Yoshiko Ueno¹, Satoru Takahashi¹, Kazuhiro Kitajima¹, Tokunori Kimura², Ikuo Aoki², Fumi Kawakami³, Hideaki Miyake⁴, Yoshiharu Ohno^1,5, and Kazuro Sugimura^1
1Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan, ²Toshiba Medical Systems, Ohtawara, Tochigi, Japan,³Department of Pathology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan, ⁴Department of Urology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan, ⁵Advanced Biomedical Imaging Research Center, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan

For prostate cancer (PCa) detection, DWI with high b-values over 1000 s/mm² is recently suggested as useful for providing good contrast between cancerous and background tissue, although several limitations were also suggested. In the last decade, computed DWI (cDWI) is proposed as a new technique that produces any b-value images from DWI acquired with at least two different b-values. The aim of our study was therefore to evaluate the ability of cDWI at b=2000 s/mm² (cDWI₂₀₀₀) for PCa detection as compared with actually obtained DWI at b=1000 (mDWI₁₀₀₀) and b=2000 s/mm² (mDWI₂₀₀₀) on a 3T MR system.

Edward M. Lawrence¹, Andrew N. Priest¹, Tristan Barrett¹, Anne Warren², Ferdia A. Gallagher¹, Vincent J. Gnanapragasam³, and Evis Sala^1
1Radiology, Addenbrooke's Hospital, Cambridge, Cambridgeshire, United Kingdom, ²Histopathology, Addenbrooke's Hospital, Cambridge, Cambridgeshire, United Kingdom, ³Urology, Addenbrooke's Hospital, Cambridge, Cambridgeshire, United Kingdom

Diffusional kurtosis imaging (DKI) attempts to more accurately quantify water movement by taking into account the possibility of a non-Gaussian distribution. Research into the potential of DKI in the setting of body MRI has been limited and the purpose of this study was to evaluate the effect of b-values and noise compensation on the evaluation of prostate cancer using DKI. Our results showed that DKI is a robust technique that allows for significant differentiation of cancerous regions, as established by whole-mount pathology, regardless of DKI method or tumor location. The highest relative contrast was gained using a high b-value of 1500 s/mm².

Nelly Tan¹, Daniel J.A. Margolis¹, David Y. Lu², Htwe K. Khin¹, Koroush Beroukhim¹, Robert E. Reiter³, and Steven S. Raman^1
1Radiology, UCLA, Los Angeles, CA, United States, ²Patholgoy, UCLA, Los Angeles, CA, United States, ³Urology, UCLA, Los Angeles, CA, United States

A retrospective study of 251 men who underwent prostate MRI prior to prostatectomy was performed. The addition of ADC and prostate volume to D'Amico risk classification performed better than D'Amico risk classfication alone in predicting high risk disease. Our results suggest that adding MR prostate volume and ADC to D'Amico classification may improve overall identification of high risk cancer.

Josephin Otto¹, Gregor Thörmer¹, Christian Schröder¹, Nikita Garnov¹, Lars-Christian Horn², Minh Hoang Do³, Jens-Uwe Stolzenburg³, Michael Moche¹, Thomas Kahn¹, and Harald Busse^1
1Diagnostic and Interventional Radiology Department, Leipzig University Hospital, Leipzig, Saxony, Germany, ²Institute of Pathology, University of Leipzig, Leipzig, Saxony, Germany, ³Department of Urology, Leipzig University Hospital, Leipzig, Saxony, Germany

Active surveillance is regarded as an option to reduce overtreatment in patients with organ-confined low-risk prostate cancer. Transrectal ultrasound-guided biopsy is currently the only method for disease monitoring but has some disadvantages due to its invasive nature and underestimation of tumor dedifferentiation. Multiparametric MRI, on the other hand, can provide quantitative parameters of tissue function that may help to assess tumor aggressiveness. This work evaluates the predictive value of combined DWI and MR spectroscopic parameters to discriminate indolent from aggressive carcinoma.

Andrew B. Rosenkrantz¹, Christian Geppert², Josef Pfeuffer³, David J. Mossa¹, and Hersh Chandarana^1
1Radiology, NYU Langone Medical Center, New York, New York, United States, ²Siemens Medical Systems, New York, New York, United States, ³Siemens Healthcare, Erlangen, Bavaria, Germany

Six volunteers underwent 3T phased-array coil prostate MRI including DWI performed with both standard EPI and with zoomed EPI incorporating parallel transmission (pTx) and 2D-selective RF pulses. Compared with standard EPI, zoomed EPI showed improved ghosting, wrap artifact, clarity of prostate capsule, and clarity of peri-urethral region on b-1000 images, as well as improved clarity of prostate capsule and overall image quality on the ADC maps. There was a small but significant increase in prostate ADC with zoomed EPI. While zoomed EPI with pTx has potential to improve prostate DWI at 3T, further optimization using smaller FOV remains necessary.

David Karow¹, Nate White¹, Jiaoti Huang², Robert Reiter³, Robert F. Mattrey⁴, Daniel J.A. Margolis⁵, Steve Raman⁵, and Anders M. Dale^6
1Radiology, UCSD, La Jolla, CA, United States, ²Pathology, UCLA, Los Angeles, CA, United States, ³Urology, UCLA, Los Angeles, CA, United States, ⁴Radiology, UCSD, San Diego, CA, United States, ⁵Radiology, UCLA, Los Angeles, CA, United States, ⁶Radiology, University of California, San Diego, La Jolla, CA, United States

Restriction spectrum imaging (RSI) is a sensitive DWI technique for probing separable water diffusion compartments in tissues. Here, we evaluate RSI cellularity maps derived from the spherically-restricted water compartment for improved prostate tumor conspicuity and delineation from non-tumor tissue compared with high b-value ADC. Our data support the MRI-derived RSI cellularity maps as potential non-invasive imaging biomarkers for prostate cancer.

Timur H. Kuru^1,2, Matthias Roethke¹, Heinz-Peter Schlemmer¹, Bram Stieltjes¹, and Michael Fenchel^1
1Department of Radiology, German Cancer Research Center (DKFZ), Heidelberg, BW, Germany, ²Department of Urology, UniversityHospital Heidelberg, Heidelberg, BW, Germany

In recent years, several studies examined the perfusion fraction (f) as well as diffusion coefficients (D) from intravoxel incoherent motion data (IVIM) in patients with prostate cancer (PCa). A multiparametric MR protocol was performed. For quantification of f and D, two distinct curve fitting algorithms were employed. Extracting IVIM parameters in unequivocal tumor regions and normal contralateral parenchyma revealed high variation in perfusion-fractions (f) for both fitting algorithms, probably due to both histological heterogeneity of underlying PCa and potential instability of the fit. In contrast, diffusion coefficient (D) was able to reliably distinguish cancerous from healthy tissue in our cohort.

Ben Babourina-Brooks^1,2, Ian Brereton², and Gary Cowin^2
1School of Cancer Sciences, University of Birmingham, Birmingham, West Midlands, United Kingdom, ²Centre for Advanced Imaging, University of Queensland, Brisbane, Queensland, Australia

DWI has been used to differentiate tumour and healthy tissue in the prostate based on ADC values, however the variation in the value is large enough to have significant overlap of healthy and tumour tissue. EPI is generally used for DWI but has inherent artefacts in imaging due to magnetic susceptibility, chemical shift and phase error. A spin echo based sequence may reduce these errors and produce a more accurate ADC value. In this study we compared HASTE to EPI in tumour detection accuracy. HASTE accuracy results were higher than EPI at the cost of scan time.

Amita Shukla-Dave¹, Cecilia Wassberg², Darko Pucar³, Heiko Schoder¹, Debra Goldman¹, Victor E. Reuter¹, James Eastham¹, Peter T. Scardino¹, Steve M. Larson¹, and Hedvig Hricak^1
1Memorial Sloan-Kettering Cancer Center, New York, New York, United States, ²Uppsala University Hospital, Uppsala, Uppsala, Sweden, ³Georgia Health Sciences University, Augusta, GA, United States

Although metabolic imaging is frequently performed in cancer patients, the underlying genomic and biochemical mechanisms and the consequent imaging findings remain poorly understood. The purpose of this study was to evaluate citrate metabolism and glucose consumption in prostate cancer (PCa) using 1H-MRSI and 18F-FDG PET. Whole mount step section pathology was used as the standard of reference. Clinical, 1H-MRSI, 18F-FDG PET data were examined in 22 patients. 1H-MRSI was better able to detect index tumors in 21 patients while 18F-FDG PET detected tumor in 3 patients. Thus, we suggest that altered citrate metabolism precedes increased glucose consumption in PCa.

Maysam Jafar¹, Rosalind Eeles², Sharon L. Giles³, Elizabeth Bancroft², Elena Castro², Veronica A. Morgan³, Catherine J. Simpkin³, and Nandita M. deSouza^4
1Cancer Research UK and EPSRC Cancer Imaging Centre, Institute of Cancer Research, Sutton, Surrey, United Kingdom, ²Genetics & Epidemiology, Institute of Cancer Research, Sutton, Surrey, United Kingdom, ³Cancer Research UK and EPSRC Cancer Imaging Centre, Royal Marsden NHS Foundation Trust, Sutton, Surrey, United Kingdom, ⁴Cancer Research UK and EPSRC Cancer Imaging Centre, Institute of Cancer Research & Royal Marsden NHS Foundation Trust, Sutton, Surrey, United Kingdom

Risk of prostate cancer in first-degree relatives is twice that of the general population; 53 single nucleotide polymorphisms (SNPs) have been associated with clinically significant disease in young patients. Diffusion-weighted combined with T2W MRI is sensitive for detecting small prostate tumours. This study prospectively investigates the relationship between histogram parametrics of the apparent diffusion coefficient (centiles, skew, kurtosis) and risk score (derived from 24 SNPs) and showed no correlation in a preliminary analysis. Inclusion of a larger number of SNPs to generate risk score is planned, as the current data fielded a score of <1 in 55% of the cohort.

Yousef Mazaheri¹, Alberto Vargas², Gregory Nyman², Amita Shukla-Dave¹, Oguz Akin², and Hedvig Hricak^2
1Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY, United States, ²Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY, United States

To compare ADC values measured from diffusion-weighted MR (DW-MR) images of the prostate obtained with both endorectal and phased-array coils (ERC+PAC) to those from DW-MRI images obtained with an eight-channel torso phased-array coil (PAC) at 3 Tesla.

Maysam Jafar¹, Veronica A. Morgan², Sharon L. Giles², Catherine J. Simpkin², Rosalind Eeles³, Elizabeth Bancroft³, Elena Castro³, and Nandita M. deSouza^4
1Cancer Research UK and EPSRC Cancer Imaging Centre, Institute of Cancer Research, Sutton, Surrey, United Kingdom, ²Cancer Research UK and EPSRC Cancer Imaging Centre, Royal Marsden NHS Foundation Trust, Sutton, Surrey, United Kingdom, ³Genetics & Epidemiology, Institute of Cancer Research, Sutton, Surrey, United Kingdom, ⁴Cancer Research UK and EPSRC Cancer Imaging Centre, Institute of Cancer Research & Royal Marsden NHS Foundation Trust, Sutton, Surrey, United Kingdom

Diffusion-weighted MRI has increased sensitivity for detecting small prostate cancers when used in conjunction with T2W imaging. This prospective study examines its sensitivity and specificity for detecting tumors in patients with a high-risk (significant family history) of prostate cancer using either qualitative (observer assessed) or quantitative (histogram) analysis. Qualitative analysis had a 77% sensitivity 92% specificity for tumor detection on a per patient basis; ROC curves of 10th and 25th centiles derived from histogram analyses indicated that for a specificity of 90%, sensitivity of these centiles was <25% for detecting tumor in central gland and peripheral zone of the prostate.

Ivan Jambor^1,2, Jukka Järvinen^1,3, Hannu J. Aronen^1,3, Jani Saunavaara³, Harri Merisaari⁴, Tommi Kauko⁵, Ronald Borra^1,3, and Marko Pesola^1,3
1Department of Diagnostic Radiology, University of Turku, Turku, Finland, ²2nd Department of Radiology, Comenius University and St. Elisabeth Oncology Institute, Bratislava, Slovakia, ³Medical Imaging Centre of Southwest Finland, Turku University Hospital, Turku, Finland, ⁴Turku PET centre, University of Turku, Turku, Finland, ⁵Department of Biostatistics, University of Turku, Turku, Finland

The optimal b-value distribution for biexponential DWI of normal prostate was determined using using Monte-Carlo simulations and in-vivo measurements. Eight healthy volunteers underwent four repeated 3T prostate DWI scans using both 16 equally distributed b-values and an optimized b-value distribution obtained from the simulations. The b-value distributions were compared in terms of measurement reliability and repeatability using Shrout-Fleiss analysis. The optimal b-value distribution was found to be a clustered distribution with b-values concentrated in the low, mid and high ranges and was shown to improve the estimation quality of biexponential DWI parameters of in-vivo experiments.

Harald Busse¹, Josephin Otto¹, Gregor Thörmer¹, Nikita Garnov¹, Lars-Christian Horn², Martin Reiss-Zimmermann¹, Thomas Kahn¹, and Michael Moche^1
1Diagnostic and Interventional Radiology Department, Leipzig University Hospital, Leipzig, Saxony, Germany, ²Institute of Pathology, University of Leipzig, Leipzig, Saxony, Germany

Diffusion-weighted imaging has potential roles in the management of prostate cancer and apparent diffusion coefficients (ADC) could potentially distinguish aggressive from indolent carcinoma. Wider validation, however, will rely on robust quantitative diffusion parameters. This work demonstrates intraindividually that the additional use of an endorectal coil and different b-value data introduce highly significant differences in the absolute ADC values in both tumor and mirror healthy tissue regions. Differences in the ratio of tumor over healthy tissue ADC averages were not significant and make normalized ADC a more robust parameter for the quantification of diffusion abnormalities in the prostate.

Wenchao Cai¹, Feiyu Li¹, Jintang Ye¹, Queenie Chan², Xiaoying Wang¹, and Xuexiang Jiang^1
1Department of Radiology, Peking University First Hospital, Beijing, Beijing, China, ²Philips Healthcare, Hong Kong, China

Intravoxel incoherent motion (IVIM) MR imaging is a non-invasive method with the ability of separation of ¡°pure¡± molecular diffusion and perfusion effects. Chronic prostatitis mainly contributes low diagnostic specificity of prostate cancer detection in the peripheral zone (PZ). In this study we assess diffusion/perfusion IVIM features in histologically confirmed chronic prostatitis, prostate cancer and normal prostate PZ and compare with conventional DWI using biexponential and monoexponential model respectively. Chronic prostatitis demonstrated significantly higher diffusion characteristics than prostate cancer, while obviously higher perfusion and lower diffusion property than normal PZ detecting via IVIM analysis. IVIM may be of great potential in the better detection of prostate cancer.

Alexander Raaijmakers¹, Ingmar Voogt¹, Dennis W. J. Klomp¹, Peter R. Luijten¹, and Nico van den Berg^1
1Imaging Division, UMC Utrecht, Utrecht, Netherlands

Prostate imaging at 7 Tesla requires advanced coil array elements that are designed according to radiative principles. The single-side adapted dipole antenna (SiSiAD) is one example of such a radiative element. Another example is the fractionated dipole antenna. It is a highly innovative segmented antenna that has demonstrated the same performance as the SiSiAD while not using the heavy and costly ceramic. Four of these elements were combined with four SiSiADs for prostate imaging. Simulations and measurements show that this setup is able to reach the same B₁⁺ efficiency in the prostate with at least 33% lower SAR levels.

Xiufeng Li¹ and Gregory J. Metzger^1
1Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, United States

Previous prostate ASL perfusion imaging exhibited large inter-subject variability in measured perfusion and arterial transit times (ATT) because of the inability of FAIR to accommodate the complicated, subject dependent architecture of vessels feeding the prostate. FAIR is sensitive to ATT differences between normal and diseased conditions and ATT changes, and also adversely prolongs ATT due to the specific characteristics of vascular geometry around the prostate. VS-ASL labels blood flowing above a specified cutoff velocity, possessing the potential to overcome these limitations. For the first time, VS-ASL imaging method has been applied outside of the brain and in the prostate.

Miriam W. Lagemaat¹, Eline K. Vos¹, Marnix C. Maas¹, Thiele Kobus¹, Andreas K. Bitz^2,3, Mark J. van Uden¹, Stephan Orzada^2,3, Arend Heerschap¹, and Tom W.J. Scheenen^1,2
1Radiology, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands, ²Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany,³Diagnostic and Interventional Radiology, University Hospital Essen, Essen, Germany

The potential of ³¹P MRSI to detect prostate cancer in vivo at 7T was investigated in 12 patients with or suspected of having prostate cancer. The metabolites ratios PE/γATP, PE/tPLM and Pi/yATP showed significant difference between prostate cancer and normal prostate tissue. The performance of ³¹P MRSI to detect prostate cancer may improve further by increases in spatial resolution.

Feiyu Li¹, Wenchao Cai¹, Jing Wang², Jue Zhang^2,3, Xiaoying Wang^1,2, and Xuexiang Jiang^1
1Department of Radiology, Peking University First Hospital, Beijing, Beijing, China, ²Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, Beijing, China, ³College of Engineering, Peking University, Beijing, Beijing, China

To explore the correlation between angiogenesis and incidence of metastasis in prostate cancer using Arterial Spin-labeling (ASL) MR Imaging

Sharon Clarke¹, Bruce Daniel², Jesse McKenney³, Manojkumar Saranathan², Brian Andrew Hargreaves², James Brooks⁴, Harachan Gill⁴, Mark Gonzalgo⁴, Benjamin Chung⁴, Emine U. Saritas⁵, Ajit Shankaranarayanan⁶, and Graham Sommer^2
1Diagnostic Radiology, Dalhousie University, Halifax, Nova Scotia, Canada, ²Diagnostic Radiology, Stanford University, Stanford, California, United States,³Anatomic Pathology, Cleveland Clinic, Cleveland, Ohio, United States, ⁴Urology, Stanford University, Stanford, California, United States, ⁵Bioengineering, University of California Berkeley, Berkeley, California, United States, ⁶GE Healthcare, Menlo Park, California, United States

Segmentation of multi-parametric MR images of the prostate gland using a maximum likelihood classification algorithm correlate well with histopathology. These results show promise for identification of clinically relevant prostate cancer for either MR-guided biopsy or focal therapy.

Daniel J.A. Margolis¹, Edward Chang², Frederick Dorey³, Jiaoti Huang⁴, Maria Luz Macairan², Shyam Natarajan⁵, Steven Raman¹, Geoff Sonn², and Leonard Marks^2
1Radiological Sciences, UCLA David Geffen School of Medicine, Los Angeles, CA, United States, ²Urology, UCLA David Geffen School of Medicine, Los Angeles, CA, United States, ³Department of Pediatrics, USC Keck School of Medicine, Los Angeles, CA, United States, ⁴Pathology, UCLA David Geffen School of Medicine, Los Angeles, CA, United States, ⁵Bioengineering, UCLA David Geffen School of Medicine, Los Angeles, CA, United States

The components of multiparametric MRI, including overall suspicion, are evaluated as predictors of the presence of any cancer and significant (Gleason pattern 4) cancer in MRI-ultrasound fusion targeted biopsies. Clinical parameters and standardized scoring of T2 appearance, dynamic contrast enhancement, and overall suspicion on a 1-5 ranked scale after published recommendations, and the quantitative apparent diffusion coefficient (ADC), were compared with the highest Gleason score in biopsy targets. All parameters were predictive of any cancer and, especially, significant cancer, with almost no significant cancer in low (score 1-2) suspicion targets. All except ADC could significantly discriminate Gleason grades in targets.

Wenchao Cai¹, Feiyu Li¹, Jing Wang², Huarui Du², Jue Zhang^2,3, Xiaoying Wang^1,3, and Xuexiang Jiang^1
1Department of Radiology, Peking University First Hospital, Beijing, Beijing, China, ²Peking University, Department of Biomedical Engineering, Beijing, Beijing, China, ³Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, Beijing, China

Pulsed arterial spin labeling (PASL) MRI is a non-invasive imaging tool capable of quantitatively measuring the microvascular perfusion characteristics of tissue through tagging arterial water to obtain the blood flow (BF) map. Angiogenesis plays a vital role in the metastatic process of prostate cancer, and bone metastasis lesion is hypervascular certificated by dynamic contrast-enhanced (DCE) MRI and histopathologic findings. We applied the PASL technique to detect bone metastasis from prostate cancer and to compare the differences BF values between the metastatic lesions and normal bone in the pelvis. The mean BFs determined by ASL MRI with different TI in the bone metastasis from prostate cancer were significantly higher than those in noncancerous bone regions (P<0.05, Paired T-test) Significant positive correlations between BF value and Ktrans, Kep were observed in all four TI , respectively. ASL is a new non-invasive imaging method with potency in detecting and monitoring therapy efficacy of bone metastasis from prostate cancer.

Alan Wright¹, Thiele Kobus¹, and Arend Heerschap^1
1Radboud University Nijmegen Medical Centre, Nijmegen, Gelderland, Netherlands

Probability maps were generated that determine the likelihood of tumour at each spatial location within the prostate based on 3D ¹H-MRSI data sets. Each spectrum was fitted with LCModel using a basis set of two model spectra, one for benign and one for tumour tissue. These basis spectra were generated by independent component analysis as the first-two stable components of a data set of 2360 spectra from 42 patients. The probability score separated tumour from benign spectra better than conventional metabolite maps (AUC: 0.782, 0.721 respectively) in this data set and successfully localised significant tumour foci in five new test patients.

Georgia Tsoumakidou¹, Herve Lang², Julien Garnon¹, Elodie Breton³, Eva Rothgang⁴, and Afshin Gangi^1,3
1Interventional Radiology, University Hospital of Strasbourg, Strasbourg, Alsace, France, ²Urology, University Hospital of Strasbourg, Strasbourg, Alsace, France, ³CNRS, ICube Strasbourg University, Strasbourg, Alsace, France, ⁴Siemens Corporation, Center for Applied Medical Imaging, Strasbourg, Alsace, France

We herein report our initial experience and technical feasibility of transperineal prostate cryoablation under MRI. Percutaneous MR-guided cryoablation was performed in 11 patients with prostatic adenocarcinoma. Real time interactive, multi-slice TrueFISP sequence BEAT_IRTTT was used for the transperineal probe positioning. Real time and high resolution T2 Blade sequences were used for ice ball monitoring. Prostate cryoablation was technically feasible in 10 out of 11 patients.The ice-ball was clearly visualized in all cases as a signal-void area in both real time and high-resolution T2-Blade sequences.

Seung Hong Choi^1
1Radiology, Seoul National University, Seoul, Select, Korea

This study is the first to demonstrate that 5-aminolevulinic acid (ALA) administration increases the intracellular iron concentration of glioblastomas by promoting the synthesis of heme, which is the metabolite of 5-ALA. As intracellular iron can be detected by MRI, we believe that 5-ALA-enhanced MRI will aid in the identification of high-grade foci in gliomas.

Daniel Coman¹, Yuegao Huang¹, Henk M. De Feyter¹, Douglas L. Rothman^1,2, and Fahmeed Hyder^1,2
1Diagnostic Radiology, Yale University, New Haven, CT, United States, ²Biomedical Engineering, Yale University, New Haven, CT, United States

Development of MRI contrast agents has provided outstanding ability to identify diseased tissue, while MRS has unlocked new windows into molecular bases of diseases. But no magnetic resonance technology exists that can extract quantitative molecular information from a contrasted region. Beyond the gray scale distinction of an affected tissue targeted by an MRI contrast agent we cannot assess the state of the affected tissue because MR signals are compromised by the presence of contrast agents. In this present work we show that TmDOTP^5- can be used as dual contrast agent for tumor detection and molecular MR reporting of cellular status.

Victor D. Schepkin¹, Thomas Morgan², Shannon Gower-Winter², Petr L. Gor'kov¹, William W. Brey¹, and Cathy W. Levenson^2
1National High Magnetic Field Lab/FSU, Tallahassee, Florida, United States, ²College of Medicine, FSU, Tallahassee, Florida, United States

Tumor progression, especially after therapeutic intervention, increases tumor resistance to therapies; consequently, it requires a much higher concentration of a chemotherapeutic drug to achieve the same response, otherwise success may not be feasible. In gliomas sodium concentration and diffusion are usually higher than normal brian and its variations demonstrate an attractive correlation with glioma drug resistance. The hypothesis is that the increased tumor resistance is determined by a more efficient energy metabolism which can be detected by the corresponding decrease of glioma sodium concentration or even diffusion; thus, MRI can noninvasively reveal emerging tumor drug resistance before therapy.

Yohan van de Looij^1,2, Audrey Bouchet^3,4, Benoit Pouyatos³, Luc Renaud⁵, Elke Bräuer-Krisch⁴, Géraldine Le Duc⁴, Jean A. Laissue⁶, and Raphaël Serduc^3
1Division of Child Growth & Development, University of Geneva, Geneva, Switzerland, ²Laboratory for Functional and Metabolic Imaging, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland, ³Grenoble Institut des Neurosciences UMR836, Université Joseph Fourier, Grenoble, France, ⁴European Synchrotron Radiation Facility, Grenoble, France, ⁵Centre de Recherche Cerveau et Cognition, Université de Toulouse, Toulouse, France, ⁶Institute of Pathology, University of Bern, Bern, Switzerland

Microbeam Radiation Therapy (MRT) is a preclinical form of radiosurgery dedicated to brain tumor treatment. It uses micrometer-wide synchrotron-generated X-ray beams on the basis of spatial beam fractionation. Rat brain external capsule was damaged using MRT at different radiation deposition doses and assessed by DTI and fiber tractography. This study shows the excellent ability of DTI to classify the degree of injury of diverse lesions by DTI derived parameters and 3D representation of the WM fibers in the injury. The severity of the damage matches very well with DTI and FT results.

Feriel Tiar¹, Teodora-Adriana Perles-Barbacaru¹, Michelle El-atifi¹, Didier Wion¹, Laurent Pelletier¹, Hana Lahrech¹, and Francois Berger^1
1INSERM U 836, Grenoble Institute of Neurosciences, La Tronche, France

A new orthotopic mouse model derived from human glioblastoma spheres was recently developed. Tumor growth kinetics and response to temozolomide treatment was assessed by MRI. Similar to clinically encountered glioblastomas, this model develops over several months, has an infiltrating growth pattern, mimics their cellular heterogeneity and presents a temozolomide failure. It will therefore be useful for the preclinical evaluation of new treatment strategies.

Ellen Ackerstaff¹, Natalia Kruchevsky¹, Radka Stoyanova², Sean D. Carlin¹, Nerissa Viola-Villegas¹, Kuntalkumar Sevak¹, Jason S. Lewis¹, and Jason A. Koutcher^1
1Memorial Sloan Kettering Cancer Center, New York, NY, United States, ²Miller School of Medicine University of Miami, Miami, FL, United States

Tumor hypoxia and pH have been related to tumor aggressiveness, treatment response, and outcome. Here, we evaluated tumoral pH, metabolism, and vascularity in human prostate cancer models using ¹H-decoupled ³¹P MR spectroscopy and dynamic contrast-enhanced MR imaging (DCE-MRI). Tumoral, extracellular pH (pHe) was measured using 3-aminopropylphosphonate (3-APP), while spatial heterogeneity of tumor hypoxia was evaluated from DCE-MRI data using a novel pattern recognition approach. In tumors without extensive necrosis, pHe appears to be only slightly acidic and tied to the extent of tumoral hypoxia, as determined from vascularity.

Ergys Subashi^1,2, Everett J. Moding³, James R. MacFall^4,5, David G. Kirsch³, Yi Qi^2,5, and G. Allan Johnson^2,5
1Medical Physics Graduate Program, Duke University Medical Center, Durham, NC, United States, ²Center for In-Vivo Microscopy, Duke University Medical Center, Durham, NC, United States, ³Department of Pharmacology and Cancer Biology, Duke University Medical Center, Durham, NC, United States,⁴Department of Biomedical Engineering, Duke University Medical Center, Durham, NC, United States, ⁵Department of Radiology, Duke University Medical Center, Durham, NC, United States

The histogram or mean value of the pharmacokinetic parameters derived from dynamic contrast-enhanced MRI is usually obtained from a manual ROI or from the entire tumor volume. These metrics include tumor regions in which the interpretation of the kinetic parameters is unclear (such as in necrotic areas). In five separate tumor cell lines, we have found that the histogram of the time-to-peak (TTP) parameter can be used to identify tumor sub-volumes with similar enhancement properties. Preliminary results show that the magnitude of response to therapy may be heterogeneous across these sub-regions.

Rocío Pérez-Carro¹ and Pilar López-Larrubia^1
1Instituto de Investigaciones Biomédicas, CSIC-UAM, Madrid, Madrid, Spain

Cerebral perfusion assessment by DSC-MRI has become a frequently used tool for evaluation of numerous neuropathologies. The technique is based on the intravenous injection of contrast agent and subsequent bolus tracking using a fast susceptibility-weighted imaging sequence. In this work we to assess the brain perfusion in a glioma rat model by using this technique and four contrast media with different relaxation and plasma half-life properties: a Gd-based T1 agent, a Dy-based T2, and two iron-oxide nanoparticles to enhance T2*-contrast. We show that that Dy chelates provide the best signal to noise ratio and the higher values for hemodynamic parameters.

Isabelle Iltis¹, Jeunghwan Choi², Manda Vollmers¹, Mithun Shenoi², John Bischof², and Gregory J. Metzger^1
1Radiology, Center for Magnetic Resonance Research - University of Minnesota, Minneapolis, Minnesota, United States, ²Department of Mechanical Engineering, Bioheat and Mass Transfer Laboratory - University of Minnesota, Minneapolis, Minnesota, United States

Pre-treatment of tumors using TNF-  based nanoparticles is a promising approach to improve the outcome of “conventional” (e.g., radiation therapy, chemotherapy, thermal therapies) treatment. The intravenous injection of nanoparticles leads to a set of physiological events specifically in the tumor (such as decreased local perfusion and increased interstitial space) known as preconditioning. To be used in clinical routine, methods for measuring pre-conditioning in vivo are highly desirable. In this work, we show in a mouse model of prostate cancer that DCE-MRI, as used routinely in patients, is an excellent candidate to assess the effects of preconditioning in vivo.

Sudath Hapuarachchige^1,2, Yoshinori Kato^1,3, and Dmitri Artemov^1,3
1Division of Cancer Imaging Research, Russell H. Morgan Department of Radiology and Radiological Sc., The Johns Hopkins University School of Medicine, Baltimore, MD, United States, ²In vivo Cellular Molecular Imaging Program, The Johns Hopkins University School of Medicine, Baltimore, MD, United States,³Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine, Baltimore, MD, United States

We have demonstrated that oscillating gradients of magnetic field induce significant damage to cells labeled with magnetic nanoparticles, such as superparamagnetic iron oxide (SPIO), in the presence of saturating static magnetic field. Specific labeling of cells with iron oxide can be achieved either by internalization of nanoparticles using standard cell transfection reagents and techniques or by modifying the cell surface with targeted magnetic nanoparticles. This novel treatment procedure, called GIFT (gradient-induced Fe therapy), can be implemented on a standard MRI system that makes the technology applicable for clinical use.

Subramaniam Sukumar¹, Robert A. Bok², Daniel B. Vigneron³, Pankaj Seth⁴, and John Kurhanewicz^1
1Radiology and Biomedical Imaging, UCSF, San Francisco, California, United States, ²Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, United States, ³Radiology and Biomedical imaging, UCSF, San Francisco, California, United States, ⁴Medicine, Beth Israel Deaconess Med Center, Boston, MA, United States

Lactate Dehydrogenase expression and activity is up-regulated in various malignancies, including prostate cancer. In a recently developed transgenic mouse model, in which the LDH-A gene is deleted selectively in a temporal fashion, hyperpolarized 13C frequency specific MRI method was used to monitor early changes in LDH-A expression within prostate tumor tissue.

Gaurav Verma¹, Manoj Kumar¹, Sona Saksena², Ranjit Ittyerah², Anatoliy V. Popov², Jenny Li³, M. Albert Thomas³, Edward James Delikatny², and Harish Poptani^1
1Department of Radiology and Radiation Oncology, University of Pennsylvania, Philadelphia, PA, United States, ²Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States, ³Department of Radiological Sciences, University of California Los Angeles, Los Angeles, CA, United States

The treatment response of rat gliomas to a choline-kinase inhibitor, MN58b, was quantified using a 2D localized correlated spectroscopy (L-COSY) sequence in a 9.4T horizontal bore scanner. In vivo 2D spectra from six normal brains, five untreated tumors and three treated tumors, showed uniquely resolvable peaks of several metabolites including phosphocholine (PC) and glycerophosphocholine (GPC). The PC/GPC ratio was found to be elevated in tumor compared to normal rat brain (1.04 vs. 0.88), and then found to decrease to an average of 0.86 following treatment with MN58b.

Chen-Hao Wu^1,2, Chuan-Han Chen¹, Yi-Ying Wu¹, Jyh-Wen Chai³, Clayton Chi-Cheng Chen³, Chung-Ming Chen², and Wen-Yih Isaac Tseng^2,4
1Department of Radiology, Taichung Veterans General Hospital, Taichung, Taiwan, ²Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan, ³Taichung Veterans General Hospital, Taichung, Taiwan, ⁴Center for Optoelectronic Biomedicine, National Taiwan University College of Medicine, Taipei, Taiwan

Early assessment of metastatic brain tumor response to radiotherapy is vital for treatment optimization for the individual cancer patient. The purpose of this study was to assess the performance of DCE, a novel MRI protocol for apoptosis, as a tool for the early detection of response of brain metastases to radiation therapy.

Philippe Garteiser¹, Mouniya Mebarki¹, Sabrina Doblas¹, Simon Auguste Lambert¹, Valérie Vilgrain², Bernard E. Van Beers², Valerie Paradis³, and Ralph Sinkus^1
1U773-CRB3, INSERM, Universite Sorbonne Paris-Cite, Paris, 75018, France, ²Service de Radiologie, AP-HP Hopital Beaujon, Clichy, 92110, France, ³Service d'Anatomo-Pathologie, AP-HP Hopital Beaujon, Clichy, 92110, France

Cells are able to sense their mechanical environment and to respond to it via appropriate cellular responses mediated via mechanotransduction. In particular, many cell types can regulate their levels of apoptosis, or programmed cell death, depending on which mechanical stimuli they receive. In the present communication, we show that calibrated levels of oscillatory shear strain, as measured by MR elastography, is sufficient to induce cellular death via apoptosis in the human colon cancer metastasis cell line, DHDK12.

Yeun-Chung Chang¹, Ang Yuan², Chia-Hsien Cheng³, Yi Fang Chen⁴, Yi-Chien Lu¹, Kua-Hung Cho⁵, and Jyh-Horng Chen^6
1Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan, Taiwan, ²Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan, Taiwan, ³Department of oncology, National Taiwan University, Taipei, Taiwan, Taiwan, ⁴Institute of Clinical Dentistry, National Taiwan University, Taipei, Taiwan, Taiwan, ⁵Instrumentation Resource Center, National Yang-Ming University, Taipei, Taiwan, Taiwan, ⁶National Taiwan University, National Taiwan University, Taipei, Taiwan, Taiwan

Combination of both DCE-MRI and DW-MRI provides more comprehensive understanding of change of internal tumor composition. Many preclinical studies have indicated that the addition of various types of antiangiogenic or antivascular therapy to single-dose or fractionated radiotherapy can synergistically improve the response of human and murine tumors to treatment.

Yi Mao¹, Rui xia¹, Lei Wang¹, yuqing wang¹, and Fabao Gao^1
1Department of Radiology, West China Hospital, Sichuan University, chengdu, sichuan, China

Metformin: A Therapeutic Opportunity in Breast Cancer? Metformin in Cancer Therapy: A New Perspective for an Old Antidiabetic Drug? But there is few creditable studies have assessed the in vivo effects of metformin in cancer. We assessed the usefulness of diffusion-weighted imaging (DWI) and bioluminescence imaging (BLI) in evaluating tumor response to metformin.

He N. Xu¹, Stephen J. Kadlececk¹, Harrilla Profka¹, Ben Pullinger¹, Jerry D. Glickson¹, Rahim Rizi¹, and Lin Z. Li^1
1University of Pennsylvania, Philadelphia, PA, United States

Increased glycolysis resulting in higher lactate production (the Warburg effect) has been demonstrated in tumor tissues in numerous studies including some that employed hyperpolarized 13C-NMR. High levels of hyperpolarized lactate were correlated with high tumor grades. In this study we aim to investigate if the difference in levels of hyperpolarized lactate reflects differences in tumor growth rate or tumor metastatic risk. We examined two breast tumor mouse models, the less metastatic but faster growing (MCF-7) and the more metastatic but slower growing (MDA-MB-231) tumors and quantitatively compared their metabolism using the hyperpolarized 13C-1-pyruvate NMR technique.

Mithun Kailavasan¹, Steven Reynolds¹, Adriana Bucur¹, Samira Kazan², Tooba Alizadeh², Gillian M. Tozer², Ishtiaq Rehman³, and Martyn Paley^1
1Academic Radiology, University of Sheffield, Sheffield, Yorkshire, United Kingdom, ²Oncology, University of Sheffield, Sheffield, Yorkshire, United Kingdom,³Human Metabolism, University of Sheffield, Sheffield, Yorkshire, United Kingdom

Prostate cancer cells with varying metastatic potential (LNCaP and LNCaP-LN3) were cultured in a customized cell bioreactor system, adapted for a 9.4T Nuclear Magnetic Resonance (NMR) probe, which allowed extended cell survival. Several metabolite levels were continuously measured over time, including lactate, fatty acid, alanine, choline, glutamine and creatine, both with and without the addition of a pyruvate dehydrogenase kinase inhibitor, dichloroacetate (DCA). Zymography was used to assess LDH isoenzymes. Rat p22 sarcoma cells were used as a control. Zymography assays (n=4), showed an absence of the LDH-B subunit in both LNCaP-LN3 and rat p22 cell lines. LNCaP-LN3 and rat p22 cells had a 18600µmol/108 cells (p<0.001) and 6600µmol/108 cells (p=0.039) median difference, respectively, in lactate levels compared to LNCaP. Median Cho/Cr ratios at 1hr decreased following DCA treatment in LNCaP and LNCAP-LN3 (p<0.001). Creatine levels increased over time in all 3 cell lines by showing efficiency of the bioreactor design.

Dania Daye^1,2, Suzanne Wehrli³, Chris Sterner^2,4, Tien-Chi Pan^2,4, Mitchell D. Schnall⁵, and Lewis A. Chodosh^2,4
1Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, United States, ²Abramson Family Cancer Research Institute, University of Pennsylvania, Philadelphia, PA, United States, ³NMR Core Facility, Children's Hospital of Philadelphia, Philadelphia, PA, United States, ⁴Department of Cancer Biology, University of Pennsylvania, Philadelphia, PA, United States, ⁵Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, United States

Among women with breast cancer, tumor recurrence represents the principal cause of mortality. Nevertheless, little is known about the molecular mechanisms underlying how breast cancer recurs. In particular, while dysregulated metabolism has long been recognized as a key feature of cancer development, the metabolic changes accompanying cancer recurrence are largely unexplored. Increased serine biosynthesis has been recently found to be important in tumorigenesis. Yet, no association has been established between this metabolic pathway and cancer progression. In this study, we investigate the differences in serine metabolism between primary and recurrent mammary tumors and assess their role as potential prognostic markers.

Kayvan R. Keshari¹, Renuka Sriram¹, Mark Van Criekinge¹, David M. Wilson¹, Zhen J. Wang¹, Daniel B. Vigneron¹, Donna M. Peehl², and John Kurhanewicz^1
1Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, United States, ²Stanford University, Stanford, CA, United States

The treatment of prostate cancer has been impeded by both the lack of clinically relevant disease models and biomarkers that track tumor progression. Hyperpolarized 13C MR has been developed to address these concerns, and safety of 13C pyruvate was confirmed in a recent clinical trial. The present study provides the first validation of HP lactate as a prostate cancer biomarker in human tissues, critical for the interpretation of in vivo studies. A prostate tissue slice culture model that recapitulates the metabolic profile of prostate cancer in vivo was developed, applied to a perfused cell (bioreactor) platform.

G. Sharma¹, Rama Jayasundar¹, T. Velpandian², R. Singh³, S. S. Chauhan³, V. Kapoor⁴, and S. N. Das^4
1NMR, All India Institute of Medical Sciences, New Delhi, India, ²Ocular Pharmacology & Pharmacy, All India Institute of Medical Sciences, New Delhi, India,³Biochemistry, All India Institute of Medical Sciences, New Delhi, India, ⁴Biotechnology, All India Institute of Medical Sciences, New Delhi, India

The study has used NMR metabolomics to profile drug response of Hep-G2 tumor cells to treatment by chemotherapeutic drug paclitaxel and four polyherbal formulations, all of which had antineoplastic activity assessed by apoptosis detection assay. Proton spectrum of untreated cells showed prominent resonances between 3.5-3.8ppm. These peaks showed drastic reduction in response to treatment by paclitaxel and formulations. In addition, there were also other spectral changes. PCA analysis of the spectral data of drug induced metabolic changes showed a clear difference between the untreated and treated cells with the spectral response to paclitaxel and one of the formulation being similar.

Tariq Shah¹, Marie-France Penet¹, Yelena Mironchik¹, Flonné Wildes¹, Anirban Maitra², and Zaver M. Bhujwalla^1
1Division of Cancer Imaging Research, Johns Hopkins University, Baltimore, MD, United States, ²Pathology, Johns Hopkins University, Baltimore, MD, United States

Pancreatic cancer is an aggressive disease that develops in a relatively symptom-free manner and is usually advanced at the time of diagnosis. There is an urgent need of biomarkers for early diagnosis with enough sensitivity and specificity to help diagnose pancreatic cancer. In this study, we have used 1H MRS to characterize the metabolic profile of a panel of pancreatic cancer cells. Immortalized pancreatic cells were used for comparison. While elevated choline containing compounds were present in all adenocarcinomas relative to immortalized pancreatic cells, differences were also observed within the adenocarcinoma cell lines. The altered choline phospholipid metabolism could be used for non-invasive diagnosis and staging of pancreatic cancer using 1H MRS. The aberrant choline metabolism may also provide novel targets in the treatment of pancreatic cancer.

Myriam Marianne Chaumeil¹, Joydeep Mukherjee², Humsa Venkatesh¹, Russell O. 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

The M2 isoform of pyruvate kinase (PKM2) induces a reprogramming of energetic metabolism in cancer cells, leading to tumor growth and metastasis. Because PKM2 modulation is being investigated as a therapeutic approach, we questioned whether hyperpolarized (HP) ¹³C MRS of pyruvate could serve as a method to probe the PKM2 status. This study shows that knocking down PKM2 expression in glioblastoma cells leads to a significant decrease in HP lactate formation. HP¹³C MRS of pyruvate could thus prove useful for evaluation of new PKM2-targeted therapies.

Tariq Shah¹, Jannie P. Wijnen¹, Flonné Wildes¹, Balaji Krishnamachary¹, Kristine Glunde¹, and Zaver M. Bhujwalla^1
1Division of Cancer Imaging Research, Johns Hopkins University, Baltimore, MD, United States

An increase of total choline is a hallmark of cancer, largely driven by increased phosphocholine and phosphoethanolamine. While significant effort has been focused on the increased phosphocholine observed in cancer cells and tumors, increased phosphoethanolamine has been underexplored. Increased phosphocholine, but not phosphoethanolamine, is observed in cells in culture because culture medium contains free choline but not ethanolamine. Here we have demonstrated that breast cancer cells in culture have the ability to form phosphoethanolamine if ethanolamine is provided in the medium, that choline kinase alpha is capable of ethanolamine kinase activity, and its choline kinase activity is influenced by ethanolamine concentrations.

Nina Tunariu^1,2, David John Collins¹, James A. d'Arcy³, Veronica A. Morgan¹, Sharon L. Giles¹, Catherine J. Simpkin¹, Timothy A. Yap⁴, and Nandita M. De Souza^5
1CR-UK and EPSRC Cancer Imaging Centre, Institute of Cancer Research & The Royal Marsden Hospital, Sutton, London, United Kingdom, ²Drug Development Unit, Institute of Cancer Research & The Royal Marsden Hospital, Sutton, London, United Kingdom, ³CR-UK and EPSRC Cancer Imaging Centre, The Institute of Cancer Research, Sutton, London, United Kingdom, ⁴Section of Medicine, Institute of Cancer Research & The Royal Marsden Hospital, Sutton, London, United Kingdom, ⁵CR-UK and EPSRC Cancer Imaging Centre, Institute of Cancer Research, Sutton, London, United Kingdom

Intrinsic susceptibility weighted (ISW) MRI and derived R2*measurements have been described as potential tool for tumour hypoxia assessment in prostate and breast cancer. The aim of this study was to measure R2* in normal liver and in liver metastases, compare these measurements and establish their reproducibility. This small study showed that R2* measurements in liver metastases are significantly different from normal liver R2* values and can be obtained with reasonable reproducibility. Improvement in data acquisition and data post processing are essential. Liver R2* values also need validation with regard to their utility as a surrogate biomarker for hypoxia.

Surachate Siripongsakun¹, Eugene K. Choi¹, Stephanie Lin¹, Steven S. Raman¹, and David S.K. Lu^1
1Radiology, David Geffen School of Medicine at UCLA, Los Angeles, California, United States

Purpose: To assess the diagnostic performance of MRI characteristics, LIRADS and OPTN criteria in distinguishing well-differentiated (grade 1) hepatocellular carcinoma (HCC-gr1) from dysplastic nodules (DN). Results: Significant differences in T1 and T2 signal, and the presence of contrast wash-in/out and a capsule between both DN and HCC-gr1 (p<0.001 - 0.008). T2 hyperintense signal, intratumoral fat and a tumor capsule were identified in 4(17.4%), 3(13%) and 4(17.4%) of DNs, respectively. Two DNs (8.7%) were assigned a LIRAD5 (definite HCC) and one HCC was an assigned a LIRADS3 (intermediate probability for HCC). In comparison, 5 (21.7%) and 10 HCC (21.7% were assigned an OPTN5 (HCC) and OPTN4 (intermediate suspicion for HCC), respectively. Conclusion: MR allows for excellent differentiation between DN and very well-differentiated HCC (grade I), although overlap in MR characteristics do exist. LIRADS performed better than OPTN criteria to distinguish between DN and gr1 HCC.

Masayuki Kanamoto^1,2, Kazuki Terashima³, Tosiaki Miyati², Kei Katahira¹, Ryoji Ida¹, Daisaku Suga⁴, and Nobukazu Fuwa^3
1Department of Radiation Tecnology, Hyogo Ion Beam Medical Center, Tatsuno, Hyogo, Japan, ²Division of Health Sciences, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa, Japan, ³Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Hyogo, Japan, ⁴Hyogo Ion Beam Medical Support, Tatsuno, Hyogo, Japan

The purpose of the study was to compare SPIO-enhanced 3D B-TFE with T2 prep and 2D T2*WI in order to detect HCC and vessel thrombus in greater detail. Twenty-three patients with a portal thrombus or venous thrombus were administered SPIO. The contrast between HCC, liver, vessel, and thrombus was calculated. The contrast between HCC and liver in T2*WI was significantly higher than in B-TFE (p < 0.05). B-TFE exhibited higher contrast between thrombus and vessels than T2*WI (p < 0.01). It may also be helpful for simultaneous detection of HCC and vessel thrombus using B-TFE.

Anokh Pahwa¹, Katrina Beckett², Stephanie Channual², Nelly Tan², David Lu², and Steven Raman^2
1Olive View-UCLA Medical Center, Sylmar, CA, United States, ²UCLA, Los Angeles, CA, United States

Hepatobiliary specific MR contrast is becoming more prevalent, and understanding its applicability with existing imaging criteria is essential for the noninvasive evaluation of the cirrhotic liver. The purpose was to determine the applicability of Gd-EOB-DTPA, an extracellular contrast agent, with and without hepatobiliary phase imaging in conjunction with established AASLD and Barcelona Criteria for imaging-based diagnosis of hepatocellular carcinoma (HCC). Hepatobiliary phase imaging when using Gd-EOB-DTPA increased sensitivity for the diagnosis of HCC when compared to using established criteria alone, with a small decrease in specificity, which supports a role for hepatobiliary specific contrast agents to improve diagnosis of HCC.

Richard Kinh Gian Do¹, David H. Gultekin², Seth S. Katz¹, Michael J. Sohn¹, Charles G. Nyman¹, Emily C. Zabor³, Chaya M. Moskowitz³, and Diane L. Reidy^4
1Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY, United States, ²Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY, United States, ³Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, United States, ⁴Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, United States

Limited data exist on the reproducibility of ADC of liver metastases using multiple b value DWI. 14 patients with neuroendocrine liver metastases were prospectively recruited. We calculated ADC and ADChigh using 5 b value from 0-500 s/mm2 or 3 b values > 100 s/mm2, respectively. Intra-class correlations (ICC) for ADC of all 44 metastases was 0.845 (CI 0.733,0.912) and for ADChigh was 0.380 (CI: 0.093,0.608). For right hepatic metastases, ADC ICC = 0.895 (CI 0.778,0.952), ADChigh ICC = 0.766 (CI 0.535,0.890). From Bland-Altman analyses, change > 0.56x10-3mm2/s in ADC of metastases (>0.46 x10-3mm2/s for right lobe metastases) would be significant.

Cecilia Besa¹, Nancy A. Cooper¹, Sara Lewis², Amita Kamath¹, Sasan Roayaie³, Marcelo Facciuto⁴, Isabel I. Fiel⁵, and Bachir Taouli^6
1Radiology, Mount Sinai Medical School, New York, NY, United States, ²Radiology, Mount Sinai Medical School, New York, NY, United States Minor Outlying Islands, ³Surgery, Mount Sinai Medical School, New York, NY, United States, ⁴Surgery, Mount Sinia Medical School, New York, NY, United States, ⁵Pathology, Mount Sinai Medical School, New York, NY, United States, ⁶Mount Sinai School of Medicine, New York, NY, United States

The diagnostic performance of the combination of hepatobiliary phase (HBP) imaging post gadoxetic acid (Gd-EOB-DTPA) and DWI compared to dynamic contrast-enhanced (CE) imaging using ASSLD 2011 criteria were assessed for detection of HCC > 1 cm. Pilot data demonstrate better sensitivity and lower specificity when using HBP + DWI compared to AASLD 2011 criteria (wash-in/wash-out) for HCC detection. Data analysis of more cases is pending

Eun-Suk Cho¹ and Jeong-Sik Yu^1
1Radiology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Korea

In gadoxetic acid-enhanced MRI of liver, 5 min-delayed hepatocyte phase imaging (HPI) using 30° flip angle (FA) has higher or similar lesion-to-liver CNR and detection rate for focal hepatic lesions, compared to 20 min HPI using 10° FA. This indicates that 5 min-delayed HPI using high FA (30°) could replace 20 min delayed HPI using standard low FA (10°) with 15 min time-saving, because the former provides higher or similar diagnostic performance compared to the latter.

Tony Clevenger^1,2, Anshuman Panda^1,3, Scott Jones^1,2, Kumar Sandrasegaran², Higinia Cardenes⁴, and Ulrike Dydak^1,2
1School of Health Sciences, Purdue University, West Lafayette, Indiana, United States, ²Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Indiana, United States, ³Department of Radiology, Mayo Clinic Arizona, Scottsdale, Arizona, United States, ⁴Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, Indiana, United States

Phosphorous-31 (31P) MRSI has been shown to distinguish well between healthy and malignant liver tissue. The current RECIST criteria to monitor response of hepatocellular cancer (HCC) to radiation therapy often take up to 6 months to show results, and can be ambiguous or erroneous. Results are presented of our pilot study showing that 31P MRSI in HCC patients can predict treatment response within one month of radiation therapy. These results indicate that 31P MRSI has potential as an early indicator of response to radiation therapy.

Johanna J. Bluemink¹, Marielle E.P. Philippens¹, Wouter Koning², Chris Terhaard¹, Frank A. Pameijer², Peter R. Luijten², and Cornelis A.T. van den Berg^1
1Radiotherapy, UMC Utrecht, Utrecht, Netherlands, ²Radiology, UMC Utrecht, Utrecht, Netherlands

Small glottic tumors are generally visualized by laryngoscopy and no imaging is used because thus far most imaging modalities have insufficient resolution to detect them. Here we demonstrate that with sequence and setup optimization both 3T and 7T MRI can have sufficient resolution to capture small structures around the larynx. The images obtained in 2 patients yielded new information to the head and neck physician concerning the preferred choice of treatment.

Tim Schakel¹, Gert van Yperen², Johan van den Brink², Frank A. Pameijer³, Chris Terhaard¹, Hans Hoogduin³, and Marielle E.P. Philippens^1
1Radiotherapy, UMC Utrecht, Utrecht, Netherlands, ²Philips Healthcare, Best, Netherlands, ³Radiology, UMC Utrecht, Utrecht, Netherlands

Current DW-EPI images are, due to the geometric distortions, unsuitable for delineation purposes for radiotherapy treatment planning in head-and-neck cancer patients. The presented alternative, DW-SPLICE, can produce distortion free images at the cost of longer acquisition times and increased blurring.

Hassan Bagher-Ebadian^1,2, Rajan Jain¹, Jayant Narang¹, and Hamid Soltanian-Zadeh^1,3
1Radiology, Henry Ford Hospital, Detroit, Michigan, United States, ²Physics, Oakland University, Rochester, Michigan, United States, ³CIPCE-Department of ECE, University of Tehran, Tehran, Tehran, Iran

This study investigates feasibility of using a model-trained Adaptive Model to estimate Mean-Transit-Time (MTT) and relative-Cerebral-Blood-Flow (rCBF) in Dynamic-Susceptibility (DSC)-MR perfusion studies. A residue function with an exponential kernel was used to model the T2*-weighted-images with bolus passage. The ANN was trained and validated using a set of central moments and K-Folding-Cross-Validation (KFCV) technique. DSC-MR perfusion and CT-perfusion studies of four patents were analyzed using the ANN and Singular-Value-Decomposition technique. Results imply that the ANN produces accurate and stable hemodynamic maps compared to the SVD technique which can be used as a fast and accurate estimator in DSC perfusion studies.

H. Prinsen¹, H. W.M. van Laarhoven^1,2, G. Bleijenberg³, M. J. Zwarts⁴, M. van der Graaf^5,6, M. Rijpkema⁷, and Arend Heerschap^5
1Medical Oncology, Radboud University Nijmegen Medical Centre, Nijmegen, Gelderland, Netherlands, ²Medical Oncology, Academic Medical Centre, University of Amsterdam, Amsterdam, Noord-Holland, Netherlands, ³Expert Centre for Chronic Fatigue, Radboud University Nijmegen Medical Centre, Nijmegen, Gelderland, Netherlands, ⁴Epilepsy Centre Kempenhaeghe, Heeze, Noord-Brabant, Netherlands, ⁵Radiology, Radboud University Nijmegen Medical Centre, Nijmegen, Gelderland, Netherlands, ⁶Clinical Physics Laboratory, Radboud University Nijmegen Medical Centre, Nijmegen, Gelderland, Netherlands, ⁷Nuclear Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, Gelderland, Netherlands

Until now, little is known about (neuro)physiological factors determining postcancer fatigue, which is a frequently occurring problem, impairing quality of life. For non-cancer patients with chronic fatigue syndrome, certain characteristics of brain morphology and metabolism were already identified. We investigated whether these volumetric and metabolic traits are a reflection of fatigue in general and thus also be of importance for postcancer fatigue. However, the studied volumetric and metabolic parameters are not related to postcancer fatigue. This may suggest that, although postcancer fatigue and chronic fatigue syndrome show strong resemblances as a clinical syndrome, the underlying physiology is different.

Ihor Luhach¹, Djaudat Idiyatullin², Conor Lynch¹, Curtis Andrew Corum³, Gary V. Martinez¹, Michael Garwood³, and Robert J. Gillies^4
1H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, United States, ²Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, United States, ³University of Minnesota, Minneapolis, MN, United States, ⁴H. Lee Moffitt Cancer Center, Tampa, FL, United States

In U.S. almost 30,000 men die from prostate cancer every year. Up to 90% of them develop bone metastasis. Early detection of metastases can be beneficial for treatment and long term survival.Sweep Imaging with Fourier Transform or SWIFT is a new MRI method capable of detecting signals with a broad range of T2 times including extremely short ones that are present in bone. In this work control and PAIII tumor bearing mice tibia were imaged with SWIFT, traditional CT, gradient echo and spin echo. SWIFT was capable to detect tumor and tumor related osteogenesis in the same image.

Ashik Amlani¹, Subhadip Ghosh-Ray¹, Katherine van Ree¹, Andreas Makris², Shirley D'Sa², Peter Ostler², Nicola Anyamene², and Anwar R. Padhani^1
1Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, London, Middlesex, United Kingdom, ²Mount Vernon Cancer Centre, London, United Kingdom

There are stepwise increases in tissue-normalised SI, ADC values and water:fat ratio when sequentially comparing YBM to RBM and malignant bone marrow disease. The polynomial relationships between both DW-SI and water:fat ratio with ADC values are independent of tumour type allowing an opportunity to set a generally applicable upper ADC limit (threshold) for untreated/relapsed disease.

Sharon L. Giles¹, Christina Messiou¹, David John Collins^1,2, Veronica A. Morgan¹, Faith E. Davies^3,4, Gareth Morgan^3,4, and Nandita M. deSouza^1,2
1MRI Department, Royal Marsden Hospital, Sutton, Surrey, United Kingdom, ²Clinical Magnetic Resonance, Institute of Cancer Research, Sutton, Surrey, United Kingdom, ³Haemato-oncology Department, Royal Marsden Hospital, Sutton, Surrey, United Kingdom, ⁴Molecular Pathology, Institute of Cancer Research, Sutton, Surrey, United Kingdom

WB-DWI offers an alternative to serum paraproteins and bone trephine for response assessment in myeloma. This prospective study compared image appearances, mean ADCs and histogram characteristics of volumetric marrow segmentions in myeloma patients pre and post treatment, using laboratory tests as the gold standard to define response. There were significant differences in ADC change between responders and non-responders (14% increase vs 6% decrease, p=0.008), with a strong correlation between change in ADC and laboratory markers of response (r = -0.77, p<0.001). WB-DWI is a useful biomarker of response, but relative roles for qualitative and quantitative analysis need to be determined.

Shanaugh McDermott¹, Ronald Borra², Michael Blake¹, Dushyant V. Sahani¹, Grae Arabasz², Shirley Hsu², Lawrence T. White², Mary Ohara², Jacob M. Hooker², Ciprian Catana³, Bruce R. Rosen², and Alexander R. Guimaraes^2
1Radioloy, Massachusetts General Hospital; Division of Abdominal Imaging and Interventional Radiology, Boston, MA, United States, ²Radiology; Massachusetts General Hospital, Martinos Center for Biomedical Imaging, Charlestown, MA, United States, ³Radiology; Massachusetts General Hospital, Massachusetts General Hospital, Charlestown, MA, United States

This study is a comparison of PET/MRI to PET/CT in a single injection study performed on the same day. Lesions that were FDG avid were compared on a lesion specific basis and categorized by anatomic region. Linear regression was performed in order to quantify the correlation.

Yuki Himoto¹, Koji Fujimoto¹, Aki Kido², Shigeaki Umeoka², Kayo Kiguchi², Fuki Shitano², Tsukasa Baba³, Ikuo Konishi³, and Kaori Togashi^2
1Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University, Kyoto, Kyoto, Japan, ²Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Hospital, Kyoto, Kyoto, Japan, ³Department of Gynecology and Obsterics, Kyoto University Hospital, Kyoto, Kyoto, Japan

To evaluate utility of quantitative measurements in MRI for the early prediction of neoadjuvant chemotherapy (NAC) effectiveness in cervical cancer, 13 patients with stage 1b-2b squamous cell carcinoma were assessed. They were performed NAC and radical hysterectomy. Tumor volume, diffusion, and perfusion parameters were correlated to the eventual tumor volume reduction rate after NAC was completed. Significant correlation was found for the early tumor volume regression rate (R=0.84, p<0.001), pretreatment Ve (R=0.64, p<0.05,) and its early change (R=�|0.63, p<0.05).

Huyen Thanh Nguyen¹, Guang Jia¹, Zarine K. Shah², Kamal S. Pohar³, Amir Mortazavi⁴, Debra L. Zynger⁵, Xiangyu Yang¹, and Michael V. Knopp^1
1Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University, Columbus, OH, United States, ²Department of Radiology, The Ohio State University, Columbus, OH, United States, ³Department of Urology, The Ohio State University, Columbus, OH, United States,⁴Department of Internal Medicine, The Ohio State University, Columbus, OH, United States, ⁵Department of Pathology, The Ohio State University, Columbus, OH, United States

Purpose: to evaluate the capability of k-means clustering of DCE-MRI pharmacokinetic parameters in predicting chemotherapeutic response of bladder cancer at mid-cycle of chemotherapy. Methods: K-means clustering of voxel-based pharmacokinetic parameters was performed to determine the three cluster centroids. For each tumor, volume fraction of each cluster was calculated; and their changes from baseline to mid-cycle were determined and correlated with the tumor’s chemotherapeutic response. Results: The changes in the volume fraction of the three clusters from baseline to mid-cycle MRIs trended in the opposite directions and were significantly different between responders and non-responders (P<0.01). Conclusion: K-means clustering of DCE-MRI pharmacokinetic parameters shows robustness in revealing the complex change of microcirculation to enable prediction of chemotherapeutic response of bladder cancer at mid-cycle MRI.

Mi Hye Yu¹, Jeong Min Lee², Jee Hyun Baek², Joon Koo Han¹, and Byung-Ihn Choi^1
1Radiology, Seoul National University Hospital, Seoul, Seoul, Korea, ²Radiology, Seoul National University, Seoul, Seoul, Korea

We investigated the imaging features of GIST of the GI tract on dynamic contrast-enhanced MRI. The most common MR imaging feature of GIST of the GI tract was well-defined, lobulated, exophytic growing tumor showing obvious and gradually progressive enhancement, and heterogeneity with intratumoral hemorrhage or necrotic/cystic change. The enhancement pattern, enhancement grade and heterogeneity of GIST were variable according to the size of the tumor. Small GIST appeared as round tumor with obvious, early strong or peripheral to central enhancement, meanwhile large GIST appeared as lobulated exophytic growing heterogeneous tumor with mild, gradually progressive enhancement.

Mohan L. Jayatilake¹, Aneela Afzal¹, Xin Li¹, Yiyi Chen², William J. Woodward¹, Tibor J. Kovacsovics³, William H. Fleming^3,4, and Wei Huang^1
1Advanced Imaging Research Center, Oregon Health & Science University, Portland, OR, United States, ²Biostatistics, Oregon Health & Science University, Portland, OR, United States, ³Center for Hematologic Malignancies, Knight Cancer Institute, Oregon Health & Science University, Portland, OR, United States,⁴Oregon Stem Cell Center, Oregon Health & Science University, Portland, OR, United States

Nine newly diagnosed acute myelogenous leukemia (AML) patients underwent DCE-MRI of vertebral body and iliac crest before standard chemotherapy. The pre-therapy bone marrow mean kep was found to be a good predictor of complete remission following therapy. DCE-MRI may be a useful noninvasive imaging method for non-solid tumor cancer studies.

Sikandar Mohammed Shaikh^1,2
1DEPT OF PET-CT & NUCLEAR MEDICINE, YASHODA HOSPITALS, HYDERABAD, ANDHRA PRADESH, India, ²DEPT OF RADIOLOGY, SHADAN MEDICAL COLLEGE, HYDERABAD, ANDHRA PRADESH, India

Purpose: To compare the diagnostic value of whole-body anatomic magnetic resonance (MR) staging of adolescent lymphoma to an enhanced positron emission tomographic (PET)/computed tomographic (CT) as reference standard. Materials and Methods Thirty-one subjects (age range, 27.3–48.0 years; 18 male, 13 female) with histologically proved lymphoma were prospectively evaluated. Pretreatment staging was performed with whole-body DWI MR imaging, fluorine 18 fluorodeoxyglucose PET/CT, and contrast agent–enhanced CT. Eleven nodal and 11 extranodal sites per patient were assessed on MR imaging by radiologist in consensus, with a nodal short-axis threshold of >1cm and predefined extranodal positivity criteria. The same sites were independantly evaluated by a nuclear medicine physician on PET/CT images. Disease positivity was defined as a maximum standardized uptake value >2.5 or nodal size >1 cm and further evaluated by ê value . Results: There was very good agreement between DWI MR imaging and the enhanced PET/CT reference standard for nodal and extranodal staging (ê = 0.96 and 0.86, respectively) which improved following elimination of perceptual errors (ê = 0.97 and 0.91, respectively). The sensitivity and specificity of DWI MR imaging (following removal of perceptual error) were 98% and 99%, respectively, for nodal disease and 91% and 99%, respectively, for extranodal disease. Conclusion: Whole-body DWI MR imaging of adult lymphoma can accurately depict nodal and extranodal disease and may provide an alternative nonionizing imaging method for anatomic disease assessment at initial staging.

Martin T. Freitag¹, Mathies Breithaupt², Ann-Kathrin Homagk², Moritz Berger², and Bram Stieltjes^1
1Quantitative Imaging-based Disease Characterization, German Cancer Research Center (DKFZ), Heidelberg, Baden-Wuerttemberg, Germany, ²Department of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Baden-Wuerttemberg, Germany

Clinical imaging of inguinal lymph nodes plays a vital role in cancer staging. However, conventional MRI approaches lacks sufficient sensitivity to detect micro-metastasis in lymph nodes. Here, we present a feasible in vivo high resolution approach to visualize inguinal lymph nodes at 7 Tesla. Using a T1 sequence and a loop-coil we could stably acquire data at a 0.38x0.38x0.38 mm³ isotropic resolution. Normal lymph node architecture could be well visualized in all healthy subjects. In the melanoma patient, the absence of a fat hilus and the nodal infiltration with pathological vessels, both signs of malignant transformation, could be recognized readily.

Nanda Deepa Thimmappa¹, Frank G. Shellock², Cristen Giangarra³, Christina Y. Ahn⁴, Martin R. Prince¹, and Joshua L. Levine^5
1Radiology, Weill Cornell Medical College, New York, NY, United States, ²Radiology, University of Southern California, Los Angeles, CA, United States,³University College of Washington University, Saint Louis, MO, United States, ⁴NYC Breast Reconstruction Center, New York, NY, United States, ⁵Plastic Surgery, The Center for the Advancement of Breast Reconstruction at NYEE, New York, NY, United States

MR safety of tissue expanders with magnetic ports implanted following mastectomy for breast cancer is controversial yet these patients often require MRI/MRA examinations while the expander is present. Based on in vitro and clinical testing in 16 patients, we found these implants create substantial artifact but no migration, local heating or other damage.