Yingli Yang¹, Minsong Cao¹, Ke Sheng¹, Yu Gao², Allen M Chen¹, Mitchell Kamrava¹, Percy Lee¹, Nzhde Agazaryan¹, James Lamb¹, David H Thomas¹, Daniel A Low¹, and Peng Hu^2
1Radiation Oncology, University of California, Los Angeles, Los Angeles, CA, United States, ²Radiological Sciences, University of California, Los Angeles, Los Angeles, CA, United States

Diffusion weighted MRI is promising for early prediction of response to radiotherapy 1, 2, and for adaptive radiotherapy, wherein the treatment plan is adapted during treatment based on patients’ response assessed by imaging. Currently DWI-based adaptive radiotherapy is not widely adopted because of scientific and practical challenges. Most importantly, the timing for DWI imaging is not well studied without longitudinal diffusion MRI data at a finer time interval (every 2-5 days) throughout the course of treatment. A recently commercialized MRI-guided radiotherapy system (ViewRay) may eliminate the current challenges and bring diffusion MRI-guided adaptive radiation therapy closer to clinical utility.

Xiang Xiao¹, Yikai Xu¹, Yuankui Wu¹, Yingjie Mei², and Queenie Chan^3
1Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou, China, People's Republic of, ²Philips Healthcare, Guangzhou, China, People's Republic of, ³Philips Healthcare, HongKong, China, People's Republic of

Radiation induced encephalopathy is one of the most serious complications of radiotherapy (RT) for treatment of nasopharyngeal carcinoma (NPC). In order to detect early radiation-induced changes in gray matter (GM) and white matter (WM) of NPC patients after RT, we recruited NPC patients before RT and after RT with normal-appearing brain for MR T1ρ examination. We found abnormal microstructure changes of WM had already happened in NPC patients after RT even when routine MRI findings are negative. MR T1ρ imaging can be used to detect early radiation-induced changes of WM following RT for NPC patients.

Xiaoli Liu¹, A. B. Madhankumar², Patti A. Miller¹, Becky Webb², James R. Connor², and Qing X. Yang^1
1Radiology, College of Medicine Penn State University, Hershey, PA, United States, ²Neurosurgery, College of Medicine Penn State University, Hershey, PA, United States

Glioma in its early stage is hard to detect and treat because MRI contrast agent and chemotoxin are not able to cross the blood brain barrier (BBB). The conventional MRI contrast agent such as Magnevist (GD-DTPA) is limited to the cases where the BBB is significantly compromised by the tumor. Present study reports the development of a novel theranostic tool, interleukin-13-liposomes-Magnevist-doxorubicine (IL-13-lip-magnevist-dox) for detection and treatment of glioma. Our results demonstrated that IL-13-lip-magnevist-dox own the potential to specifically target, concomitantly detect and treat glioma in its early stage when BBB is still intact. 

Alina Tudorica¹, Karen Y Oh¹, Stephen Y-C Chui¹, Nicole Roy¹, Megan L Troxell¹, Arpana Naik¹, Kathleen Kemmer¹, Yiyi Chen¹, Megan L Holtorf¹, Aneela Afzal¹, Charles S Springer, Jr¹, Xin Li¹, and Wei Huang^1
1Oregon Health & Science University, Portland, OR, United States

DCE-MRI was performed in 28 breast cancer patients (29 tumors) before, during, and after neoadjuvant chemotherapy (NACT).  Several DCE-MRI pharmacokinetic (PK) parameters were found to be good early predictors of pathologic complete response (pCR) vs. non-pCR after only one NACT cycle.  In addition, several PK parameters and tumor size were significantly correlated with pathologically measured residual cancer burden (RCB).

Jana Cebulla¹, Eugene Kim¹, Dan E Meyer², Karina Langseth³, Tone F Bathen¹, Siver A Moestue¹, and Else Marie Huuse^1,4
1Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway, ²Diagnostics, Imaging and Biomedical Technologies, Niskayuna, NY, United States, ³GE Healthcare AS, Oslo, Norway, ⁴Department of Medical Imaging, St. Olavs University Hospital, Trondheim, Norway

Preclinical-phase iron oxide particles (GEH121333), with a high r₁/r₂ ratio compared to other iron oxide nanoparticles, were used for monitoring vascular response to bevacizumab treatment in ovarian cancer xenografts. Susceptibility contrast MRI using T₂ and T₂* mapping revealed a treatment induced decrease in blood volume and vessel density, but not in vessel size. Additionally, DCE-MRI using gadodiamide detected a decrease in perfusion and/or permeability. In combination, these two methods provide a comprehensive assessment of anti-angiogenic treatment effects. 
Lastly, GEH121333 particles induced a strong signal increase in T₁w images, which shows promise for its use also as a positive contrast agent.

Anthony Malamas¹ and Zheng-Rong Lu^1
1Biomedical Engineering, Case Western Reserve University, Cleveland, OH, United States

To apply DCE-MRI with a biodegradable macromolecular contrast agent in assessment of the efficacy of targeted ECO/siRNA nanoparticles for silencing HIF-1α expression for cancer therapy in a mouse colon cancer model. DCE-MRI non-invasively revealed that the treatment resulted in over 70% reduction in average tumor blood flow (Fp), permeability-surface area product (PS), and plasma volume fraction (Vp) in the treatment group as compared to the saline control group (p < 0.05). The treatment was effective to inhibit tumor angiogenesis and proliferation.

Pavithra Viswanath¹, Russell Pieper², and Sabrina M Ronen^1
1Radiology, University of California San Francisco, San Francisco, CA, United States, ²Neurological Surgery, University of California San Francisco, San Francisco, CA, United States

Mutations in IDH1 are predominant in low-grade gliomas, and inhibitors of the mutant IDH1 enzyme are under investigation as therapeutic agents. Beyond 2-HG production, the IDH1 mutation also induces a broader pattern of ¹H-MRS-detectable metabolic alterations. In this study, we investigated whether inhibiting mutant IDH1 using AGI-5198 reverses the metabolic reprogramming observed in IDH1 mutant glioma cells. Our results indicate that AGI-5198 treatment, while completely inhibiting 2-HG production, nevertheless only partially reverses other metabolic alterations and results in a moderate effect on clonogenicity of IDH1 mutant cells. 

Michael Josef Dubec¹ and Lucy Elizabeth Kershaw^1,2
1CMPE, The Christie NHS Foundation Trust, Manchester, United Kingdom, ²Institute of Cancer Sciences, University Of Manchester, Manchester, United Kingdom

Dynamic contrast enhanced MRI (DCE-MRI) allows quantitative assessment of tumour status. The addition of a relaxation rate (R₁) measurement following the dynamic acquisition in DCE-MRI studies allows the uncertainty in the conversion from signal intensity (S) to R₁ to be assessed. In this work the effect of errors in flip angle and pre-contrast signal estimation on the S(t) to R₁(t) conversion were evaluated. Results indicated that uncertainty in the measurement of S_pre had greater effect than realistic flip angle variations on the S(t) to R₁(t) conversion, and that the error was tissue dependent. 

Hemant Parmar¹, Daniel Wahl², Priyanka Pramanik², Michelle Kim², Theodore S Lawrence², and Yue Cao^1,2
1Radiology, University of Michigan, Ann Arbor, MI, United States, ²Radiation Oncology, University of Michigan, Ann Arbor, MI, United States

Standard imaging for glioblastoma relies on post-contrast T1 and T2 FLAIR MRI sequences, which do not accurately reflect tumor biology. Advanced MRI techniques can define biologically relevant and prognostic features of glioblastoma including perfusion-based volumes with high cerebral blood volume (V_hCBV) and high b-value diffusion-based hypercellular subvolume (HCV). We defined V_hCBV and HCV in 24 patients with glioblastoma prior to undergoing chemoradiation. Surprisingly, there was little overlap between V_hCBV and HCV within individual patients, which suggests that these volumes represent distinct aspects of tumor biology and may be independently prognostic. Analysis of failure patterns and prognostic relevance is ongoing.

Marcus Christiaan de Jong¹, Pim de Graaf¹, Petra Pouwels¹, Jan-Willem Beenakker², Jeroen Geurts¹, Annette C. Moll¹, Jonas A. Castelijns¹, Paul van der Valk¹, and Louise van der Weerd^2
1VU University Medical Center, Amsterdam, Netherlands, ²Leiden University Medical Center, Leiden, Netherlands

Staging of retinoblastoma – the most common pediatric eye cancer – is currently performed in vivo at 1.5 or 3.0 T and allows for images with voxel sizes <0.5x0.5x2 mm³. We performed ex vivo ultrahigh-resolution MRI at 9.4 and 17.6 T of enucleated retinoblastoma eyes. This method allowed us to generate high-resolution images (voxel size: 59x59x59 to 100x100x100 μm³) of different aspects of retinoblastoma showing the potential of ultrahigh-resolution MRI for staging retinoblastoma and gaining insight in anatomical details. 

Jinrong Qu¹, Hui Liu², Zhaoqi Wang³, Ihab R Kamel⁴, Kiefer Berthold⁵, Nickel Marcel Dominik⁵, and Hailiang Li^1
1Radiology, Henan Cancer Hospital, Zhengzhou, China, People's Republic of, ²MR Collaboration, Siemens Healthcare, Shanghai, China, People's Republic of, ³Radiology, the affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China, People's Republic of, ⁴Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, United States, ⁵MR Pre-development, Siemens Healthcare, Erlangen, Germany

Overall, 6 arterial sub-phases TWIST-VIBE showed higher detection of recurrent HCCs compared with the equivalent-to-conventional single arterial phase exams by providing an optimized wide observation window for tumor vascularity evaluation. This is especially valuable in improving the detection of hypervascular recurrent HCCs with diameters of less than 2cm.

Trang Pham^1,2,3, Michael Barton^1,2,3, Dale Roach⁴, Karen Wong^1,2,3, Daniel Moses^2,5, Christopher Henderson^2,6,7, Mark Lee¹, Robba Rai¹, Benjamin Schmitt⁸, and Gary Liney^1,3,9,10
1Radiation Oncology, Liverpool Hospital, Sydney, Australia, ²Faculty of Medicine, University of New South Wales, Sydney, Australia, ³Ingham Institute for Applied Medical Research, Sydney, Australia,⁴Faculty of Physics, University of Sydney, Sydney, Australia, ⁵Radiology, Prince of Wales Hospital, Sydney, Australia, ⁶Anatomical Pathology, Liverpool Hospital, Sydney, Australia, ⁷Faculty of Medicine, Western Sydney University, Sydney, Australia, ⁸Siemens Healthcare Pty Ltd, Sydney, Australia, ⁹Faculty of Radiation and Medical Physics, University of Wollongong, Wollongong, Australia, ¹⁰University of New South Wales, Sydney, Australia

A complete protocol using quantitative diffusion weighted imaging (DWI) and dynamic contrast enhanced (DCE) imaging in combination, and a voxel-by-voxel histogram analysis strategy was successfully developed for multi-parametric MRI prediction of treatment response in rectal cancer.  In good responders, the week 3 histograms showed a combined shift in distribution of ADC of voxels to higher values and K^trans of voxels to lower values compared to the pre-CRT. Multi-parametric histogram analysis of ADC and K^trans appears to be a promising and feasible method of assessing tumour heterogeneity and its changes in response to CRT in rectal cancer.

Chang-Zheng Shi¹, Dong Zhang², Liang-Ping LUO³, and Yong Zhang^4
1Jinan University, Guangzhou, China, People's Republic of, ²guangzhou, China, People's Republic of, ³Guangzhou, China, People's Republic of, ⁴GE Healthcare MR Research China, Beijing, Beijing, China, People's Republic of

Studies showed that vascular disrupting agents and angiogenesis inhibitors had a synergistic effect for the treatment of cancer. Few previous reports used MRI to assess the combination of anti-angiogenesis drugs in non-small cell lung cancer(NSCLC). MR multi-b value diffusion-weighted imaging can be used to monitor the treatment of tumor by anti-angiogenesis drugs. In our study , the nude mice xenograft model was used to evaluate the role of vascular disrupting agents combing angiogenesis inhibitor in NSCLC by multiple b-value diffusion weighted imaging (DWI).

Davide Prezzi¹, Radhouene Neji², James Stirling¹, Sami Jeljeli¹, Hema Verma³, Tim O'Brien⁴, Ben Challacombe⁴, Ashish Chandra⁵, Vicky Goh¹, and Ralph Sinkus^1
1Division of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom, ²MR Research Collaborations, Siemens Healthcare, Frimley, United Kingdom, ³Department of Radiology, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom, ⁴Urology Centre, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom, ⁵Department of Histopathology, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom

Incidentally detected renal tumors are overtreated surgically, as up to 15% of them are benign, most frequently oncocytomas. We hypothesize that integrating biomechanical with morphological MRI assessment can improve lesion characterization, precluding unnecessary surgery. Initial experience and pathological correlation in four resected renal oncocytomas and renal cell carcinomas (RCC) demonstrate that 30Hz MRE with shear modulus elastography parametric mapping is feasible, correlating spatially with gross pathology, with lower viscosity/elasticity (y) ratios [mean = 0.22] in malignant RCCs compared to oncocytomas [mean = 0.46], showing promise for clinical application.

Dechun Zheng¹, Yunbin Chen¹, Meng Liu¹, Qiuyuan Yue¹, Xiaoxiao Zhang¹, Hao Lin¹, Xiangyi Liu¹, Wang Ren¹, Weibo Chen², and Queenie Chan^3
1Radiology, Fujian Provincial Cancer Hospital, Fuzhou, China, People's Republic of, ²Philips Healthcare, Shanghai, China, People's Republic of, ³Philips Healthcare, Hong Kong, Hong Kong

DKI is an emerging technique and shows advantage than traditional DWI. Prior DCE-MRI studies suggested it had utility in early monitoring radiotherapy and chemotherapy sensitivity in anti-tumor treatment. However, there are a few studies investigated whether a combination of multi-modalities functional MRI techniques could improve diagnostic efficacy for prediction of anti-tumor outcome. This study enrolled 53 patients who received both DCE-MRI and DKI exams during NAC courses and suggested there were collaboration between DCE-MRI and DKI to early monitor NAC treatments in NPC. In addition, two NAC cycles is a better time point to non-invasive assess NAC response using fMRI.

Daisy Q Huang¹, Daniel Margolis¹, Daniel Grossi Marconi², José Humberto Tavares Guerreiro Fregnani², Ana Karina Borges ², FR Lucchesi², Rodrigo Rossini ², Pechin Lo³, Bharath Ramakrishna³, Grace Lee³, and Mitchell Kamrava^4
1Radiology, Ronald Reagon UCLA Medical Center, Los Angeles, CA, United States, ²Radiation Oncology, Barretos Cancer Hospital, Barretos, Brazil, ³Radiological Sciences, Ronald Reagon UCLA Medical Center, Los Angeles, CA, United States, ⁴Radiation Oncology, Ronald Reagon UCLA Medical Center, Los Angeles, CA, United States

FDG-PET is optimal for evaluating and predicting treatment response in cervical cancer; however, developing countries where cervical cancer remains prevalent are more likely to have access to MR than radiotracer. Our prospective study explores the utility of MR for predicting treatment response. Patients with locally advanced cervical cancer underwent MR at baseline, midway through chemoradiation and after chemoradiation. Patients demonstrated robust tumor volume reduction (>93%) and increase in ADC values after treatment. The discriminatory value of the standard deviation of ADC at baseline suggests that tumor heterogeneity may be predictive of response, supporting MR’s role in identifying more aggressive tumors. 

Khushbu Agarwal¹, Gururao Hariprasad², Komal Rani², Uma Sharma¹, Sandeep Mathur³, Vurthaluru Seenu⁴, Rajinder Parshad⁴, and Naranamangalam R Jagannathan^1
1Department of NMR and MRI Facility, All India Institute of Medical Sciences, Delhi, India, ²Department of Biophysics, All India Institute of Medical Sciences, New Delhi, India, ³Department of Pathology, All India Institute of Medical Sciences, Delhi, India, ⁴Department of Surgical Disciplines, All India Institute of Medical Sciences, Delhi, India

We evaluated the correlation of tCho and β-catenin concentrations were correlated with molecular biomarkers (ER, PR and Her2neu) in breast cancer patients. The nuclear β-catenin expression was significantly higher compared to cytosolic expression. A positive correlation between tCho and β-catenin (cytosolic and nuclear fractions) concentrations was seen. The PR- tumors had significantly higher cytosolic β-catenin compared to PR+ tumors. This may be because progesterone acts as an inhibitor of Wnt pathway and thus its absence may lead to increased cytosolic β-catenin in PR- tumors. Results demonstrated role of tCho, β-catenin and progesterone in breast cancer progression.

Ileana Hancu¹, Elizabeth Morris², Christopher Sevinsky¹, Fiona Ginty¹, and Sunitha Thakur^2
1GE Global Research Center, Niskayuna, NY, United States, ²Memorial Sloan Kettering Cancer Center, New York City, NY, United States

Differential expression of lipid metabolism genes was recently reported in breast cancer patients. In this pilot study, single voxel MRS data was used to assess the spatial and spectral lipid profile of normal volunteers and subjects undergoing neo-adjuvant chemotherapy. Statistically significant differences in lipid profiles from different voxels in single volunteers and between volunteers were found. Moreover, some lipid peak ratios provided good tumor/normal tissue separation. MRI/MRS-based profiling of lipid metabolism may provide a unique tool for better breast cancer tumor detection and characterization. 

Wei Huang^1,2, Alina Tudorica³, Karen Y. Oh³, Stephen Y-C. Chui^2,4, Nicole Roy³, Megan L. Troxell^2,5, Arpana Naik^2,6, Kathleen A. Kemmer⁴, Yiyi Chen^2,7, Megan L. Holtorf², Aneela Afzal¹, Xin Li¹, and Charles S. Springer, Jr.^1
1Advanced Imaging Research Center, Oregon Health & Science University, Portland, OR, United States, ²Knight Cancer Institute, Oregon Health & Science University, Portland, OR, United States,³Diagnostic Radiology, Oregon Health & Science University, Portland, OR, United States, ⁴Medical Oncology, Oregon Health & Science University, Portland, OR, United States, ⁵Pathology, Oregon Health & Science University, Portland, OR, United States, ⁶Surgical Oncology, Oregon Health & Science University, Portland, OR, United States, ⁷Public Health and Preventive Medicine, Oregon Health & Science University, Portland, OR, United States

The new DCE-MRI biomarker k_io measures on-going vital metabolic activity.  For subjects with biopsy-proven breast IDC, it monitors the course of neoadjuvant therapy.  While k_io decreases for most tumors, for a sub-set it increases during therapy.  

Pamela R Jackson¹, Andrea Hawkins-Daarud¹, Joshua Jacobs², Timothy Ung³, Hani Malone³, Joo Kim⁴, Olya Stringfield⁵, Lauren DeGirolamo¹, Emilio Benbassat⁶, Anthony Rosenberg⁶, Joseph Crisman⁶, Robert Gatenby⁴, Savannah Partridge⁷, Peter Canoll³, and Kristin Swanson^1
1Neurological Surgery, Mayo Clinic, Scottsdale, AZ, United States, ²Mayo Clinic, Rochester, MN, United States, ³Pathology, Columbia University, New York City, NY, United States, ⁴Diagnostic Imaging and Interventional Radiology, H. Lee Moffitt Cancer Center, Tampa, FL, United States, ⁵Cancer Imaging and Metabolism, H. Lee Moffitt Cancer Center, Tampa, FL, United States, ⁶Chicago, IL, United States,⁷Radiology, Seattle Cancer Care Alliance, Seattle, WA, United States

We hypothesize that tumors with different invasiveness indices (D/ρ), as predicted by the Proliferation-Invasion (PI) mathematical model, will exhibit differences in ADC. Segmented tumor volumes were determined on T1Gd and FLAIR MRIs for six GBM patients. The ROIs were used to mask registered ADC maps and parameterize the PI model for calculating D/ρ. Lower quartile ADC values within the FLAIR and FLAIR penumbra ROIs were positively correlated with D/ρ (p=0.041 and p=0.026, respectively).  ADC skewness within the T1Gd ROI negatively correlated with D/ρ (p=0.021). Understanding the relationship between D/ρ and ADC could be important for targeting brain tumor therapies.

Hyun Su Kim¹, Jae-Hun Kim¹, and Young Cheol Yoon^1
1Radiology, Samsung medical center, Seoul, Korea, Republic of

Myxoid soft tissue tumors (STTs) are histologically unique group of tumors that have been proven to have significantly higher ADC values than nonmyxoid counterparts. In addition, no significant difference of mean ADC value exists between benign and malignant myxoid STTs. We propose texture of ADC value as a new parameter for differentiating benign and malignant myxoid STTs. The global (mean, standard deviation, skewness and kurtosis), regional (intensity variability and size-zone variability), and local features (energy, entropy, correlation, contrast, homogeneity, variance and maximum probability) were extracted from ADC values of each tumor group for texture analysis and statistical comparisons were performed.

Ye Ju¹, Ai-lian Liu¹, Qing-wei Song¹, Mei-yu Sun¹, Jing-hong LIU¹, Li-hua Chen¹, Zheng Han¹, Yi-min WANG¹, and Li-zhi Xie^2
1The First Affiliated Hospital of Dalian Medical University, Dalian, China, People's Republic of, ²GE Healthcare, MR Research China, Beijing, Beijing, China, People's Republic of

The diffusion property of tumor tissues largely depends on cell density, which may also be predictive features of malignancy in some types of tumors. Intravoxel incoherent motion (IVIM) imaging is an extension of diffusion weighted imaging (DWI) that can be used to investigate both diffusion and perfusion changes in tissues.  Comparing the  IVIM parameters between carcinoma (HCC), hepatic hemangioma and hepatic metastasis, we found that IVIM can facilitates understanding of tumor tissue characteristics of perfusion and diffusion, and it may provide more useful information to distinguish hemangiomas from other two malignant tumors.

Basetti Madhu¹, Sean McGuire¹, Alexandra Jauhiainen², and John R Griffiths^1
1Molecular Imaging (MRI & MRS), Cancer Research UK Cambridge Institute, Cambridge, United Kingdom, ²Early Clinical Biometrics, AstraZeneca AB R&D, Molndal, Sweden

Human brain tumour tissues from glioblastoma multiforme, astrocytoma, meningioma, oligodendroglioma and metastatic tumours were analyzed by metabolite-metabolite correlation analysis of HRMAS 1H NMR spectra from the eTumour database. The following metabolites were quantified using a modified LC-Model basis set: alanine (Ala), choline (Cho), creatine (Cr), lactate (Lac), glutamine (Gln), glutamate (Glu), glycine (Glyn), N-acetylaspartate (NAA), phosphocholine (PCh), phosphocreatine (PCr), taurine (tau), myo-inositol (Ino) and various lipids/macromolecules. The estimated metabolite concentrations from LCModel fittings were used in the investigation of pairwise metabolite-metabolite correlations. Pairwise metabolite-metabolite correlations can serve as an overview of metabolism and can be helpful in understanding the cellular metabolism.

Niloufar Zarinabad^1,2, Christopher Bennett^1,2, Simrandip Gill^1,2, Martin P Wilson¹, Nigel P Davies^1,2,3, and Andrew Peet^1,2
1Institute of Cancer and Geonomic Sciences, University of Birmingham, Birmingham, United Kingdom, ²Birmingham Children’s Hospital NHS foundation trust, Birmingham, United Kingdom, ³Department of Medical Physics,University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom

Classification of paediatric brain tumours from Magnetic-Resonance-Spectroscopy has many desirable characteristics. However the imbalanced nature of the data introduces difficulties in uncovering regularities within the small rare tumour type group and attempts to train learning algorithms without correcting the skewed distribution may be premature. By fusing oversampling and classification techniques together, an improved classification performance across different classes with a good discrimination for minority class can be achieved. The choice of learning algorithm, use of oversampling-technique and classifier input (complete spectra versus metabolite-concentration) depends on the data distribution, required accuracy in discriminating specific groups and degree of post-processing complexity.

Puneet Bagga¹, Srisha Bolledula¹, Harsith Reddy¹, Rishika Reddy¹, Apoorva Sudini¹, Hari Hariharan¹, and Ravinder Reddy^1
1Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States

Alanine is a highly abundant non-essential amino acid which provides an alternate source of TCA cycle intermediates for energy and cell survival. It has been shown that myc-driven tumors utilize alanine as an energy source over lactate. Currently, alanine can be detected in vivo only by ¹³C NMR spectroscopy. Chemical Exchange Saturation Transfer (CEST) MRI is an imaging technique which exploits the properties of exchangeable protons on the molecule for imaging. In the present study, we have shown the in vitro CEST effect of solution containing alanine.

RAJ MOHAN PASPULATI¹, KARIN HERMAN¹, and AMIT GUPTA^1
1RADIOLOGY, UNIVERSITY HOSPITALS, CASE WESTERN RESERVE UNIVERSITY, CLEVELAND, OH, United States

In this exhibit we share our 3 year experience of sequential design PET-MR (Phillips Ingenuity TF PET/MR) application in staging and follow up of gynecologic cancers. Hybrid PET-MR imaging is a new evolving technique and has a useful role in staging, treatment planning and follow up of gynecologic cancers. Standardization of the imaging protocol and understanding its limitations and pit falls is essential before considering regular clinical application.

Amit Mehndiratta^1,2, Abhimanyu Sahai¹, Esha Baidya Kayal ¹, Jayendra Tiru Alampally³, Sameer Bakhshi⁴, Devasenathipathy K³, and Raju Sharma^3
1Center for Biomedical Engineering, Indian Institute of Technology Delhi, New Delhi, India, ²Department of Biomedical Engineering, All Indian Institute of Medical Sciences, New Delhi, India, ³Department of Radiology, All India Institute of Medical Sciences, New Delhi, India, ⁴BRA IRCH, All India Institute of Medical Sciences, New Delhi, India

Accurate demarcation of tumors on DWI MRimages could play a crucial role in diagnosis and prognosis when using quantitative image analysis like ADC or IVIM. Manual demarcation of tumour on each slice of a 3D stack is usually not feasible. Automated or semi-automated methods of segmentation are thus desirable specifically for DWimages that can be used to identify the tumor region, optimizing on both speed and accuracy. Our results reveals that semi-automated algorithms based on both Otsu-threshold or Active-Contours based region growing perform tumour segmentation with acceptable level of accuracy in diffusion MRimages and reduce time and manual effort required.

Jingfeng Zhang¹, lingxiang Ruan², Qidong Wang², and Bingying Lin^2
1Dept. of Radiology, 1st Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China, People's Republic of, ²Hangzhou, China, People's Republic of

Superficial soft-tissue masses are common in clinical practice, and most of them are solid. The radiological imaging is available to provide more detailed information, which is more helpful to make a diagnosis and differential diagnosis. Additionally, analysis of imaging features is useful in distinguishing between benign and malignant lesions, which can help make a strategy for therapy , such as preoperative planning of the extent of surgery and whether adjuvant chemotherapy/radiotherapy. Lesions that are assigned benign can be followed expectantly, whereas indeterminate or malignant lesions can be subjected to histological evaluation.The location of a solid mass within the superficial tissue is best described as cutaneous (epidermis and dermis); subcutaneous (adipose tissue, nerve tissue, fibrous tissue and vascular tissue etc.); or fascial (overlying the muscle). Cutaneous lesions may arise in association with the epidermis or dermis, and subcutaneous lesions may arise in the adipose tissue, or the fascia overlying the muscle. However, some lesions can invade the cutaneous and subcutaneous tissue simultaneously. For purposes of comprehensive understanding and analysis, it is most useful to categorize superficial soft-tissue solid masses by histology as skin appendage tumors, mesenchymal tumors and metastatic tumors. 

Yi Xiong Ong¹, Fang Yang Sim¹, and Le Roy Chong^1
1Changi General Hospital, Singapore, Singapore

An educational video which uses simple animations to describe the random thermal molecular motion that is diffusion, and how the diffusion process can be demonstrated with the magnetic resonance signal.

Courtney K Morrison¹, Leah C Henze Bancroft¹, Kang Wang², James H Holmes², Frank R Korosec^1,3, and Roberta M Strigel^1,3
1Medical Physics, University of Wisconsin-Madison, Madison, WI, United States, ²Global MR Applications and Workflow, GE Healthcare, Madison, WI, United States, ³Radiology, University of Wisconsin-Madison, Madison, WI, United States

Fat suppression can be achieved in a variety of ways, including using water-only excitation or using a Dixon method. Each of these methods exhibits strengths and limitations. In this work, we evaluated the characteristics of water excitation compared to a 2-point Dixon fat suppression method used in high spatiotemporal resolution DCE breast MRI.

Akane Ohashi¹, Masako Kataoka¹, Syotaro Kanao¹, Mami Iima¹, Onishi Natsuko¹, Makiko Kawai¹, Masakazu Toi², Elizabeth Weiland³, and Kaori Togashi^1
1Department of Diagnostic Imaging and Nuclear Medicine, Kyoto Univercity Graduate School of Medicine, Kyoto, Japan, ²Breast Surgery, Kyoto Univercity, Kyoto, Japan, ³Siemens Healthcare GmbH, Erlangen, Germany

Maximum slope (MS) is a kinetic parameter obtained from the very early phase of ultrafast DCE MRI. Diagnostic performance of MS in breast lesions were compared to washout index (WI), a conventional semi-quantitative kinetic parameters obtained from standard DCE MRI. Ultrafast DCE MRI was obtained using KWIC and analyzed by TWIST Breast Viewer. MS demonstrated significantly higher AUC (0.91) than WI (0.80, p=0.03) with fewer false positive cases of fibrocystic changes than WI. MS is a promising kinetic parameters that provides information complimentary to WI in diagnosing breast lesions. 

Charles S. Springer, Jr.^1,2, Xin Li¹, Alina Tudorica³, Karen Y. Oh³, Stephen Y-C. Chui^2,4, Nicole Roy³, Megan L. Troxell^2,5, Arpana Naik^2,6, Kathleen A. Kemmer⁴, Yiyi Chen^2,7, Megan L. Holtorf², Aneela Afzal¹, and Wei Huang^1,2
1Advanced Imaging Research Center, Oregon Health & Science University, Portland, OR, United States, ²Knight Cancer Institute, Oregon Health & Science University, Portland, OR, United States,³Diagnostic Radiology, Oregon Health & Science University, Portland, OR, United States, ⁴Medical Oncology, Oregon Health & Science University, Portland, OR, United States, ⁵Pathology, Oregon Health & Science University, Portland, OR, United States, ⁶Surgical Oncology, Oregon Health & Science University, Portland, OR, United States, ⁷Public Health and Preventive Medicine, Oregon Health & Science University, Portland, OR, United States

The new DCE-MRI biomarker k_io measures on-going vital metabolic activity.  Whole breast tumor k_io correlates well with pathology determinations of residual cancer burden and tumor invasive cell volume fraction from surgical specimens obtained just a few days later.  

Martin D Pickles¹, Martin Lowry¹, and Peter Gibbs^1
1Centre for Magnetic Resonance Investigations, Hull York Medical School at University of Hull, Hull, United Kingdom

Tumours can have high levels of heterogeneity. Lesions demonstrating high levels of heterogeneity have an ‘aggressive’ phenotype. Assessing heterogeneity might provide superior insights into treatment response than traditional mean/median values. The aims of this study were to determine if histogram analysis of pre-treatment DCE-MRI parameters are associated with traditional prognostic indicators and early breast cancer recurrence.

Breast dynamic datasets from 208 individuals underwent histogram analysis. U-tests and survival analysis indicated that DCE-MRI histogram parameters are associated with traditional prognostic indicators, have superior prognostic information than mean/median values and provide independent prognostic information regarding breast cancer recurrence prior to therapy initiation.

Natsuko Onishi¹, Masako Kataoka¹, Shotaro Kanao¹, Mami Iima¹, Makiko Kawai¹, Akane Ohashi¹, Katsutoshi Murata², Benjamin Schmitt³, and Kaori Togashi^1
1Dept of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan, ²Research & Collaboration Dpt., Siemens Japan K.K., Tokyo, Japan, ³Healthcare Sector, Siemens Ltd, Melbourne, Australia

Amide proton transfer (APT) imaging is the representative endogenous chemical exchange saturation transfer (CEST) imaging that has been applied to some clinical cancer studies. However, little is known about the clinical usefulness of APT imaging in breast cancer. In this study, 3T MRI studies including APT imaging were performed for 24 breast cancer lesions, and the possible utility of APT imaging in evaluating biochemical information induced by breast cancer was demonstrated. APT CEST imaging is a potentially useful MRI technique for breast cancer.

Ella F Jones¹, Lisa J Wilmes¹, Wen Li¹, Jessica Gibbs¹, David C Newitt¹, John Kornak², Evelyn Proctor¹, Bonnie N Joe¹, and Nola M Hylton^1
1Radiology and Biomedical Imaging, UCSF, San Francisco, CA, United States, ²Epidemiology and Biostatistics, UCSF, San Francisco, CA, United States

The purpose of this study was to assess breast tissue measurements using diffusion MRI techniques in repeated studies to evaluate the variability of ADC and FA measurements within- and between-subjects.

Jing Yuan¹, Gladys Lo², Oilei Wong¹, Helen H.L. Chan², Ting Ting Wong³, and Polly S.Y. Cheung^3
1Medical Physics and Research Department, Hong Kong Sanatorium&Hospital, Hong Kong, Hong Kong, ²Department of Diagnostic & Interventional Radiology, Hong Kong Sanatorium&Hospital, Hong Kong, Hong Kong, ³Breast Care Center, Hong Kong Sanatorium&Hospital, Hong Kong, Hong Kong

This study aims to explore the use of quantitative breast DWI at 3T to distinguish DCIS pathological grades. In a cohort of 30 pathology confirmed pure DCIS, the mean ADC was 1.26±0.19, 1.51±0.29 and 1.13±0.26 x10^-3 mm²/s for low (n=5), intermediate (n=9) and high-grade (n=16) DCIS respectively. The high-grade DCIS could be distinguished by the significantly lower mean ADC from non-high grade DCIS (low and intermediate grades, 1.42±0.28 x10^-3 mm²/s, p=0.0057). Quantitative DWI has potentials to aid DCIS risk stratification and management.

Elizabeth Jane Sutton¹, Duc A. Fehr², Brittany Z. Dashevsky^1,3, Sunitha B Thakur², Joseph O. Deasy², Elizabeth A Morris¹, and Harini Veeraraghavan^2
1Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, United States, ²Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, United States, ³Radiology, University of Chicago, Chicago, IL, United States

Neoadjuvant chemotherapy (NAC) is used in breast cancer and pathologic complete response (pCR) is associated with improved survival. Computer extracted MRI features generate quantitative metrics of treatment response. We used an interactive Grow-Cut method to volumetrically segment breast cancers on multiparametric breast MRI pre and post NAC and then computed Haralick features for each sequence.  We found a difference in the MRI tumor texture features pre and post NAC. We also found this difference to be statistically significant between tumors with pCR and no-pCR. These metrics demonstrate changes in tumor microenvironment post NAC and are biomarkers for pCR. 

Elizabeth Anne Maxine O'Flynn¹, Maria A Schmidt¹, David Collins¹, James D'arcy¹, and Nandita M deSouza^1
1Cancer Research UK Cancer Imaging Centre, Institute of Cancer Research and Royal Marsden Hospital, Sutton, United Kingdom

The aim of this pilot study was to explore whether functional MRI metrics from a multi-parametric acquisition can predict for disease recurrence or death in breast cancer following neo-adjuvant chemotherapy. 60 months after commencement of the study, a lower R2* value was found at baseline in the women who are alive and disease free, suggesting that these tumours were less hypoxic and better oxygenated than those who developed metastatic disease or died in the interim

Masako Ohno¹, Tosiaki Miyati², Naoki Ohno², Hiroko Kawashima², Kazuto Kozaka¹, Yukihiro Matsuura¹, and Toshifumi Gabata^1
1Kanazawa University Hospital, Kanazawa, Japan, ²Kanazawa University, Kanazawa, Japan

To acquire more detailed information on perfusion and diffusion in breast cancer, we analyzed three diffusion components using triexponential function. Perfusion-related diffusion (D_p), fast free diffusion (D_f), and slow restricted diffusion coefficients (D_s) were calculated from triexponential function. We compared these parameters between invasive ductal carcinoma (IDC) and ductal carcinoma in situ (DCIS) groups. D_s was significantly lower in the IDC group than those in the DCIS group because of difference in the cellularity. Triexponential analysis makes it possible to noninvasively obtain more detailed information on perfusion and diffusion in breast cancer, thereby assisting in the diagnosis.

Jana Tesdorff¹, Frederik Laun², Stefan Delorme¹, Wolfgang Lederer³, Heidi Daniel⁴, Heinz-Peter Schlemmer¹, and Sebastian Bickelhaupt^1
1Radiology, German Cancer Research Center, Heidelberg, Germany, ²Medical Physics, German Cancer Research Center, Heidelberg, Germany, ³Heidelberg, Germany, ⁴Mannheim, Germany

Diffusion-weighted imaging (DWI) can be helpful to differentiate benign and malignant lesions in the female breast. We compared the diagnostic performance of conventional DWI and DWIBS (DWI with background suppression) derived ADC maps with different definitions of the region of interest used to measure the ADC value (1.5T Philips). Texture analysis of suspicious breast lesions was performed utilizing ADC mapping in 59 lesions. Statistical analysis revealed the highest accuracy for lesion differentiation if using the mean ADC-value calculated of three small regions-of interest in the DWIBS derived ADC.

Chao Jin¹, Ting Liang¹, Hongwen Du¹, Gang Niu¹, Zihua Su¹, Peng Cao¹, Yonghao Du¹, Chenxia Li¹, Yitong Bian¹, and Jian Yang^1
1Department of Radiology, the First Affiliated Hospital of Xi’an Jiaotong University, Xi'an, China, People's Republic of

To clarify the diagnostic efficiency of histogram and mean in tumor detection, this study aims to compare the efficiency of mean and histogram metrics (i.e. skewness, kurtosis, median, variance, entropy and energy) of K^trans and k_ep at transverse slice with tumor biggest diameter in discriminating benign lesion, grade II- and III-invasive ductal carcinomas (IDC). The results indicate that in breast DCE-MRI, both mean and histogram-metrics provide roughly comparable values in identifying malignancy from benignancy. However, histogram-metrics are considerably more informative and enable to discriminate pathological grade of IDCs. k_ep presented better diagnostic efficiency than K^trans.

Dattesh D Shanbhag¹, Parita Sanghani¹, Reem Bedair ², Venkata Veerendranadh Chebrolu¹, Uday Patil¹, Sandeep N Gupta³, Scott Reid ⁴, Fiona Gilbert ², Andrew Patterson ², Rakesh Mullick¹, and Martin Graves^2
1GE Global Research, Bangalore, India, ²University of Cambridge, Cambridge, United Kingdom, ³GE Global Research, Niskayuna, NY, United States, ⁴GE Healthcare, Leeds, United Kingdom

In DCE-MRI, T₁ map is necessary for signal to concentration conversion. In highly fat-water mixed tissue such as breast, contrast uptake primarily changes T₁ values of water protons. Therefore, DCE quantification in breast cancer must reliably measure water T₁. We evaluated T₁ maps obtained using Dixon based fat-water separated VFA method and compared values in fat, fibro-glandular tissue and tumors. We observed that T₁ mapping with Dixon based VFA method and non-linear fitting recovers T₁ values for tissue in breast by reducing partial volume. We conclude that water only T1 mapping will improve accuracy of PK modeling in breast cancer.

Eddy Solomon¹, Noam Nissan², Rita Schmidt¹, Edna Furman-Haran³, Uriel Ben-Aharon⁴, and Lucio Frydman^1
1Chemical Physics Department, Weizmann Institute of Science, Rehovot, Israel, ²Biological Regulation Department, Weizmann Institute of Science, Rehovot, Israel, ³Unit of Biological Services, Weizmann Institute of Science, Rehovot, Israel, ⁴Breast Surgery Unit, Meuhedet Clinic, Ashdod, Israel

A new ADC-mapping methodology based on SPatio-temporal ENcoding (SPEN) was applied to augmented breasts, organs possessing multiple spectral components.  SPEN provides a robust single-shot alternative to echo-planar-imaging (EPI) in terms of overcoming B0-inhomogeneities, while being able to resolve—and thereby suppress—the contributions of different chemical sites. Diffusion SPEN measurements were carried out at 3T on healthy volunteers with silicone-implant augmentation and compared against SE-EPI counterparts, confirming SPEN’s ability to yield more reliable ADC maps, free from the dominant silicone signal contributions, in a single shot. This opens new screening possibilities for cancer detection in breast augmented patients.

Tess E. Wallace¹, Andrew J. Patterson², Oshaani Abeyakoon¹, Reem Bedair¹, Roie Manavaki¹, Mary A. McLean³, James P. B. O'Connor⁴, Martin J. Graves², and Fiona J. Gilbert^1
1Department of Radiology, University of Cambridge, Cambridge, United Kingdom, ²Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom, ³Cancer Research UK Cambridge Institute, Cambridge, United Kingdom, ⁴Institute of Cancer Sciences, University of Manchester, Manchester, United Kingdom

Blood oxygenation level-dependent (BOLD) MRI with hyperoxic/hypercapnic gas stimuli has potential to non-invasively probe vascular function, which could help characterize tumors, predict treatment susceptibility and monitor response. This work evaluates BOLD contrast changes in healthy breast parenchyma in response to air and oxygen interleaved with 2% and 5% carbogen gas mixtures, relative to an all-air control. We found that oxygen vs. 5% carbogen was the most robust stimulus for inducing BOLD contrast in the breast. Measurements may be confounded by physiological fluctuations and menstrual cycle changes. Response in breast carcinoma was variable and may indicate underlying differences in vascular function.

Gene Young Cho^1,2,3, Lucas Gennaro², Elizabeth J Sutton², Emily C Zabor², Zhigang Zhang², Linda Moy¹, Daniel K Sodickson¹, Elizabeth A Morris², Eric E Sigmund¹, and Sunitha B Thakur^2
1Department of Radiology, Center for Advanced Imaging Innovation and Research (CAI2R) and Bernard and Irene Schwartz Center for Biomedical Imaging, New York University School of Medicine, New York, NY, United States, ²Memorial Sloan Kettering Cancer Center, New York, NY, United States, ³The Sackler Institute of Graduate Biomedical Sciences, New York University School of Medicine, New York, NY, United States

Using the intravoxel incoherent motion (IVIM) effect, one can characterize the tumor microenvironment in terms of vascularity and cellularity. Combined with histogram analysis of these IVIM biomarkers, these metrics are compared to clinical responders and nonresponders of neoadjuvent treatment (NAT) in breast cancer patients. We examine the prognostic capabilities of these IVIM metrics and find that (1) certain IVIM parameters significantly differentiate between responders and nonresponders to NAT and (2) IVIM parameters change between pre- and post-treatment MRI scans. This data shows IVIM MRI to be a potentially powerful prognostic tool in breast cancer.

Paula M.C. Donahue¹, Allison O. Scott², Rachelle Crescenzi², Aditi Desai², Vaughn Braxton², and Manus J. Donahue^2
1Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN, United States, ²Radiology, Vanderbilt University Medical Center, Nashville, TN, United States

The overall goal of this work is to develop quantitative biomarkers of lymphatic system structure and function using noninvasive 3T MRI.  Here, we focus on breast cancer treatment-related lymphedema (BCRL) where we hypothesize quantitative T2 is elevated in patients relative to controls resulting from greater fluid content in the region of interests, and which reduces following manual lymphatic drainage (a commonly performed therapy intervention).  Findings suggest abilities to detect changes consistent with intervention-elicited lymphatic dynamics by using internal measures of tissue composition from MRI otherwise not detected using more common limb volume, bioimpedance spectroscopy and tissue dielectric constant measures.

MASAKO Y KATAOKA¹, Shotaro Kanao¹, Mami Iima¹, Natsuko Onishi¹, Makiko Kawai¹, Akane Ohashi¹, Rena Sakaguchi¹, Masakazu Toi², and Kaori Togashi^1
1Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan, ²Breast Surgery, Kyoto University, Kyoto, Japan

Eighteen breast lesions underwent high resolution (HR) diffusion-weighted MRI (DWI) with a resolution of 1.1 x 1.1 x 1.4 mm and b value of 0 and 850 sec/mm² using readout-segmented echo-planar imaging (rs-EPI). Computed (c) DWI with b value of 1200 sec/mm² were calculated. Lesion conspicuity and maximum size on these images were compared to those on HR DCE MRI. Masses showed relatively good lesion conspicuity on rs-EPI, slightly deteriorated on cDWI. Size was similar between rs-EPI and HR-DCE, while slightly smaller for cDWI. In contrast, NME is often poorly visualized on rs-EPI and cDWI, resulting in underestimation of NME.  

Wen Li¹, Vignesh Arasu¹, Ella F Jones¹, David C Newitt¹, Lisa J Wilmes¹, John Kornak², Laura Esserman³, and Nola M Hylton^1
1Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, CA, United States, ²Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, United States, ³Surgery, University of California San Francisco, San Francisco, CA, United States

This study demonstrated the effect of changing the cut-point of the functional tumor volume measured in breast MRI on the prediction of pathologic complete response (pCR) for breast cancer patients undergoing neoadjuvant chemotherapy. The study was performed using the retrospective data of a multi-center clinical trial as a full cohort and in subsets defined by clinically-relevant breast cancer subtypes. Optimal cut-point was selected by minimizing a penalty equation that considered different relative consequences of false negative and false positive predictions. Results showed that the optimal cut-point chosen in subtype had superior negative predictive value than using the one chosen from the full cohort.

Lina Zhang¹, Qingwei Song¹, Lizhi Xie ², Ailian Liu¹, Yanwei Miao¹, Weisheng Zhang¹, Zhijin Lang¹, Jianyun Kang¹, Qiang Wei¹, and Bin Xu^1
1The 1st affiliated hospital of Dalian Medical University, Da lian, China, People's Republic of, ²GE Healthcare, MR Research China, Beijing, beijing, China, People's Republic of

This work has evaluated the breast characteristics of invasive cancers on DCE-MRI and DWI assessed as parameters in comparison with different molecular subtypes, and found that they all could provide novel quantitative information reflecting invasive cancers microenvironment changes, with a potential role in the differentiation of molecular subtypes and to facilitate lesion-specific targeted therapies.  

Erica Markiewicz¹, Xiaobing Fan¹, Devkumar Mustafi¹, Marta Zamora¹, Suzanne D. Conzen², and Gregory S Karczmar^1
1Radiology, University of Chicago, Chicago, IL, United States, ²Medicine, Hematology/Oncology, University of Chicago, Chicago, IL, United States

Contrast media injected directly into mammary ducts clearly shows mammary gland structure with 3D-MRI. Development of in situ cancer causes changes in the leakage rates and contrast agent distribution in ductal lumens and surrounding tissue. Differences we describe here between FVB/N mice and the SV40Tag mammary cancer mouse model, indicate that in situ cancer significantly changes the permeability of the ductal epithelium. Information gained from imaging these glands following intra-ductal injection can be used to develop new MRI-detectable biomarkers for early detection of in situ cancer, improve understanding of mammary cancer biology, and guide the design of new therapy.

Rebecca Rakow-Penner¹, Nathan White¹, Boya Abudu¹, Joshua Kuperman¹, Hauke Bartsch¹, Natalie Schenker-Ahmed¹, David Karow¹, Haydee Ojeda-Fournier¹, and Anders Dale^1
1Radiology, UCSD, San Diego, CA, United States

Restriction Spectrum Imaging (RSI) is an advanced diffusion imaging technique that has potential to correct for B0 distortions and non-invasively predict tumor grade. This abstract is an initial evaluation of RSI in breast imaging.  We evaluated RSI on 11 patients with biopsy proven cancer.  Our results indicate that RSI significantly increases conspicuity of cancer relative to the standard ADC.

Ting Liang^1,2, Chao Jin¹, Hongwen Du¹, Gang Niu¹, Peng Cao¹, Chenxia Li¹, Miaomiao Wang¹, and Jian Yang^1
1Department of Radiology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China, People's Republic of, ²School of Life Science and Technology, Xi' an Jiaotong University, Department of Biomedical Engineering, China, People's Republic of

The combined strategy of DCE-MRI and DWI shows promising diagnosis efficiency in breast cancer. This paper is to explore the diagnostic value of combined DCE- MRI and DWI based on histogram-metrical in discriminating breast masses. The results indicate that combined DWI and DCE-MRI based on histogram-metrical analysis have superior efficacy than either DCE-MRI or DWI alone in discriminating breast masses; moreover, the parameters based on histogram-metrical can offer additional features of tumor heterogeneity.

Vignesh A Arasu¹, Roy Harnish¹, Cody McHargue¹, Wen Li¹, Lisa J Wilmes¹, David Newitt¹, Ella Jones¹, Laura J Esserman², Bonnie N Joe¹, and Nola M Hylton^1
1Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States, ²Surgery, University of California, San Francisco, San Francisco, CA, United States

Automated measurements of whole breast segmentation are becoming an essential process to the development of quantitative and reproducible imaging biomarkers.  We have developed a method for automated whole breast tissue segmentation and assess its performance using a test dataset, and found approximately 75% of cases had satisfactory segmentation requiring none to minimal manual modification. The current method can likely provide accurate assessment of mean background parenchymal enhancement, but further refinement of breast-chest wall boundary identification is required for other measurements (e.g. breast density).

Yu Guo¹, Penghui Wang¹, Xiaodong Ji¹, Chao Chai¹, Yu Zhang², and Wen Shen^1
1Department of Radiology, Tianjin first center hospital, Tianjin, China, People's Republic of, ²Philips Healthcare, Beijing, China, People's Republic of

The purpose of the study was to investigate the diffusion and perfusion coefficients among prostate cancer(PCa), normal peripheral zone (PZ) and benign prostatic hyperplasia (BPH) using the IVIM technique. The IVIM was performed at 11 b values of 0, 10, 20, 30, 50, 75, 100, 250, 500, 750 and 1000s/mm2. The perfusion fractions in prostate cancer were significantly higher than those found in the PZ and lower than BPH, which different with some studies. But our results are more consistent with some DCE-MRI studies in tumors Future work will recruit more volunteers and subjects and combined with DCE-MRI for further validation.

Stefanie Hectors¹, Idoia Corcuera-Solano², Mathilde Wagner¹, Sara Lewis², Nicholas Titelbaum³, Ashutosh Tewari⁴, Ardeshir Rastinehad⁴, and Bachir Taouli^1,2
1Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States, ²Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States, ³Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States, ⁴Department of Urology, Icahn School of Medicine at Mount SInai, New York, NY, United States

Diagonal single shot EPI (SS-EPI) diffusion-weighted imaging (DWI) potentially allows for reduced acquisition time with preserved image quality. In this study, diagonal DWI was compared to standard SS EPI 3-scan-trace DWI of the prostate in terms of image quality and quantitative ADC. ADC values were similar between the 2 sequences (coefficient of variation <4 %). Significant fewer artifacts were observed in the diagonal acquisition. These results show that diagonal DWI can provide substantial reduction in acquisition time (40%) while maintaining adequate image quality. 

Zan Ke¹ and Liang Wang^1
1Radiology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan,China, China, People's Republic of

This study is to investigate the diagnostic utility of fractional anisotropy(FA) and apparent diffusion coefficient(ADC) values of diffusion tensor imaging(DTI) to differentiate and classify abnormal signal nodules in prostate transition zone. Eighty-four patients were included in our study and divided into 5 groups: BPH,Gleason score(GS)≤6,GS=7,GS=8,GS≥9,measured FA and ADC of the region of interest, using one-way ANOVA to compare the difference among groups. There was significant statistical difference between the groups of FA and ADC values(F=20.986,P=0.000; F=26.560,P=0.000).Comparison among five groups: just BPH had significant statistical difference(P=0.000) with other four groups. The FA and ADC values of DTI had higher value for distinguishing benign and malignant nodules, but no obvious advantages in the further classification.

Elmira Hassanzadeh¹, Olutayo I Olubiyi¹, Andriy Fedorov ¹, Daniel I Glazer¹, Clare M Tempany¹, and Fiona M Fennessy^1,2
1Brigham and Women's Hospital, Boston, MA, United States, ²Dana-Farber Cancer Institute, Boston, MA, United States

One of the challenges in prostate cancer (PCa) management is the ability to differentiate aggressive tumors that require prompt treatment from indolent tumors that can safely undergo active surveillance. To promote global standardization and diminish variation in the acquisition, interpretation, and reporting of prostate multi-parametric MRI (mpMRI) examinations, Prostate Imaging Reporting and Data System (PI-RADS) has been introduced. The second version of PI-RADS (PI-RADS v2) was released early in 2015, but requires clinical validation. Here, we present the results of a study investigating the performance of PI-RADS v2 compared to quantitative ADC (qADC) values in discriminate high-grade from low-grade PCa.  

Lynne E. Bilston^1,2, Lauriane Jugé ^1,3, and Roger Bourne^4
1Neuroscience Research Australia, Randwick, NSW, Australia, ²Prince of Wales Clinical School, University of New South Wales, Kensington, NSW, Australia, ³School of Medical Sciences, University of New South Wales, Kensington, NSW, Australia, ⁴Discipline of Medical Radiation Sciences, Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia

MR elastography (MRE) and diffusion weighted imaging (DWI) techniques are sensitive to microstructural changes, as reflected in the tissue stiffness and water diffusion properties respectively. These results showed that mechanical and diffusion properties varied between fresh and fixed prostate tissue, but were not highly correlated with each other, suggesting that multifrequency MRE and DWI have the potential to be complementary imaging tools for tracking the alterations in soft tissue microstructure, such as those that occur in cancer and other diseases. 

Novena Rangwala¹, Kyunghyun Sung¹, and Holden Wu^1
1Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States

The purpose of this study was to minimize echo planar imaging (EPI)-related distortion artifacts while maintaining the time-efficiency for prostate diffusion-weighted MRI (DWI) using a reduced field of view (rFOV) readout-segmented EPI (RESOLVE) technique. Image distortions in clinical standard DW single-shot (ss) EPI (5:52min) were compared with a matched RESOLVE protocol (seven segments, 7:03min) and rFOV RESOLVE (five segments, 4:59min) using the Dice similarity coefficient (DSC) on forward and reverse phase-encoded images.  DSC was significantly higher (0.91±0.05) in rFOV RESOLVE compared with the other protocols, indicating that rFOV RESOLVE can improve DWI quality and visualization in the prostate compared with ss-EPI, with higher time efficiency than regular RESOLVE.

Mattijs Elschot¹, Elise Sandsmark¹, Kirsten Margrete Selnæs^1,2, Jose Teruel¹, Brage Krüger-Stokke^1,3, Øystein Størkersen⁴, Helena Bertilsson ^5,6, May-Britt Tessem¹, Siver Andreas Moestue^1,2, and Tone Frost Bathen^1,2
1Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway, ²St Olavs Hospital, Trondheim, Norway, ³Department of Radiology, St Olavs Hospital, Trondheim, Norway, ⁴Department of Pathology, St Olavs Hospital, Trondheim, Norway, ⁵Department of Urology, St Olavs Hospital, Trondheim, Norway, ⁶Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway

Computer-assisted algorithms have been proposed to support radiological reading of multiparametric MRI (mpMRI) images for detection of localized primary prostate cancer. In this work, we investigated if standardized uptake values (SUV) from combined ¹⁸F-Fluciclovine PET/mpMRI can improve automated classification of tumor and non-tumor voxels. We found that a PET/mpMRI model (features: T2W, ADC, K_trans, V_e and SUV) did not significantly improve the area under the receiver operating curve in comparison with an mpMRI-only model (features: T2W, ADC, K_trans, V_e), suggesting limited additional value of SUV in voxel classification for computer-assisted detection of primary prostate cancer.

Kofi Deh¹, Marjan Zaman¹, Padraic O'Malley¹, Richard Lee¹, Pascal Spincemaille¹, and Yi Wang^1
1Weill Cornell Medicine, New York, NY, United States

Quantitative susceptibility mapping (QSM) is a recently developed technique for quantifying magnetic susceptibility and it may be useful in quantifying super-paramagnetic iron oxide (SPIO) nanoparticles for prostate cancer therapy. Previously, researchers have been hampered in extending the use of this technique to cancers outside the brain because of problems such as chemical shift and a large dynamic susceptibility range. Recently developed algorithms, however, allow us to overcome these problems and we demonstrate their use for quantifying SPIO in a prostate cancer xenograft model for magnetic hyperthermia.

Edward William Johnston¹, Kenneth Cheung¹, Nikolas Dikaios¹, Harbir Singh Sidhu¹, Mrishta Brizmohun Appayya¹, Lucy Simmons², Alex Freeman³, Hashim Ahmed², David Atkinson¹, and Shonit Punwani^1
1UCL Centre for Medical Imaging, London, United Kingdom, ²Department of Urology, University College Hospital, London, United Kingdom, ³Cellular Pathology, University College Hospital, London, United Kingdom

Quantitative imaging metrics forming multiparametric prostate MRI have been shown to correlate with Gleason grade. We therefore aimed to develop logistic regression models which predict aggressive prostate cancer in focal lesions using quantitative MRI parameters. Models were constructed separately for the transition and peripheral zones, using data from 176 examinations.  

 

In the peripheral zone, a combination of 3 simple parameters were found to predict a Gleason 4/5 component with a similar sensitivity and specificity to experienced radiologists. However, performance was relatively poor in the transition zone. Logistic regression models may therefore prove useful when training radiologists to characterise prostate cancer.

Debra F. McGivney¹, Alice Yu², Chaitra Badve³, Mark A. Griswold^1,4, and Vikas Gulani^1,3
1Radiology, Case Western Reserve University, Cleveland, OH, United States, ²School of Medicine, Case Western Reserve University, Cleveland, OH, United States, ³Radiology, University Hospitals, Cleveland, OH, United States, ⁴Biomedical Engineering, Case Western Reserve University, Cleveland, OH, United States

MR fingerprinting provides a way to generate quantitative information on tissue parameters, giving a set of multidimensional data at each pixel. Having a method to interpret this multidimensional data will aid in an objective and efficient means for differentiating between normal and healthy tissues, or variations between disease states. We apply principal component analysis (PCA) to MRF data along with the apparent diffusion coefficient (ADC) to differentiate between normal and diseased (prostate cancer, prostatitis) tissue within the prostate. 

chenglin zhao¹, ge gao¹, dong fang¹, he wang¹, xuedong yang¹, feiyu li¹, and xiaoying wang^1
1Peking University First Hospital, Beijing, China, People's Republic of

Multiparametric MRI (mpMRI) has been well used for detecting prostate cancer and provides helpful information before biopsy. Prostate Imaging Reporting and Data System (PI-RADS version 2), which is a standard protocol for it, need to be evaluated.  In this study, we aims to investigated the efficiency and accuracy of mpMRI using PI-RADS version 2 in the diagnosis of clinically significant prostate cancer. Finally, the diagnostic efficiency for clinically significant cancer of mpMRI using PI-RADS version 2 shows good accuracy using PI-RADS. However the consistency of interobserver should be improved in the future.

Rajakumar Nagarajan¹, Zohaib Iqbal¹, Neil Wilson¹, Daniel J Margolis¹, Steven S Raman¹, Robert E Reiter², and M.Albert Thomas^1
1Radiological Sciences, University of California Los Angeles, Los Angeles, CA, United States, ²Urology, University of California Los Angeles, Los Angeles, CA, United States

Prostate cancer (PCa) is the second leading cause of cancer related death in Western countries. Conventional 3D MRSI in PCa using weighted encoding and long echo time. One dimensional MRSI suffers from overlapping of metabolites. In this study, a non-uniformly undersampled (NUS) five dimensional (5D) echo planar J-Resolved spectroscopic imaging (EP-JRESI) sequence using semi LASER radio-frequency pulses for optimal refocusing was used to record 2D J-resolved spectra from multiple prostate locations and to quantify changes in prostate metabolites, Cit, Cr, Ch and mI after compressed sensing reconstruction of the NUS 5D EP-JRESI data by minimizing total variation method. Also, we found the prostate metabolites ratios (Ch+Cr/Cit and Ch+Cr/mI) were inversely correlated with ADC values.

Veronica A Morgan^1,2, Chris Parker³, and Nandita M deSouza^1,2
1MRI, Royal Marsden Hospital, Sutton, United Kingdom, ²Clinical Magnetic Resonance Unit, Institute of Cancer Research, London, United Kingdom, ³Urology, Royal Marsden Hospital, Sutton, United Kingdom

We evaluated relationship between tumor doubling time and ADC in prostate cancer patients managed by active surveillance. Tumor (defined as a low signal-intensity T2-W region showing restricted diffusion and a Type3 contrast-enhanced curve within a biopsy positive octant) volume was calculated at 3 time-points ~12-24mths apart in 22 patients by drawing regions-of-interest on the T2-W images. Mean tumor ADC was estimated centrally through the tumor. Five of 22 tumors (22.7%) showed growth acceleration after the second time-point.  A 10% decrease in ADC identified 3 of 4 tumors and missed 1 of 22 cases with a doubling time of <12 months.

Mihaela Rata¹, Monica Celli², Veronica Morgan¹, Geoffrey Payne¹, Jonathan Gear², Emma Alexander¹, Sue Chua², David Dearnaley¹, and Nandita deSouza^1
1Radiotherapy and Imaging, CR-UK and EPSRC Cancer Imaging Centre, The Institute of Cancer Research and Royal Marsden Hospital, London, United Kingdom, ²Department of Nuclear Medicine and PET/CT, Royal Marsden Hospital, Sutton, United Kingdom

Intracellular choline, a putative marker of prostate cancer, may be measured using ¹H-MRS, while uptake of extrinsic radiolabelled choline derivatives (¹¹C-choline and ¹⁸F-choline) on PET is used to identify prostate cancer. We compared the steady-state concentrations of total choline (¹H-MRS) with the uptake of ¹⁸F-Choline on PET in a cohort of 11 prostate cancer patients. The measured choline/water ratio in tumor was 0.09±0.02 x10^-3 units; the normalized ¹⁸F-Choline uptake was 2.69±1.There was a weak negative correlation between measured MRS and early PET uptake (-0.61, p=0.04) suggesting an increased avidity of prostate tumors for choline when internal concentrations are low.

Novena Rangwala¹, Isabel Dregely¹, Holden Wu¹, and Kyunghyun Sung^1
1Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States

The purpose of this study was to demonstrate improved T₁ estimation in the prostate using the Reference Region Variable Flip Angle (RR-VFA) B₁+ mapping and correction across multiple MRI scanners with different RF transmission modes. Prostate T₁ measurements were compared in four volunteers on three MRI scanners before and after B₁+ correction. The results showed that, for each volunteer,T₁ variations across scanners decreased by 62% after RR-VFA correction, to an average of 10% among scanners, highlighting the need for B₁+ correction and the ability to effectively yield precise T₁estimations in a multi-scanner setting using RR-VFA.

Kristin L Granlund^1,2, Hebert A Vargas¹, Serge K Lyashchenko³, Phillip J DeNoble³, Vincent A Laudone⁴, James Eastham⁴, Ramon A Sosa¹, Matthew A Kennedy¹, Duane Nicholson¹, YanWei W Guo¹, Albert P Chen⁵, James Tropp⁶, Hedvig Hricak^1,2, and Kayvan R Keshari^1,2
1Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, United States, ²Molecular Pharmacology, Memorial Sloan Kettering Cancer Center, New York, NY, United States, ³Radiochemistry & Imaging Probes (RMIP) Core, Memorial Sloan Kettering Cancer Center, New York, NY, United States, ⁴Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, United States, ⁵GE Healthcare, Toronto, ON, Canada, ⁶GE Healthcare, Fremont, CA, United States

Hyperpolarized (HP) pyruvate has the potential to improve tumor grading and evaluate response to treatment by probing the metabolism of lesions.  Three patients with biopsy-proven prostate cancers have been scanned with a 2D dynamic hyperpolarized pyruvate protocol.  Repeatability has been evaluated in 2 patients to date. The data from these first 5 injections confirm that HP prostate imaging is feasible and reproducible, and the 2D dynamics will inform 3D static acquisition timing.

Nicole Wake¹, Samir S Taneja², Daniel K Sodickson¹, and Andrew B Rosenkrantz^1
1Bernard and Irene Schwartz Center for Biomedical Imaging, Center for Advanced Imaging Innovation and Research, Department of Radiology, New York University School of Medicine, New York, NY, United States, ²Department of Urology, New York University School of Medicine, New York, NY, United States

Strategies for the follow-up of focal ablation of prostate cancer combine serial post-procedural PSA, multiparametric MRI examinations, and biopsy, although the optimal follow-up regimen remains controversial.  In this study, we propose a co-registration and 3D visualization method for comparing prostate tumors on pre-treatment T2W-MRI and ablation cavities on post-treatment DCE-MRI as a measure of proper treatment coverage. Our preliminary findings suggest that this co-registration method may be used to help assess treatment efficacy.

Natalie M Schenker-Ahmed¹, Ghiam Yamin¹, Ahmed Shabaik¹, Dennis Adams¹, Hauke Bartsch¹, Joshua Kuperman¹, Nathan S White¹, Rebecca A Rakow-Penner¹, Kevin McCammack¹, J Kellogg Parsons¹, Christopher Kane¹, Anders Dale¹, and David Karow^1
1UC-San Diego, La Jolla, CA, United States

Current multiparametric magnetic resonance imaging techniques for detecting prostate cancer are limited with respect to tumor conspicuity assessment, in vivo characterization and localization. We demonstrate that a novel diffusion-based MRI technique, restriction spectrum imaging (RSI-MRI), differentiates among benign, low-grade and high-grade PCa at voxel-level resolution. Using an RSI-MRI index to differentiate between low- and high-grade categories of tumor PCa aggressiveness may help improve and refine diagnosis and staging of PCa.  Additionally, because it can detect intratumor variation, RSI-MRI may have particular relevance for planning targeted therapies such as radiation seed therapy placement, MR-guided focused ultrasound surgery, and MR-guided targeted biopsy.

Basetti Madhu¹, Greg Shaw¹, David Neal¹, and John R Griffiths^1
1Molecular Imaging (MRI & MRS), Cancer Research UK Cambridge Institute, Cambridge, United Kingdom

Absolute concentrations of metabolites were measured in samples of Benign Prostate Hypertrophy (BPH) and high grade prostate cancer tissues from intact and castrate patients (Degarelix treated). Lactate, alanine, choline compounds  concentrations were significantly elevated in high-grade prostate cancer biopsies when compared to BPH samples. Castration resulted in the significant decrease of lactate and t-choline concentrations in high grade prostate cancer biopsies. The reduced metabolite concentrations of lactate and t-choline observed in this study due to Degarelix shows that there is a potential application of in vivo ¹H MRS to monitor non-invasively the effects of castration in prostate cancer .

Kirsten Margrete Selnæs^1,2, Mattijs Elschot¹, Brage Krüger-Stokke^1,3, Håkon Johansen⁴, May-Britt Tessem¹, Siver Andreas Moestue^1,2, Arne Solberg⁵, Helena Bertilsson^6,7, and Tone Frost Bathen^1,2
1Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway, ²St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway,³Department of Radiology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway, ⁴Department of Nuclear Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway, ⁵Clinic of Oncology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway, ⁶Department of Urology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway,⁷Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway

Prostate cancer patients with biochemical relapse (rising PSA) after initial treatment are a diagnostic challenge. Simultaneous PET/MRI combines the excellent soft-tissue contrast of MRI with the high molecular sensitivity of PET in a single imaging session. The aim of this exploratory study is to evaluate detection rate of simultaneous 18F-Fluciclovine PET/MRI for recurrent prostate cancer. The overall detection rate in an initial cohort of 16 patients was 43.8% for combined 18F-Fluciclovine PET/MR. Combined 18F-Fluciclovine PET/MR can detect areas suspicious for prostate cancer recurrence even in patients with very low PSA levels.

Harald Busse¹, Josephin Otto¹, Alexander Schaudinn¹, Nicolas Linder¹, Simone Mucha¹, Nikita Garnov¹, Minh Do², Roman Ganzer², Jens-Uwe Stolzenburg², Lars-Christian Horn³, Thomas Kahn¹, and Michael Moche^1
1Diagnostic and Interventional Radiology Department, Leipzig University Hospital, Leipzig, Germany, ²Urology Department, Leipzig University Hospital, Leipzig, Germany, ³Institute of Pathology, University of Leipzig, Leipzig, Germany

Multiparametric MRI has been shown to improve the detection and localization of prostate cancer and is therefore ideally suited for targeting as well. While biopsy guidance in an MRI system typically requires more efforts and time (30-120 min) than under ultrasound imaging, MRI provides unparalleled contrast of the prostate substructures. Diagnostic detection rates show large variability between patient groups and sites (about 10-60%). With a custom-made navigation option for a commercial device, any intraprocedural MRI data can be used for stereotactic real-time biopsy targeting. This work presents navigation features, indications and clinical biopsy results for a total of 75 patients. 

Andrew McPartlin¹, Peter Chung¹, Anna Simeonov¹, Theodorus van der Kwast¹, Sangeet Ghai¹, Charles Catton¹, Robert Bristow¹, Andrew Bayley¹, Padraig Warde¹, Mary Gospodarowicz¹, and Cynthia Menard^1,2
1Princess Margaret Cancer Centre, Toronto, ON, Canada, ²CHUM, Montreal, QC, Canada

We performed MRI-guided biopsy in patients with known localized prostate cancer to confirm MRI findings and guide focal therapy.  We found that MRI-guided biopsy had limited impact on the treatment planning process for dose-painted radiotherapy with dose-escalation to tumor-bearing regions.

Ahmed Othman¹, Florian Falkner¹, Petros Martirosian¹, Jakob Weiss¹, Stephan Kruck², Robert Grimm³, Konstantin Nikolaou¹, and Mike Notohamiprodjo^1
1Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany, ²Department of Urology, University Hospital Tübingen, Tübingen, Germany, ³Siemens Healthcare, Siemens Healthcare, Erlangen, Germany

The Choice of arterial input function (AIF) is a potential source of variability in DCE-MRI studies.  In clinical practice, it’s not always possible to estimate individual AIFs due to artifacts or difficulties in vessel detection, particularly in transversal slices, which are typically acquired for prostate MRI. Therefore, population averaged AIFs (pAIFs) are often used. In the present study we assessed the effect of different pAIFs on parameter estimates in DCE-MRI of the prostate. We found that choosing various pAIF types causes high variability in pharmacokinetic parameter estimates. Therefore, it is important to keep AIF type selection constant in DCE-MRI studies.

Nikolaos Dikaios¹, Ed William Johnston¹, Hashim Ahmed², Lucy, Simmons³, Alex Freeman⁴, Clare Allen⁵, David Atkinson¹, and Shonit Punwani^1
1Centre of Medical Imaging, UCL, London, United Kingdom, ²Department:Research Department of Urology, UCL, London, United Kingdom, ³Div of Surgery & Interventional Sci, UCL, London, United Kingdom, ⁴Histopathology, UCL, London, United Kingdom, ⁵Radiology, UCL, London, United Kingdom

Diagnostic models for classifying prostate cancer within the transition zone based on multi-parametric magnetic resonance imaging (mp-MRI) have been proposed to improve radiologist’s performance. Such diagnostic models are trained on mp-MRI data acquired at 1.5T or 3T MRI scanners, but to the best of our knowledge no-one has yet examined whether these magnet specific models are interchangeable. This work applied a previously published diagnostic model trained on mp-MRI data acquired at a 1.5T scanner, on an independent cohort of patients with mp-MRI data acquired at a 3T and found that the performance of the model doesn’t drop significantly.

Tariq Shah¹, Balaji Krishnamachary¹, Flonne Wildes¹, Jannie Wijnen², Kristine Glunde¹, and Zaver M Bhujwalla^1
1Radiology, Johns Hopkins University, Baltimore, MD, United States, ²Utrecht, Netherlands

In understanding the aberrant choline metabolism of cancer, significant effort has been focused on phosphocholine (PC) but the role of phosphoethanolamine (PE) is relatively underexplored, even though tumors show increased PE as consistently as increased PC.  Our previous findings in breast cancer cells have led us to expand our study to understand the role of ethanolamine kinase-1 (EtnK-1) and PE in pancreatic cell lines.  We have demonstrated that EtnK-1 is the major contributor to PE levels in these cells and may be a potential therapeutic target.

Samata Kakkad¹, Desmond Jacob¹, Marie-France Penet^1,2, Jiangyang Zhang ¹, Kristine Glunde^1,2, and Zaver M. Bhujwalla^1,2
1JHU ICMIC program, Division of Cancer Imaging Research, The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, United States, ²Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine, Baltimore, MD, United States

The dense desmoplastic stroma present in pancreatic ductal adenocarcinoma (PDAC) limits the delivery of diagnostic imaging probes and therapeutic agents leading to poor prognosis of PDAC from a combination of late-stage diagnosis and limited response to chemotherapy.  Collagen 1 (Col1) fibers form a major component of this desmoplastic stroma.  By combining noninvasive diffusion MRI with optical imaging we characterized the relationship between Col1 fibers and diffusion MRI in PDAC. A good correlation was observed between Col1 fibers and diffusion MRI parameters providing a rationale for detecting PDAC with diffusion MRI, and characterizing the relationship between Col1 fibers and diffusion MRI.

Yuankui Wu^1,2,3, Shruti Agarwal⁴, Craig K Jones^2,3, Andrew G Webb⁵, Peter C.M. van Zijl^2,3, Jun Hua^2,3, and Jay J Pillai^4
1Department of Medical Imaging, Nanfang Hospital, Southern Medical University, Guangzhou, China, People's Republic of, ²Neurosection, Div. of MRI Research, Dept. of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, United States, ³F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, United States, ⁴Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, United States, ⁵Department of Radiology, C.J.Gorter Center for High Field MRI, University Medical Center, Leiden, Netherlands

The purpose of this study is to evaluate the potential diagnostic value of inflow-based vascular-space-occupancy (iVASO) MRI in brain tumor patients by comparing it with the widely used dynamic-susceptibility-contrast (DSC) MRI. The iVASO approach can measure arteriolar cerebral blood volume (CBVa) without using an exogenous contrast agent. The measured CBVa by iVASO showed a stronger association with tumor grade than DSC CBV. As the total scan times for iVASO and DSC are comparable, iVASO MRI may be a useful alternative for the assessment of tumor perfusion, especially when exogenous contrast agent administration is difficult or contraindicated in certain patient populations.

Zaki Ahmed¹ and Ives Levesque^1,2
1Medical Physics Unit, McGill University, Montreal, QC, Canada, ²Research Institute of the McGill University Health Centre, Montreal, QC, Canada

The reference region model allows quantification of tumour perfusion through DCE-MRI without needing an arterial input function. One limitation is that the model does not account for plasma volume which could be non-negligible in highly vascularized tissues such as tumours. This study introduces a reference region model that accounts for the plasma volume. The performance of this model is evaluated in simulation and invivo data.

 

Atle Bjørnerud^1,2, Magne Mørk Kleppestø¹, Tracy T Batchelor^3,4, Patrick Y Wen⁵, Gregory Sorensen⁶, and Kyrre Eeg Emblem^1,7
1The Intervention Centre, Oslo University Hospital, Oslo, Norway, ²Dept. of Physics, University of Oslo, Oslo, Norway, ³Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States, ⁴Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States, ⁵Center for Neuro-Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, United States, ⁶Siemens Healthcare Health Services, Malvern, MA, United States, ⁷MGH-HST A.A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States

Contrast agent extravasation is known to be a serious confounder in estimations of cerebral blood volume (CBV) analysis of primary brain tumors using DSC-MRI. We here propose a modified MTT-insensitive method for correction of contrast agent extravasation based on parametric analysis of the tissue impulse response function from a two-compartment kinetic model combined with automated global arterial input function (AIF) approximation. Using DSC-MRI data from 28 patients with recurrent glioblastoma which were scanned twice prior to treatment initiation, we show that the proposed method yields test-retest stability similar to the current reference method, but with the added advantage of reduced MTT sensitivity. 

Ning Lang¹, Hon J. Yu², Huishu Yuan¹, and Min-Ying Su^2
1Department of Radiology, Peking University Third Hospital, Beijing, China, People's Republic of, ²Center for Functional Onco-Imaging, Department of Radiological Sciences, University of California, Irvine, CA, United States

26 patients with giant cell tumor in the spine and 12 patients with chordoma received DCE-MRI were analyzed. The morphological features (lesion location, vertebral compression, paraspinal soft tissue mass, bone expansion change, fiber separation, and MR signal on T1W1 and T2W1) and DCE pharmacokinetic parameters were compared. Several typical morphological features could be used for differential diagnosis, but there was a substantial overlap. DCE-MRI may provide very helpful information. Giant cell tumor had a significantly higher Ktrans and kep compared to chordoma, and by using a cut-off value of kep=0.43/min, it could achieve a very high accuracy of 95%.

Ning Lang¹, Hon J. Yu², Huishu Yuan¹, and Min-Ying Su^2
1Department of Radiology, Peking University Third Hospital, Beijing, China, People's Republic of, ²Center for Functional Onco-Imaging, Department of Radiological Sciences, University of California, Irvine, CA, United States

A retrospective DCE-MRI of 76 patients with different metastatic cancers in the spine (35 lung, 11 thyroid, 12 breast, 7 prostate, 7 liver and 4 kidney) were studied. Three heuristic parameters: the maximum and steepest wash-in signal enhancement ratio and the wash-out slope were measured. Two-compartmental pharmacokinetic analysis was performed to obtain Ktrans and kep. The maximum and wash-in SE ratio were highly correlated with Ktrans; and the wash-out slope was highly correlated with kep. The lung cancer had the widest variation, the breast cancer had the highest wash-in SE ratio, and the thyroid cancer had the greatest wash-out slope.

Kimberly Li^1,2, Abdallah S.R. Mohamed³, Yao Ding⁴, Musaddiq J Awan⁵, Steven J Frank³, Jihong Wang⁶, John D Hazle⁴, Kate Hutcheson⁷, Stephan Y Lai⁷, Jayashree Kalpathy-Cramer⁸, Xin Li², Clifton D Fuller³, and Wei Huang^2
1International School of Beaverton, Beaverton, OR, United States, ²Advanced Imaging Research Center, Oregon Health & Science University, Portland, OR, United States, ³Department of Radiation Oncology, U.T. MD Anderson Cancer Center, Houston, TX, United States, ⁴Department of Imaging Physics, U.T. MD Anderson Cancer Center, Houston, TX, United States, ⁵Department of Radiation Oncology, Case Western Reserve University, Cleveland, OH, United States, ⁶Department of Radiation Physics, U.T. MD Anderson Cancer Center, Houston, TX, United States, ⁷Department of Head and Neck Surgery, U.T. MD Anderson Cancer Center, Houston, TX, United States, ⁸Harvard Medical School, Boston, MA, United States

Head and neck cancer patients are commonly treated with chemoradiotherapy as standard of care. Although the conventional wisdom is that radiation does not cause long-term adverse effects in healthy, well-perfused tissues such as muscle, few studies have evaluated potential biological changes in irradiated muscle tissues longitudinally during the course of treatment. Here, we report preliminary findings of such changes as measured by Dynamic Contrast Enhanced Magnetic Resonance Imaging (DCE-MRI) before, during, and after chemoradiotherapy treatment of a subset of human papilloma positive (HPV+) oropharyngeal cancer (OPC).

Moran Artzi¹, Gilad Liberman^2,3, Deborah Blumenthal⁴, Orna Aizenstein¹, and Dafna Ben Bashat^1,5
1Functional Brain Center, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel, ²Functional Brain Centerasky Medical Cente, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel, ³Department of Chemical Physics, Weizmann Institute, Rehovot, Israel, ⁴Neuro-Oncology Service, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel, ⁵Sackler Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel-Aviv, Israel

DCE-MRI parameters have been shown to be useful for therapy response assessment in patient with glioblastoma, yet the estimated parameters may show high variation in their values. This study investigated the reliability of DCE parameters for quantitative longitudinal assessment of brain tumors. 14% standard-deviation in the WM and 12% in the GM, were detected for v_p in healthy subjects(n=27). Results from six patients showed mean differences of 3.2%/9.7% in v_p for WM/GM in the hemisphere contralateral to the lesion, comparing two longitudinal scans. Parametric-response-maps calculated within lesion areas based on the threshold values from the healthy controls supported radiological assessment.

Yewei Liu^1,2, Ting Yin¹, Yuanbo Feng¹, Jie Yu¹, Gang Huang², Jianjun Liu², Shaoli Song², Johannes V Swinnen³, Guy Bormans⁴, Uwe Himmelreich⁵, Raymond Oyen⁶, and Yicheng Ni^1
1Theragnostic Laboratory, MoSAIC, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium, ²Renji Hospital, Shanghai Jiao Tong University, School of Medicine, Department of Nuclear Medicine, Shanghai, China, People's Republic of, ³Laboratory of Lipid Metabolism and Cancer, Department of Oncology, Faculty of Medicine, KU Leuven, Leuven, Belgium,⁴Radiopharmacy, Department of Pharmaceutical and Pharmacological Sciences, Faculty of Medicine, KU Leuven, Leuven, Belgium, ⁵Biomedical MRI, MoSAIC, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium, ⁶Radiology, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium

Vasculogenic mimicry (VM) refers to tumor cells mimicking endothelial cells and directly participating in blood vessel formation, which appears in 2 distinctive forms, namely, the tubular type and the patterned matrix type. In liver cancer, VM is associated with tumor aggressiveness and poor clinical outcome. DENA-induced primary liver cancer model in rat appears an optimal VM model with both the 2 VM types. DWI and DCE-MRI were used to characterize and distinguish different VM types, and sensitively predicting diverse therapeutic responses to a vascular-disrupting agent CA4P.

Hassan Bagher-Ebadian^1,2, Ana deCarvalho¹, Tavarekere Nagaraja¹, Azimeh NV Dehkordi³, Susan Irtenkauf¹, Swayamparva Panda¹, Robert Knight¹, and James R Ewing^1,2
1Henry Ford Hospital, Detroit, MI, United States, ²Oakland University, Rochester, MI, United States, ³Shahid Beheshti University, Tehran, Iran

In human glioblastoma multiforme (GBM), infiltrating cells are found in remote locations, even in the hemisphere contralateral to the primary lesion.  Although MRI allows approximation of the extent of tumor cell infiltration, the actual extent of infiltration may be greater or less than the edema, and there is no standard MRI practice that can be used to assess the infiltrating tumor burden. This pilot study investigates the feasibility of using a set of MR modalities for the development of an MRI estimate of infiltrating tumor burden in Patient-Derived Mouse Xenografts model of GBM using an adaptive model.

Moran Artzi¹, Gilad Liberman^2,3, Deborah Blumenthal⁴, Felix Bokstein⁴, Orna Aizenstein¹, and Dafna Ben Bashat^1,5
1Functional Brain Center, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel, ²Functional Brain Centerasky Medical Cente, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel, ³Department of Chemical Physics, Weizmann Institute, Rehovot, Israel, ⁴Neuro-Oncology Service, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel, ⁵Sackler Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel-Aviv, Israel

Segmentation of lesion area in patients with glioblastoma (GB) into active tumor, tissue necrosis, vasogenic edema and infiltrative disease, is highly important for patient monitoring, yet is challenging using standard radiological assessment. The aim of this study was to segment the lesion area into these four tissue types in GB patients. Voxel-wise classification was performed using support-vector-machine based on anatomical and DCE-MRI parameters. Significant differences were detected between the tissue types for FLAIR, v_p, and k^trans. Sensitivity and specificity of the training-set were measured based on 2-fold-cross-validation analysis, showing high sensitivities and specificities of 94-100% for the different tissue types.

Meng Lin¹, Xiaoduo Yu¹, Han Ouyang¹, Dehong Luo¹, Chunwu Zhou¹, and Bing Wu^2
1Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China, People's Republic of, ²GE Healthcare MR research China, Beijing, Beijing, China, People's Republic of

Tumor extent assessment of NPC is critical for delineating the radio-therapeutic target region. We aimed to investigate the use of the fusion images of fat suppressed (FS)-T2 with arterial spin labeling (ASL) in measuring the volume of NPC. Two observers measured the volume of 21 untreated NPC using FS-T2, FS-T2/ASL (with PLD=1.0, 1.5 and 2.0s) fusion images and enhanced-T1WI separately. Compared to those obtained using FS-T2 alone, measurements made using FS-T2/ASL were more consistent with those made using enhanced-T1WI. The FS-T2/ASL fusion image has the potential to be an alternative to enhanced-T1WI, when contrast administration can not be performed.

Jimi Huh¹, Kyung Won Kim¹, Chang Kyung Lee¹, Jisuk Park¹, In Seong Kim², Su Jung Ham¹, and Bumwoo park^1
1radiology, Asan medical cencer, Seoul, Korea, Republic of, ²Siemens Healthcare, Seoul, Korea, Republic of

For evaluation of tumor vascularity of hepatoma, we aim to compare the DCE-MRI using Gd-EOB-DTPA and Gd-DTPA. When we perform DCE-MRI twice with 24-hours interval: first scan using Gd-DTPA and second scan using Gd-EOB-DTPA, the time-intensity curve patterns were quite different between the two scans. These findings imply that Gd-DTPA distributes between blood vessels and EES, working as a extracellular contrast agent, whereas Gd-EOB-DTPA distribute blood vessels, EES, and intracellular space in the hepatoma, working as a hepatobiliary contrast agent. Therefore, the conventional two-compartment model does not fit DCE-MRI using Gd-EOB-DTPA in subjects with hepatoma which may express OATP receptors.

Ellen Ackerstaff¹, Nirilanto Ramamonjisoa¹, H. Carl LeKaye¹, Kristen L. Zakian¹, Ekaterina Moroz¹, Inna S. Serganova¹, Ronald G. Blasberg¹, and Jason A. Koutcher^1
1Memorial Sloan Kettering Cancer Center, New York, NY, United States

Aggressive, treatment-resistant tumors have been associated with high tumor lactate. For the absolute quantification of in vivo tumor lactate by the substitution method, it is essential to correct for differences between reference phantom and in vivo lactate T₁ and T₂ relaxation times (LacT₁/T₂). The LacT₁/T₂ acquisition requires specialized MR sequences and is hampered in vivo by long acquisition times and low lactate SNR. Here, we measure LacT₁/T₂ for various orthotopic breast and subcutaneous prostate cancer models in immune-competent and immune-compromised hosts. Our results indicate that using an average LacT₁/T₂ correction factor introduces less than 20% error in the lactate quantification.

Gilberto S Almeida¹, Rafal Panek^1,2, Albert Hallsworth³, Hannah Webber³, Efthymia Papaevangelou¹, Jessica KR Boult¹, Yann Jamin¹, Louis Chesler³, and Simon P Robinson^1
1Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom, ²The Institute of Cancer Research/ Royal Marsden NHS Foundation Trust, London, United Kingdom, ³Cancer Therapeutics and Clinical Studies, The Institute of Cancer Research, London, United Kingdom

The use of clinical MRI scanners to conduct preclinical research facilitates a more direct or matched comparison with clinical studies. The increased use of orthotopic and transgenic mouse tumour models in cancer research demands non-invasive methods to accurately assess their progression and treatment response in vivo. The purpose of this study was to evaluate the utility and sensitivity of anatomical and functional MRI data/biomarkers acquired from transgenic mouse models of neuroblastoma using a non-bespoke asymmetric high resolution RF coil on a clinical 3T scanner.

Yuko Nakamura¹, Marcelino Bernardo¹, Tadanobu Nagaya¹, Kazuhide Sato¹, Toshiko Harada¹, Peter L. Choyke¹, and Hisataka Kobayashi^1
1Molecular Imaging Program, Center for Cancer Research, National Cancer Institute, Bethesda, MD, United States

Near infrared photoimmunotherapy (NIR-PIT) is a new cancer treatment that combines the specificity of antibodies for targeting tumors with the toxicity induced by photon absorbers after irradiation with NIR light. The purpose of this study was to determine if MR imaging can detect changes in the MR properties of tumor within several hours of NIR-PIT in an animal model. Prolongation of T2, reductions in apparent diffusion coefficient (ADC) and increased enhancement using gadofosveset are seen within 2 hours of NIR-PIT treatment of tumors. Thus, MRI can be a useful imaging biomarker for detecting early therapeutic changes after NIR-PIT.

Yuanyu Shen¹, Gang Xiao², Zhiwei Shen¹, Xiaolei Zhang¹, Wei Hu¹, Xiangyong Tang¹, Zhiyan Zhang¹, Jitian Guan¹, and Renhua Wu^1
12nd Affilicated Hospital, Shantou University Medical College, Shantou, China, People's Republic of, ²Hanshan Normal University, Chaozhou, China, People's Republic of

        Our aim was to demonstrate the feasibility of nuclear Overhauser enhancement (NOE) imaging to detect the characteristic of patients with brain tumors. Six healthy volunteers and eleven patients with brain tumors were recruited for undergoing MRI scan at 3T. As a result, we found NOE value was greater in white matter compared to gray matter. However, in human brain tumors, NOE value was slightly hypointense in glioma and little difference in meningioma. NOE imaging may help to distinguish the heterogeneity of benign or malignant tumors, and it is important in diagnosis and treatment planning for patients with brain tumors.

Kavindra Nath¹, David Nelson¹, Dennis Leeper², and Jerry Glickson^1
1University of Pennsylvania, Philadelphia, PA, United States, ²Thomas Jefferson University, Philadelphia, PA, United States

Lonidamine (LND) effects were measured in vivo by ³¹P and ¹H MRS in androgen-independent (PC3) and androgen-dependent (LNCaP) prostate cancer xenografts indicating a sustained and tumor-selective decrease in intracellular pH (pHi) and extracellular pH (pHe), and decrease in tumor bioenergetics (βNTP/Pi) by 75.0 % and 79.0 % in PC3 and LNCaP, respectively, relative to the baseline levels. Steady-state levels of tumor lactate were significantly increased ~ 2 fold at 60 min. post-LND. The decline of pHi, pHe, bioenergetics and increase in lactate produced increased therapeutic efficacy when LND was combined with other therapeutic interventions (chemotherapy, radiation, and hyperthermia).    

Alexandre A Khrapitchev¹, James R Larkin¹, Stavros Melemenidis¹, Peter E Thelwall², and Nicola R Sibson^1
1Department of Oncology, University of Oxford, Oxford, United Kingdom, ²Newcastle Magnetic Resonance Centre, Newcastle University, Newcastle upon Tyne, United Kingdom

The imaging of lungs with MRI is difficult owing to low proton density. Imaging with hyperpolarized noble gases has overcome some of these limitations but at great expense and effort. We have investigated damage caused by radiation of mouse lungs using ¹⁹F MRI of perfluorohexane – a cheap biocompatible liquid at room temperature. Using lungs filled with perfluorohexane, we were able to obtain high resolution scans with comparable SNRs to hyperpolarized xenon imaging and high resolution. These bright and stable lung images provide a very sensitive tool to monitor the lung damage development.

Mounia Beloueche-Babari¹, Slawomir Wantuch¹, Harold G Parkes¹, Markella Koniordou¹, Vaitha Arunan¹, Thomas R Eykyn¹, Paul D Smith², and Martin O Leach^1
1CRUK Cancer Imaging Centre, The Institute of Cancer Research & Royal Marsden NHS Foundation Trust, London, United Kingdom, ²AstraZeneca, Cambridge, United Kingdom

The monocarboxylate transporter 1 (MCT1), which mediates the bidirectional movement of molecules such as lactate and pyruvate, is upregulated in cancer and constitutes a promising drug target. Using MRS we investigate the impact of the MCT1 inhibitor AZD3965, currently in phase-I clinical trials, on human cancer cell metabolism to assess potential for pharmacodynamic biomarker discovery. We show that AZD3965 inhibits lactate efflux and blocks hyperpolarised ¹³C-pyruvate-lactate exchange in human cancer cells in an MCT4-dependent manner. Thus, intracellular lactate and hyperpolarized ¹³C-pyruvate-lactate exchange are promising metabolic imaging biomarkers for monitoring the action of AZD3965 and potentially other MCT1 inhibitors.

William Dominguez-Viqueira¹, Pedro Miguel Enriquez Navas¹, Gary Martinez¹, Epifanio Ruiz ¹, David Morse¹, Robert Gillies¹, and Susan Frost^2
1Department of Cancer Imaging and Metabolism, Moffitt Cancer Center, Tampa, FL, United States, ²Biochemistry and Molecular Biology, University of Florida, Gainesville, FL, United States

Membrane-bound carbonic anhydrase (CA-IX) plays an important role in maintaining an acidic extracellular pH (pHe) in tumors. We investigate the effect of inhibiting CA-IX on the pHe of patient derived xenografts (PDX) from a triple negative breast cancer using ³¹P MRS of 3-aminopropylphosphonate (3-APP) as a pH biomarker. Mice were imaged before the injection of the ureido-sulfonamide CA-IX inhibitor (cpd25) and again at 2.5 and 24 hours after injection. There was an increase in pH in 5/6 animals in the first 24 hours. This is first in vivo evidence that CA-IX inhibition disrupts pH in vivo.

Hugo Dorez¹, Raphaël Sablong¹, Laurence Canaple², Sophie Gaillard¹, Hervé Saint-Jalmes^3,4, Driffa Moussata⁵, and Olivier Beuf^1
1CREATIS, Université de Lyon ; CNRS UMR5220 ; Inserm U1044 ; INSA-Lyon ; Université Claude Bernard Lyon 1, Villeurbanne, France, ²IGFL, ENS Lyon, Lyon, France, ³LTSI - Inserm U642, Rennes, France,⁴CRLCC, Rennes, France, ⁵Hôpital Régional Universitaire de Tours, Tours, France

The purpose of this project is to provide new tools and protocols to evaluate digestive pathologies. To this end, endoscopic MRI, using endoluminal coils, was combined with confocal endomicroscopy (CEM). Both modalities provide complementary information. CEM is well suited to investigate the surface of the colon wall whereas endoscopic MRI can assess deeper structures. It allows characterizing and staging the first steps of cancer development. The study was performed on a mouse model of colitis following 24 animals. This opens perspectives to better understand digestive pathologies such as colorectal cancer and inflammatory bowel disease.

Abby Y. Ding¹, Oi Lei Wong¹, Jing Yuan¹, Max W.K. Law¹, K.F. Cheng², K. T. Chan², Gladys G. Lo³, K.Y. Cheung¹, and Siu Ki Yu^1
1Medical Physics & Research Department, Hong Kong Sanatorium & Hospital, Hong Kong, China, People's Republic of, ²Department of Radiotherapy, Hong Kong Sanatorium & Hospital, Hong Kong, China, People's Republic of, ³Department of Diagnostic & Interventional Radiology, Hong Kong Sanatorium & Hospital, Hong Kong, China, People's Republic of

Current positioning verification in radiotherapy mainly relies on bony structures using X-ray based imaging techniques, where visualization of tumor and soft organ-at-risk is relatively poor. This study aimed to assess the positional repeatability of soft and bony structures, and investigate the correlation between the positional deviations of various head and neck (H&N) tissues. Our results suggested that the current positioning verification practice for radiotherapy relying mainly on bony structure may be inadequate and inefficient in H&N. MR-simulator may play a potential role in improving H&N radiotherapy by enabling positional verification directly on target tissues rather than simply on bony structure.

Wei Huang¹, Aneela Afzal¹, Alina Tudorica¹, Yiyi Chen¹, Stephen Y-C Chui¹, Arpana Naik¹, Megan Troxell¹, Kathleen Kemmer¹, Karen Y Oh¹, Nicole Roy¹, Megan L Holtorf¹, and Xin Li^1
1Oregon Health & Science University, Portland, OR, United States

15 breast cancer patients undergoing neoadjuvant chemotherapy (NACT) consented to two DCE-MRI studies at the same time points before, during, and after NACT: one with high temporal resolution (tRes) and the other with low tRes.  There were systematic errors in estimated pharmacokinetic (PK) parameters from the low tRes data compared to the high tRes data.  However, the abilities of PK parameters for early prediction of pathologic response to NACT were not affected by poorer tRes.

Naranamangalam R Jagannathan¹, Khushbu Agarwal¹, Uma Sharma¹, Sandeep Mathur², Vurthaluru Seenu³, and Rajinder Parshad^3
1Department of NMR and MRI Facility, All India Institute of Medical Sciences, New Delhi, India, ²Department of Pathology, All India Institute of Medical Sciences, New Delhi, India, ³Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India

We evaluated the changes in tCho levels and β-catenin expression (membrane and cytoplasm) after III neoadjuvant chemotherapy in breast cancer patients. Significant reduction in β-catenin expression (membranous and cytoplasmic) was observed after therapy. Post-therapy, tCho reduced significantly in tumors with Grades 1 and 2 membranous β-catenin expression and also in tumors with IRS 0 and Grade 1 cytoplasmic β-catenin. Prior to therapy, tCho was positively associated with cytoplasmic β-catenin while negatively with membranous protein. However post-therapy tCho was negatively associated with both cytoplasmic and membranous β-catenin. This signifies antiproliferative and apoptosis induction effects of chemotherapy drugs on breast cancer patients.

Lei Tang¹, Ying-Shi Sun¹, Zi-Yu Li², Xiao-Ting Li ¹, Fei Shan², Zi-Ran Li², and Jia-Fu Ji^2
1Radiology, Peking University Cancer Hospital & Institute, Beijing, China, People's Republic of, ²GI surgery, Peking University Cancer Hospital & Institute, Beijing, China, People's Republic of

The percentage changes of ADC after neoadjuvant chemotherapy of gastric carcinoma have correlation with long-term prognosis. The significantly increased ADC after chemotherapy is more prone to signify long-term survival, and has potential to be a surrogate imaging biomarker for the prediction of the prognosis. ADCentire for the whole lesion is better than ADCmin for high signal area in the prognosis prediction.

Jérémie P. Fouquet¹, Julie Constanzo¹, Laurence Masson-Côté^1,2, Luc Tremblay¹, Philippe Sarret³, Sameh Geha⁴, Kevin Whittingstall⁵, Benoit Paquette¹, and Martin Lepage^1
1Department of Nuclear Medicine and Radiobiology, Université de Sherbrooke, Sherbrooke, QC, Canada, ²Service of Radiation Oncology, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada, ³Department of Pharmacology-Physiology, Université de Sherbrooke, Sherbrooke, QC, Canada, ⁴Department of Pathology, Université de Sherbrooke, Sherbrooke, QC, Canada, ⁵Department of Diagnostic Radiology, Université de Sherbrooke, Sherbrooke, QC, Canada

Radiation dose delivered to healthy tissues during brain tumors radiosurgery can cause important side effects. We imaged an animal model of brain irradiation with DCE-MRI and T2*-weighted imaging at different time points after treatment. DCE-MRI allowed the discrimination of areas with high vessel permeability and necrotic regions. T2*-weighted imaging enabled the visualization of a necrotic core and micro-lesions at its periphery. Micro-lesions were initially co-localized with permeable vessels and later evolved into necrosis. Together, DCE-MRI and T2*-weighted images provided a coherent picture on the phenomena involved in radionecrosis progression, which could help in the management of associated problems.

Raquel Perez-Lopez^1,2, Matthew D. Blackledge^1,2, Joaquin Mateo^1,2, David J. Collins^1,2, Veronica A. Morgan^1,2, Alison MacDonald^1,2, Diletta Bianchini^1,2, Zafeiris Zafeiriou^1,2, Pasquale Rescigno^1,2, Michael Kolinsky^1,2, Daniel Nava Rodrigues^1,2, Helen Mossop¹, Nuria Porta¹, Emma Hall¹, Martin O. Leach^1,2, Johann S. de Bono^1,2, Dow-Mu Koh^1,2, and Nina Tunariu^1,2
1The Institute of Cancer Research, Sutton, United Kingdom, ²The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom

We hypothesized that changes in the median apparent diffusion coefficient (mADC) and volume of bone metastases (BM), quantified by whole body (WB) diffusion-weighted imaging (DWI), are response biomarkers in metastatic castration-resistant prostate cancer (mCRPC). 21 patients completed WB-DWI at baseline and after 12 weeks of treatment in a sub-study within a clinical trial of olaparib in mCRPC, performed on a 1.5-T Siemens Avanto scanner. Four different segmentation techniques were explored including axial skeleton analyses and simpler methods including 5 target lesions. Changes in mADC and volume of BM associated with response to therapy. The simplified approach also showed promising results, warranting further evaluation.

Sanjeev Chawla¹, Sumei Wang¹, Gaurav Verma¹, Aaron Skolnik¹, Sulaiman Sheriff², Katelyn M Reilly¹, Lisa Desiderio¹, Andrew Maudsley², Steven Brem³, Katherine Peters⁴, Harish Poptani⁵, and Suyash Mohan^1
1Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States, ²Radiology, University of Miami, Miami, FL, United States, ³Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States, ⁴Neurology, Duke University Medical Center, Durham, NC, United States, ⁵Department of Cellular and Molecular Physiology, University of Liverpool, Liverpool, United Kingdom

Tumor treating fields (TTFields) are a novel antimitotic treatment modality for treatment of patients with glioblastoma (GBM). To assess response to TTFields, 4 GBM patients underwent diffusion, perfusion and 3D-echo-planar spectroscopic imaging prior to initiation of TTFields and at one and two month follow-up periods. A trend towards increased MD and a decrease in FA and rCBV_max was noted in most patients at 2-month relative to baseline indicating inhibited tumor growth and vascularity. Cho/Cr values did not exhibit any trend probably due to heterogeneity in response. These preliminary data indicate the potential of advanced MR imaging in assessing response to TTFields.   

Ma Xiaohong¹, Zhao Xinming¹, Ouyang Han¹, and Zhou Chunwu^1
1Diagnostic Radiology, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China, People's Republic of

The purpose of this study was to explore the efficacy of functional MRI (diffusion-weighted imaging (DWI), IntraVoxel incoherent motion (IVIM) and perfusion-weighted imaging (PWI)) quantitative analysis in predicting therapeutic outcome of TACE on HCC.  The D_^fast, K^trans, ΔD_fast and ΔK^trans of HCC acquired before and after TACE obviously correlated with PFS and was valuable in the prediction of the clinical outcome of HCC treated with TACE.

Yong Zhang¹, Bing Wu¹, Xin Chen², and Zaiyi Liu^2
1GE Healthcare MR Research China, Beijing, China, People's Republic of, ²Radiology, Guangdong General Hospital, Guangzhou, China, People's Republic of

Antiangiogenic therapy is efficient to treat hypervascular tumor such as hepatocelluar carcinoma (HCC). Unlike chemotherapy and radiation therapy, tumor dimension doesn’t change in its early phase. Hence traditional reponse criteria based on morphological change fails to early assess the therapeutic response of antiangiogenic treatment. This study used intravoxel incoherent motion (IVIM) theory to separate perfusion and diffusion characteristics in HCC over sereval time points after antiangiogenic Sorafenib administration. It was found that IVIM-derived pure diffusivity and pseudo-diffusivity were able to detect the microvascular collapse and cellular edema in HCC at early phase of antiangiogenic medication.  

Evangelia Kaza¹, Matthew Blackledge¹, David John Collins¹, Erica Scurr², Helen McNair³, Richard Symonds-Tayler¹, Fiona McDonald², Martin Osmund Leach¹, and Dow-Mu Koh^2
1The Institute of Cancer Research and Royal Marsden Hospital, London, United Kingdom, ²The Royal Marsden NHS Foundation Trust, London, United Kingdom, ³Department of Radiotherapy, Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London, United Kingdom

Imaging with an Active Breathing Coordinator (ABC) modified for MR use was performed on lung cancer patients to acquire spatially matching diffusion-weighted images (DWI) before, during and after Radiotherapy. DWI spatially matched the CT and depicted mediastinal nodal involvement as well as internal tumour heterogeneity. ADC maps provided information about changes in solid and fluid components throughout therapy. Treatment response was evaluated by applying multi-parametric tumour heterogeneity characterisation using Gaussian Mixture Modelling. Differences in ADC and volume behavior of separate cancerous tissue components at various treatment time points may indicate tumour sub-volumes and provide detailed cancer characterisation.

Jessica M Winfield^1,2, Aisha Miah³, Dirk Strauss⁴, Khin Thway⁵, Andrew Hayes⁴, Daniel Henderson³, David J Collins^1,2, Nandita M deSouza^1,2, Martin O Leach^1,2, Sharon L Giles^1,2, Veronica A Morgan^1,2, and Christina Messiou^1,2
1MRI, Royal Marsden Hospital, Sutton, United Kingdom, ²Division of Radiotherapy and Imaging, Cancer Research UK Cancer Imaging Centre, Institute of Cancer Research, London, United Kingdom,³Department of Radiotherapy, Royal Marsden Hospital, London, United Kingdom, ⁴Department of Surgery, Royal Marsden Hospital, London, United Kingdom, ⁵Department of Histopathology, Royal Marsden Hospital, London, United Kingdom

Soft tissue sarcomas are often highly heterogeneous tumours and post-treatment changes cannot be described by standard size criteria. Functional imaging may provide a non-invasive method of assessing response to treatment. Knowledge of baseline functional imaging characteristics and the repeatability of estimated parameters is essential in development of future studies. In this study, 22 patients with retroperitoneal sarcoma were imaged before treatment. Whole-tumour assessments of apparent diffusion coefficient (ADC), parameters of the intra-voxel incoherent motion model (IVIM: diffusion coefficient D, fraction f, fast exponential component D*), transverse relaxation rate (R₂*), fat fraction and enhancing fraction (EF) showed large ranges of median estimates, indicating wide inter-tumour heterogeneity. The large standard deviation of parameters within tumours reflects the intra-tumour heterogeneity. In 21 patients, a second examination was carried out to assess repeatability of ADC, D, f, D* and R₂*. Excellent repeatability of fitted parameters, particularly ADC, indicates high sensitivity to treatment-induced changes. 

Jessica M Winfield^1,2, Matthew D Blackledge², Aisha Miah³, Dirk Strauss⁴, Khin Thway⁵, David J Collins^1,2, Martin O Leach^1,2, Sharon L Giles^1,2, Daniel Henderson³, and Christina Messiou^1,2
1MRI, Royal Marsden Hospital, Sutton, United Kingdom, ²Division of Radiotherapy and Imaging, Cancer Research UK Cancer Imaging Centre, Institute of Cancer Research, London, United Kingdom,³Department of Radiotherapy, Royal Marsden Hospital, London, United Kingdom, ⁴Department of Surgery, Royal Marsden Hospital, London, United Kingdom, ⁵Department of Histopathology, Royal Marsden Hospital, London, United Kingdom

Multi-parametric functional imaging may enable non-invasive assessment of response to treatment in soft tissue sarcomas. Image analysis is complicated, however, by the highly heterogeneous nature of these tumours, which can include regions of cellular tumour, fat, necrosis and cystic change that may respond differently to treatment. In this study, patients with retroperitoneal sarcoma were imaged before and after radiotherapy using DW-MRI, Dixon and pre-/post-contrast T₁-w imaging for evaluation of enhancing fraction (EF). Gaussian mixture modelling was applied to classify pixels in the tumour volume according to their functional imaging behaviour, combining ADC, fat fraction and EF to characterise tumour components. This method enabled segmentation of highly heterogeneous tumours and estimation of mean ADC and volume of each tumour component. Heterogeneous changes post-radiotherapy were summarised in tissue classification maps, which combine multiple functional imaging parameters. Combined analysis of functional imaging parameters may provide greater insight into tumour behaviour, for example identification of viable tumour. 

Jessica M Winfield^1,2, Aisha Miah³, Dirk Strauss⁴, Khin Thway⁵, David J Collins^1,2, Martin O Leach^1,2, Sharon L Giles^1,2, Daniel Henderson³, Shane Zaidi⁶, and Christina Messiou^1,2
1MRI, Royal Marsden Hospital, Sutton, United Kingdom, ²Division of Radiotherapy and Imaging, Cancer Research UK Cancer Imaging Centre, Institute of Cancer Research, London, United Kingdom,³Department of Radiotherapy, Royal Marsden Hospital, London, United Kingdom, ⁴Department of Surgery, Royal Marsden Hospital, London, United Kingdom, ⁵Department of Histopathology, Royal Marsden Hospital, London, United Kingdom, ⁶Department of Clinical Oncology, Royal Marsden Hospital, London, United Kingdom

Functional imaging provides scope for non-invasive assessment of response to radiotherapy and/or systemic agents in retroperitoneal sarcomas and investigation of heterogeneity of response in this highly heterogeneous tumour type. In this study 9 patients with retroperitoneal sarcoma were imaged before treatment and 2-4 weeks after radiotherapy. Whilst some tumours exhibited large increases in median ADC and enhancing fraction after radiotherapy, the overall changes for the cohort were not significant and there were no clear changes in fat fraction. Thresholded ADC maps and enhancement maps, however, reveal localised post-radiotherapy changes in ADC and enhancement that are not fully characterised by whole-tumour metrics.  

Hatef Mehrabian^1,2, Kimberly L Desmond³, Anne L Martel^1,2, Arjun Sahgal^1,4, Hany Soliman^1,4, and Greg J Stanisz^1,2
1Physical Sciences, Sunnybrook Research Institute, Toronto, ON, Canada, ²Medical Biophysics, University of Toronto, Toronto, ON, Canada, ³Medical Physics and Applied Radiation Sciences, McMaster University, Hamilton, ON, Canada, ⁴Radiation Oncology, Odette Cancer Centre, Toronto, ON, Canada

Quantitative MRI techniques that probe the metabolic and micro-structural changes in the tumor have the potential to assess response of brain metastases to stereotactic radiosurgery early after treatment. Two techniques were investigated here: a) Chemical Exchange Saturation Transfer (CEST), b) Relaxometry.

Among all model parameters, early changes in the intracellular-extracellular water exchange rate in relaxometry, and peak amplitude of nuclear overhauser effect at the ipsilateral normal appearing white matter in CEST provided the strongest correlation with tumor volume change one-month post-treatment. We also demonstrated that these two parameters were highly correlated suggesting they could provide complementary information about treatment effects.

Ke Nie¹, Liming Shi², Ning Yue¹, Jabbour Salma¹, Xi Hu², Liwen Qian², Tingyu Mao², Qin Chen², Xiaonan Sun², and Tianye Niu^2,3,4
1Radiation Oncology, Rutgers-Cancer Institute of New Jersey, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, United States, ²Radiation Oncology, Sir Run Run Shaw Hospital, Zhejiang University of Medicine, Hangzhou, China, People's Republic of, ³Institute of Translational Medicine, Hangzhou, China, People's Republic of, ⁴Radiology, Sir Run Run Shaw Hospital, Zhejiang University of Medicine, Hangzhou, China, People's Republic of

We are one of the first to investigate the predictive value of combined anatomical, DCE-MRI and DWI for good pathological response at different time points during the pre-operative chemo-radiation treatment (CRT) in patients with locally advanced rectal cancer (LARC). The pre-treatment ADC and internal heterogeneity enhancement measured by texture features from DCE-MRI and the relative change of the ADC values during the treatment showed good prognostic value with pathological response. Overall, this study provides new information of the optimal use of MRI in predicting response to the pre-operative CRT, which may further help tailor the treatment into the era of personalized medicine.

Gigin Lin¹, Yu-Chun Lin¹, Hsi-Mu Chen ¹, and Chiun-Chieh Wang^2
1Medical Imaging and Intervention, Chang Gung Memorial Hospital, Taoyuan, Taiwan, ²Radiation Oncology, Chang Gung Memorial Hospital, Taoyuan, Taiwan

The intracellular storage and utilization of lipids are critical for cancer cells to maintain energy homeostasis. In this study, we investigated the changes of lipid metabolites in murine TRAMP-C prostate cancer cells and tumors following radiotherapy. The lipid profile following radiotherapy demonstrated increased levels of fatty acids and triacylglycerols, before the change of tumor size. The increase of lipids signals can potentially serve as early response biomakers in clinical setting for prostate cancer patients following radiotherapy.

Dattesh D Shanbhag¹, Parita Sanghani¹, Reem Bedair ², Venkata Veerendranadh Chebrolu¹, Sandeep N Gupta³, Scott Reid ⁴, Fiona Gilbert ², Andrew Patterson ², Rakesh Mullick¹, and Martin Graves^2
1GE Global Research, Bangalore, India, ²University of Cambridge, Cambridge, United Kingdom, ³GE Global Research, Niskayuna, NY, United States, ⁴GE Healthcare, Leeds, United Kingdom

In this work, we investigated the impact of incorporating T₁ and/or B₁ maps on PK parameters in breast cancer patients and impact of these PK maps on assessing therapy response in longitudinal data.  DCE-MRI PK parameters in six breast cancer patients was investigated with four different processing schemes comprising combinations of T₁ and B₁ map with DCE and its trend assessed in longitudinal data . We demonstrate that in breast tumor imaging, a DCE protocol incorporating T₁ and B₁ mapping can be more reliable in reflecting tumor heterogeneity and predicting therapy response longitudinally.­­

Edna Furman-Haran¹, Noam Nissan², Hadassa Degani², and Julia Camps Herrero^3
1Department of Biological Services, The Weizmann Institute of Science, Rehovot, Israel, ²Department of Biological Regulation, The Weizmann Institute of Science, Rehovot, Israel, ³Radiology, Hospital de la Ribera, Alzira, Spain

We have evaluated the ability of diffusion tensor imaging (DTI) to assess breast cancer response to neoadjuvant chemotherapy. Changes in lesion size and diffusion parameters in response to therapy were determined. Diameter and volume measurement derived from DTI were compared to those derived from dynamic contrast enhanced (DCE) MRI and to post surgery pathological reports. A high congruence was found between DTI and DCE-MRI for tumor size and response evaluation, with both methods showing a good agreement with pathology results.

Leslie R. Euceda¹, Tonje H. Haukaas^1,2, Guro F. Giskeødegård¹, Riyas Vettukattil¹, Geert Postma³, Laxmi Silwal-Pandit^2,4, Jasper Engel⁵, Lutgarde M.C. Buydens³, Anne-Lise Børresen-Dale^2,4, Olav Engebraaten⁶, and Tone F. Bathen^1,2
1Department of Circulation and Medical Imaging, The Norwegian University of Science and Technology, Trondheim, Norway, ²K.G. Jebsen Center for Breast Cancer Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway, ³Institute for Molecules and Materials, Radboud University Nijmegen, Nijmegen, Netherlands, ⁴Department of Genetics, Institute for Cancer Research, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, Norway, ⁵NERC Biomolecular Analysis Facility Metabolomics Node (NBAF-B), School of Biosciences, University of Birmingham, Birmingham, United Kingdom, ⁶Department of Oncology, Department of Tumor Biology, Oslo University Hospital, Oslo, Norway

This study used HR MAS magnetic resonance based metabolic profiles from breast tumor tissue to explore the metabolic changes occurring as an effect of overall neoadjuvant therapy, discriminate therapy responders from nonresponders, and determine metabolic differences between patients receiving or not receiving the antiangiogenic drug bevacizumab. Changes as an effect of chemotherapy were detected and responders were successfully discriminated from nonresponders after treatment, showing potential for assessment of patient benefit to treatment and the understanding of underlying mechanisms affecting response. Although metabolic differences based on bevacizumab administration were not prominent, glutathione was identified to be possibly affected by the drug.

Erwin Krikken¹, Wybe J.M. van der Kemp¹, Hanneke W.M. van Laarhoven², Dennis W.J. Klomp¹, and Jannie P. Wijnen^1
1Radiology, University Medical Center Utrecht, Utrecht, Netherlands, ²Medical Oncology, Academic Medical Center Amsterdam, Amsterdam, Netherlands

Neoadjuvant chemotherapy plays an important role in the treatment of breast cancer patients. During chemotherapy, the phospholipid metabolism changes which can be measured by ³¹P-MRS at 7 tesla. Eight patients were examined, using the AMESING sequence to receive metabolic signals in the tumor. The ³¹P-MRS data were analyzed on group level, which enables the detection of changes the levels of phospholipid metabolites in an early stage of the treatment, directly after the first cycle of chemotherapy.

Mojtaba Safari¹, Anahita Fathi Kazerooni^1,2, Maryam Babaie³, Mahnaz Nabil⁴, Mahsa Rostamie¹, Parvin Ghavami¹, Morteza Saneie Taheri³, and Hamidreza Saligheh Rad^1,2
1Quantitative MR Imaging and Spectroscopy Group (QMISG), Research Center for Molecular and Cellular Imaging (RCMCI), Tehran University of Medical Sciences, Tehran, Iran, ²Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran, ³Radiology Department, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran, ⁴Department of Mathematics, Islamic Azad University, Qazvin Branch, Qazvin, Iran

Meningioma brain tumors constitute the majority of adult primary brain tumors, in which the role of apparent diffusion coefficient (ADC) is controversial. We hypothesize that analysis of the heterogeneity within a tumorous ecological region can reveal biological tissue properties, which could further assist decision making about the optimum patient-specific treatment strategy. In the present work, we propose an automated computer-aided diagnosis method for phenotyping meningioma brain tumors, based on features representing spatial heterogeneity in ADC-maps, with classification accuracy of 85.1%. In conclusion, it is demonstrated that heterogeneity of meningioma brain tumors can be a potential discriminating biomarker of tumor malignancy.

Ben R Dickie^1,2, Lucy E Kershaw^1,2, Bernadette M Carrington³, Suzanne Bonington³, Susan E Davidson³, Catharine ML West¹, and Chris J Rose^4
1Institute of Cancer Sciences, The University of Manchester, Manchester, United Kingdom, ²Christie Medical Physics and Engineering, Christie NHS Foundation Trust, Manchester, United Kingdom,³Diagnostic Radiology, Christie NHS Foundation Trust, Manchester, United Kingdom, ⁴Centre for Imaging Sciences, The University of Manchester, Manchester, United Kingdom

There is a clinical need for non-invasive imaging biomarkers capable of accurately predicting outcomes in locally advanced cancers. Microvascular heterogeneity measurements obtained from dynamic contrast enhanced-MRI have shown prognostic utility however no attempt has been made to compare the prognostic value of the available methods across disease and identify which type of heterogeneity (statistical or spatial) is important for survival. In this study we identify heterogeneity biomarkers that are universally prognostic across cancers of the cervix, bladder, and head and neck and compare their prognostic value to standard clinicopathologic factors such as disease stage.  

Marlies Christina Hoelzl¹, Marco Fiorito², Ondrej Holub³, Gilbert Fruhwirth⁴, and Ralph Sinkus^1
1Biomedical Engineering, King's College London, London, United Kingdom, ²Imaging Chemistry and Biology, King's College London, London, United Kingdom, ³London, United Kingdom, ⁴Imaging Chemistry and Biology, King's College London, Lodnon, United Kingdom

Major reasons of cancer related deaths are repercussion of the dissemination of cancer cells from the primary tumour site and an outgrowth at the secondary metastatic site. The microenvironment where the cancer cells reside with various signals, are central factors to provide cancer cell spread throughout the body; signals can be (bio)chemical or mechanical nature. Translation of mechanical forces, displacements and deformations into biochemical signals (i.e. mechanotransduction) affects their adhesion, spread and survival. We show here, that focussed shear waves operating at specific frequency and amplitude affects the metastatic behaviour of cancer cells by reducing the invasive behaviour and growth. 

Manijeh Beigi¹, Anahita Fathi Kazerooni¹, Mojtaba Safari², Marzieh Alamolhoda³, Ahmad Ameri⁴, Shiva Moghadam⁵, Mohsen Shojaee Moghadam⁶, and Hamidreza SalighehRad^2
1, Tehran University of Medical Sciences, Quantitative MR Imaging and Spectroscopy Group, Research Center for Cellular and Molecular Imaging, Institute for Advanced Medical Imaging, Tehran, Iran,²Tehran University of Medical Sciences, Quantitative MR Imaging and Spectroscopy Group, Research Center for Cellular and Molecular Imaging, Institute for Advanced Medical Imaging, Tehran, Iran,³Statistics, Shiraz University of Medical Science, Shiraz, Iran, ⁴Jorjani Radiotherapy Center, Shahid Beheshti of Medical Sciense, Tehran, Iran, ⁵Shahid Beheshti University of Medical Science, Tehran, Iran,⁶Payambaran MRI center, Tehran, Iran

Induction chemotherapy is an effective way to control subclinical metastasis in locally-advanced nasopharyngeal cancer patients. Diffusion-weighted MRI is a noninvasive imaging technique allowing some degree of tissue characterization by showing and quantifying molecular diffusion. Histogram analysis on ADC map could be carried out to reveal physiological alterations early after IC.  For this purpose, several quantitative metrics from ADC-map were explored to obtain the most accurate feature(s) as potential predictive biomarker for early response of the lymphnode to IC. If the outcome can be predicted at an early stage of the treatment, the patient could be spared from unnecessary treatment toxicity.  

Heling Zhou¹, James Campbell¹, Zhang Zhang², Debabrata Saha², Rebecca Denney¹, Mary Lynn Trawick³, Kevin G Pinney³, and Ralph P Mason^1
1Radiology, UT Southwestern Medical Center, Dallas, TX, United States, ²Radiation Oncology, UT Southwestern Medical Center, Dallas, TX, United States, ³Chemistry and Biochemistry, Baylor University, Waco, TX, United States

Vascular disrupting agents (VDAs), selectively damage the endothelial cells of tumor blood vessels, inducing ischemia and consequent hypoxia and cell death. We investigated the impact of a novel indole-based VDA (OXi6197) to tumor perfusion and oxygenation using multi-parametric MRI on a lung tumor animal model. DCE MRI showed decreased blood flow after administration of VDA. Oxygen sensitive MRI, BOLD and TOLD, showed progression of hypoxia at 24 hours.  Multimodality imaging provides useful information to evaluate the efficacy of VDA. The findings in this study will be important for dose optimization and potential combination therapy in the future.