Jin Yamamura¹, Björn Schönnagel¹, Manuela Tavares de Sousa¹, Chressen Much¹, Friedrich Ueberle², Gerhard Adam¹, Fabian Kording¹, and Fabian Kording^1
1Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, Hamburg, Hamburg, Germany, ²Biomedical Technology Fakultät Life Sciences / Medizintechnik, University of Applied Sciences Hamburg, Hamburg, Hamburg, Germany

The purpose of this study was to perform fetal cardiac MRI using a newly developed Doppler ultrasound sensor (DUS) for external fetal cardiac gating in a human fetus for the first time. For the first time, cine cardiac MRI could be performed in a human fetus using a newly developed DUS device and dedicated software for fetal cardiac triggering. Fetal cardiac functional parameters revealed high agreement in comparison with standard fetal echocardiography.

Jie Luo¹, Esra Abaci Turk¹, Tobias Hahn¹, María Teulón González^1,2, Borjan Gagoski³, Carolina Bibbo⁴, Arvind Palanisamy⁵, Clare M Tempany-Afdhal⁶, Ángel Torrado-Carvajal^1,7, Norberto Malpica^1,7, Judith Martínez González⁸, Julian N Robinson⁴, Juan A Hernández-Tamames^1,7, Elfar Adelsteinsson^1,9, and Patricia Ellen Grant^3
1Madrid-MIT M+Vision Consortium in RLE, Massachusetts Institute of Technology, Cambridge, MA, United States, ²Department of Obstetrics and Gynecology, Hospital Universitario de Fuenlabrada, Madrid, Spain, ³Fetal-Neonatal Neuroimaging & Developmental Science Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States, ⁴Department of Obstetrics and Gynecology, Division of Maternal and Fetal Medicine, Brigham and Women’s Hospital, Boston, MA, United States, ⁵Department of Anaesthesia, Brigham and Women's Hospital, Boston, MA, United States, ⁶Department of Radiology, Brigham and Women’s Hospital, Boston, MA, United States, ⁷Medical Image Analysis and Biometry Laboratory, Universidad Rey Juan Carlos, Madrid, Spain, ⁸Department of Radiology, Hospital Universitario de Fuenlabrada, Madrid, Spain, ⁹Department of Electrical Engineering and Computer Science,Harvard-MIT Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA, United States

Adequate oxygen transport across the placenta from mother to fetus is critical for fetal growth and development. Clinical assessment of placental insufficiency relies on Doppler ultrasound. BOLD MRI can detect oxygenation changes in the placenta and fetal organs during maternal hyperoxygenation in healthy human subjects. In addition maternal hyperoxygenation has successfully differentiated rat intrauterine growth restriction (IUGR) models from normal, indicating a potential in detecting and monitoring human IUGR. In this study, we have characterized for the first time functionally different placental regions and fetal response to maternal hyperoxygenation in an IUGR pregnancy.

Anahita Fathi Kazerooni^1,2, Mojtaba Safari¹, Hamidreza Haghighatkhah³, Mahnaz Nabil⁴, and Hamidreza Saligheh Rad^1,2
1Quantitative MR Imaging and Spectroscopy Group, Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Tehran, Iran, ²Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran, ³Department of Radiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran, ⁴Department of Statistics, Tarbiat Modares University, Tehran, Iran

Successful treatment outcome in complex ovarian masses depends on their accurate characterization. Despite the critical role of quantitative ADC-maps in characterization of pathologies, their contribution is still a matter of debate in complex ovarian masses. This is mainly due to the inherently high heterogeneity of this type of tumor, both in inter- and intra-patient levels. To overcome this challenging issue, in this work, we have carried out whole-tumor texture analysis on ADC-maps to quantitatively account for heterogeneous pattern of ovarian cancers. Moreover, we exploit an automated classification approach for evaluation and selection of the best representative features of tumor non-uniformity.

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

Choline MRS has shown added value in detecting and grading cancer, however MRS in cervical cancer is challenging. Using the boosted SNR at 7T with internal antennas, we investigated the potential of detecting choline levels in cervical cancer.

Jessica M Winfield¹, Katherine Downey², Matthew R Orton², John H Shepherd³, Veronica A Morgan¹, Sharon L Giles¹, Thomas E J Ind³, and Nandita M deSouza^1,2
1MRI Unit, Royal Marsden NHS Foundation Trust, Sutton, Surrey, United Kingdom, ²CRUK Cancer Imaging Centre, Institute of Cancer Research, Sutton, Surrey, United Kingdom, ³Department of Gynecology, Royal Marsden NHS Foundation Trust, Sutton, Surrey, United Kingdom

The goodness-of-fit of mono-exponential, stretched exponential and bi-exponential models were compared in diffusion-weighted MRI data from cervical tumours in 20 patients. Models were compared using the Bayesian Information Criterion, which penalises additional parameters. Two-way analysis of variance was used to assess differences between types (squamous cell carcinoma and adenocarcinoma) and grades (well/moderately differentiated or poorly differentiated) of tumours for each fitted parameter. Stretched exponential and bi-exponential models were preferred over the mono-exponential model. The extra parameters, α or f, can be used to distinguish between squamous cell carcinoma and adenocarcinoma, while ADC or D distinguish between grades of tumours.

mengyuan zhu^1,2, Sujana Madathil¹, Sarah Keating³, Natasha Milligan¹, Steven Miller⁴, Rory Windrim⁵, Sharon Portnoy⁶, John G. Sled⁷, Christopher Macgowan⁷, John Kingdom⁸, and Mike Seed^1
1Heart Centre, The Hospital for Sick Children, Toronto, Ontario, Canada, ²Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada,³Pathology & Laboratory Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada, ⁴Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada,⁵Maternal-Fetal Medicine, Mount Sinai Hospital, Ontario, Canada, ⁶Mouse Imaging Centre, The Hospital for Sick Children, Toronto, Ontario, Canada,⁷Physiology & Experimental Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada, ⁸Obstetrics & Gynaecology, Mount Sinai Hospital, Toronto, Ontario, Canada

Current monitoring methods for late-onset intrauterine growth restriction pregnancies suffer from poor sensitivity and specificity. This study used new MRI phase contrast and T2 mapping technology to compare measurements of fetal vessel blood flow and oximetry in fetuses with and without IUGR. The results show redistribution of the fetal circulation and hypoxia in small for gestational age fetuses in keeping with previous models of placental insufficiency. In addition, fetal oxygen delivery was strongly correlated with placental weight. We speculate that MRI may provide a clinically useful diagnostic tool for identifying IUGR.

Uday Krishnamurthy^1,2, Jaladhar Neelavalli^1,2, Pavan Kumar Jella¹, Ehsan Hamtaei¹, Swati Mody¹, Brijesh Kumar Yadav^1,2, Edgar Hernandez-Andrade^3,4, Lami Yeo^3,4, Maria D Cabrera¹, Ewart Mark Haacke^1,2, Sonia S Hassan^3,4, and Roberto Romero^4
1Department of Radiology, Wayne State University, Detroit, Michigan, United States, ²Department of Biomedical Engineering, Wayne State University, Detroit, Michigan, United States, ³Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan, United States, ⁴Perinatology Research Branch, NICHD, NIH, DHHS, Wayne State University, Detroit, Michigan, United States

Doppler Ultrasound (US) is the standard clinical tools used for evaluating fetal vessels. However, the efficacy of these techniques is operator dependent and may be difficult in certain cases. On the other hand, MRI is ideally suited for vascular imaging. Fetal vascular imaging is limited not only by the imaging resolution but also by motion artifacts. In this study we evaluated the feasibility of acquiring non-contrast enhanced magnetic resonance angiographic (MRA) in the human fetus and further, simulated a compressed sensing CS sampling scheme to evaluate the potential utility of CS reconstruction in fetal MR angiography.

Esra Abaci Turk¹, Jie Luo¹, Angel Torrado-Carvajal^1,2, Tobias Hahn¹, Maria Teulon Gonzalez^1,3, Borjan Gagoski⁴, Carolina Bibbo⁵, Julian N Robinson⁵, Juan A Hernandez-Tamames^1,2, Patricia Ellen Grant⁴, Elfar Adalsteinsson^1,6, Javier Pascau^1,7, and Norberto Malpica^1,2
1Madrid-MIT M+Vision Consortium in RLE, Massachusetts Institute of Technology, Cambridge, MA, United States, ²Medical Image Analysis and Biometry Laboratory, Universidad Rey Juan Carlos, Mostoles, Madrid, Spain, ³Department of Obstetrics and Gynecology, Hospital Universitario de Fuenlabrada, Madrid, Spain, ⁴Fetal-Neonatal Neuroimaging & Developmental Science Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States, ⁵Department of Obstetrics and Gynecology, Division of Maternal and Fetal Medicine, Brigham and Women's Hospital, Boston, MA, United States,⁶Dept. of Electrical Engineering and Computer Science, Harvard-MIT Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA, United States, ⁷Department of Biomedica Eng., Universidad Carlos III de Madrid – Instituto de Investigacion Sanitaria Gregorio Maranon, Madrid, Spain

Measuring oxygen transport across the placenta can be critical for evaluating fetal growth and development. Blood oxygen level-dependent (BOLD) magnetic resonance imaging (MRI) with oxygen exposure can be used as a non-invasive tool to detect oxygenation changes in the placenta and fetal organs. So far, for the signal analysis, the manual segmentation is being used as gold standard when there are fetal and maternal movements; however it is highly time-consuming and therefore not a realistic solution for large-scale studies. In this study, we have demonstrated different registration pipelines to automate ROI extraction in the placenta and the fetal body.

Kate Downey¹, Veronica Morgan¹, Alison MacDonald¹, Sharon Giles¹, John Shepherd², Thomas Ind², Ayoma Attygalle³, Steve Hazell³, and Nandita deSouza^1
1CRUK Cancer Imaging Centre, The Institute of Cancer Research and The Royal Marsden Hospital, Sutton, Surrey, United Kingdom, ²Gynaecological Surgery, The Royal Marsden Hospital, London, United Kingdom, ³Histopathology, The Royal Marsden Hospital, London, United Kingdom

Endovaginal MRI using T2-W sequences is more sensitive (87% vs. 73.9%) but less specific (80% vs. 93.3%) than equivalent optimized external array imaging for detecting suspected Ia1/2 and Ib1 cervical tumors. Addition of diffusion-weighted sequences to T2-W protocols obtained with an endovaginal coil substantially improves specificity (80% to 93.3%). Addition of diffusion-weighted imaging to T2-W protocols acquired using an external array coil however merely serves to reduce sensitivity (73.9% to 65.2%) for detecting these small (1cm) tumors.

Craig Olmstead¹, Lanette Friesen-Waldner², Abraam Soliman^3,4, Kevin Sinclair², Barbra de Vrijer⁵, and Charles McKenzie^2,3
1Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada, ²Department of Medical Biophysics, University of Western Ontario, London, Ontario, Canada, ³Robarts Research Institute, University of Western Ontario, London, Ontario, Canada, ⁴Department of Biomedical Engineering, University of Western Ontario, London, Ontario, Canada, ⁵Department of Obstetrics and Gynaecology, University of Western Ontario, London, Ontario, Canada

Water-fat separation techniques using MRI have the potential to provide fetal fat distributions in utero. This metabolic information may have applications to high-BMI expectant mothers and in detection of growth restricted fetuses. Using the LAVA Flex sequence, we obtained fetal fat fraction images in 7 patients, including both normal weight and high-BMI patients. In all cases, fat fraction maps could be segmented into fetal subcutaneous and intra-abdominal compartments. Fetal liver ROIs were obtained, demonstrating average liver fat fractions of less than 1% in all fetuses. This research demonstrates the technical viability of fetal fat fraction in a clinical setting.