| Pelvis & Fetal |
|
Monday 20 April 2009 |
| Room 316A |
14:00-16:00 |
Moderators: |
Nandita de Souza and Patricia Noël |
|
|
| |
|
14:00 |
80. |
Better Understanding Maturation Arrested Men Through
HR-MAS Spectroscopy of Human Testicular Biopsy
Tissue |
|
|
|
Rahwa Berhanu Iman1,
Mark Swanson1, Thomas Walsh2,
David Aaronson2, Shoujun Zhao, Ying Lu,
John Kurhanewicz1
1Radiology, University of California, San
Francisco, San Francisco, CA, USA; 2Urology,
University of California, San Francisco, USA |
|
|
|
1H high resolution magic
angle spinning (HR-MAS) spectroscopy was used to
determine metabolic profiles of normal, maturation
arrested, and azoospermatic human testicular biopsy
tissues. Twenty seven 1H HR-MAS spectra were
acquired and quantified using the electronic
standard ERETIC and the algorithm HR-QUEST.
Phosphocholine (PC), phosphoethanolamine (PE), and
glutamine were found to significantly differentiate
between normal and azoospermatic tissue. This study
further suggests that PC could serve as a specific
in vivo marker for fertility in 1H MRSI
studies of human testes and a model can be used to
predict fertility of maturation arrested men. |
|
|
|
|
|
14:12 |
81. |
31P Chemical Shift Imaging of Testicular Infertility
at 3.0 Tesla |
|
|
|
Jonathan P. Dyke1,2,
Darius A. Paduch3, Joseph Kiper3,
Eric Aronowitz1, Peter N. Schlegel3,
Douglas Ballon1,2
1Citigroup Biomedical Imaging Center, Weill
Cornell Medical College, New York, NY, USA; 2Radiology,
Weill Cornell Medical College, New York, NY, USA;
3Urology, Weill Cornell Medical College,
New York, NY, USA |
|
|
|
31P chemical shift
imaging (CSI) at 3.0 Tesla provided localized
metabolic information in the testes of subjects
presenting with male infertility. Spectroscopic
results were compared with testicular sperm
extraction (TSE) which confirmed the presence of
viable sperm. The PM/β-ATP ratio was decreased in
subjects that lacked viable sperm compared to those
containing viable sperm. This technique may provide
information aiding clinicians in finding regions of
viability in the testes during TSE. Future utility
of 31P spectroscopic imaging may allow non-invasive
serial assessment of testicular function that would
allow for patient specific timing and tailoring of
therapy. |
|
|
|
|
|
14:24 |
82. |
Diffusion Weighted Imaging of Uterine Fibroids:
Predicting Volumetric Response Following Uterine
Artery Embolization |
|
|
|
Kinh Gian Do1,
Stella Kang1, Timothy Clark1,
Elizabeth Hecht1
1Radiology, NYU Medical Center, New York, NY,
USA |
|
|
|
In 8 patients with 21
uterine fibroids, higher apparent diffusion
coefficient of uterine fibroids on pre-procedural
MRI correlate with greater volumetric reduction
following uterine artery embolization. Fibroid
volume reduction did not correlate with fibroid size
or relative enhancement. |
|
|
|
|
|
14:36 |
83. |
Diffusion-Weighted MR Hysterography: Initial
Evaluation and Determination of Optimal Imaging
Timing During the Menstruation Cycle |
|
|
|
Wenche M. Klerkx1,
Taro Takahara2, Qvinny Leemans2,
Thomas C. Kwee2, Peter Luijten2,
Willem P. Mali2
1Gynecology, University Medical Center
Utrecht, Utrecht, Netherlands; 2Radiology,
University Medical Center Utrecht, Utrecht,
Netherlands |
|
|
|
Hysteroscopy, saline
infusion sonohysterography, and
hysterosalpingography are commonly used for the
evaluation of uterine pathologies, but are invasive
and operator-dependant procedures. MRI does not have
these disadvantages, but evaluation of the shape of
the uterine cavity is often difficult using
conventional MRI. MR hysterography, using a
diffusion-weighted sequence based on the concept of
Diffusion weighted Whole body Imaging with
Background body signal Suppression (DWIBS) may be an
excellent alternative. In this study, we introduce
the MR hysterography technique and show that the
best visualization of the uterine cavity can be
obtained in the follicular phase of the menstruation
cycle. |
|
|
|
|
|
14:48 |
84. |
Staging of Ovarian Cancer with Continuously Moving
Table MR Acquisitions: A Comparison to Computed
Tomography |
| |
|
Ute
Ariane Ludwig1, Gregor Pache2,
Tobias Baumann2, Jürgen Hennig1,
Oliver Schäfer2
1Department of Diagnostic Radiology,
Medical Physics, University Hospital Freiburg,
Freiburg, Germany; 2Department of
Diagnostic Radiology, University Hospital Freiburg,
Freiburg, Germany |
|
|
|
Ovarian cancer is one of
the most frequently occurring cancer diseases
amongst women. Currently, whole body staging of
ovarian cancer is performed with Computed Tomography
(CT), but small peritoneal nodules are hardly
detectable using this imaging modality. In this
study a MRI protocol including high resolution
pelvic and Sliding Multi Slice (SMS) imaging with
continuously moving table was investigated for whole
body staging of ovarian cancer and images were
compared to CT. It could be demonstrated that MRI
was superior to CT for staging of local tumor extent
and showed excellent detection of peritoneal or
metastatic spread from ovarian cancer. |
|
|
|
|
|
15:00 |
85. |
The Role of 3 Tesla DWI in Evaluation of Primary and
Metastatic Ovarian Cancer Before and After
Neo-Adjuvant Chemotherapy |
|
|
|
Masako Yano Kataoka1,
Andrew Nicholas Priest1, Martin J. Graves1,
Ilse Joubert1, Robin Crawford2,
Helena Earl3, James Brenton3,4,
Mary A. McLean4, John R. Griffiths4,
David J. Lomas1, Evis Sala1
1Radiology, Addenbrooke's Hospital, University
of Cambridge, Cambridge, UK; 2Obstetrics
& Gynaecology, Addenbrooke's Hospital, University of
Cambridge, Cambridge, UK; 3Oncology,
Addenbrooke's Hospital, University of Cambridge,
Cambridge, UK; 4Cancer Research UK,
Cambridge Research Institute, Cambridge, UK |
|
|
|
We evaluated the ADC
values of primary ovarian, omental and peritoneal
lesions in 16 patients with advanced ovarian cancer
before and after neo-adjuvant chemotherapy. Baseline
ADC values of peritoneal implants were considerably
lower than that of primary ovarian lesions and
significantly lower than those of omental cake. The
primary ovarian tumours tended to have the highest
ADC values which increased significantly after
treatment. Our findings may reflect mixed treatment
response that frequently occurs clinically at
different sites of disease. This may be explained by
variable blood supply and hypoxia which limits
delivery and efficacy of chemotherapy at certain
anatomical sites. |
|
|
|
|
|
15:12 |
86. |
Tumour Necrosis Assessed by Magnetic Resonance
Dynamic Contrast-Enhanced Subtraction Imaging Is a
Predictor of Chemoradiotherapy Response in Advanced
Cervical Cancer |
|
|
|
Lorenzo Mannelli1,
Andrew N. Priest1, Martin J. Graves1,
Ilse Joubert1, Li Tee Tan2,
Robin Crawford3, James Brenton2,4,
David J. Lomas1, Evis Sala1
1Radiology, Addenbrooke's Hospital and
University of Cambridge, Cambridge, UK; 2Oncology,
Addenbrooke's Hospital and University of Cambridge,
Cambridge, UK; 3Obstetrics & Gynaecology,
Addenbrooke's Hospital and University of Cambridge,
Cambridge, UK; 4Cambridge Research
Institute, Cancer Research UK, Cambridge, UK |
|
|
|
Radiotherapy is usually
effective in cervix cancer treatment. Imaging
techniques that can predict treatment outcome would
allow further treatment individualisation. There is
a current lack of standardised and independently
validated analysis of quantitative DCE-MRI
parameters. Subtraction imaging is easy, widely
available and it overcomes protocols variability.
The pre-treatment percentage of non enhancing tumour
was visually assessed in 13 patients using
subtracted images. The tumour volume regression from
pre-treatment to post-treatment was calculated. A
strong correlation (r = -0.821; p < 0.001) was found
between the pre-treatment percentage of
non-enhancing tumour and the percentage of tumour
volume regression. |
| |
|
|
|
15:24 |
87. |
Differentiation Between Malignant and Benign
Cervical Tissue on the Basis of the Apparent
Diffusion Coefficient Is Sensitive and Independent
of the B-Value Combination Used for ADC Calculation. |
| |
|
Jaap Hoogendam1,
Wenche Margrethe Klerkx2, Gerard de Kort1,
Ronald Zweemer1, Willem Mali1,
Wouter Veldhuis1
1University Medical
Center Utrecht; 2Radiology, University
Medical Center Utrecht, Utrecht, Netherlands |
| |
|
In diffusion weighted
imaging a variety of b-value combinations is used to
calculate apparent diffusion coefficients (ADC) for
malignancy discrimination. We scanned 35 patients
with cervical cancer at 3T and investigated three
b-value combinations used in the literature
(b=0,1000 vs 0,150,500,1000 vs 150,500,1000 s/mm2)
for their influence on ADC and the ability to
identify cervical malignancies. Results show a
significantly lower ADC in cervical malignancies
compared to benign cervical tissue. A high
sensitivity and specificity (all over 90%) was found
at all optimal ADC cut-off values, independent of
the b-value combination used to calculate ADC. |
| |
|
|
|
15:36 |
88. |
High Resolution MR Imaging of the Fetal Heart with
Cardiac Triggering: A Feasibility Study in the Sheep
Fetus |
| |
|
Jin Yamamura1,
Bernhard Schnackenburg2, Hendrik Kooijman2,
Michael Frisch1, Gerhard Adam1,
Ulrike Wedegaertner1
1Diagnostic and Interventional Radiology,
University Hospital Hamburg-Eppendorf, Hamburg,
Germany; 2Philips Medical Systems |
|
|
|
Although the fetal MRI
has already been applied to almost all fetal organs,
the evaluation of the fetal heart has been omitted
so far due to technical problems. Usually, cardiac
imaging requires electro-cardiogram (ECG) triggering
and breath holds of the patient during measurements.
Since the fetal heart lies within the uterus, there
is no possibility for a direct triggering of the
fetal heart frequency. The visualization of
anomalies both of the heart and the great vessels is
actually of great importance for prenatal
diagnostics, though not yet feasible. In this here
present study the attempt was to develop a fetal
cardiac MRI by using a fetal sheep model and thus to
improve the image quality of fetal cardiac imaging.
This feasibility study is based on performing fetal
cardiac MR imaging by triggering the fetal heart
beat in utero in a sheep model. |
|
|
|
|
|
15:48 |
89. |
In-Vivo MRI Measurement of Fetal Blood Oxygen
Saturation in Cardiac Ventricles of Fetal Sheep: A
Feasibility Study |
| |
|
Ulrike Wedegärtner1,
Hendrik Kooijman2, Jin Yamamura1,
Michael Frisch1, Kurt Hecher1,
Gerhard Adam1
1University Hospital Hamburg Eppendorf,
Hamburg, Germany; 2Philips Medical
Systems, Germany |
|
|
|
T2-based MR oximetry
might allow the assessment of fetal oxygen
saturation non-invasively which is important for
high risk pregnancies. However, for practical
application of this method to detect fetuses at
risk, measurements have to be more accurate.
Therefore technical difficulties due to the fetal
model have to be improved. |
|
|
|
|
|