessed the performance of three different AIF reconstruction methods using both gadopentetate dimeglumine and gadobenate dimeglumine in 12 healthy human subjects for pulmonary blood flow (PBF) measurements. There were no observed differences in PBF between all three AIF reconsturction methods using Gd-DTPA, however there were differences using Gd-BOPTA that need to be considered within a clinical setting. Lung enhancement was improved with GD-BOPTA.

Hisanobu Koyama¹, Yoshiharu Ohno^1,2, Shinichiro Seki¹, Mizuho Nishio², Nobukazu Aoyama³, Takeshi Yoshikawa², Sumiaki Matsumoto², and Kazuro Sugimura^1
1Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan, ²Advanced Biomedical Imaging Research Center, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan, ³Radiology, Kobe University Hospital, Kobe, Hyogo, Japan

Recently, image quality and diagnostic capability of chest MR imaging have been improving and chest DWI were reported the utility of diagnosis of solitary pulmonary nodules (SPNs) including lung cancer. Under these circumstances, it is important that comparisons of methods for evaluating SPNs differentiation and selecting b values result in useful contributions to clinical practice. The purpose of this study was to determine the appropriate parameters and evaluation method for quantitative differentiation of SPNs by means of DWI.

Jose L Ulloa^1,2, Weijuan Zhang², Josephine Naish², Alexandra R Morgan^1,2, and Geoffrey JM Parker^1,2
1Bioxydyn Ltd, Manchester, United Kingdom, ²Centre for Imaging Sciences, University of Manchester, Manchester, United Kingdom

An input function characterizing the amount of inspired oxygen is required to allow standardized parameterization of changes in T1 contrast due to oxygen inhalation when performing oxygen-enhanced MRI. In this work, we propose a functional form of an oxygen input function (OIF) derived from inspired oxygen measured in 110 dataset using two standard disposable non-rebreathing clinical masks. Results show that the OIF wash-in and wash-out can be adequately described by bi-exponential functions and a population-based OIF may provide an adequate description of the true OIF at the individual level.

Marta Tibiletti¹, Jan Paul², Detlef Stiller³, and Volker Rasche^1,2
1Core Facility Small Animal MRI, University of Ulm, Ulm, BW, Germany, ²Department of Internal Medicin II, University Hospital Ulm, Ulm, BW, Germany,³Target Discovery Research Germany, Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach, BW, Germany

We have tested the effect of prospective respiratory gating on image sharpness in two radial short T2 method (THRIVE and UTE) for lung imaging in human volunteers at 3T. Qualitative and quantitative results show a significant increase in image sharpness in gated acquisition with respect to not gated ones. We have demonstrated that respiratory gating is necessary when high definition images of lung vessels and airways are needed, even if radial acquisitions are robust to movement artifacts and prospective gating typically double acquisition time. UTE acquisitions show promising results for vessels visualization without contrast agent.

Yu Li¹, David Roach^1,2, and Jason Woods^1,2
1Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States, ²Center for Pulmonary Imaging Research, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States

We developed a new non-contrast-enhanced lung imaging technique using high-speed dynamic data acquisition and phase dispersion analysis. By evaluating regional MRI phase dispersion of dynamic lung images during free breathing, image contrast may be generated from susceptibility changes in pulmonary parenchyma. We found that temporal behaviors of MRI phase dispersion may be used to investigate lung function by examining regional susceptibility changes dynamically in every respiration cycle. This offers a new imaging technique that has the potential to improve functional imaging of the lung.

Rui Carlos Sá¹, Amran K Asadi¹, Rebecca J Theilmann², and G. Kim Prisk^1,2
1Medicine, University of California, San Diego, La Jolla, CA, United States, ²Radiology, University of California, San Diego, La Jolla, CA, United States

Asthma is a dynamic disease that possesses strong, poorly understood temporal components. We describe an improved analysis of Specific Ventilation Imaging - a quantitative oxygen-enhanced MR-technique - that may be useful in elucidating time-varying ventilation heterogeneity after acute asthma events. Specific ventilation is quantified by comparing the modeled response of ideal lung units with individual voxel signal intensity time-series, following changes from breathing air to oxygen. Temporal changes are captured using an overlapping running window (120 breaths, 600s, shifted by 200s). Regional ventilation is seen to recover towards baseline over time following bronchoconstriction of a mild asthmatic subject with methacholine.

Weijing Ma¹, Khadija Sheikh^1,2, Jonathon Leipsic³, Harvey O Coxson³, David G McCormack⁴, Roya Etemad-Rezai⁵, and Grace Parraga^1,2
1Imaging Research Laboratories, Robarts Research Institute, London, Ontario, Canada, ²Department of Medical Biophysics, The University of Western Ontario, Ontario, Canada, ³Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada, ⁴Department of Medicine, The University of Western Ontario, London, Ontario, Canada, ⁵Department of Medical Imaging, The University of Western Ontario, London, Ontario, Canada

We developed thoracic 32-channel ultra-short echo time radial 1H MRI with compressed sensing to achieve quantitative 1H signal intensity maps on a clinical 3T scanner for quantitative measurements of the lung parenchyma. Such measurements were directly compared in healthy volunteers at different lung volumes and in patients with COPD and bronchiectasis with 3He MRI apparent diffusion coefficients, CT measurements of tissue density and pulmonary function test measurements. Compressed sensing UTE MRI was successfully implemented at 3T and showed significantly improved SI measurements acquired at expiration breath-hold that is safe and practical for patients with chronic respiratory disease.

Konstantinos G. Zeimpekis^1,2, Gaspar Delso³, Florian Wiesinger⁴, Patrick Veit-Haibach⁵, and Gustav von Schulthess^5
1University Hospital, Zurich, Zurich, Switzerland, ²Information Technology and Electrical Engineering, ETHZ, Zurich, Zurich, Switzerland, ³Global MR Applications & Workflow, GE Healthcare, Waukesha, WI, United States, ⁴GE Global Research, Munich, Germany, ⁵University Hospital, Zurich, Switzerland

On this project, we propose a lung imaging gating with self-gating navigator extraction based on the DC signal of multiple acquisitions. The Dc navigator is based on the maximum values along DC the superimposed DC signals of all acquisitions of the coil nearest to the diaphragm. Gating is achieved without any applying any threshold and the images look significantly improved concerning resolution, motion correction near the diaphragm structures and contrast regaining.

Durgesh Kumar Dwivedi¹, Girdhar Singh Bora², Rajeev Kumar², Sanjay Thulkar³, Sanjay Sharma³, Siddhartha Datta Gupta⁴, and Naranamangalam Raghunathan Jagannathan^1
1Dept of NMR & MRI Facility, All India Institute of Medical Sciences, New Delhi, Delhi, India, ²Dept of Urology, All India Institute of Medical Sciences, New Delhi, Delhi, India, ³Dept of Radio-diagnosis, All India Institute of Medical Sciences, New Delhi, Delhi, India, ⁴Dept of Pathology, All India Institute of Medical Sciences, New Delhi, Delhi, India

Recently there has been an annual increase of 2% in the incidence of renal cell carcinoma (RCC) worldwide. It is detected on computed tomography or ultrasound. Diffusion imaging has been shown to have potential in diagnosing various malignancies. We studied RCC lesions using diffusion-weighted MRI (DW-MRI). We found ADC values for RCC to be significantly lower than normal kidney tissue. Our results suggested that DW-MRI has potential in the prognostication of the patient and possibly could guide in therapeutic management.

Luke Xie^1,2, Ergys Subashi^2,3, Yi Qi², and G. Allan Johnson^1,2
1Biomedical Engineering, Duke University, Durham, North Carolina, United States, ²Center for In Vivo Microscopy, Radiology, Duke University Medical Center, Durham, North Carolina, United States, ³Medical Physics Graduate Program, Duke University Medical Center, Durham, North Carolina, United States

We acquired high spatiotemporal resolution datasets of the developing mouse kidney. The data were acquired with a cryogenic surface coil and a dynamic contrast enhanced (DCE) MRI sequence, allowing 3D images (125³ μm³) to be obtained every 7.7 sec over a 50-min scan (390 time points). The DCE curves were used to determine a 3D time-to-peak map (time of injection to peak enhancement). Time-to-peak values and volumes were determined in three renal regions—cortex, outer medulla, and inner medulla. These functional and structural changes were measured over 17 weeks at 6 points (3, 5, 7, 9, 13, 17 weeks).

Jeff L Zhang¹, Christopher C Conlin¹, Jason Mendes¹, Niels Oesingmann², and Vivian S Lee^1
1Department of Radiology, University of Utah, Salt Lake City, Utah, United States, ²Siemens Medical Solutions USA, Inc., New York, United States

Current models for analyzing renal ASL data assume rectangular-shape function for tagged arterial input function (AIF). With imperfect magnetization inversion, this assumption can cause significant errors in the estimated perfusion. In this study using coronal FAIR labeling, we propose to sample AIF from renal segmental artery, and after some calibration with proton density, use the AIF to estimate renal tissue perfusion from ASL images. In a human subject data, we found that perfusion estimated with the ¡®ideal¡¯ rectangular AIF was lower than that from the sampled AIF, which agreed with our expectation.

Anneloes de Boer¹, Eva E Vink², Tim Leiner³, Peter J Blankestijn², and Hans M Hoogduin^3
1Nephrology, University Medical Center, Utrecht, Utrecht, Netherlands, ²Nephrology, University Medical Center, Utrecht, Netherlands, ³Radiology, University Medical Center, Utrecht, Netherlands

Renal denervation (RD) is a promising new therapy for resistant hypertension. The mechanism of action is proposed to be a decrease in sympathetic activity, resulting in altered sodium handling by the kidneys and a decrease in peripheral vascular resistance. As a consequence, one can hypothesize that renal blood flow and oxygenation will increase. To assess changes in oxygenation in the kidney after RD, BOLD MRI was performed in 38 patients before and 12 months after RD. Data were analyzed using the compartmental method of Ebrahimi et al. No change in renal oxygenation was demonstrated.

Inge Brinkmann¹, Niravkumar Darji², Oliver Speck², and Michael Bock^1
1Radiology - Medical Physics, University Medical Center Freiburg, Freiburg, Germany, ²Otto von Guericke University Magdeburg, Magdeburg, Germany

BOLD MRI of the kidneys has been proposed to determine renal oxygenation through the measurement of R2* changes during water loading. In this work we report first preliminary results of renal BOLD MRI at 7T using a dedicated parallel transmission coil setup. To increase the B1+ homogeneity at kidney region the B1+ profile was shimmed successfully by more than 30%. The measurements were done with a multi-echo 2D FLASH sequence. The experiments show strong changes of R2* in the renal medulla and cortex both at baseline and during water loading which facilitates the detection of the R2* changes at 7T.

Lu-Ping Li^1,2, Tammy Franklin¹, Richard Solomon³, and Pottumarthi V Prasad^1,2
1Radiology, Northshore University HealthSystem, Evanston, IL, United States, ²University of Chicago Pritzker School of Medicine, Chicago, IL, United States, ³University of Vermont College of Medicine, VT, United States

Iodinated contrast induced acute kidney injury (CIAKI) is the third cause of hospital-acquired AKI. Diabetes is one direct risk factor. Streptozotocin (STZ) treated rat is the most common model of human diabetes. The effects of iodinated contrast were evaluated in STZ treated rats using BOLD MRI. Our preliminary data show R2* responses are much smaller than those previously observed in alternate model of CIAKI. This is probably due to the persistent hyperfiltration in this model resulting in enhanced washout of contrast medium. Future studies may be necessary to evaluate whether fluid restriction could make the responses comparable to previous models.

Joshua D Kaggie¹, Vivian S Lee¹, and Glen R Morrell^1
1Utah Center for Advanced Imaging Research, Radiology, University of Utah, Salt Lake City, UT, United States

Renal BOLD-MRI has been proposed as a method of functional renal imaging. Baseline values of T2* (R2*) and change in T2* in the kidneys after administration of a diuretic such as furosemide have been reported to correlate with severity of kidney disease. However, other published data shows no correlation between renal R2* and severity of chronic kidney disease. Among the potential confounding factors for accurate T2* quantification are B0 inhomogeneities that can result in varying T2* values between measurements. In this work, B0 maps are used to correct the T2* images for more accurate quantification.

Jeff L Zhang¹, Christopher C Conlin¹, Jason Mendes¹, Niels Oesingmann², and Vivian S Lee^1
1Department of Radiology, University of Utah, Salt Lake City, Utah, United States, ²Siemens Medical Solutions USA, Inc., New York, United States

Conventional perfusion quantification model for renal ASL data ignores transit delay from tagging site to tissue voxels. In this study, we compared a convolution-based model incorporating transit delay to the conventional approach using both simulated and human kidney ASL data. We found that the conventional method to estimate renal perfusion from ASL data was sensitive to the selection of inversion time (TI), while by acquiring signals at multiple TIs and analyzing them with a convolution-based model, we can estimate renal perfusion with much lower variability.

Ruitian Song¹, Ralf B. Loeffler¹, Aaryani Tipirneni-Sajja¹, Adam M. Winchell¹, Mary B McCarville¹, Melissa M. Hudson², Sheri L. Spunt², and Claudia M Hillenbrand^1
1Radiological Sciences, St Jude Children's Research Hospital, Memphis, Tennessee, United States, ²Oncology, St Jude Children's Research Hospital, Memphis, Tennessee, United States

ASL MRI was applied to investigate renal perfusion irradiated and non-irradiated long-term survivors of Wilms’ tumor and in healthy volunteers. Between survivors no significant differences were observed in cortical and medullary blood flow (CBF and MBF), and glomerular filtration rate (GFR). MBF values of survivors were significantly higher than those of healthy volunteers. Normalized CBF and MBF were well correlated with absolute GFR.

Huan Tan¹, Jon Thacker², Tammy Franklin³, and Pottumarthi V Prasad^1,3
1University of Chicago, Chicago, IL, United States, ²Northwestern University, Evanston, IL, United States, ³NorthShore University HealthSystem, Evanston, IL, United States

The objective of this study was to investigate whether arterial spin labeling (ASL) MRI in rat kidneys can be sensitive to pharmacologically induced vasodilation and vasoconstriction. The preliminary results demonstrated the sensitivity of ASL to changes in renal cortical perfusion and showed the estimates to be reproducible (with adenosine) and cumulative (with L-NAME).

Qing Yuan¹, Koji Sagiyama², Yue Zhang¹, Naira Muradyan³, Annanth Madhuranthakam^1,2, Yin Xi¹, Ivan E Dimitrov^2,4, Vitaly Margulis⁵, James Brugarolas^6,7, Payal Kapur^5,8, and Ivan Pedrosa^1,2
1Radiology, UT Southwestern Medical Center, Dallas, TX, United States, ²Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, TX, United States, ³iCAD, Inc., Nashua, NH, United States, ⁴Philips Medical Systems, Cleveland, OH, United States, ⁵Urology, UT Southwestern Medical Center, Dallas, TX, United States, ⁶Internal Medicine, UT Southwestern Medical Center, Dallas, TX, United States, ⁷Developmental Biology, UT Southwestern Medical Center, Dallas, TX, United States, ⁸Pathology, UT Southwestern Medical Center, Dallas, TX, United States

The purpose of this study is to investigate the correlation between the in vivo heterogeneity in tumor perfusion and cellularity in renal masses using dynamic contrast-enhanced (DCE) and diffusion-weighted imaging (DWI) techniques. Quantitative DCE and DWI parameters were obtained from the whole tumor, and from areas with high- and low-enhancement in the tumor. High-enhancement tumor regions demonstrated significant higher perfusion measures as well as lower ADC values. Our results confirm the correlation between intra-tumoral heterogeneity in blood flow and ADC in patients with renal masses.

Yuancheng Wang¹ and Shenghong Ju^1
1Zhongda Hospital, Medical School of Southeast University, Nanjing, Jiangsu, China

renal scintigraphy may fail to accurately access the renal function on patients with obstructive hydronephrosis, we seek to find a more robust as well as non-invasive method to serve as an alternative. Dynamic Contrast Enhanced - Magnetic Resonance Renography has been proved to be a promising method in calculating split renal functions. How would it perform in the context of hydronephrosis? We conducted this preliminary study on the above issue.

Lu-Ping Li^1,2, Jon Thacker^1,3, Tammy Franklin¹, Jing Lu^2,4, Ying Zhou⁵, Maria Papadopulou-Rosenzweig⁶, Richard Solomon⁷, and Pottumarthi V Prasad^1,2
1Radiology, Northshore University HealthSystem, Evanston, IL, United States, ²University of Chicago Pritzker School of Medicine, Chicago, IL, United States, ³Biomedical Engineering, Northwestern University, Evanston, IL, United States, ⁴Obstetrics and Gynaecology, Northshore University HealthSystem, Evanston, IL, United States, ⁵Center for Clinical & Research Informatics, Northshore University HealthSystem, Evanston, IL, United States, ⁶Radiation Medicine, Northshore University HealthSystem, Evanston, IL, United States, ⁷Nephrology, University of Vermont College of Medicine, Burlington, VT, United States

Clinical definition of iodinated contrast induced (CI) acute kidney injury (AKI) is based on serum creatinine measurements made 48-72 hours post-contrast administration. Such a delay results in poor specificity in terms of causal relationship. Novel marker urinary neutrophil gelatinase-associated lipocalin (NGAL) has shown response 8 hours post-contrast. Previous reports have shown that changes in R2* by MRI can demonstrate responses in real time with contrast administration. Here, we evaluated the effects of interventions to prevent CIAKI using BOLD MRI and compare them to urinary NGAL measurements made at baseline and 4 hrs post-contrast in a CIAKI susceptible rat model.

El-Sayed H. Ibrahim¹, Robert A. Pooley¹, Mellena D. Bridges¹, Joseph G. Cernigliaro¹, Peter Kollasch², and William E. Haley^1
1Mayo Clinic, Jacksonville, Florida, United States, ²Siemens Healthcare, MN, United States

Computed tomography is the current gold-standard for imaging kidney stones, albeit at the cost of radiation exposure. Conventional MRI sequences are insensitive to detecting kidney stones because their appearance as signal void. With the development of 2D ultra-short echo-time (UTE) MRI sequences, it becomes possible to image kidney stones in-vitro, despite the limitations of long scan-time and low sensitivity for stone detection. In this work, we optimize and implement a modified 3D UTE sequence for high-resolution in-vitro imaging of kidney stones at 3.0T while avoiding the previously mentioned limitations, which makes this sequence a candidate for imaging kidney stone patients.

Marica Cutajar¹, David L Thomas², Tina Banks³, Christopher A Clark¹, and Isky Gordon^1
1Imaging and Biophysics, UCL, Institute of Child Health, London, London, United Kingdom, ²Department of Brain Repair and Rehabilitation, UCL, Institute of Neurology, London, London, United Kingdom, ³Department of Radiology, Great Ormond Street Hospital, London, London, United Kingdom

This study is the first to measure renal plasma flow (RPF) non-invasively in kidney donors before and after donation. RPF obtained using Arterial Spin Labelling MRI combined with 51Cr-EDTA filtration (GFR) was used to calculate renal filtration fraction and hence assess the effect of nephrectomy on renal function. 7 healthy kidney transplant donors underwent two MRI scans (without the use of exogenous contrast agents) as well as multiple blood samples 51Cr-EDTA, prior to nephrectomy and one year after donation. We found that GFR increased more than RPF hence causing the FF to increase.

Eli Eikefjord^1,2, Erling Andersen³, Jan Anker Monssen⁴, Erlend Hodneland⁵, Frank Zoellner⁶, Erik Hanson⁷, Arvid Lundervold^5,8, and Jarle Tor Rørvik^4,9
1Haukeland University Hospital (HUH), Bergen, Hordaland, Norway, ²University of Bergen (UoB), Bergen, Hordaland, Norway, ³Dept. of Clinical Engineering, HUH, Bergen, Norway, ⁴Dept. of Radiology, HUH, Bergen, Norway, ⁵Dept. of Biomedicine, UoB, Bergen, Norway, ⁶Dept. of Computer Assisted Clinical Medicine, Heidelberg University, Mannheim, Germany, ⁷Dept. of Mathematics, UoB, Bergen, Norway, ⁸HUS, Bergen, Norway, ⁹Dept. of Clinical Medicine, UoB, Bergen, Norway

A reliable and reproducible MR Renography technique may provide valuable information about renal functional status. In this project we studied the relationship between image quality and the ability to estimate GFR reliably, using two different DCE-MRI sequences (Kwic and Flash) in 10 healthy subjects and the same post-processing scheme. The correlation between image quality and accuracy appeared to be strong. Considering the Iohexol-clearance as GFR gold-standard, we found the FLASH sequence to give better GFR-estimates than KWIC. In quantitative MRI image quality should be documented to assure good technical compromises in the design of fast imaging techniques.

Jon Thacker¹, Huan Tan², Lu-Ping Li^3,4, Wei Li³, Stuart Sprague^4,5, Orly Kohn⁶, Ivana Lazich⁶, and Pottumarthi V Prasad^3,4
1Northwestern University, Evanston, IL, United States, ²Department of Surgery, University of Chicago, IL, United States, ³Department of Radiology, Northshore University HealthSystem, IL, United States, ⁴The University of Chicago Pritzker School of Medicine, IL, United States, ⁵Division of Nephrology, Northshore University HealthSystem, IL, United States, ⁶Section of Nephrology, The University of Chicago Pritzker School of Medicine, IL, United States

In this study we sought to assess if there was a correlation between arterial spin labeled perfusion and blood oxygen level dependent oxygenation measurements in healthy subjects and patients with chronic kidney disease (CKD). We found that there was no significant correlation between the two, suggesting that, unlike most organs, renal oxygenation is not determined by blood flow. Additionally we found a significant R2* change in healthy subject’s renal medulla between baseline and furosemide challenge. No significant change in R2* was observed in other regions or CKD patients.

Maryam Seif¹, Chris Boesch¹, and Peter Vermathen^1
1Depts Clinical Research and Radiology, University of Bern, Bern, Bern, Switzerland

Blood oxygenation level dependent (BOLD) MRI is a non-invasive approach that can play an important role in investigating renal dysfunctions. To minimize respiratory motion, BOLD kidney MRI has been performed in breath hold, which may not be feasible for patients. Therefore the aim of this study is evaluating the feasibility of the PACE triggered renal BOLD MRI in comparison with breath-hold BOLD MRI. The small difference of means and the correlations between BH-BOLD and PACE-BOLD R2* values suggest that PACE-BOLD MRI can facilitate renal measurements on elderly and diseased subjects, who may have problems holding their breath.

Yoshiko Ueno¹, Satoru Takahashi¹, Katsusuke Kyotani², Yu Ueda², Tomoyuki Okuaki³, Kazuhiro Kitajima¹, Nobukazu Aoyama², Hideaki Kawamitsu², and Kazuro Sugimura^1
1Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan, ²Division of Radiology, Kobe University Hospital, Kobe, Hyogo, Japan, ³MR Clinical Science Asia Pacific, Philips Healthcare, Minatoku, Tokyo, Japan

Recently, tissue-specific prescribed signal evolutions, achieved by variable refocusing RF-pulse flip angles (tissue-specific VRFA), have been used to decrease blurring and obtain better contrast for turbo spin-echo imaging. Our aim was to assess the impact of tissue-specific VRFA sequence on 3D T2W-TSE image quality of prostate at 3T by comparing to conventional 3D and 2D sequence.

Radhouene Neji¹ and Vladimir Jellus^1
1Siemens Healthcare, Erlangen, Bayern, Germany

The influence of coil channel phasing on the quality of 3D CSI prostate spectroscopy data is evaluated. Two methods are compared: phasing using the first point of the FID and phasing using prescan data. It is shown that the coil phasing technique has an influence on the quality of the obtained spectra.

Souichirou Tateishi¹, Masato Uchikochi², Shohei Miyazaki¹, Hitoshi Matsui¹, Takashi Horinouchi¹, Yasuhiko Tomita³, Kazuo Nishimura⁴, and Katsuyuki Nakanishi^1
1Radiology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Osaka, Japan, ²SIEMENS JAPAN K.K., Tokyo, Japan, ³Pathology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan, ⁴Urology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan

More accurate estimation of prostate volume is important for therapeutic trials. A recently evolved 3D-TSE T2WI sequence termed SPACE provides a high spatial resolution and isotropic volume image compared with the conventional 2D-TSE sequences. These improvements expect to provide more accuracy in prostate volume estimation. We compared 3D-SPACE with 2D-TSE about prostate volumes. Reference standard of prostate volume was obtained from pathology report as a gold standard. 3D-SPACE showed a higher correlation (SPACE; r=0.98, 2D-TSE; r=0.96) and a less relative error (p<0.01): (SPACE; 0.12�}0.13, 2D-TSE; 0.19�}0.15) with reference standard of prostate volume.

Adam Froemming¹, Dan Rettmann², Kohei Sasaguri¹, Judson Frye¹, Manojkumar Saranathan³, Kang Wang⁴, and Akira Kawashima^1
1Radiology, Mayo Clinic, Rochester, MN, United States, ²Global Applied Science Lab, GE Healthcare, Rochester, MN, United States, ³Radiology, Stanford University, Stanford, CA, United States, ⁴Global Applied Science Lab, GE Healthcare, Madison, WI, United States

Analysis of a new dynamic contrast enhanced MRI sequence (DISCO, GE Healthcare) with both very high temporal resolution as well as excellent spatial resolution for application to prostate perfusion imaging.

Yoshiko Ueno¹, Satoru Takahashi¹, Kazuhiro Kitajima¹, Yu Ueda², Masamori Kassai³, Masao Yui³, Yoshiharu Ohno^1,4, and Kazuro Sugimura^1
1Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan, ²Division of Radiology, Kobe University Hospital, Kobe, Hyogo, Japan, ³MRI Systems Development Department, Toshiba Medical Systems Corp., Otawara, Tochigi, Japan, ⁴Advanced Biomedical Imaging Research, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan

Computed DWI (cDWI) is proposed as a new technique that produces any b-value images from DWIs acquired with at least two different b-values. However, it remains unclear which combination of b-values is optimal for generating high-b-value images. We hypothesize that appropriate b value selection for cDWI can improve image quality and detection capability on cDWI as compared with actual DWI with ultra-high b value. The aim of this study was to determine the appropriate b-value combination for generating cDWI at b=2000 s/mm² to improve prostate cancer detection, when compared with actual DWI at b=2000 s/mm² on a 3T MR system.

Mao-Yuan Marine Su¹, Kuo-How Huang², Chin-Chen Chang¹, Vin-Cent Wu³, Wen-Chau Wu⁴, Kao-Lang Liu¹, and Wen-Yih Isaac Tseng^1,5
1Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan, ²Department of Urology, National Taiwan University Hospital, Taipei, Taiwan, ³Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan, ⁴Graduate Institute of Oncology, National Taiwan University, Taipei, Taiwan, ⁵Center for Optoelectronic Medicine, National Taiwan University College of Medicine, Taipei, Taiwan

This study aimed to evaluate the adaptive responses of the contralateral kidney in patients with renal cell carcinoma (RCC) following radical nephrectomy (RN). Eleven patients with RCC scheduled for RN and 15 control patients scheduled for adrenalectomy (Control) were prospectively studied. All the subjects underwent 4 MRI studies: 1 before surgery and 3 at 1 week, 1 month and 3 months after surgery, respectively. Our results indicated that RN in patients with RCC results in an early increase in renal blood flow (RBF) of the contralateral kidney. At 3 months, the patients showed normalization of the RBF, accompanied by compensatory renal hypertrophy. In patients with reduced renal mass, an early increase in RBF was associated with late renal hypertrophy. Therefore, given healthy conditions of the kidneys at baseline, we might be able to predict the late renal function of the contralateral kidney based on its early response to RBF.

Ijin Joo¹, Jeong Min Lee¹, Dong Ho Lee¹, Ju Hyeon Jeon¹, Joon Koo Han¹, and Byung Ihn Choi^1
1Seoul National University Hospital, Seoul, Seoul, Korea

Jiyoung Hwang¹, Young Kon Kim², Mi Hee Lee³, and Hyun-joo Kim^1
1Department of Radiology, Soonchunhyang University Seoul Hospital, Seoul, Seoul, Korea, ²Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Seoul, Korea, ³Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Seoul, Korea

Purpose: To evaluate gadoxetic acid-enhanced MR imaging with an emphasis on the usefulness of hepatobiliary phase (HBP) in T-staging of gallbladder carcinoma. Methods: 66 patients with confirmed gallbladder carcinoma underwent gadoxetic acid-enhanced MR imaging. Two radiologists independently reviewed two sets of MR imaging without / with HBP for local tumor spread. Results: This study yielded acceptable diagnostic performance with gadoxetic acid-enhanced MR imaging with the overall accuracies of 86.4% and 87.9% for each observer. By adding HBP, the sensitivities to differentiate ¡Â T2 versus ¡Ã T3 lesions were increased for both observers although there was no significant difference (P > 0.05). Conclusions: Gadoxetic acid-enhanced MR imaging provided acceptable diagnostic performance for T-staging of gallbladder carcinoma. Addition of HBP aids in detection of liver invasion.

Cecilia Besa¹, Ally Rosen¹, Karen Lee¹, Elizabeth Chorney¹, Guido Jajamovich¹, Ashley Knight-greenfield¹, and Bachir Taouli^1
1Icahn School of Medicine at Mount Sinai, New York, NY, United States

The purpose of this study was to compare breath-hold cartesian 3D T1 VIBE (BH-VIBE) to free breathing (FB) Radial-VIBE during hepatobiliary phase (HBP) in terms of image quality (IQ) and HCC detection and lesion conspicuity (LC). Radial-VIBE at HBP phase was comparable in terms of HCC detection to BH-VIBE, with better LC for one reader. Lower degradation of image quality due to respiratory motion artifacts was found for Radial-VIBE in comparison with BH-VIBE for two readers.

Pardeep Mittal¹, Juan C Camacho¹, Kiran K Maddu¹, Brian Quigley², Nima Kokabi¹, Kelly Cox¹, Sadhna Nandwana¹, and Courtney C Moreno^1
1Radiology and Imaging Sciences, Emory Uni School of Medicine, Atlanta, Georgia, United States, ²Pathology, Emory Uni School of Medicine, Atlanta, Georgia, United States

Focal nodular hyperplasia (FNH) is a hyperplastic process in which all the normal constituents of liver are present but in an abnormally organized pattern. It is crucial to differentiate hypervascular lesions mimicking FNH such as HCC especially fibrolamellar, hepatic adenoma to ensure proper treatment. MRI is invaluable tool in diagnosing primary liver lesions such as FNH and identifying several entities that MIMIC focal nodular hyperplasia and thereby assist physicians in detection and management of such pathologies.

Eun-Suk Cho¹, Jeong-Sik Yu¹, Da Hye Lee¹, Joo Hee Kim¹, and Jae-Joon Chung^1
1Radiology, Gangnam Severance Hospital, Seoul, Korea

On Gd-EOB-DTPA-enhanced MRI for detection of liver metastases, 10-min delayed hepatocyte phase imaging (HPI) using a 30¡Æ flip angle (FA) had higher lesion-to-liver CNR with no difference in lesion detection sensitivity compared to 20-min delayed HPI with a standard 10¡Æ FA. This result indicates that 10-min delayed HPI with a 30¡Æ FA could replace 20-min delayed HPI with better diagnostic performance for the detection of liver metastases and also allows 10 minutes of time-saving.

James Glockner^1
1Radiology, Mayo Clinic, Rochester, Minnesota, United States

MRI characteristics of 28 pathologically proven inflammatory hepatic adenomas were examined. 38% of lesions showed hyperenhancement relative to adjacent normal liver on hepatobiliary phase images, and 35% showed the presence of internal lipid. In our experience atypical presentations of inflammatory hepatic adenomas are not uncommon, in particular the presence of hyperenhancement on hepatobiliary phase post-gadolinium images.

Chen-Te Chou^1,2 and Ran-Chou Chen^3
1Radiology, Chang-Hua Christain Hospital, Chang-Hua, Taiwan, Taiwan, ²Biomedical Imaging and Radiological Science, National Yang-Ming Medical University, Taipei, Taiwan, Taiwan, ³Biomedical Imaging and Radiological Science, National Yang-Ming Medical University, Taiwan, Taiwan

Diagnosis of HCC can be made by tumor showing typical features of HCC (hypervascularity in the arterial phase and washout in the venous/delayed phase) on dynamic study in stead of pathology. However, some HCCs may present atypical features in dynamic studies. These atypical HCCs are diagnostically challenging in our daily practice. Our study was to evaluate the efficacy of gadoxetic acid-enhanced hepatocyte-phase imaging in characterizing HCCs with atypical enhancing pattern in CT dynamic studies. In our results, gadoxetic acid-enhanced hepatocyte-phase imaging provided higher diagnostic performance than other MR characteristics in characterization of the atypical nodules among high HCC risk patients.

Sharon Ngu¹, Lizza Lebron-Zapata¹, Christy Pomeranz^1,2, Seth Katz¹, Scott Gerst¹, Michael Sohn¹, Junting Zheng³, Chaya Moskowitz³, and Richard K. G. Do^1
1Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York, United States, ²New York Presbyterian Hospital - Weill Cornell, New York, New York, United States, ³Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York, United States

A retrospective study was conducted to assess interobserver agreement in the qualitative and quantitative evaluation of liver lesions signal intensity (SI) on delayed hepatobiliary phase MRI with gadoxetic acid (Gd-EOB-DTPA). In 50 patients, four readers (2 fellows, 2 experts) assessed lesion SI compared to liver on a 4 point scale and measured SI of the lesion and adjacent liver parenchyma. Result showed almost perfect agreement in expert readers and substantial agreement among fellows. A cutoff point of lesion to liver SI ratio of 0.876 was found to differentiate hypointense from iso- to hyperintense liver lesions on delayed hepatobiliary phase.

Jiyoung Hwang¹, Young Kon Kim², Mi Hee Lee³, and Hyun-joo Kim^4
1Radiology, Soonchunhyang University Seoul Hospital, Seoul, Seoul, Korea, ²Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Seoul, Korea, ³Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Seoul, Korea, ⁴Department of Radiology, Soonchunhyang University Seoul Hospital, Seoul, S, Korea

Tomoyuki Okuaki¹, Yukihisa Takayama², Akihiko Nishie³, Makoto Obara⁴, Tetsuo Ogino⁴, Hiroshi Honda³, and Marc Van Cauteren^1
1Philips Healthcare APAC, Tokyo, Japan, ²Department of Molecular Imaging and Diagnosis, Kyushu University, Graduate School of Medical Sciences, Fukuoka, Japan, ³Graduate School of Medical Sciences, Department of clinical Radiology, Kyushu University, Fukuoka, Japan, ⁴Philips Electronics Japan, Tokyo, Japan

Two stretched type adiabatic locking pulses were applied to obtain homogeneous spin locking with flexible TSL setting, and compared with block pulse locking. Visual evaluation was done to assess the homogeneity of the T1rho maps and T1rho values obtained by the three methods were measured. The visual evaluation of T1rho maps obtained by stretched type adiabatic pulses were scored higher and T1rho values obtained by stretched type adiabatic(HS8_5) was significantly different between normal and Child-Pugh BorC, normal and Child-Pugh A. The Stretched type adiabatic provided homogeneous and artifact free liver T1rho maps with flexible TSL setting at 3T.

Antonella Meloni^1,2, J. Michael Tyszka³, Alessia Pepe¹, Massimo Lombardi¹, and John C Wood^2,4
1CMR Unit, Fondazione G.Monasterio CNR-Regione Toscana and Institute of Clinical Physiology, Pisa, Italy, ²Department of Pediatrics, Division of Cardiology, Children’s Hospital Los Angeles, Los Angeles, California, United States, ³Division of Biology, California Institute of Technology, Pasadena, California, United States, ⁴Department of Radiology, Children’s Hospital Los Angeles, Los Angeles, California, United States

This represents the first study to compare the impact of fat saturation prepulse on R2* quantitation in transfusional siderosis. We demonstrate that SPIR fat suppression systematically lowered R2* estimates by 3.9% – 7.0, and introduced comparable random uncertainty between the two measurements. Since calibration curves have been derived using non-fat saturated images, these biases should be corrected when reporting LIC values from fat saturated images.

Liana Guerra Sanches-Rocha¹, Ludmila Ribeiro¹, Karine Minaif Martins², Ralph Markus Strecker³, Xiadong Zhong⁴, Stephan Kannengiesser⁵, and Ronaldo Hueb Baroni^2
1Imaging, Albert Einstein Hospital, São Paulo, São Paulo, Brazil, ²Imaging, Albert Einstein Hospital, São Paulo, Brazil, ³Siemens Ltda, São Paulo, Brazil, ⁴MR R&D Collaborations, Siemens Healthcare MR R&D Collaborations, Georgia, United States, ⁵MR R&D Collaborations, Siemens Medical Solutions, Germany

The fat fraction measure using magnetic resonance imaging has been highly accurate alternative method to the biopsy procedure. The spectroscopy has been used as accurated methodology to access and monitor liver steatosis. The method had some of it's problem solved with the T2 correction in a fast aquisition (HISTO). In this study, we aimed to validate against the HISTO spectroscopy, a new 6-echoes-gradient-echo sequence, that uses a hybrid magnitude/complex data algorithm, including correction for T1 bias and T2* decay, and multipeak fat spectrum, that already has been validated at 3T system, at a clinical wide -bore 1,5T system. We evaluated 69 sets from patients that are waiting for liver transplantation and had undergone abdominal MRI. The fat percentage result from inline HISTO report and the proton density fat fraction (PDFF) obtained from the map generate inline from the new sequence were correlated. The intraclass correlation coefficient (ICC) between both sequenceswas 0,830 (CI95%=0,737 to 0,891) for fat percentage . We conclued that the new sequence, with multipeak fat spectral modeling and six-echo chemical shift encoding, has a good correlation with HISTO spectroscopy in the PDFF for chronic liver disease patients at 1,5T.

Xiang He¹, Serter Gumus¹, and Kyong Tae Bae^1
1Department of Radiology, University of Pittsburgh, Pittsburgh, PA, United States

Hepatic tissue hypoxia is a significant indicator of cellular dysfunction in liver diseases and may predict the outcome of interventions. While BOLD or oxygen-enhanced BOLD can provide qualitative assessment of tissue oxygenation, the measurement is relative and lacks specific. In this study, we have demonstrated the feasibility of utilizing the liver qBOLD technique to non-invasively estimate the regional hepatic blood oxygen saturation and hepatic blood volume. Our results were in good agreement with the reported values in literature.

Cecilia Besa¹, Octavia Bane¹, Guido Jajamovich¹, Joseph Marchione¹, and Bachir Taouli^1
1Icahn School of Medicine at Mount Sinai, New York, NY, United States

The purpose of this study was to assess the diagnostic value of a novel 3D FLASH dual-flip-angle (DFA) T1 mapping sequence with whole liver coverage, used before and after injection of gadoxetic acid for the evaluation of diffuse liver disease. We found significantly lower T1 at hepatobiliary phase and lower T1 changes (ΔT1) in cirrhotic patients compared with non-cirrhotic patients, and between Child Pugh B+C in comparison with Child Pugh A patients. 3D T1 mapping sequence with whole liver coverage used before and after gadoxetic acid injection can help detect cirrhosis and evaluate liver function.

Philippe Garteiser¹, Sabrina Doblas¹, Gaspard D'Assignies², Doryssema Tchatat^3,4, Simon Msika⁵, Muriel Coupaye⁶, Pierre Bedossa^1,7, Valérie Vilgrain^1,8, Elisabeth Dion⁹, Pauline Jouet¹⁰, and Bernard E Van Beers^1,8
1CRB3, INSERM, Paris, 75018, France, ²Radiology department, Hôpital Beaujon, AP-HP, Clichy, France, ³Groupement hospitalier Paris Nord, AP-HP, Colombes, France, ⁴Hepato-gastroenterology department, Hôpital Louis Mourier, AP-HP, Colombes, France, ⁵Visceral Surgery department, Hôpital Louis Mourier, AP-HP, Colombes, France, ⁶Endocrinology Department, Hôpital Louis Mourier, AP-HP, Colombes, France, ⁷Anatomo-pathology Department, Hôpital Beaujon, AP-HP, Clichy, France, ⁸Radiology Department, Hôpital Beaujon, AP-HP, Clichy, France, ⁹Radiology Department, Hôpital Louis Mourier, AP-HP, Colombes, France,¹⁰Hepato-gastroenterology Department, Hôpital Louis Mourier, AP-HP, Colombes, France

Quantification of intrahepatic fat represents an important challenge in disease management for morbidly obese patients. Liver biopsy is often problematic with associated risks and limited volume of coverage. Alternate techniques include serum tests such as Steatotest and MRI fat quantification. Moreover, obese patients are often difficult to examine in conventional MRI systems and may require examinations in open magnets at low field strengths. In this report, using histopathological analyses of liver biopsies as gold standard, the diagnostic performance of 1.0T open field MR fat quantification was found to significantly outperform the serum marker Steatotest in the determination of hepatic steatosis.

Octavia Bane¹, Cecilia Besa¹, Niels Oesingmann², Hadrien Dyvorne³, Guido Jajamovich¹, Marcelo Facciutto⁴, Sasan Roayaie⁴, and Bachir Taouli^1
1Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, United States, ²US MR Division R&D, Siemens Healthcare, New York, NY, United States, ³ranslational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, United States, ⁴Transplant Institute, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, United States

Measurement of the transverse magnetization relaxation rate (R2*) is of great interest as a potential non-invasive marker of tumor oxygenation. The purpose of our study was to quantify R2* at baseline and after hyperoxic and hyperoxic-hypercapnic respiratory challenges, in hepatocellular carcinoma (HCC) lesions, liver and muscle. R2* measurements were reproducible within a 15% coefficient of variation at 1.5T for all tissues and gas challenges studied, but showed greater variability at 3T. The response of HCC lesions to oxygen and carbogen challenge, quantified by change in R2*, was highly variable, and will be correlated with pathologic findings in a future study.

Radhouene Neji¹, Nashiely Sofia Pineda Alonso¹, Pedro Miguel Itriago Leon¹, Heinrich von Busch¹, Stephan Kannengiesser¹, and Berthold Kiefer^1
1Siemens Healthcare, Erlangen, Bayern, Germany

Using the HISTO sequence, which is a five-echo STEAM single voxel spectroscopy technique, we validate the linear relationship between liver R2 values at 3T and 1.5T and the value of the regression slope. Fourteen volunteers underwent a HISTO measurement at 1.5T and at 3T, and the voxel positioning was made consistent across the measurements. Possible applications for this study are the extrapolation of iron overload level classification at 1.5T to 3T based on the R2 values.

Nashiely Sofia Pineda Alonso¹, Radhouene Neji¹, Pedro Miguel Itriago Leon¹, Heinrich von Busch¹, Stephan Kannengiesser¹, and Berthold Kiefer^1
1Siemens Helathcare, Erlangen, Bayern, Germany

We assessed the accuracy of HISTO-based liver fat quantification at 3T in subjects with a very low fat fraction in the liver (<15%). The results of liver fat quantification, relaxivity of water and relaxivity of fat were validated and compared to the results obtained at 1.5T for the same subjects.

Arthur Peter Wunderlich¹, Volker Rasche^2,3, Holger Cario⁴, Markus Juchems¹, and Meinrad Beer^1
1Dept. for Diagnostic and Interventional Radiology, Univ.-Clinic Ulm, Ulm, Germany, ²Experimental Cardiovascular Imaging, Univ.-Clinic Ulm, Ulm, Germany,³Internal Medicine II, Univ.-Clinic Ulm, Ulm, Germany, ⁴Pediatry, Univ.-Clinic Ulm, Ulm, Germany

Signal Intensity Ratio (SIR) between liver and reference tissue (paraspinal muscle) has proven to be a reliable method for determination of liver iron content (LIC). However, we found that SIR values depend on activation of RF spoiling. In a preliminary analysis, we determined LIC with the method published by Gandonin data with and without RF spoiling and compared these values to LIC determined from the commercial Ferriscan® method. Linear correlation between both methods was performed and R² was evaluated. While we achieve a good R² value without RF spoiling, it was significantly worse with RF spoiling.

Arthur Peter Wunderlich¹, Markus Juchems¹, Holger Cario², Matthias Weigel³, and Meinrad Beer^1
1Dept. for Diagnostic and Interventional Radiology, Univ.-Clinic Ulm, Ulm, Germany, ²Pediatry, Univ.-Clinic Ulm, Ulm, Germany, ³Radiological Physics, University of Basel Hospital, Basel, Switzerland

A method previously described by Jensen et al. was implemented and tested in a clinical setting. 20 patients suspected for liver iron overload were scanned by MRI using spin-echo (SE) and multi-contrast spin-echo (MC-SE) sequences. Data of MC-SE were fitted to theory to get tissue parameters which are hypothesized to allow a differentiation between aggregated and dispersed liver iron. The two parameters in question were correlated to liver iron content (LIC) determined from SE sequences. Only the aggregation index A correlated positively to LIC. The other parameter reduced transverse relaxation rate RR2 showed no significant correlation to LIC.

Arthur Peter Wunderlich¹, Steffen Klömpken¹, Holger Cario², Markus Juchems¹, and Meinrad Beer^1
1Dept. for Diagnostic and Interventional Radiology, Univ.-Clinic Ulm, Ulm, Germany, ²Pediatry, Univ.-Clinic Ulm, Ulm, Germany

The liver of highly iron overloaded patients was scanned with breathhold GRE sequences at 1.5 T and 3 T. To address high liver iron content (LIC), we measured the signal intensity ratio (SIR) between liver and paraspinal muscle serving as reference. In theory, logarithm of these SIR values are expected to depend linearly on R₂* difference between liver and muscle tissue which itself varies with LIC due to R₂* changes with iron deposition in the liver. Dependence of SIR on LIC was evaluated and results compared between field strengths.

Xiaoke Wang¹, Diego Hernando², and Scott B Reeder^2,3
1Biomedical Engineering, University of Wisconsin, Madison, WI, United States, ²Radiology, University of Wisconsin, Madison, Wisconsin, United States,³Medical Physics, University of Wisconsin, Madison, Wisconsin, United States

In chemical shift encoded (CSE) fat water imaging, it has been shown that multi-peak spectral modeling of fat, compared with single peak models of fat, is necessary for accurate fat quantification. Different spectral models of fat (triglycerides) in the liver has been reported, and it is unknown how these differences will impact the technical accuracy and reproducibility of fat quantification. This work is evaluates the sensitivity of chemical shift encoded fat quantification to different spectral models of fat. Our results show that the use of spectral modeling of fat is needed for accurate CSE fat quantification. However, the specific choice of spectral model (among recently proposed choices) has a much smaller impact on fat quantification accuracy.

Yong Eun Chung¹, Hye-Jeong Lee², Mi-Suk Park³, and Myeong-Jin Kim^4
1Radiology, Yonsei University College of Medicine, Seoul, ., Korea, ²Radiology, Yonsei Univeristy College of Medicine, Seoul, ., Korea, ³Radiology, Yonsei Univeristy College of Medicine, Seoul, Korea, ⁴Radiology, Yonsei Univeristy College of Medicine, Korea

Recently, the number of patients who has fatty liver is increasing and fat deposition of the liver (Lfat) can be a confounding variable in quantitative MRI. In this study, we tried to assess the effect of Lfat on multi-parametric MRI values at 3.0T MRI. There was a significant correlation between T2 value and Lfat and between T2* value and Lfat. However, there was no significant correlation between Lfat and other MR parameters (T1, ADC, complex-,shear- and loss modulus). Hence, Lfat should be adjusted when T2/T2* values were used as quantitative parameter for the evaluation of focal or diffuse liver disease

Sarah Keller¹, Björn Schönnagel¹, Charlotte Pfeifer¹, Zhiyue Jerry Wang², Roland Fischer³, Christoph Berliner¹, Moritz Brehmer¹, Gerhard Adam¹, and Jin Yamamura^1
1Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, Hamburg, Hamburg, Germany, ²Department of Radiology, Children's Medical Center Dallas, Dallas, Tx, United States, ³Department for Biochemistry, University Medical Center Hamburg-Eppendorf, Hamburg, Hamburg, Germany

Due to the increased iron stores, patients with iron overloading diseases eventually develop hepato- and splenomegaly. The purpose of this study was 1.) to investigate the accuracy of liver volumen measurements using MR-volumetry and ultasonic planimetry and 2.) to correlate liver volume with liver iron concentration assessed with MR-R2* relaxometry in patients with iron overloading diseases.

Stefan Ruschke¹, Thomas Baum¹, Hendrik Kooijman², Marcus Settles¹, Axel Haase³, Ernst J. Rummeny¹, and Dimitrios C. Karampinos^1
1Department of Diagnostic and Interventional Radiology, Technische Universität München, Munich, Germany, ²Philips Healthcare, Hamburg, Germany,³Zentralinstitut für Medizintechnik, Technische Universität München, Garching, Germany

MR spectroscopy has been previously employed as a technique for estimating fat unsaturation. However, if the fat fraction is low and the water peak overlaps with the olefinic fat peak, the quantification of fat unsaturation can become challenging. Long-TE PRESS sequences have been suggested as a way to reduce the water peak and measure fat unsaturation. However, a TE of the order of 200 ms should be employed to reduce J-coupling effects, resulting in a low SNR. We present an alternative approach to measure fat unsaturation using a diffusion-weighted STEAM sequence, which is shown to be able to reduce the water peak at moderate TEs.

Patricia Maria Nunes¹, Barbara Janssen¹, Andor Veltien¹, Henk Arnts², Cees Tack³, and Arend Heeschap^1
1Radiology, Radboud University Nijmegen Medical Centre, Nijmegen, Gelderland, Netherlands, ²Central Animal Laboratory, Radboud University Nijmegen Medical Centre, Nijmegen, Gelderland, Netherlands, ³Internal Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, Gelderland, Netherlands

Caloric overload stresses energy homeostasis maintenance in key metabolic tissues as the skeletal muscle. This phenomenon is, in the long run, characterized by intramyocellular lipid accumulation and impaired oxidative capacity. We tested in leptin deficient mice (Ob/Ob) mice whether ATP synthesis was impaired, by means of 31P MRS. The overall muscular PiATP flux assessed with ST showed no differences between WT and Ob/Ob mice, despite greater Pi concentration. When stimulated, muscles of Ob/Ob mice produced lower force and were prone to fatigue. Preliminary data suggests that Ob/Ob mice have higher mitochondrial ATP synthesis, as alluded by the PCr recovery curves.

Patricia Maria Nunes¹, Andreas Boss², Alan Wright¹, Andor Veltien¹, Cees Tack³, John Jones⁴, and Arend Heeschap^1
1Radiology, Radboud University Nijmegen Medical Centre, Nijmegen, Gelderland, Netherlands, ²Radiology, Radboud University Nijmegen Medical Centre, Gelderland, Netherlands, ³Internal Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, Gelderland, Netherlands, ⁴Life sciences, Centre for Neurosciences and Cell Biology, Coimbra, Portugal

Excess fructose consumption has been associated with poor hepatic ATP synthesis. Yet it is unclear whether a chronic supply of fructose can per secompromise hepatic ATP homeostasis. Furthermore, the deleterious effects attributed to fructose do not seem disassociated from increased caloric intake. Thus, we assessed throughout 6 weeks, the hepatic high energy content of mice fed fructose or its isocaloric equivalent glucose, with 31P MRSI. Our results support that fructose feeding is not sufficient to alter hepatic ATP levels, differently from glucose. However it does increase more rapidly hepatic lipid content.

Lucas Lindeboom¹, Christine Nabuurs¹, Joris Hoeks², Maarten Vosselman², Bram Brouwers², Tineke van de Weijer¹, Silvie Timmers², Esther Phielix², Eline Kooi¹, Matthijs Hesselink³, Joachim Wildberger¹, Patrick Schrauwen², and Vera Schrauwen-Hinderling^1
1Dept. of Radiology, MUMC+, Maastricht, Netherlands, ²Dept. of Human Biology, MUMC+, Maastricht, Netherlands, ³Dept. of Human Movement Sciences, MUMC+, Maastricht, Netherlands

The use of long TE in 1H-MRS enhances the visibility of the acetylcarnitine peak at 2.13 ppm. In this study we measured acetylcarnitine concentration in four groups, chosen to cover the whole range of metabolic health, from type 2 diabetic patients to endurance trained athletes. We found lower acetylcarnitine concentrations in subjects with lower insulin sensitivity. These results may indicate that T2DM subjects have a lower ability to form acetylcarnitine, possibly underlying a decreased insulin sensitivity and metabolic flexibility.

Elin Lundström¹, Lars Johansson^1,2, Peter Bergsten³, Håkan Ahlström¹, and Joel Kullberg^1
1Department of Radiology, Uppsala University, Uppsala, Sweden, ²AstraZeneca, R&D Mölndal, Sweden, ³Department of Medical Cell Biology, Uppsala University, Uppsala, Sweden

The purpose of this work was two-fold: 1) To evaluate the effect of 3h cooling on human cervical-supraclavicular adipose tissue fat fraction (FF) and R2* 2) To evaluate the potential of a cooling-reheating water-fat MRI protocol for assessing brown adipose tissue (BAT) amount and activity. Imaging was performed in nine volunteers (22-37 years, 5 males). A general decrease in FF following 3h cold exposure was observed, which confirms results from previous PET/CT-studies. By adding a reheating timepoint to the cold exposure protocol, the BAT activity in terms of intracellular lipid consumption could potentially be separated from perfusion effects.

Sharon Janssens¹, Klaas Nicolay¹, and Jeanine J. Prompers^1
1Eindhoven University of Technology, Eindhoven, Netherlands

Excessive use of caloric sweeteners such as glucose and fructose causes hepatic steatosis and obesity. To sweeten food and drinks without the excessive calories, non-caloric sweeteners can be used. In this study lipid metabolism in the liver of rats receiving different caloric and non-caloric sweeteners is examined using ¹H-[¹³C] MRS combined with the administration of ¹³C-labeled lipids. The non-caloric sweetener aspartame did not have any effect on liver lipid content or metabolism. In contrast, carbohydrate consumption resulted in increased liver lipid content, which was not accompanied by an increased uptake of dietary lipids and is thus likely caused by increased lipogenesis.

Jadegoud Yaligar¹, Venkatesh Gopalan¹, Swee Shean Lee¹, Bhanu Prakash KN¹, and S Sendhil Velan^1
1LABORATORY OF MOLECULAR IMAGING, SINGAPORE BIOIMAGING CONSORTIUM, Singapore, SINGAPORE, Singapore

Hepatic hyperlipidemia and hepatic glycogen content in insulin resistant non-alcoholic fatty liver model will help in understanding the early metabolic changes in liver metabolism. In this study we have evaluated the liver fat and glycogen content in non-alcoholic fatty liver using a diet induced insulin resistant rat model and compared with normal liver by in vivo and ex vivo MRS. Our preliminary studies show that the reduction in glycogen content in fatty liver compared to normal liver might be due to low glycogen synthase defects under hyperlipidemia and insulin resistant condition. Liver fat content in fatty liver is inversely correlated with glycogen indicating the impairment in glycogen synthesis due to lipotoxicity.

Paul Begovatz¹, Chrysi Koliaki¹, Julia Szendroedi¹, Guido Giani², Juergen Bunke³, and Michael Roden^1,4
1Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Duesseldorf, Germany,²Institute for Biometry and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Germany, ³Philips Healthcare, Hamburg, Germany, ⁴Department of Endocrinology and Diabetology, University Clinics, Heinrich Heine University, Duesseldorf, Germany

Pancreatic steatosis has been linked to â-cell dysfunction in the development of type 2 diabetes (T2DM). However, ¹H-MRS and MRI studies investigating pancreatic fat and â-cell function have shown conflicting results. In this work, mDIXON imaging with a noise reduction fat fraction algorithm was verified in comparison to ¹H-MRS liver fat measurements. Pancreas fat was then measured in 48 participants: lean, overweight/obese, and T2DM. Results showed that avoiding regions of interlobular fat revealed clear regions of parenchymal tissue void of any lipid accumulation. These results show for that the pancreas does not consist of intracellular fat leading to pancreatic steatosis.

Jun Lu¹, Elaine Rush², Lindsay Plank³, and Janet Rowan^4
1Faculty of Health & Environmental Sciences and Institute of Biomedical Technology, Auckland University of Technology, Auckland, Auckland, New Zealand, ²Faculty of Health & Environmental Sciences, Auckland University of Technology, Auckland, New Zealand, ³Department of Medicine, University of Auckland, Auckland, New Zealand, ⁴Auckland District Health Board, Auckland, New Zealand

We used free breathing Dixon vibe protocol on a Siemens 3T Skyra scanner to study abdominal fat and MRS to study liver fat of 7-9 year old children born from mothers with gestational diabetes. We obtained clear and processable images and spectra. Intra-abdominal fat percentage showed good correlation with liver MRS. Total abdominal fat determined by MRI showed good correlation with DEXA scan. Free breathing protocols are suitable to study children.

Christoffer Laustsen^1,2, Sara Lycke³, Fredrik Palm^3,4, Jakob Appel Østergaard^5,6, Bo Martin Bibby⁷, Rikke Nørregaard⁸, Allan Flyvbjerg⁵, Michael Pedersen¹, and Jan Henrik Ardenkjaer-larsen^9,10
1MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Aarhus, Denmark, ²bDanish Research Centre for Magnetic Resonance, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark, ³Department of Medical Cell Biology, Uppsala University, Uppsala, Sweden,⁴Division of Drug Research, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden, ⁵Department of Endocrinology and Internal Medicine, Aarhus University, Aarhus, Denmark, ⁶The Danish Diabetes Academy, Aarhus, Denmark, ⁷Department of Biostatistics, Aarhus University, Aarhus, Denmark, ⁸Department of Clinical Medicine, Aarhus University, Aarhus, Denmark, ⁹GE Healthcare, Broendby, Denmark,¹⁰Department of Electrical Engineering, Technical University of Denmark, Kgs. Lyngby, Denmark

We demonstrated an increased oxygen sensitivity in kidneys of diabetic patients, using hyperpolarized [1-¹³C]pyruvate and BOLD MRI. This finding may explain the observed increased risk of developing nephropathy in diabetic patients inspiring reduced oxygen (<20%). The underlying explanation is likely explained by an acceleration of the hyperglycemia mediated polyol pathway cascade, leading to an overproduction of nicotinamide adenine dinucleotide (NADH), thereby increasing the lactate pool, while the oxidative phosphorylation is unaffected. In parallel, we observed a correlation between the [1-¹³C]pyruvate derivates: alanine and bicarbonate; which may potentially be used as a sensitive marker for intrarenal oxygen deficiency.

Mei-Lan Chu^1,2, Hing-Chiu Chang², Mustafa R Bashir³, and Nan-Kuei Chen^2,3
1Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan, Taiwan, ²Brain Imaging and Analysis Center, Duke University, Durham, North Carolina, United States, ³Department of Radiology, Duke University, Durham, North Carolina, United States

We present a new technique to enable high-quality and artifact-free abdominal MRI data. The developed ReKAM module incorporates bootstrapping in k-t space and multiplexed sensitivity encoding to produce high-quality image. The ReKAM module can effectively remove motion-related artifacts resulting from global and local motion during free-breathing abdominal MRI scan, without navigator echo or any pulse sequence modification.

Benedicte MA Delattre^1,2, Peter Koken³, Christian Stehning³, Holger Eggers³, Susanne Heinzer², Giel Mens⁴, and Peter Börnert^3
1Department of Radiology, Geneva University Hospitals, Geneva, Switzerland, ²Philips AG Healthcare, Zürich, Switzerland, ³Philips Research Laboratories, Hamburg, Germany, ⁴Philips, Best, Netherlands

With the recent introduction of hybrid modalities such as PET/MR, whole-body MRI reinforces its importance in the staging and follow-up of oncologic patients. A typical whole-body MRI exam contains T2w and T1w sequences as well as diffusion-weighted imaging with background suppression (DWIBS). We propose a flexible whole-body MR protocol using an interleaved multi-station approach where T1w and T2w sequences are acquired during the same breath-hold and DWIBS during free-breathing. This allows reduced number of breath-holds asked to the patient and guarantee perfect registration of images to facilitate for optimal clinical diagnosis and to support proper attenuation correction for the PET.

Guihua Zhai¹, Guihua Zhai¹, Bo Chen¹, Hyunki Kim¹, Kurt Zinn¹, and Anupam Agarwal^1
1University of Alabama at Birmingham, Birmingham, AL, United States

The purpose of this study was to confirm that apparent diffusion coefficient (ADC) is a reliable biomarker for the assessment of renal fibrosis in a murine model of unilateral ureteral obstruction (UUO). On day 0, group 1 had surgery for UUO, while group 2 was used as a sham group (only incision was applied). ADC and volume of kidneys were measured on days 1, 3 and 7. Relative ADC (ADC of ipsilateral side divided by ADC of contralateral side) of parenchyma differed significantly on days 3 and 7 between UUO group and control group. Our results suggest the relative ADC may serve as a reliable imaging biomarker.

Bjorn Stemkens¹, Rob H. Tijssen¹, Baudouin Denis de Senneville^2,3, Jan J.W. Lagendijk¹, and Cornelis A.T. van den Berg^1
1Department of Radiotherapy, UMC Utrecht, Utrecht, Netherlands, ²Image Science Institute, UMC Utrecht, Utrecht, Netherlands, ³IMB, UMR 5251 CNRS/University Bordeaux, Bordeaux, France

Patient specific online characterization of abdominal organ motion will open the possibility for adaptive radiotherapy treatment that accounts for day to day variations in tumor motion and motion of surrounding organs. In this abstract we propose an online method, based on retrospective binning of the data with respect to the respiratory cycle, which allows 4D motion characterization in less than 15 minutes. The method utilizes a clinically available pulse sequence, and Matlab based reconstruction and post-processing software.

Patrick J Bolan¹, Amrutesh Puranik², John W Osborn Jr.³, Maria Razzoli³, Alessandro Bartolomucci³, Pu Tzu Liu⁴, Yi-Wei Lin⁴, and Li-Na Wei^4
1Radiology - CMRR, University of Minnesota, Minneapolis, Minnesota, United States, ²Mayo Clinic, Rochester, MN, United States, ³Integrative Biology and Physiology, University of Minnesota, Minneapolis, MN, United States, ⁴Pharmacology, University of Minnesota, Minneapolis, MN, United States

This work demonstrates anatomic and parametric water-fat imaging of adipose tissues in post mortem mice at 9.4 T with spatial resolution (156 µm isotropic) substantially higher than previous studies. Anatomic and fat fraction images were used to segment different adipose tissue compartments (e.g., visceral vs. subcutaneous); fat fraction and R2* maps were used to distinctly identify brown adipose tissue depots. This approach is applicable for finely-segmented quantitative volumetry of brown and white adipose tissue depots.

John O Glass¹, Emily M Paulus¹, Zoltan Patay², John T Sandlund³, and Wilburn E Reddick^1
1Division of Translational Imaging Research, St. Jude Children's Research Hospital, Memphis, TN, United States, ²Division of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, TN, United States, ³Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, United States

This study examined the white matter (WM) integrity of 19 pediatric mature B-cell lymphoma patients without clinical signs or symptoms of neurotoxicity at five time points during treatment using fractional anisotropy (FA) and radial diffusion. FA from a defined region of interest was plotted for each patient, and two distinct patterns were found. Eleven patients showed a decrease in FA followed by a slow return toward baseline, consistent with demylination / remylination. Eight patients demonstrated an immediate spike in FA followed by a return to normal appearing development, possibly explained by restricted diffusion related to steroid therapy.

Irene A. Burger¹, Jeanne M. Gunzinger², Porto Miguel², Patrick Veit-Haibach², and Delso Gaspar^3
1Nuclear medicine, University Hospital Zurich, Zurich, Zurich, Switzerland, ²Nuclear medicine, University Hospital Zurich, Zurich, Switzerland, ³Global MR Applications & Workflow, GE Healthcare, Zurich, Switzerland

First results for metal artifact reduction for dental alloys in PET/MR imaging using a modified MAVRIC sequence, covering the jaw in only 3.5 minutes.

Rajiv Ramasawmy*^1,2, Manil Chouhan*^1,3, Dipok Kumar Dhar⁴, Adrienne E. Campbell-Washburn⁵, Jack Anthony Wells¹, Rosamund Barbara Pedley², Massimo Malago³, Raj Mookerjee⁴, Stuart A. Taylor³, Mark Francis Lythgoe†¹, and Simon Walker-Samuel†^1
1Centre for Advanced Biomedical Imaging, University College London, London, Greater London, United Kingdom, ²Cancer Institute, University College London, London, Greater London, United Kingdom, ³Centre for Medical Imaging, University College London, London, Greater London, United Kingdom,⁴Institute for Liver and Digestive Health, University College London, London, Greater London, United Kingdom, ⁵National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD, United States

Recently developed surgical procedures utilise the liver’s unique regenerational properties to promote lobe growth prior to curative partial hepatectomy in patients with liver malignancies. MRI offers accurate, non-invasive characterisation of anatomical changes, furthermore it can utilise perfusion imaging to functionally assess the proposed post-surgery liver remnant. This study monitored gross lobe changes in a novel rat model of liver regeneration using high-resolution anatomical MRI and applied hepatic arterial spin labelling to evaluate tissue viability. One week after selective PVL surgery, average lobe hypertrophy was 74% and average lobe atrophy was -43% from typical volume. A perfusion difference was observed between the atrophic and hypertrophic liver lobes.

Francisco Donato Jr¹, Daniel N. Costa¹, Qing Yuan¹, Neil M. Rofsky¹, Robert E. Lenkinski¹, and Ivan Pedrosa^1
1UT Southwestern Medical Center, Dallas, TX, United States

This study is the first investigation assessing parameters that may influence geometric distortion on DWI of the prostate. We explored the causes and degree of geometric distortion observed in DWI of the prostate and assessed different acquisition strategies to mitigate deformation. The magnitude of distortion was assessed in patients and the effects of phase-encoding direction, receiver bandwidth, and parallel imaging were assessed in a prostate phantom on two different 3T MRI scanners from different manufacturers. We found that distortion occurs in the phase-encoding direction, and is less pronounced when higher bandwidth or parallel imaging is used.

Jeong Hee Yoon¹, Jeong Min Lee¹, Eun Ju Kim², Tomoyuki Okuaki³, Joon Koo Han¹, and Byung Ihn Choi^1
1Radiology, Seoul National University Hospital, Seoul, Seoul, Korea, ²Philips Healthcare Korea, Seoul, Seoul, Korea, ³Philips Healthcare Japan, Tokyo, Japan

The purpose of this study is to determine whether T1 mapping sequence with fast multi-slice B1 correction shows better diagnostic performance than T1 mapping without B1 correction, for estimating liver function on Gd-EOB-DTPA enhanced MRI. Postcontrast T1 relaxation times (R1) with B1 correction of the liver on Gd-EOB-DTPA MRI were significantly different among different C-P score groups: 427.8¡¾145.8 msec in A5; 502.5¡¾134.9 msec in A6; and 640.9¡¾370.8 msec in B7 (P<0.001). As for R1s of the liver without B1 correction, values were 375.9¡¾156.8 msec in A5; 338.3¡¾82.8 msec in A6; and 565.2¡¾336.2 msec in B7. T1 mapping using VFA and B1 correction can be used for quantitatively estimate liver function using hepatocyte-specific contrast enhanced MRI.

Bryan T Addeman¹, Robert A Hegele², Houchun H Hu³, and Charles A McKenzie^1,2
1Medical Biophysics, Western University, London, Ontario, Canada, ²The Robarts Research Institute, London, Ontario, Canada, ³Department of Radiology, Children’s Hospital Los Angeles, Los Angeles, California, United States

Measurement of muscle volume and fat distribution in the extremities is clinically important for the study of degenerative muscle diseases and aging. We aimed to extend, and validate a previously introduced abdominal adipose segmentation tool for use in the extremities. Using automatic segmentation of water and fat images, the volumes of subcutaneous adipose tissue, inter-muscular adipose tissue, and muscle were validated against manual segmentation. Excellent agreement between manual and automated methods was found, with automated segmentation being 80x faster. The automated tool is suitable for use in the extremities enabling rapid segmentation of complete tissue volumes rather than single-slices.

Nicolas Linder^1,2, Alexander Schaudinn^1,2, Nikita Garnov^1,2, Tatjana Schütz², Veronika Peter², Arne Dietrich^2,3, Thomas Kahn¹, and Harald Busse^1
1Diagnostic and Interventional Radiology Department, Leipzig University Hospital, Leipzig, Saxony, Germany, ²IFB Adipositas Diseases, University Medicine Leipzig, Saxony, Germany, ³Department of Visceral-, Transplantation-, Thorax- and Vascular Surgery, Leipzig University Hospital, Leipzig, Saxony, Germany

MRI quantification of visceral adipose tissue (VAT) has promising applications in risk assessment and therapy monitoring of obesity-related diseases. The aim was to evaluate whether an accelerated, partial data analysis can be used to estimate total VAT in 70 morbidly obese patients. As observed in less obese patients, single-slice volume estimates at vertebral disc levels L3/4 (female) and L1/2 (male) were good predictors for total VAT volume. Analysis of 5 slices was found to be slightly beneficial in both groups. Small volume changes occurring under minor interventions like diets still seem to require a complete analysis of all (here 37) slices.

Patrik Tunón¹, Thobias Romu^1,2, Anette Karlsson^1,2, Sepher Zanjanis³, Solveig Gjellan³, Fredrik H Nyström³, Peter Lundberg^1,3, Örjan Smedby^1,3, Magnus Borga^1,2, and Olof Dahlqvist Leinhard^1,3
1Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden, ²Department of Biomedical Engineering, Linköping University, Linköping, Sweden, ³Department of medical and health sciences, Linköping University, Linköping, Sweden

A method for calculation of total lean and adipose tissue volume based on intensity corrected whole body water-fat separated MRI is presented. The method was validated comparing data acquired from healthy volunteers scanned at different field strengths, resolutions and vendors. The whole body adipose tissue volume was also compared to air displacement plethysmography. Both adipose and lean tissue measurements showed excellent reproducibility between different MRI measurements as well as compared to air displacement plethysmography.

Hiroyoshi Isoda¹, Akihiro Furuta¹, Rikiya Yamashita¹, Tsuyoshi Ohno¹, Seiya Kawahara¹, Hironori Shimizu¹, Aki Kido¹, Koji Fujimoto¹, Yasutaka Fushimi¹, Kaori Togashi¹, and Hiroshi Kusahara^2
1Kyoto University Graduate School of Medicine, Kyoto, Kyoto, Japan, ²Toshiba Medical Systems Corporation, Otawara, Tochigi, Japan

Long TI of a selective tagging pulse in flow-out method is favorable for peripheral vessel visualization to maintain background signal suppression using a nonselective inversion recovery pulse. The aim of this study was to compare and evaluate images of non-contrast-enhanced MR arteriography acquired with two different methods, the flow-in and modified flow-out methods using the selective tagging pulse with long TI. The vessel-to-liver contrast and the quality of vessel visualization were better with the modified flow-out than flow-in method. Non-contrast-enhanced MR arteriography with the modified flow-out method improved the visualization of the intrahepatic artery in comparison with the flow-in method.

Oi Lei Wong^1,2, Glady G Lo³, Raymond Lee³, Po Lung Polo Chan³, Wing Wa Li³, Siu Ki Yu⁴, and Michael D Noseworthy^5,6
1Department of Medical Physics and Applied Radiation Science, McMaster University, Hamilton, Ontario, Canada, ²Medical Physics and Research Department, Hong Kong Sanatorium & Hospital, Hong Kong, Hong Kong, Hong Kong, ³Department of Diagnostic & Interventional Radiology, Hong Kong Sanatorium & Hospital, Hong Kong, Hong Kong, ⁴Medical Physics and Research Department, Hong Kong Sanatorium & Hospital, Hong Kong, Hong Kong,⁵Department of Electrical and Computer Engineering, McMaster University, Hamilton, Ontario, Canada, ⁶St.Joseph's Healthcare, Hamilton, Ontario, Canada

Performing diffusion weighted imaging at the left liver lobe is often problematic due to regional signal loss. From the literature, the regional signal loss is possibly related to respiratory and cardiac motion. In this study, we studied the effect of cardiac phase, and hence motion, on liver DTI metrics, performed at various cardiac trigger delay settings. Significant change in DT metrics between systole and diastole was observed in the left liver lobe, but not the right liver lobe. This suggests that these metrics are sensitive to cardiac phase, and thus likely deformation.

Naama Lev-Cohain¹, Qing Yuan¹, Daniella Pinho¹, Yin Xi¹, and Ivan M. Pedrosa^1
1Radiology, UT Southwestern Medical Center, Dallas, TX, United States

Diffusion weighted imaging (DWI) acquisitions of the liver are performed for lesion detection and characterization. Respiratory triggered acquisitions (RT) are used to eliminate anatomic misregistration caused by respiratory motion. To our knowledge, the effectiveness of RT strategies has not been explored. We analyzed the effect of respiratory motion on slice misregistration in DWI acquisitions. 74% of the DWI acquisitions in our study had at least misregistration in one of the 4 anatomic locations analyzed. Our results indicate that the utility RT DWI for lesion characterization in the liver may lack the robustness needed for broad applicability in clinical practice.

Guido Hugo Jajamovich¹, Hadrien Dyvorne¹, Cecilia Besa¹, and Bachir Taouli^1
1Icahn School of Medicine at Mount Sinai, New York, NY, United States

This study assesses diffusion and perfusion characteristics of hepatocellular carcinoma (HCC) and background liver parenchyma measured through the use of both DWI and DCE-MRI acquisition techniques. Semi-quantitative DCE-MRI parameters time to peak (TTP), slope and area under the curve at 60s (AUC60) and DWI parameters apparent diffusion coefficient (ADC) and true diffusion coefficient (D) demonstrated significant differences in HCC vs. liver parenchyma. There was no correlation between DWI and DCE-MRI metrics. These results suggest that the combination of DWI and DCE-MRI in a multiparametric MRI scan provides non-redundant information about HCC tumor biology.

Yong Cui¹, Hadrien Dyvorne¹, Cecilia Besa¹, Guido Jajamovich¹, Octavia Bane¹, and Bachir Taouli^1
1Icahn School of Medicine at Mount Sinai, New York, NY, United States

This study assessed Intravoxel Incoherent Motion (IVIM) diffusion-weighted imaging in the liver parenchyma at 1.5T and 3.0 T in terms of image quality, parameter quantification and inter-platform reproducibility. IVIM DWI at 3.0T provided better image quality than 1.5T. ADC and D were more reproducible than PF and D* between the two platforms.

Anshuman Panda¹, Judy R James¹, and Alvin C Silva^1
1Department of Radiology, Mayo Clinic, Scottsdale, Arizona, United States

Qualitative and quantitative impact on the liver DWI in the presence of a hepatobiliary contrast agent has been reported to be insignificant. However, our observation contradicts those findings. A year-long trial with over 25 healthy liver donor patients showed a significant change in the b-maps and ADC values in the pre- and post-gadoxetate disodium DWI. In particular, the signal drop was significantly higher post contrast when an inversion recovery (IR) pulse was added for fat suppression. Thus, we suggest that liver DWI should be performed pre-contrast when possible, or without an IR pulse post-contrast.

Sonia Isabel Goncalves¹, Goncalo Cachola², Filipe Caseiro-Alves^3,4, and Miguel Castelo-Branco^1
1IBILI-Faculty of Medicine, University of Coimbra, Coimbra, Coimbra, Portugal, ²Faculty of Sciences and Technology, Universidade Nova de Lisboa, Setubal, Portugal, ³Faculty of Medicine, University of Coimbra, Coimbra, Portugal, ⁴Radiology, University Hospital Coimbra, Coimbra, Portugal

Intra-voxel incoherent motion (IVIM) imaging differentiates between true molecular diffusion, diffusion due to perfusion, and quantifies perfusion fraction. Results from its clinical application have been ambiguous and this can be, at least in part, explained by the dependence of IVIM parameter estimation on the choice of b-value combination that is used to sample the data. In this paper we explore the influence of the perfusion rate regime in the total error propagated into IVIM diffusion/perfusion parameters, in order to optimize the b-value distribution that is used to sample the data.

Himanshu Bhat¹, Thomas Doring², Daniel Cornfeld³, Ralph Strecker⁴, Stephen F. Cauley⁵, Kawin Setsompop⁵, Leonardo Kayat Bittencourt², Romeu Domingues², and Keith Heberlein^1
1Siemens Medical Solutions USA Inc, Charlestown, MA, United States, ²CDPI/DASA, Rio de Janeiro, Rio de Janeiro, Brazil, ³Department of Diagnostic Radiology, Yale-New Haven Hospital, New Haven, CT, United States, ⁴Siemens Ltda, São Paulo, São Paulo, Brazil, ⁵A. A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, United States

The goal of this work was to apply the blipped CAIPIRINHA slice acceleration technique to spin echo EPI based whole-body DWI and compare the results with a conventional non slice accelerated acquisition. 8 healthy volunteers and 6 patients were scanned with both sequences. Quantitative comparison between the two sequences showed similar ADC values in multiple organs. Qualitative comparison showed comparable image quality and diagnosis in all 6 patients with both sequences.

Nina Tunariu^1,2, David J Collins^1,2, Matthew D Blackledge^1,2, Mihaela Rata^1,2, Julie Hughes¹, Zaki Ahmad¹, Raquel PerezLopez^1,2, Amelia Altavilla^1,2, Roberta Ferraldeschi^1,2, Gerhardt Attard^1,2, Johann S de Bono^1,2, Martin O Leach^1,2, and Dow-Mu Koh^1,2
1The Royal Marsden NHS Foundation Trust, Sutton, London, United Kingdom, ²The Institute of Cancer Research, Sutton, London, United Kingdom

More than 70% of castration-resistant prostate cancer patients have metastatic bone disease; the only available imaging response criteria are those of disease progression on bone scans, with no imaging criteria to positively assess therapy benefit. Diffusion weighted imaging (DWI) and fat fraction (FF) quantification are promising tools for detection and therapy monitoring of bone metastases. Currently, there are no published data documenting the reproducibility of total tumour volume (TTV) bone disease apparent diffusion coefficient (ADC) or FF values. The aim of this study was to document the reproducibility of TTV defined on DWI, ADC and FF using histograms methods.

Arash Latifoltojar¹, Paul Humphries², Stephen Daw³, Ananth Shankar³, Stuart Taylor⁴, and Shonit Punwani^4
1Centre for Medical Imaging, University College London, London, London, United Kingdom, ²Radiology, University College London Hospital, London, United Kingdom, ³University College London Hospital, London, United Kingdom, ⁴Centre for Medical Imaging, University College London, London, United Kingdom

Whole body MRI is being increasingly used as an alternative imaging modality to PET-CT in paediatric lymphoma. Moreover the addition of diffusion weighted images to whole body protocol makes the functional assessment of tumour possible. In this work the inter observer agreement on size measurement and quantitative derived parameters is investigated for anatomical and functional MRI,

Julie Absil¹, Helena Torrao¹, Thierry Metens¹, Monia Bali¹, and Celso Matos^1
1MRI Unit - Radiology, CUB Hôpital Erasme, Brussels, Brussels, Belgium

In this IRB approved study, the quantification of Intravoxel Incoherent Motion (IVIM) parameters as well as monoexponential DWI parameters was performed in healthy pancreas in order to assess changes during secretin stimulation. Fifteen healthy volunteers underwent 3T diffusion-weighted SE-EPI MRI before and at 3 and 8 minutes following secretin injection (1CU/KgBW). Monoexponential apparent diffusion coefficients (calculated with different sets of b-values) as well as IVIM perfusion fraction significantly increased at 3 minutes after secretin administration, reflecting the expected increase in both perfusion and the exocrine free water release. All parameters decreased between 3 and 8 minutes after secretin administration.

Peng Cao^1,2, Shu-Juan J. FAN^1,2, Anna M. Wang^1,2, Victor B. Xie^1,2, Iris Y. Zhou^1,2, and Ed X. Wu^1,2
1Laboratory of Biomedical Imaging and Signal Processing, The University of Hong Kong, Hong Kong, Hong Kong SAR, China, ²Department of Electrical and Electronic Engineering, The University of Hong Kong, Hong Kong, Hong Kong SAR, China

The liver proton MR spectroscopy (MRS) is typically used for quantifying lipid content. Previous proton MRS studies have reported the quantifications of liver lipid profile and liver choline in vivo. This study aimed to examine whether dynamic proton MRS can assess the time courses of liver choline level and lipid profile in response to the acute lipid intake. Our preliminary results suggested that dynamic proton MRS could measure the changes of choline level and lipid profile in normal rat liver with acute intravenous lipid infusion.

Irene Maria Louise van Kalleveen¹, Jaap P. Hoogendam¹, Alexander J.E. Raaijmakers¹, Fredy Visser¹, Hugo Kroeze¹, Peter R. Luijten¹, Wouter B. Veldhuis¹, and Dennis W.J. Klomp^1
1UMC Utrecht, Utrecht, Utrecht, Netherlands

In cervical cancer, high resolution T₂ images are desired for determining loco-regional tumour spread. This requires an increased SNR, which may be provided at higher field strengths. Using external antennas combined with an internal antenna, we demonstrate that the SNR at 7T can be increased with an additional factor 3.2. Additionally, TSE visualization of the entire female pelvis is achieved. The boosted SNR is used to obtain high resolution T₂-weighted MRI of the human cervix uteri and parametria, not only showing a high level of details, but also alterations in T₂ contrasts that enables distinguishing the cervix from the parametria.

Maysam Jafar¹, Katherine Downey¹, Sharon L Giles², Veronica A Morgan², Geoffrey S Payne¹, and Nandita M DeSouza^1
1Clinical Magnetic Resonance Unit, Institute of Cancer Research, Sutton, Surrey, United Kingdom, ²Clinical Magnetic Resonance Unit, Royal Marsden Hospital, Sutton, Surrey, United Kingdom

DW sequences improve detection of cervical tumor but are prone to distortions, worse when using an endovaginal receiver coil. We corrected image distortions by acquiring forward and reverse gradient images and then used Chang&Fitzpatrick’s reverse gradient algorithm. Assessment of the correction by measuring the angle of the endocervical canal to the horizontal on corrected and uncorrected high b-value images showed significant differences in the former but not the latter when compared to measurements from T2-W images. Normalised cross-correlation using template matching to assess similarities between corrected/uncorrected DW and T2-W images varied marginally, indicating the need for feature tracking techniques.

Erin Bravo¹, Krupa Patel-Lippmann², Kristie Guite³, Jessica Robbins³, David Kushner², Ahmed Al-Niaimi², and Elizabeth Sadowski^2
1Radiology, University of Wisconsin, Madison, Wisconsin, United States, ²University of Wisconsin, Wisconsin, United States, ³Radiology, University of Wisconsin, Wisconsin, United States

In grade 1 endometrial cancer there is debate whether or not lymphadenectomy is necessary. Strong evidence exists that women without myometrial or cervical invasion have decreased risk of lymph node metastasis, thus may potentially avoid lymphadenectomy. The goal of our study was to evaluate myometrial and cervical invasion in women with grade 1 endometrial cancer on preoperative MRI when being read by abdominal radiologists compared with surgical pathology. Our study determined the negative predictive value of MRI in detecting myometrial and/or cervical invasion is 96%, which may decrease the need for lymphadenectomy in women with very low risk for lymph node metastasis.

Mayumi Takeuchi¹, Kenji Matsuzaki¹, and Masafumi Harada^1
1Department of Radiology, University of Tokushima, Tokushima, Tokushima, Japan

We evaluated the MR findings (morphologic appearances, ADC values on DWI and metabolite concentration on MRS) of pathologically proven 11 carcinosarcomas of the uterus. The mean and minimum ADCs were 0.92+/-0.21, and 0.73+/-0.16, respectively. The choline and lipid concentrations (mM) were 5.38+/-2.83 and 145.39+/-122.65, respectively. We conclude that large exophytic endometrial mass, often exhibiting �gtumor prolapse�h, containing strongly enhanced areas may suggest carcinosarcoma. Relatively higher mean ADC with low minimum ADC, relative low choline concentration and high lipid peak may reflect internal heterogeneity of carcinosarcoma due to the admixture of high-grade malignant tumor cells, necrosis, and epithelial glandular cystic components.

Mengqiu Cao¹, Shiteng Suo¹, Xuebin Zhang¹, and Jianrong Xu^1
1Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

The present study for the first time demonstrated that entropy of T2-weighted imaging as well as apparent diffusion coefficient (ADC) of leiomyomas before uterine artery embolization (UAE) has predictive value for leiomyoma volume reduction 6 months after embolization. A combination of entropy and ADC may help interventional radiologists with patient selection, preoperative planning and evaluation.

Elahe Kia^1,2, Anahita Fathi Kazerooni^1,2, Alireza Ahmadian¹, and Hamidreza Saligheh Rad^1,2
1Medical Physics and Biomedical Engineering Department, School of Medicine,Tehran University of Medical Sciences, Tehran, Tehran, Iran, ²Quantitative MR Imaging and Spectroscopy Group, Research Center for Cellular and Molecular Imaging,Tehran University of Medical Sciences, Tehran, Tehran, Iran

Dynamic contrast enhanced MRI (DCE-MRI) has shown to be promising for quantitative assessment of complex ovarian cancers. Quantification of DCE-MR images could be affected by motion artifacts and intensity inhomogeneity induced by bias fields. Proper selection of a registration algorithm could impact the outcome of this problem. In this work, we proposed an efficient non-rigid registration method in a group-wise setting to non-rigidly align DCE-MR images to reliable quantification of ovarian masses.

Martin D Pickles¹ and Lindsay W Turnbull^1
1Centre for Magnetic Resonance Investigations, HYMS at University of Hull, Hull, East Yorkshire, United Kingdom

The purpose of this study is to determine the technical feasibility of spatially selective small FOV DWI in the imaging of the female pelvis and to obtain preliminary comparative data against traditional T2W images. FOCUS DWI was successfully obtained from 14 patients utilising a 3.0T scanner. The images were then compared against T2W data. Discordance was noted in 6/14 cases. In each of these cases FOCUS images indicated less extensive disease than T2W images. Additionally, diagnostic confidence was increased in 12/14 cases. These preliminary results suggest that FOCUS is not only feasible but results in an increased diagnostic confidence.

UdayBhaskar Krishnamurthy^1,2, Yimin Shen¹, Gabor Szalai³, Jaladhar Neelavalli^1,2, Bing Wang³, Tinnakorn Chaiworapongsa^3,4, Edgar Hernandez-Andrad^3,4, Nandor Gabor Than^3,4, Ewart Mark Haacke^1,2, and Roberto Romero^3
1Radiology, Wayne State University, Detroit, MI, United States, ²Biomedical Engineering, Wayne State University, Detroit, MI, United States, ³Perinatology Research Branch, NICHD, NIH, DHHS, Detroit, MI, United States, ⁴Obstetrics and Gynecology, Wayne State University, Detroit, MI, United States

To quantify the T2 relaxation parameter in the different constituent regions of murine placenta at different gestational ages and to study their relative contributions to the overall change in placental T2 with gestational age

Christopher K Macgowan¹, Beverly Tsai Goodman², Mashael Alrujaib³, and Mike Seed^4
1Departments of Medical Biophysics and Medical Imaging, Hospital for Sick Children / University of Toronto, Toronto, Ontario, Canada, ²Department of Paediatric Cardiology, Bristol Children's Hospital / University of Bristol, United Kingdom, ³Department of Paediatrics and Division of Cardiology, Hospital for Sick Children / University of Toronto, Ontario, Canada, ⁴Department of Paediatrics and Division of Cardiology, Hospital for Sick Children / University of Toronto, Toronto, Ontario, Canada

Quantification of human fetal blood flow using phase contrast (PC) MR with metric optimized gating (MOG) has recently been demonstrated in normal pregnancies and fetal left-sided congenital heart disease. These studies were performed at a field strength of 1.5T; however, there is growing interest in fetal imaging at higher field strengths to improve SNR. The goal of this pilot study was to evaluate the agreement between fetal flows measured at 1.5T and 3.0T, using PC MR with MOG.

Tetsu Niwa¹, Tomoaki Nagaoka², Noriko Aida³, Koki Kusagiri³, Kumiko Nozawa³, Taro Takahara⁴, and Yutaka Imai^1
1Radiology, Tokai University School of Medicine, Isehara, Kanagawa, Japan, ²EMC group, National Institute of Information and Communications Technology, Koganei, Tokyo, Japan, ³Radiology, Kanagawa Children's Medical Center, Kanagawa, Japan, ⁴Biomedical Engineering, Tokai University School of Engineering, Isehara, Japan

Seven fetuses images of whole body 3D-true fisp were assessed for fetal organ development. Whole-body 3D-true-FISP images were segmented with semiautomated method. The volume of the brain, lung, heart, liver and kidneys were calculated. As a result, positive correlations between the fetal organ volumes and the gestational week were found. Whole-body 3D-FISP imaging may reflect the volumetric development of the fetal organs along with the gestational age.

Nicholas Hilliard¹, Rebecca Baker¹, Andrew Patterson¹, Martin Graves¹, Christoph Lees², Pat Set¹, and David J Lomas^1
1Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, Cambridgeshire, United Kingdom, ²Maternal And Fetal Assessment Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, Cambridgeshire, United Kingdom

This is a small pilot study comparing a rapid method of MRI measurement of amniotic fluid volume with standard manual planimetric (MP) approaches. The rapid method uses projection hydrography (PH) to compare amniotic signal with a reference fluid volume. Comparison is made with ultrasound as a ‘gold standard’ modality. Results show that PH shows strong correlation with MP, and they both show moderate correlation with ultrasound. Further development of this technique may prove useful in MRI assessment of the fetus.

UdayBhaskar Krishnamurthy^1,2, Wei Feng¹, Jaladhar Neelavalli^1,2, Pavan Kumar Jella^1,2, Ehsan Hamtaei¹, Edgar Hernandez-Andrade^3,4, Swati Mody¹, Lami Yeo³, S. Ehterami¹, M. D. Cabrera¹, Ewart Mark Haacke^1,2, S. S. Hassan³, and Roberto Romero^3
1Radiology, Wayne State University, Detroit, MI, United States, ²Biomedical Engineering, Wayne State University, Detroit, MI, United States, ³Perinatology Research Branch, NICHD, NIH, DHHS, Detroit, MI, United States, ⁴Obstetrics and Gynecology, Wayne State University, Detroit, MI, United States

Adaptation of time resolved PC-MRI technique which is used to measure the average velocity of the fetal umbilical vessels in utero

Yong Eun Chung¹, Hye-Jeong Lee¹, Mi-Suk Park², and Myeong-Jin Kim^2
1Radiology, Yonsei University College of Medicine, Seoul, ., Korea, ²Radiology, Yonsei Univeristy College of Medicine, Seoul, ., Korea

We tried to assess the normal value of shear modulus (Gd), loss modulus (Gl) and complex modulus (G*) of the healthy liver, and evaluate their reproducibility at 3.0T MRI. Multi-frequency MR rheology with transducer frequency of 28Hz, 56Hz and 84Hz was acquired in 60 healthy volunteers. Three modulus were calculated from central 4 slices, central 2 slices and the upper most 1 slice in each frequency. The reproducibility of MRR was higher at lower transducer frequency and MRR modulus should be calculated from the data which were obtained from at least central 2 slices of MRR.

Chen-Te Chou^1,2, Ran-Chou Chen^3,4, and Chih-Wei Lee^1
1Chang-Hua Christian Hospital, Chang-Hua, Taiwan, Taiwan, ²Biomedical Imaging and Radiological Science, National Yang-Ming Medical University, Taipei, Taiwan, Taiwan, ³Radiology, Taipei city Hospital, Taipei, Taiwan, Taiwan, ⁴Biomedical Imaging and Radiological Science, National Yang-Ming Medical University, Taiwan, Taiwan

According to the AASLD guidelines, aggressive treatment is advised for patients with hepatic fibrosis stages ¡Ý 2. Biopsy is the gold standard, but it is invasive. MR elastography (MRE) is a noninvasive method of measuring the hepatic viscoelastic properties. In our results, the stiffness values had a good correlation with the pathological fibrosis stage. In differentiation of fibrosis stage ¡Ý 2 from stage 0/1, the sensitivity and specificity were 93.4% and 91.0%, respectively, with a cutoff value of 2.83 kPa. MRE was a promising, noninvasive technique for prediction of fibrosis stage among Asia patients with chronic liver disease.

Nikolaus M Szeverenyi¹, Claude Sirlin¹, William M Haufe¹, Michael S Middleton¹, Yu Shi², Kevin Glaser², Richard Ehman², and Rohit Loomba^1
1Univ. of California, San Diego, San Diego, CA, United States, ²Mayo Clinic, MN, United States

This prospective study was performed to assess the accuracy of MR elastography (MRE)-derived shear stiffness values as predictors for non-alcoholic steatohepatitis (NASH) and advanced fibrosis in adults with known or suspected non-alcoholic fatty liver disease (NAFLD), using contemporaneous liver biopsy as reference. We found that MRE acquired using relatively low-frequency mechanical waves and a 3D inversion algorithm provides high accuracy in the diagnosis of NASH and advanced fibrosis in patients with NAFLD.

Yu Shi^1,2, Qiyong Guo¹, Fei Xia³, Bogdan Dzyubak², Kevin J. Glaser², and Richard L. Ehman^2
1Department of radiology, Shengjing hospital, Shenyang, Liaoning, China, ²Mayo Clinic, Rochester, MN, United States, ³Department of infectious diseases, Shengjing hospital, Shenyang, Liaoning, China

MRE had a high diagnostic accuracy for hepatic fibrosis in chronic hepatitis B. Both fibrosis stage and necroinflammation grade were independent factors contributing to liver stiffness (Multivariate linear regression, ©¬=0.798, 0.275; P< .001). For liver tissue with F¡Â2 fibrosis, necroinflammation accounts for a portion of the elevated liver stiffness.

Zhitao Li¹, Ali Bilgin^1,2, Jean-Philippe Galons³, Puneet Sharma³, Diego Martin³, and Maria Altbach^3
1Electrical and Computer Engineering, University of Arizona, Tucson, Arizona, United States, ²Biomedical Engineering, University of Arizona, Tucson, Arizona, United States, ³Department of Medical Imaging, University of Arizona, Tucson, Arizona, United States

Chronic liver disease due to Hepatitis B/C or non-alcoholic steatohepatitis is a major health problem. The first manifestation of CLD is inflammation, which can progress to fibrosis and cancer. Staging of liver fibrosis requires an invasive liver biopsy with associated morbidity, cost, and sampling errors. This study is to investigate if structural changes of fibrosis can be detected by localized frequency analysis of liver images using wavelets. The work is carried out in ex vivo tissue samples that resemble in vivo Gd-enhanced images.

Stephanie Lyn Coleman¹, Lindsey Storer², Doro Gheorghe³, Stephan Anderson¹, and Jaroslaw Tkacz^1
1Radiology, Boston Medical Center, Boston, MA, United States, ²Boston University, Boston, MA, United States, ³Biostatistics, Boston University, MA, United States

Ultrasound imaging has known limitations and large variations in the sensitivity and specificity of diagnosis of acute cholecystitis. There is limited literature on the sensitivity and specificity of MR imaging, however, the reported are similar to ultrasound, but without the variation. We did a retrospective review of MR imaging in patients with suspected acute cholecystitis. Results showed that MRCP is very insensitive, but has excellent specificity in diagnosis of acute cholecystitis. In conclusion, additional imaging approaches are suggested such as those including functional imaging such as HIDA or MRI with the use of hepatobiliary contrast agents.

Temel Tirkes¹, Chen Lin¹, Jordan K Swensson¹, Zachary E Ballenger², Chenkun Wang³, Evan Fogel⁴, Kumaresan Sandrasegaran⁵, Alex Aisen¹, and Fatih Akisik^1
1Diagnostic Radiology and Clinical Sciences, Indiana University School of Medicine, Indianapolis, Indiana, United States, ²Indiana University School of Medicine, Indianapolis, Indiana, United States, ³Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana, United States,⁴Department of Gastroenterology, Indiana University School of Medicine, Indianapolis, Indiana, United States, ⁵Diagnostic Radiology and Clinical Sciences, Indiana University School of Medicine, Indianapolis, IN, United States

Diagnosis of early chronic pancreatitis is challenging for both the gastroenterologist and the radiologist since the pancreatic ductal findings are usually normal. Diagnosis often times requires performing an endoscopic stimulation test collecting the pancreatic juice to check for decreased exocrine function in these patients. This study showed that decrease in the relative T1-weighted signal of the pancreas can be used as an indicator of decreased exocrine function in patients with suspected early chronic pancreatitis.

Pardeep Mittal¹, William Small¹, Juan C Camacho¹, Kiran K Maddu¹, Volkan Adsay², Burcu Saka², Courtney C Moreno¹, and Bobby Kalb^3
1Radiology and Imaging Sciences, Emory Uni School of Medicine, Atlanta, Georgia, United States, ²Pathology, Emory Uni School of Medicine, Atlanta, Georgia, United States, ³Diagnostic Radiology, University of Arizona, Tucson, Arizona, United States

Paraduodenal pancreatitis is rare form chronic pancreatitis and its appearance may resemble pancreatic adenocarcinoma as both entities can lead to dilatation of biliary and pancreatic ducts .Distinction between these two entities remain challenging .Contrast enhanced MRI may help accurately identify paraduodenal pancreatitis from entities having similar features such as adenocarcinoma and aid in therapeutic decisions.

Minoru Hayashida¹, Akihiko Kanki¹, Akira Yamamoto¹, Tsutomu Tamada¹, Kazuya Yasokawa¹, Daigo Tanimoto¹, Atsushi Higaki¹, Yasufumi Noda¹, and Katsuyoshi Ito^1
1Diagnostic Radiology, Kawasaki Medical School, Kurashiki, Okayama, Japan

The purpose of this study was to determine the feasibility of directly and noninvasively visualizing physiological bile flow in the extrahepatic bile duct by means of non-pharmacologic cine-dynamic MRCP with a spatially selective inversion-recovery (IR) pulse and to assess the flow dynamic pattern of bile in the extrahepatic bile duct. Thirty-five patients without known pancreatobiliary diseases and 11 patients with dilatation of the extrahepatic bile duct were included. Non-pharmacological, cine-dynamic MRCP with a spatially selective IR pulse allowed direct and noninvasive visualization of antegrade/reversed bile flow in the extrahepatic bile duct, demonstrating that reversed bile flow is a physiological phenomenon.

KAUZUYA YASOKAWA¹, AKIRA YAMAMOTO¹, TSUTOMU TAMADA¹, AKIHIKO KANKI¹, ATSUSHI HIGAKI¹, YASUFUMI NODA¹, HIDEMITU SOTOZONO¹, AYUMU KIDO¹, AKANE UCHINO¹, and KATSUYOSHI ITO^1
1Radiology, Kawasaki Medical School, Kurashiki, Okayama, Japan

This study investigated whether cine dynamic MRCP with a spatially selective inversion recovery pulse can be used for evaluation of exocrine pancreatic functions in 10 patients with suspected chronic pancreatitis in comparison with currently available pancreatic exocrine function test with N-benzoyl-L-tyrosyl-p-aminobenzoic acid (BT-PABA) reagent. The urinary PABA excretion rate (%) had significant positive correlations with both the mean secretion grade (the distance that the pancreatic juice moved in the pancreatic duct) and the frequency that the pancreatic juice flowed in the pancreatic duct. This technique has a potential to evaluate pancreatic exocrine function noninvasively in patients with suspected chronic pancreatitis.

Su Xu^1,2, Diana Vivian³, Kunrong Cheng⁴, Sandeep Khurana⁴, Wenjun Zhu^1,2, Andrew Marshall^1,2, Rao Gullapalli^1,2, James Polli³, and Jean-Pierre Raufman^4
1Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, United States, ²Core for Translational Research in Imaging @ Maryland, Baltimore, MD, United States, ³Department of Pharmaceutical Sciences, University of Maryland School of Pharmacy, Baltimore, MD, United States, ⁴Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, United States

Using in vivo ¹⁹F MRI, a novel synthesized trifluorinated bile acid – CA-lys-TFA was tested for its ability to concentrate in the gallbladders of C57BL/6 mice after oral gavage. Mice orally gavaged with ¹⁹F labled CA-lys-TFA revealed robust ¹⁹F signals from the gallbladder in vivo, and correlated with the concentrations determined independently using LC-MS on ex vivo tissue. The results from the study suggest that CA-lys-TFA, a fluorinated non-radioactive bile acid analogue, has potential for use in MRI to measure in vivo bile acid transport and diagnose bile acid malabsorption and other conditions associated with impaired bile acid transport.

Keitaro Sofue¹, Takeshi Yoshikawa², Nobukazu Aoyama³, Yoshiharu Ohno², Katsusuke Kyotani³, Saori Sato⁴, Naoki Kanata¹, Mizuho Nishio², Hisanobu Koyama¹, and Kazuro Sugimura^1
1Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan, ²Advanced Biomedical Imaging Research Center, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan, ³Division of Radiology and Radiation Oncology, Kobe University Hospital, Kobe, Hyogo, Japan, ⁴Toshiba Medical Systems Corporation, Otawara, Tochigi, Japan

The assessment and classification of anatomy of hepatic artery is an essential step for both diagnosis and management of various diseases in the upper abdomen. Development of non- invasive imaging techniques for this purpose is an urgent problem. Our results suggested that anatomy of hepatic artery can be assessed and classified using non-contrast MR arteriography using time-SLIP technique at 3T-MRI.

Daniel Aguirre¹, Camila Muñoz¹, Cristian Tejos¹, Pablo Irarrazaval¹, Sergio Uribe², and Marcelo E Andia^2
1Biomedical Imaging Centre, Pontificia Universidad Catolica de Chile, Santiago, Chile, ²Radiology Department, Pontificia Universidad Catolica de Chile, Santiago, Santiago, Chile

The increase in the intrahepatic blood flow resistance in chronic liver disease has been identified as one of the most sensitive parameters to detect liver cirrhosis progression. Portal vein liver perfusion is affected very early during the liver diseases progression. In this work we investigated the feasibility of selectively visualizing the intrahepatic portal vein and estimating its intrahepatic volume in healthy subjects and patients with cirrhosis as a marker of liver perfusion, using a new Arterial Spin Labeling technique without the need of subtraction (TIR-ASL).

Zoran Stankovic¹, Michael Markl¹, Edouard Semaan¹, Robert Lewandowski¹, Albert Nemcek¹, Frank Miller¹, Riad Salem¹, james Carr¹, and Jeremy Collins^1
1Radiology, Northwestern University, Chicago, USA, United States

4D flow MRI provides visual and quantitative assessment of arterial and portal venous hemodynamics of the hepatic system. This study shows a high correlation between peak velocities as a flow parameter and the clinical disease scores in selected vessels of the arterial and portal venous system. 4D flow MRI may have the potential to provide biomarker in the early disease stage improving the detectability of the disease, but also the patient management.

Takayuki Masui¹, Motoyuki Katayama¹, Yuji Iwadate², Kimihiko Sato¹, Naoyuki Takei², Kei Tsukamoto¹, Kenichi Mizuki¹, and Masayoshi Sugimura^1
1Radiology, Seirei Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan, ²GE Healthcare Japan, Hino, Tokyo, Japan

The purpose was to evaluate the feasibility of dynamic contrast study during free-breathing with navigator technique for evaluation of the lesions in the pancreas or liver. In all patients, dynamic contrast MR imaging of the pancreas and liver could be performed under free-breathing with acceptable image quality, temporal resolutions and lesion recognitions. Thus, this technique may be useful for evaluations of the patients who cannot hold their breaths.

Yasunari Fujinaga¹, Ayumi Ohya¹, Akira Yamada¹, Masahiro Kurozumi¹, Kazuhiko Ueda¹, Yoshihiro Kitou², Hitoshi Ueda², Katsuya Maruyama³, and Masumi Kadoya^1
1Department of Radiology, Shinshu University, School of Medicine, Matsumoto, Nagano, Japan, ²Radiology Division, Shinshu University Hospital, Matsumoto, Nagano, Japan, ³Imaging & Therapy Systems Division, Siemens Japan. K. K., Tokyo, Japan

The radial volumetric imaging breath-hold examination with k-space-weighted image contrast reconstruction (r-VIBE-KWIC) allows powerful view sharing and provides high temporal resolution sub-frame images as well as a full-frame image. Dynamic contrast-enhanced MRI (DCE-MRI) using r-VIBE-KWIC has the potential to provide high spatial and temporal resolution images like a dynamic CT during hepatic arteriography (dyn-CTHA) without an invasive procedure or radiation exposure. We compared hemodynamics of HCC in DCE-MRI using r-VIBE-KWIC with that in dyn-CTHA, and revealed that DCE-MRI using r-VIBE-KWIC had a diagnostic potential comparable to dyn-CTHA in the hemodynamic evaluation of HCC.

Amy Watkins¹, Ka-Loh Li¹, Xiaoping Zhu¹, and Alan Jackson^1
1Wolfson Molecular Imaging Centre, University of Manchester, Manchester, United Kingdom

Mapping kinetic parameters from DCE-MRI traditionally requires compromise in terms of spatial resolution, temporal resolution, and volume coverage. This study investigated feasibility of applying a dual injection DCE-MRI approach, which has been applied for brain tumor study, in liver. Combining information content from high temporal resolution (HTR) and high spatial resolution (HSR) data in liver produces a high quality HTR AIF, allowing kinetic mapping the HSR data with full liver coverage and a voxel size of 2 mm3. The low dose HTR data can also be advantageously used for kinetic analysis, e.g., providing more accurate bolus arrival time (BAT) maps.

Philipp Maximilian Kazmierczak¹, Daniel Theisen¹, Wieland Sommer¹, Kolja Thierfelder¹, Maximilian F Reiser¹, and Konstantin Nikolaou^1
1Department of Clinical Radiology, University Hospitals Munich, Grosshadern Campus, Muenchen, Germany

Dynamic contrast-enhanced T1w-3D-fs-GRE with multi-arterial volumetric interpolated breath-hold examination (multi-arterial VIBE) allows for the acquistion of five arterial subphases during a single breath-hold. The diagnostic performance of this technique was studied in twenty-five patients with known focal liver lesions. Two independent readers evaluated the diagnostic value of the five dynamic arterial subphases compared to the standard hepatic arterial, portal venous, delayed and hepatobiliary phases and the single shot turbo-spin echo sequence. Multi-arterial VIBE demonstrated greater diagnostic accuary at the detection of hypervascularized focal liver lesions as compared to the hepatic arterial standard phase.

Mitchell Anthony Cooper^1,2, Bo Xu¹, Shan Hu², Silvina Dutruel², Martin R. Prince², Yi Wang¹, and Pascal Spincemaille^2
1Biomedical Engineering, Cornell University, Ithaca, New York, United States, ²Radiology, Weill Cornell Medical College, New York, New York, United States

Capturing the arterial phase is crucial for the optimal detection and characterization of liver tumors using dynamic contrast enhanced imaging. Recently, TRACER, a method for high temporal liver imaging was proposed which uses a spiral readout in conjunction with a non-linear reconstruction to reconstruct 3D images with a sub-second temporal frame rate. It was demonstrated that this reconstruction increased the likelihood of capturing the arterial phase after bolus injection. However, the reader is now presented with a large number of images Here we adapt a previously proposed algorithm to automatically select the optimal arterial phase from a series of 3D dynamic contrast enhanced hepatic images reconstructed with TRACER

R. Klaassen^1,2, O. J. Gurney-Champion³, E. G.W. ter Voert⁴, A. Heerschap⁴, M. F. Bijlsma², M. G.H. Besselink⁵, G. van Tienhoven⁶, C. Y. Nio³, J. Stoker³, C. J.A. Punt¹, J. W. Wilmink¹, H. W.M. van Laarhoven¹, and A. J. Nederveen^3
1Department of Medical Oncology, Academic Medical Center - University of Amsterdam, Amsterdam, Netherlands, ²Department of Experimental Oncology and Radiation Biology, Academic Medical Center - University of Amsterdam, Amsterdam, Netherlands, ³Department of Radiology, Academic Medical Center - University of Amsterdam, Amsterdam, Netherlands, ⁴Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands,⁵Department of Surgery, Academic Medical Center - University of Amsterdam, Amsterdam, Netherlands, ⁶Department of Radiation Oncology, Academic Medical Center - University of Amsterdam, Amsterdam, Netherlands

Breathing and peristaltic motions make reliable quantification of DCE-MRI of the pancreas difficult. Here we present an approach to minimize the effects of movement on the quantification of DCE-MRI of the pancreas. Three patients with proven pancreatic cancer were scanned with our 3T DCE-MRI protocol. Images at expiration were selected and registered. Quantification was performed with a two compartment model. Ktrans maps after motion correction showed better correlation with anatomical structures. A larger patient group will show if motion correction favours the capability of DCE-MRI to discriminate between tumour and healthy tissue and if it increases reproducibility between scans.

Lei Wang¹, Sheng Xie², YongLiang Sun², ZhiYing Yang², Jia Ning³, and HuiJun Chen^3
1China-Japan Friendship Hospital, BeiJing, BeiJing, China, ²China-Japan Friendship Hospital, BeiJing, China, ³QingHua University, BeiJing, China

Purpose: To analyze the perfusion measurements of the liver with a simple method and to investigate the correlation of clinical results with parameters. Methods and materials: Patients with various levels of fibrosis underwent perfusion MRI of the liver. The time-intensity curves of MR signal from the perfusion MRI were analyzed by linear fitting in segments. Tin, Tout ,Kup and ratio were measured and compared between the S0-2 group and S3-4 group. Results: A significant difference of each parameter (Tin, Tout, Kup and Ratio) between two groups was detected. Conclusion: The new procedure quantifies the hepatocyte-specific uptake of the contrast agent.

Dinesh K. Sundarakumar¹, Gregory J. Wilson¹, Sherif Osman¹, and Jeffrey H. Maki^1
1Radiology, University of Washington, Seattle, WA, United States

Subtraction of the pre-contrast phase in dynamic contrast enhanced (DCE) liver images is often necessary for accurate enhancement characterization of T1 hyperintense lesions such as treated hepatocellular carcinoma (HCC). However, variable displacement of the liver in successive breath-holds can lead to subtraction artifacts, making interpretation difficult. Furthermore, the liver is an elastic organ, and its displacement is not simply a rigid transformation. To address these issues, we evaluated an automatic 3D deformable registration algorithm for use in subtracted liver DCE. The method significantly reduced displacement (measured by anatomical landmarks) and improved the quality of subtracted images.

Zhaoyang Fan¹, Jianing Pang^1,2, Wensha Yang¹, Yong Yue¹, Richard Tuli¹, Guoxi Xie^1,3, Xiaoming Bi⁴, Benedick Fraass¹, and Debiao Li^1
1Cedars-Sinai Medical Center, Los Angeles, CA, United States, ²Northwestern University, Chicago, IL, United States, ³Shenzhen Institutes of Advanced Technology, Shenzhen, Guangdong, United States, ⁴MR R&D Siemens Healthcare, Los Angeles, CA, United States

Four-dimensional CT is currently a standard in radiotherapy planning to assess breathing motion and determine treatment margins for organ tumors. However, this modality has poor soft-tissue (or tumor) contrast and involves high radiation dose. These limitations can be overcome by using 4D MRI. The present work developed a retrospective 4D MRI technique (respiratory phase-resolved 3D MRI) that features: a) isotropic high spatial resolution (1.56 mm), b) a fixed scan time (8 minutes or less), c) an estimate of average respiratory phase resolved motion pattern with, and d) minimal intra-phase motion artifact.

Pardeep Mittal¹, Courtney C Moreno¹, Juan C Camacho¹, Brian Quigley², Kiran K Maddu¹, Nima Kokabi¹, William Small¹, and Bobby Kalb^3
1Radiology and Imaging Sciences, Emory Uni School of Medicine, Atlanta, Georgia, United States, ²Pathology, Emory Uni School of Medicine, Atlanta, Georgia, United States, ³Diagnostic Radiology, Univesity of Arizona, Tucson, Arizona, United States

Liver is an important organ from oncologic perspective. Primary liver cancers are more common in presence of CLD than non CLD such as cirrhosis etc. and arise from different components of liver such as hepatocytes, bile duct epithelium, neuroendocrine cells and mesenchymal cells. Therefore imaging and histopathological features of primary liver cancers and their common and uncommon mimics will be discussed in this presentation. MRI has become the most important diagnostic tool over other imaging modalities due to its excellent soft tissue contrast and multi planar capabilities which assist in diagnostic accuracy of liver lesions as well as promoting successful management