Zhijun Geng¹, Yunfei Zhang², Hui Li¹, Jing Zhao¹, Sihui Zeng¹, Cheng Zhang¹, Chuanmiao Xie¹, and Yongming Dai^2
1Sun Yat-sen University Cancer Center, Guangzhou, China, ²United Imaging Healthcare, Shanghai, China

Tightly correlated with the prognosis, microvascular invasion (MVI) serves as one significant predictor determining the clinical management. Abnormal angiogenesis, one typical character during carcinogenesis, can lead to the abnormal micro-vessel manifestations including micro-hemorrhage and more, which may correlate with another abnormal vascular manifestations—MVI. Hence, this research aims to predict the MVI via visualizing the intra-tumor hemorrhage with susceptibility weighted imaging (SWI) widely proven to be powerful for imaging hemorrhage and IVIM hypothesized to be effective for visualizing the hemorrhage via quantifying the abnormal perfusion. The results displayed that visualizing the micro-hemorrhage holds great potential for predicting MVI of HCC.

Zhe Zhang¹, Ailian Liu¹, Ying Zhao¹, Jingjun Wu¹, Nan Wang¹, Dahua Cui¹, Tao Lin¹, Qingwei Song¹, Xin Li¹, Tingfan Wu¹, and Yan Guo^1
1Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian, China, Dalian, China

The purpose of this study was to preoperatively evaluate pathological differentiation of the whole hepatocellular carcinoma (HCC) by 3D ROI histogram of ADC, D, D* and f. The results showed that 3D ROI histogram of ADC, D can identify poor differentiated HCC. The D-5th achieved the highest AUC values (AUC: 0.778; sensitivity: 66.7%; specificity: 78.4%). Although there was no significant difference between AUC of 3D ROI histogram and routine ROI, 3D ROI histogram can reflect the heterogeneity to evaluate the differentiation of the whole tumor.

Xue Han¹, Yunfei Zhang², Qi Wang¹, Yan Ding¹, Hui Liu¹, Xiaojing Ma¹, Gaofeng Shi¹, and Yongming Dai^2
1The Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang, China, ²United Imaging Healthcare, Shanghai, China

Imaging manifestations and pathological findings are tightly correlated to each other as they all provide the portraying of the tumor from different perspectives. We hypothesized that exploiting the quantitative markers from MR images would be a feasible way for simultaneously predicting the multiple pathological indexes. With regard to conventional “mean value” of ROI, histogram metrics, taking the tumor heterogeneity into consideration, can give full play of quantitative indicators. This research aims to preliminarily evaluate the feasibility of simultaneously predicting the multiple pathological indexes with a single Intravoxel incoherent motion (IVIM) scan by extracting multiple histogram metrics of parametric images.  

Ying Zhao¹, Ailian Liu¹, Jingjun Wu¹, Nan Wang¹, Dahua Cui¹, Tao Lin¹, Qingwei Song¹, Xin Li², Tingfan Wu², and Yan Guo^3
1The First Affiliated Hospital of Dalian Medical University, Dalian, China, ²Translational Medicine Team, GE Healthcare, Shanghai, China, ³GE Healthcare, Beijing, China

In the current study, dynamic enhanced MRI-based radiomics model was applied to predict therapeutic response in hepatocellular carcinoma treated with transcatheter arterial chemoembolization. In order to obtain the optimal radiomics model, we compared the diagnostic performance of the model built by different classifiers.

Ying Zhao¹, Ailian Liu¹, Jingjun Wu¹, Dahua Cui¹, Tao Lin¹, Qingwei Song¹, Xin Li², Tingfan Wu², Yan Guo³, Lizhi Xie³, and Jingjing Cui^4
1The First Affiliated Hospital of Dalian Medical University, Dalian, China, ²Translational Medicine Team, GE Healthcare, Shanghai, China, ³GE Healthcare, Beijing, China, ⁴Huiying Medical Technology Inc., Beijing, China

In the current study, multi-sequence MRI radiomics nomogram was demonstrated to be capable to predict  two-year recurrence in hepatocellular carcinoma after partial hepatectomy, which will provide more prognostic information and facilitate clinical management.

Yudai Syogan¹, Satoshi Kobayashi¹, Yu Ueda², Noboru Taniguchi¹, Naoki Ohno¹, Tosiaki Miyati¹, Toshifumi Gabata³, Takeshi Terashima⁴, Kuniaki Arai⁴, and Tatsuya Yamashita^4
1Quantum Medical Technology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan, ²Philips.Japan, Tokyo, Japan, ³Radiology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan, ⁴Gastroenterology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan

Hepatocyte fraction index (HeFra index) obtained from gadoxetic acid-enhanced MR imaging might be possible surrogate marker of liver function after molecular targeting therapy to advanced HCC, and the molecular targeting therapy to advanced HCC do not affect the function of background liver parenchyma.

Fei Xing¹, Xue qin Zhang¹, Jian Lu¹, and Xiao fen Miao ^1
1The Third Hospital Affiliated of Nantong University, Nantong, China

Using LI-RADS v2018 on MRI, LR-2, LR-3 and LR-4 lesions in cirrhosis have different natural outcomes, LI-RADS lesions demonstrate increasing risk of progression to HCC with increasing category. About two-fifths of LR-4 observations progressed to a malignant category. LR-3 observations with APHE or threshold/subthreshold growth upgraded to LR-5 were significantly higher. Most LR-2 observations that remain stable in category for at least a year.

Liuji Sheng¹, Ailian Liu¹, Ying Zhao ¹, Jingjun Wu¹, Nan Wang¹, Dahua Cui¹, Tao Lin¹, Qingwei Song¹, Xin Li², Tingfan Wu², and Yan Guo^3
1Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian, China, ²Translational Medicine Team, GE Healthcare, Shanghai, China, ³GE Healthcare, Beijing, China

The main purpose of this work was to use multi-quantitative parameters of DKI  to evaluate the pathological grade of HCC before surgery. The results showed that FA have a powerful value in preoperative assessment of pathological grade of HCC (AUC:0.716; sensitivity:73.7%; specificity: 65.0%).

Yi Wei¹, Zheng Ye¹, Hehan Tang¹, Bin Song¹, Xiaocheng Wei², Lisha Nie², and Hancheng Yang^2
1West China Hospital, Sichuan University, Chengdu, China, ²GE Healthcare, MR Research, Beijing, China

Microvascular invasion (MVI) is one of the most important factors for the recurrence of hepatocellular carcinoma (HCC), however, accurate preoperative evaluation of MVI is quietly difficult because of the controversy results caused by the conventional imaging features. Compared with diffusion-weighted imaging (DWI), Intravoxel incoherent motion (IVIM) diffusion-weighted MR imaging could better characterize heterogeneity and irregularity of tissue components, and thus may have the potential to better evaluate MVI. In this study, we prospectively determine the usefulness of IVIM parameters and conventional radiologic features for preoperative prediction of MVI in patients with HCC.

Rushi Chen¹, Yan Bai², Ge Zhang², Kaiyu Wang³, and Meiyun Wang^2
1Henan provincial people's hospital& Zhengzhou University People’s Hospital, Zhengzhou, China, ²Henan provincial people's hospital, Zhengzhou, China, ³GE Healthcare, MR Research, Beijing, China

Accurate diagnosis and evaluation of HCC is important for improving the efficiency of HCC treatment and patient prognosis. Glypican-3 (GPC3) has been considered as a promising diagnostic and prognostic biomarker and a target for immune-therapeutic in HCC. Our study aimed to investigate the utility of IDEAL IQ MRI to prospectively evaluate the expression status of GPC3. Our results showed that the intratumoral R2* value was significantly higher in the positive-GPC3 HCC patients than in the negative-GPC3 HCC patients (P=0.003). The IDEAL IQ MRI may have potential for non-invasively predict GPC3 expression status.

Hanyu Jiang^1,2, Bin Song¹, and Mustafa Shadi Rifaat Bashir^2
1Department of Radiology, West China Hospital, Sichuan University, Chengdu, China, ²Department of Radiology, Duke University Medical Center, Durham, NC, United States

The aim of this study was to develop diagnostic models comprising serological tumor markers and gadoxetate disodium-enhanced magnetic resonance imaging (EOB-MRI) features for patients with LR-M lesions by LI-RADS version 2018 (v2018). We retrospectively analyzed prospectively collected data from 45 consecutive at risk patients with LR-M observations and generated diagnostic models for LR-M to predict tumors with a cholangiocarcinoma component (M-CC). Among these models, carbohydrate antigen (CA) 19-9 alone demonstrated excellent diagnostic specificity, while the model integrating both CA 19-9 and the EOB-MRI feature “blood products in mass” achieved optimal overall performance.

Nobuyuki Kawai¹, Yoshifumi Noda¹, Satoshi Goshima², Keita Fujimoto¹, Kimihiro Kajita³, Hiroshi Kawada¹, Yukichi Tanahashi¹, and Masayuki Matsuo^1
1Radiology, Gifu University, Gifu, Japan, ²Diagnostic Radiology and Nuclear Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan, ³Radiology Services, Gifu University Hospital, Gifu, Japan

Gadoxetic acid-enhanced MR imaging is an essential modality for the screening and assessment of hepatic diseases, which has an incremental value when combined with contrast-enhanced computed tomography for detecting colorectal liver metastasis (CLM). We assessed the diagnostic performance of an abbreviated protocol (axial heavily T2-weighted + axial and reconstructed-coronal hepatobiliary phase + axial diffusion-weighted imaging) compared with the standard routine clinical one for CLM screening. Our results demonstrated excellent performance for the detection of CLM comparable to standard one less than one third of acquisition time.

Takeshi Yoshikawa¹, Yoshiharu Ohno², Ryo Shiroishi³, Masao Yui³, Yoshimori Kassai³, Shinichiro Seki⁴, Katsusuke Kyotani⁵, and Yuji Kishida^6
1Kobe University Graduate School of Medicine, Kobe, Japan, ²Fujita Health University School of Medicine, Toyoake, Japan, ³Canon Medical Systems Corporation, Otawara, Japan, ⁴Hyogo Prefectural Tamba Medical Center, Tamba, Japan, ⁵Kobe University Hospital, Kobe, Japan, ⁶Konan Medical Center, Kobe, Japan

Texture analysis can characterize spatial variations of gray levels on an image. Our results showed texture analysis has a potential to improve MR ability in diagnosis of hepatocellular carcinoma. Optimal imaging techniques might be different from ones for visual assessment. Capsule, hemorrhage, and cellularity in HCC are possible influential factors.

Fei Wang¹, Yupei Zhang¹, Mengxiao Liu², and Juan Zhu^1
1Department of MRI,AnQing Municipal Hospital, Anqing, China, ²MR scientific Marketing, Diagnostic Imaging, Siemens Healthcare Ltd, Shanghai, China

In this study, pre- and post-contrast T1-mapping technique and DWI were used for differential diagnosis of hepatic cyst, hemangioma and HCC. pre- and post-contrast T1 value, the decrease rate of T1 value and ADC value of the three types of lesions were compared and analyzed.T1-mapping technology for differential diagnosis of hepatic cyst，hemangioma and HCC provides a new quantitative method, especially for no-enhanced T1-mapping, have promise of clinical application.

Sonal Krishan¹ and Prabhat Kumar^2
1Medanta Hospital, Gurgaon, India, ²Medanta Hospital, GURGAON, India

Clinical data on the course of sub-centimeter-sized nodules (SCSNs) detected during surveillance for HCC is limited. Through this study we wished to evaluate arterially enhancing SCSN evolving into HCC. We tried identify specific size cut off, rate of growth, enhancement features which can predict which SCSN will turn into HCC. 47.5% of SCSN have the potential to turn into HCC.  8.55 mm is the optimal size cut off above which risk of developing HCC increases with a sensitivity of 71.4%.  Diffusion restriction was seen in 50% and non uptake of hepatobiliary contrast in 91% of  SCSN which developed into HCC.

Yunsong Liu¹, Lihua Chen¹, Weiping Yang¹, Xinmiao Bu¹, Jianqing Sun², Jiazheng Wang², Zhiwei Shen², and Ailian Liu^1
1The First Affiliated Hospital of Dalian Medical University, Dalian, China, ²Philips Healthcare, Beijing, China

The present study aimed to explore the value of amide proton transfer-weighted (APTw) imaging combined with diffusional kurtosis imaging (DKI) in the differential diagnosis between benign prostatic hyperplasia (BPH) and prostatic cancer. The results showed that the combined technique had a good diagnostic effect. When APT value was combined with 3 DKI parameters (FA, MK, Ka), the diagnostic efficacy significantly enhanced  (AUC: 0.872; sensitivity: 76.5%; specificity: 90.9%).

Luguang Chen¹, Pengyi Xin¹, Qingsong Yang¹, Tao Song¹, Chao Ma¹, Robert Grimm², Caixia Fu³, and Jianping Lu^1
1Radiology, Changhai Hospital of Shanghai, Shanghai, China, ²Application Predevelopment, Siemens Healthcare, Erlangen, Germany, ³Application Development, Siemens Shenzhen Magnetic Resonace Ltd, Shenzhen, China

Histogram and texture analysis have the potential in evaluating the heterogeneous features of tumors. This study aimed to assess the usefulness of histogram and texture analysis of ADC maps for differentiating PCa from BPH with pathology as the reference. 90 PCa and 112 BPH patients were enrolled and analyzed using histogram and texture analyses. Significant differences were observed in age, PSA, lesion volume and histogram parameters (except kurtosis) of ADC map between the PCa and BPH patients. The whole-lesion histogram and texture analysis-based parameters from the quantitative ADC map may serve as a useful biological characterization of prostate cancer.

Nicole Seyfried¹, Amr Mahran^1,2, Ananya Panda³, Verena Obmann⁴, Christina Buzzy^1,2, Yun Jiang⁵, Katie Wright⁵, Dean Nakamoto⁶, Indravadan Patel⁷, Britt Conroy^1,2, Lee Ponsky^1,2, and Vikas Gulani^5
1School of Medicine, Case Western Reserve University, Cleveland, OH, United States, ²Urology Institute, University Hospitals, Cleveland, OH, United States, ³Radiology, Mayo Clinic, Rochester, MN, United States, ⁴Department of Diagnostic, Interventional and Pediatric Radiology, Bern University Hospital, Bern, Switzerland, ⁵Department of Radiology, University of Michigan, Ann Arbor, MI, United States, ⁶Radiology, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, United States, ⁷Radiology, Mayo Clinic, Scottsdale, AZ, United States

The value of incremental biopsy cores during in-gantry MRI-guided targeted prostate biopsy for prostate cancer diagnosis was examined. 135 patients with 175 lesions underwent in-gantry targeted prostate biopsy and the rates of pathology upgrading for sequential cores were determined. Significant upgrading was observed when increasing from 1 to 2 cores and from 2 to 3 cores, but not from core 3 to 4. Higher Prostate Imaging Reporting and Data System (PI-RADS) Version 2.0 score and anteriorly located lesions were more likely to result in an upgrade.

Ingrid Framås Syversen¹, Mattijs Elschot², Tone Frost Bathen², and Pål Erik Goa^3
1Kavli Institute for Systems Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway, ²Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway, ³Department of Physics, Norwegian University of Science and Technology, Trondheim, Norway

T2 and diffusion-weighted imaging (DWI) are increasingly used in the detection and staging of prostate cancer, however, usually under the assumption that the T2 values and apparent diffusion coefficients (ADC) are independent of each other. Using hybrid multidimensional imaging, where images are acquired at two echo times and two b-values, we estimate volume fractions of slow and fast diffusion compartments in the prostate with a two-compartment model. The results suggest that the volume fractions can be used to discriminate between tumor and normal prostate tissue.

Karthik Meenakshi Sundaram¹, Ali B Syed¹, Stephanie Tzu-Ying Chang^1,2, and Andreas Markus Loening^1
1Radiology, Stanford University School of Medicine, Stanford, CA, United States, ²Department of Radiology, Veterans Affair Palo Alto Healthcare System, Palo Alto, CA, United States

ACR PI-RADs guidelines suggest anti-spasmodic agents may be beneficial for some patients during multi-parametric prostate MRI (mpMRI). Recent evidence suggests that the anti-spasmodic scopolamine butylbromide improves image quality on mpMRI. However, no studies have evaluated intramuscular (IM) injected glucagon. This retrospective IRB approved single-center study performed data-mining of 2595 mpMRI radiology reports (693 with glucagon) and subjective image quality assessment of 63 mpMRI exams (32 with glucagon). No significant benefit of IM glucagon for prostate evaluation was found on mpMRI. Our findings suggest that the risks associated with IM glucagon (medication side effects, patient discomfort, cost) may outweigh any benefits.

Peter S LaViolette¹, Sean D McGarry², John D Bukowy¹, Allison K Lowman¹, Anjishnu Banerjee³, Dariya Malyarenko⁴, Tom Chenevert⁴, Yue Cao^4,5, Andrey Fedorov⁶, Laura C Bell⁷, Chad Quarles⁷, Melissa A Prah², Kathleen M Schmainda², Stefanie Hectors⁸, Bachir Taouli⁸, Eve LoCastro⁹, Yousef Mazaheri^9,10, Amita Shukla-Dave^9,10, Thomas Yankeelov¹¹, David Hormuth II¹¹, Ananth J Madhuranthakam¹², Keith Hulsey¹², Wei Huang¹³, Mark Muzi¹⁴, Michael Jacobs¹⁵, Meiyappan Solaiyappan¹⁵, Kenneth Jacobsohn¹⁶, Mark Hohenwalter¹, Petar Duvnjak¹, Michael Griffin¹, Watchareepohn Palanghmonthip^17,18, William See¹⁶, Marja Nevalainen¹⁷, and Kenneth Iczkowski^17
1Radiology, Medical College of Wisconsin, Milwaukee, WI, United States, ²Biophysics, Medical College of Wisconsin, Milwaukee, WI, United States, ³Biostatistics, Medical College of Wisconsin, Milwaukee, WI, United States, ⁴Radiology, University of Michigan, Ann Arbor, MI, United States, ⁵Radiation Oncology, University of Michigan, Ann Arbor, MI, United States, ⁶Radiology, Brigham and Womens Hospital, Boston, MA, United States, ⁷Neuroimaging Research, Barrow Neurological Institute, Phoenix, AZ, United States, ⁸Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States, ⁹Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, United States, ¹⁰Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, United States, ¹¹Institute for Computer Engineering and Sciences, University of Texas, Austin, TX, United States, ¹²radiology, University of Texas Southwestern Medical Center, Dallas, TX, United States, ¹³Advanced Imaging Research Center, Oregon Health Sciences University, Portland, OR, United States, ¹⁴Radiology and Neurology, University of Washington, Seattle, WA, United States, ¹⁵Radiology, Johns Hopkins University, Baltimore, MD, United States, ¹⁶Urological Surgery, Medical College of Wisconsin, Milwaukee, WI, United States, ¹⁷Pathology, Medical College of Wisconsin, Milwaukee, WI, United States, ¹⁸Pathology, Chiang Mai University, Chiang Mai, Thailand

This study presents a multi-site study measuring the ability of site-specific diffusion weighted imaging fitting algorithms for differentiating prostate cancer. A dataset of DWI collected from 33 patients and a simulated digital reference object was distributed to thirteen sites who fit the multi-b DWI models with onsite-implemented software. Derived parametric maps were then submitted for central analysis. Each map was aligned to the T2-weighted image, and DWI metrics were extracted from aligned pathologist annotations. A statistical analysis was performed to determine the ability of each metric to differentiate PCA and to determine how fits of simulated data differed between sites.

Anugayathri Jawahar¹, Ali B Syed ¹, Peter Wei ¹, Lloyd Estkowski², Arnaud Guidon³, Perla Subbaiah⁴, Bruce Lewis Daniel¹, and Andreas M Loening ^1
1Body MRI, Stanford University, PALO ALTO, CA, United States, ²Global MR Applications & Workflow, GE Healthcare, Waukesha, WI, United States, ³MR Body Applications & Workflow, GE Healthcare, Boston, MA, United States, ⁴Mathematics, Oakland University, Rochester, MI, United States

Diffusion-weighted imaging (DWI) using echo-planar technique is highly sensitive to susceptibility artifacts, in prostate MRI this is mainly due to rectal gas. In the hopes of identifying a sequence with better robustness to rectal gas, we compared multi-shot DWI using MUSE (with 3 shots) with a rFOV-DWI acquisition. In this IRB approved prospective study, 3 readers performed visual grading of MUSE and rFOV-DWI on 50 consecutive prostate MRI studies. MUSE-DWI and ADC maps showed statistically significant improvements in image quality for anatomic contour, lesion conspicuity, and overall image quality, as well as significantly reduced susceptibility artifacts related to rectal gas.

Yu Ueda¹, Tsutomu Tamada², Koji Yoshida², Ayumu Kido², Makoto Obara¹, Masami Yoneyama¹, Yuta Akamine¹, and Marc Van Cauteren^3
1Philips Japan, Tokyo, Japan, ²Kawasaki medical school, Kurashiki, Japan, ³Philips Healthcare, Asia Pacific, Tokyo, Japan

DWI is a key component of mp-MRI in prostate and the usefulness of high b-value DWI has been reported. However, the quality might depend on magnetic field strength and scanner performance. It would be beneficial to acquire sufficient diffusion contrast and ADC using standard b-value of 1000 s/mm² without an additional higher b-value acquisition. We exploited the difference of T1 between cancer and normal to improve contrast. The contrast of T1 enhanced DWI₁₀₀₀ using short TR was better compared to that of DWI₁₀₀₀ with normal long TR but it was less than that of DWI₂₀₀₀ with normal long TR.

Tustomu Tamada¹, Yu Ueda², Kosuke Ito³, Takeshi Fukunaga¹, Ayumu Kido¹, Tomohiro Mochizuki⁴, and Akira Yamamoto^1
1Radiology, Kawasaki Medical School, Kurashiki City, Japan, ²Philips Japan, Minato-ku, Japan, ³Kawasaki Medical School, Kurashiki City, Japan, ⁴Philips Japan, Osaka, Japan

T2WI is a key component of mpMRI in prostate. 2D T2WI obtained in multi plane is recommend in PI-RADS v2, resulting in prolonged examination time. The usefulness of 3D-VRFA-TSE, which  has a potential to reduce scan time by multiplanar postprocessing reconstruction of images into any desired plane, has been reported. As an further effective way to accelerate scan time is provided by C-SENSE, which uses undersampling of the k-space, we compared 3D-VRFA-TSE with 3D-VRFA-TSE with C-SENSE. C-SENSE enables a reduction in acquisition time of 40% in 3D-VRFA-TSE, maintaining image quality and lesion conspicuity except for clarity of prostatic capsule.

Edward M Lawrence¹, Yuxin Zhang¹, Jitka Starekova¹, Zihan Wang², and Diego Hernando^1
1Radiology, University of Wisconsin-Madison, Madison, WI, United States, ²Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, United States

Diffusion weighted imaging (DWI) non-invasively evaluates tissue microstructure, relevant in the setting of prostate cancer. Distortion from susceptibility effects can confound standard single-shot echo planar imaging (ssEPI). Reduced-distortion techniques, including reduced field of view (rFOV) and multi-shot EPI (msEPI), may improve prostate imaging quality but further evaluation is warranted. Therefore, a prospective comparison of rFOV and msEPI to ssEPI, in either biopsy proven or suspected prostate cancer patients, was performed. Our results demonstrate that both rFOV and msEPI reduce distortion artifacts, and improve image quality, in comparison to ssEPI.  Furthermore, ADC quantification was reproducible across these three techniques. 

Ayumu Kido¹, Tsutomu Tamada¹, Yu Ueda², Tomohiro Mochizuki³, Takeshi Fukunaga¹, and Akira Yamamoto^1
1Radiology, Kawasaki Medical School, Kurashiki, Japan, ²Philips Japan, Minato-ku, Japan, ³Philips Japan, Osaka, Japan

 APT-MRI is a contrast-agent-free MRI technique that exploits signal from the amide protons (NH groups) contained in proteins and peptides. No studies have reported the use of 3DAPT. Quantitative analysis (ADC and APT SI (%)) were calculated for PC lesions and for benign regions that included normal PZ and benign prostatic lesions. APT SI was comparable among normal regions, benign lesions, and PC. However, APT SI was significantly higher in large PC than in small PC. In addition, the APT SIs of PC lesions correlated well with PSA. APT SI may represent tumor volume, PC staging, and prognosis.

Durgesh Kumar Dwivedi^1,2, Aritrick Chatterjee¹, Ajit Devaraj³, Ambereen Yousuf¹, Gregory S Karczmar¹, Tatjana Antic⁴, Scott Eggener⁵, and Aytekin Oto^1
1Department of Radiology, University of Chicago, Chicago, IL, United States, ²Department of Radiodiagnosis, King George's Medical University, Lucknow, India, ³Philips Research North America, Cambridge, MA, United States, ⁴Department of Pathology, University of Chicago, Chicago, IL, United States, ⁵Department of Urology, University of Chicago, Chicago, IL, United States

There are conflicting reports on the use of endorectal coil in the detection of prostate cancer at 3T due to increased patient discomfort and susceptibility artifacts. The purpose of the present study was to evaluate the feasibility of Hybrid Multidimensional MRI (HM-MRI) without an endorectal coil (using pelvic phased-array coil only) in the detection of prostate cancer (PCa) and to calculate fractional volumes of prostatic tissue composition, non-invasively.  A non-endorectal coil HM-MRI is feasible. We obtained a significant difference in epithelium volume between normal and PCa (p = 0.02), however stromal and luminal volume did not reach a significance level.

Li Zhang¹, Longchao Li¹, Min Tang¹, Yinzhong Wang², and Xiaoyan Wang^2
1Department of MRI, Shaanxi Provincial People’s hospital, Xi’an, China, ²Lanzhou university First Hospital, Lanzhou, China

PI-RADS Version 2.1 makes several minor modifications aimed at addressing these issues and simplifying the scoring system without changing the overall framework for acquisition or interpretation using the principles of the dominant sequence paradigm. Formal investigations of the Interobserver agreement of the PI-RADS version 2.1 scoring system are critical to confirm that it is attaining its primary aim of standardization.

Weicui Chen¹, Ling Li², Yingjie Mei³, Jilei Zhang³, Weikang Huang¹, Bo Liu¹, and Xian Liu^1
1Radiology, The second Affiliated hospital of Guangzhou University of Chinese Medicine, Guangzhou, China, ²Guangzhou University of Chinese Medicine; The second Affiliated hospital of Guangzhou University of Chinese Medicine;, Guangzhou, China, ³Clinical Science,Philips Healthcare;, Shanghai, China

We explore the utility of 3D APTw imaging and DKI in assessing the pathological factors of rectal adenocarcinoma. The mean APTSI and MK was higher with the advanced staging and grading in rectal adenocarcinoma. In addition, the mean APTw SI have a significantly positive correlation with WHO grades. Therefore, the mean APTw SI is promising to be a non-invasive biomarker in clinical practice and to become a potential predictor for estimating the prognosis of rectal adenocarcinoma.

rui qi¹ and ying wan^2
1radiology, Sichuan university, Chengdu, China, ²pathology, Sichuan university, Chengdu, China

To investigate the correlation between the ADC value of MRI-DWI and the pathological prognostic factors of rectal cancer. 87 patients with rectal cancer were grouped according to the pathological prognostic factors. The mean ADC values of tumor tissues were measured, and the relationship between ADC values of different groups was analyzed. The differences of ADC values of the different differentiation groups, pN stage groups and P53 expression groups had statistical significance. The P53 expression level and ADC value showed a moderate negative correlation. It is expected the biological behavior of tumors can be predicted by quantitative analysis of ADC values.

Tijmen Koëter¹, Rutger CH Stijns¹, Bart JW Philips², Jurgen J Futterer², Patrick Zamecnik², Sjaak JA van Asten², Marnix C Maas², and Tom WJ Scheenen^2
1Radiology and Nuclear Medicine, Department of Surgery, Radboudumc, Nijmegen, Netherlands, ²Radiology and Nuclear Medicine, Radboudumc, Nijmegen, Netherlands

Six patients with rectal cancer underwent USPIO-enhanced MRI at 3 and 7T. The presence and appearance of lymph nodes was annotated by two trained radiologists. Lymph nodes were matched between 3 and 7T, and ROIs were drawn inside the nodes to calculate mean R2* relaxation rates in order to assess the possibilities of quantitative thresholds in R2* between suspicious and benign lymph nodes at both field strengths.

Gesheng Song¹, Aiyin Li¹, Jingjing Cui², and Yan Jia^2
1Shandong Provincial Qianfoshan Hospital，the First Hospital Affiliated with Shandong First Medical, Jinan, China, ²Huiying Medical Technology Co., Ltd., Beijing, China

MRI based radiomics machine learning model could differentiating metastatic lymph node in rectal cancer.

Anliang Chen¹, Ailian Liu¹, Xuedong Wang¹, Yunsong Liu¹, Jingjun Wu¹, Qingwei Song¹, Renwang Pu¹, Jiazheng Wang², Zhiwei Shen², and Liangjie Lin^2
1Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China, ²Philips Healthcare, Beijing, China

Amide proton transfer-weighted (APTw) imaging can be used to assess changes of intracellular protein concentration and the pH value.And the T2 mapping allows non-invasive visualization and quantification of tissue composition. Here, weaimsto explore the value of APTw imaging in combination with T2 mapping in comparative analysesof rental cancer with and without chemotherapy. Results indicated that a ultrahigh diagnostic efficacy (AUC: 1.000; sensitivity: 100%; specificity: 100%) was achieved with combination of APT and T2 values.

Jingjun Wu¹, Ailian Liu¹, Jiazheng Wang², Zhongping Zhang², Anliang Chen¹, Xuedong Wang¹, Yunsong Liu¹, Lihua Chen¹, Qingwei Song¹, Renwang Pu¹, and Bingbing Gao^1
1Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian, China, ²Philips Healthcare, Beijing, China

Rectal cancer is the third most common cancer and the second cause of cancer-related death worldwide. DWI is now recommended as a routine addition to the MRI protocol for the assessment of rectal cancer. However, the effect of the b-value on the diagnostic performance has not yet been explored.  The current study aims to evaluate the value of texture analysis based on DWI with different B values to evaluate the heterogeneity of rectal cancer patients. The skewness and kurtosis were all significantly different in DWI with different B values, and they were obviously changed when B reached 800. 

Xuedong Wang¹, Anliang Chen¹, Qingwei Song¹, Jiazheng Wang², and Ailian Liu^1
1The first affiliated hospital of dalian medical university, DaLian, China, ²Philips Healthcare, China, Beijing, China

We aimed to explore the difference of amide proton transfer-weighted (APTw)  imaging combined with DKI between the chemotherapy group and non-chemotherapy group of rectal cancer. The result showed that the highest diagnostic efficacy(AUC: 0.986; sensitivity: 91.8%; specificity: 100%) was acquired using APT combined with DKI, rather than APT and DKI value respectively. 

Xuedong Wang¹, Ailian Liu¹, Jiazheng Wang², Yishi Wang², Anliang Chen¹, Lihua Chen¹, and Qingwei Song^1
1The first affiliated hospital of dalian medical university, DaLian, China, ²Philips Healthcare, China, Beijing, China

The purpose of this study was to investigate the feasibility of using APTw for the diagnosis of rectal cancer.

Lan Zhang¹ and Xin Li^1
1Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

We speculate that APT value may be a useful biomarker for assessing rectal pathological characteristics, which could have a potential impact on the clinical therapeutic strategies for patients. A baseline of APT value needs to be established for rectal cancer, which remains challenging due to the susceptibility effects. So we need to optimize the sequence by adjusting duration and power level of saturation pulse

Ali B Syed¹, Anugayathri Jawahar¹, and Vipul R Sheth^1
1Department of Radiology, Stanford University, Stanford, CA, United States

There is growing literature supporting the use of diffusion weighted imaging (DWI) for staging and re-staging of rectal cancer. We investigated the performance of reduced FOV (rFOV) DWI in comparison with conventional whole pelvis DWI. Two readers graded rFOV and conventional DWI for anatomic detail, lesion conspicuity, tumor margin delineation, artifact, and overall image quality. rFOV DWI showed statistically significant improvement in anatomic detail, lesion conspicuity, tumor margin delineation, and overall image quality. No significant difference in artifact/distortion or lymph nodes was detected. rFOV DWI is a promising technique in rectal cancer evaluation and improves tumor visualization.

Yunsong Liu¹, Anliang Chen¹, Jingjun Wu¹, Xuedong Wang¹, Lihua Chen¹, Yishi Wang², Jiazheng Wang², Zhiwei Shen², and Ailian Liu^1
1The First Affiliated Hospital of Dalian Medical University, Dalian, China, ²Philips Healthcare, Beijing, China

The current study aimed to investigate the value of T2 mapping in evaluating the difference of rectal cancer before and after chemotherapy. The results showed that T2 mapping had high diagnostic value in the two groups (AUC: 0.92; sensitivity: 100%; specificity: 80%).

Archana Vadiraj Malagi¹, Arjun Lokesh², Esha Baidya Kayal¹, Kedar Khare³, Virendra Kumar⁴, Chandan J. Das², and Amit Mehndiratta^1,5
1Centre for Biomedical Engineering, Indian Institute of Technology Delhi, New Delhi, India, ²Department of Radiodiagnosis, All India Institute of Medical Sciences Delhi, New Delhi, India, ³Department of Physics, Indian Institute of Technology Delhi, New Delhi, India, ⁴Department of Nuclear Magnetic Resonance (NMR), All India Institute of Medical Sciences Delhi, New Delhi, India, ⁵Department of Biomedical Engineering, All India Institute of Medical Sciences Delhi, New Delhi, India

Currently in countries with poor resources availability of higher magnetic strength 3T MRI is low. Objective is to analyze whether with lower magnetic strength 1.5T MRI with advanced parameter reconstruction method can perform better or equivalent to 3T MRI. IVIM-DKI signal was modelled using hybrid (HY) model which produces non-physiological inhomogeneity in parameter map. This inhomogeneity can be corrected by using total variation penalty function (TV) with HY model. IVIM-DKI maps obtained from HY with TV produced more clinically reliable than HY model. Even with low magnetic strength i.e. 1.5T, overall HY+TV model outperformed qualitatively & quantitatively against 3T MRI results.

Xiangyu Wang¹, Fan Lin¹, and Yi Lei^1
1The First Affiliated Hospital of Shenzhen University, Shenzhen, China

31 male volunteers were examined with VERDICT MRI of the prostate. The derived VERDICT parameters (the fIC, fEES and fVASC) were analyzed with a histogram based on the whole prostate volume and the PZ, CG and AS ROIs. There were statistical differences between histogram parameters and regions of the prostate. Among different anatomical zones, for PZ, Age has a negative correlation with fIC, and positive correlation with fEES. According to CG, there was also positive correlation between age and fEES.

Xiangyu Wang¹, Fan Lin¹, and Yi Lei^1
1The First Affiliated Hospital of Shenzhen University, Shenzhen, China

229 PZ and 270 TZ lesions were included in this study. The proportion of overall PCa and clinically important PCa detection (Gleason score≥3+4) for each PI-RADS version 2.1 category was determined. The performance of PI-RADS version 2.1 in cancer detection was evaluated. The diagnostic accuracy of the overall(82.6%) and csPCa TZ lesions(83.0%) is higher than the accuracy of PZ lesions(80.4%, 77.7%). For the csPCa diagnosis, the AUCs of PI-RADS version 2.1 in TZ(0.84) was higher than in PZ(0.77) without significance(P=0.06). Higher PI-RADS version 2.1 scores were associated with increasing likelihood of the presence of clinically important PCa (P<0.01).

Ren Huipeng¹, Fan Qing¹, Wang Xiaohu¹, Wei Xiaocheng², and Ren Zhuanqin^1
1Baoji Central Hospital, Baoji, China, ²GE Healthcare China, Beijing, China

The purpose of this study is to evaluate the efficacy of advanced diffusion weighted imaging (DWI) in the differential diagnosis of benign prostatic hyperplasia(BPH) with inflammation and Low-grade prostate transitional zone (TZ) cancer. By comparing the D, DDC and MK from advanced DWI with ADC value, it is found that the diagnostic efficiency of advanced DWI is better than the conventional DWI, and the combined diagnosis of (D + DDC + MK) has the highest efficiency.

Hirotoshi Maruyama¹, Yasuhiro Fujiwara², and Akira Takahashi^1
1Radiology, Kumamoto Saishun Medical Center, Kumamoto, Japan, ²Department of Medical Imaging, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan

We propose a sequence to simultaneously acquire apparent diffusion coefficient (ADC) and T2 values for detecting prostate cancer. ADC and T2 values of prostate cancer can simultaneously be acquired using not only a diffusion-weighted image, but also multiple echo time (TE) images without motion-probing gradient using echo-planar imaging (EPI). Moreover, the quantitative ADC and T2 maps can be produced in approximately 5 min. Combining ADC and T2 values was effective in differentiating between prostate cancer and the normal peripheral zone. Our rapid quantification imaging technique improves the accuracy of the diagnosis of prostate cancer.

Liang WANG ^1
1Tongji Hospital,Tongji Medical College,  Huazhong University of Science & Technology, Wuhan, China

Prostate cancer is the 2nd leading diagnosed cancer in men worldwide. Radiomics extracts large amounts of quantitative image features from radiologic images and selects stable and clinically relevant radiomics biomarkers for disease assessment. 90 patients  underwent mpMRI before radical prostatectomy, with subsequent pathologic evaluation.  The texture features were extracted by the python-based pyradiomics package. The AUC of the model was 0.841, with sensitivity 69.6% and specificity 91.2%, which was significantly higher than mean ADC value or single texture feature. MRI ADC map texture evaluation may facilitate noninvasive assessment of aggressiveness of prostate cancer.

Dharmesh Singh¹, Saumya Diwan², Virendra Kumar³, Chandan J Das⁴, Anup Singh^1,5, and Amit Mehndiratta^1,5
1Centre for Biomedical Engineering, Indian Institute of Technology (IIT) Delhi, New Delhi, India, ²Delhi Technological University, Delhi, India, ³Department of NMR, All India Institute of Medical Sciences Delhi, New Delhi, India, ⁴Department of Radiology, All India Institute of Medical Sciences Delhi, New Delhi, India, ⁵Department of Biomedical Engineering, All India Institute of Medical Sciences Delhi, New Delhi, India

Accurate estimation of tumor size is a challenging task due to the large variation in shape of prostatic tumors. Measurement of diameter and volume of tumor are useful for the staging of prostate cancer(PCa). Therefore, an appropriate method for tumor assessment is essential to assist clinical management of PCa. The goal of this study was to investigate the role of tumor size estimation methods (2D vs. 3D) for the Prostate Imaging Reporting and Data System version-2(PI-RADS v2) assessment of PCa using multiparametric MRI. Automatic tumor size assessment using ellipse-fitting approach showed relatively better performance of PCa assessment compared to radiologist-assessment.

Li Zhang¹, Longchao Li¹, and Min Tang^1
1Department of MRI, Shaanxi Provincial People’s hospital, Xi’an, China

In 2019, the updated version of PI-RADS Version 2.1 was introduced. This version did not change the entire framework, but made several modifications to address limitations and simplify the scoring system. Between 442 patients, both readers had 96 discordant cases in terms of five-point Version 2.1 scoring. Version 2.1 provides high accuracy for detecting clinically significant PCa with category 4 as the threshold. Both readers have good inter-reader reliability. However, agreement for TZ was lower than for PZ lesions.

Ya nan Wu¹, Mei yu Sun¹, Ai lian Liu¹, Jia zheng Wang², Yi shi Wang², Cheng yan Wang¹, Li hua Chen¹, Qing wei Song¹, Ren wang Pu¹, and Bing bing Gao^1
1The First Affiliated Hospital of Dalian Medical University, Da lian, China, ²Philips Healthcare,China, Bei jing, China

Compressed sensing(CS)technology is currently used less in prostate diseases. This study aims to explore the feasibility of CS and SENSE technology with different acceleration factors for prostate 3D magnetic resonance imaging(MRI). The preliminary exploration concluded that the SNR and CNR with CS 5 in prostate 3D mDIXON imaging are similar to the SENSE 2, and the imaging time is reduced by 28%, which effectively improves the MR scanning efficiency.

Ming Deng¹, Haibo Xu², Xiaoyong Zhang³, and Yingao Zhang^4
1Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan University,, Wuhan, China, ²Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China, ³MR Collaborations, Siemens Healthcare Ltd, Shenzhen, China, ⁴Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China

The aim of this study was to evaluate the diagnostic performance of a convolutional neural network (CNN)-based deep learning technique for the differentiation of prostate cancer (PC) using dynamic contrast agent–enhanced magnetic resonance imaging (DCE-MRI) data. Our patient study demonstrated that the quantitative image features derived from the DCE-MR images based on the self-defined CNN model can be effective in distinguishing PC from the normal, and the automated extraction of Ktrans, TDC, DR, and DY features can significantly promote PC diagnosis. The high performance of the proposed CNN-based deep learning method statistical analysis demonstrated its potential for improving PC diagnosis.

 

Aileen O'Shea¹, Arnaud Guidon², Robert Marc Lebel³, Ersin Bayram⁴, Theodore Pierce¹, Amirkasra Mojtahed¹, and Mukesh G Harisinghani^1
1Massachusetts General Hospital, Boston, MA, United States, ²Applications and Workflow, GE Healthcare, Boston, MA, United States, ³Applications and Workflow, GE Healthcare, Calgary, AB, Canada, ⁴Applications and Workflow, GE Healthcare, Houston, TX, United States

Increasing the speed of multiparametric prostate MRI (mpMRI) is highly desirable.  However, usual tradeoffs between signal-to-noise (SNR), scan time and lesion conspicuity must be considered.  One recently proposed approach consists of using a bi-parametric protocol, whereby only the T2 and diffusion-weighted images are collected, thus highlighting the particular significance of achieving a robust, high-quality T2-weighted acquisition.  As such, this work focuses on evaluating a Deep Learning reconstruction technique which shows promises to cut acquisition time of prostate T2-weighted imaging in half and would therefore benefit both bi-parametric as well as mpMRI.

Jing Zhang¹, Yang Song¹, Yu-dong Zhang², Xu Yan³, Yefeng Yao¹, and Guang Yang^1
1Shanghai Key Laboratory of Magnetic Resonance, Department of Physics, East China Normal University, shanghai, China, ²Department of Radiology, The First Affiliated Hospital with Nanjing Medical University,, Nanjing, China, ³MR Scientific Marketing, Siemens Healthcare, shanghai, China

Texture features plays an important role in radiomics. To make the texture features rotation-invariant, pyradiomics computes the texture features along all directions and use their mean values. In this study, we demonstrated that maximum and minimum values of these features along different directions, which is also rotation-invariant, may provide added value to radiomics studies. We trained models using mean, maximum and minimum values of texture features along different directions to classify clinically significant (CS) prostate cancer (PCa) and non-CS PCa on PROSTATEx dataset. We found that using extremum instead of mean texture features improved the performance of model.

Collin J. Harlan¹, Zhan Xu ¹, Keith A. Michel^1,2, Christopher M. Walker¹, Sanjaya D. Lokugama³, Mark D. Pagel^2,3, and James A. Bankson^1,2
1Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States, ²The University of Texas MD Anderson Cancer Center UT Health Graduate School of Biomedical Sciences, Houston, TX, United States, ³Department of Cancer Systems Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, United States

Multiparametric and hyperpolarized (HP) ¹³C Magnetic Resonance Imaging (MRI) are attractive multi-modality methods for prostate cancer imaging studies because of their non-invasiveness and characterization of changes in tumor metabolism. A ¹³C-urea calibration reference is required when conducting HP ¹³C MRI studies, which must be heavily doped with Gd⁺ to facilitate rapid calibrations. Care must be taken to ensure that the highly relaxed ¹H signal does not compromise DCE-MRI via hyperintense imaging artifacts. Deuteration and lyophilization of ¹³C-urea can be useful in creating a calibration reference that does not lead to imaging artifacts in ¹H Images.

Anqin Li¹, Zhen Li¹, and Daoyu Hu^1
1Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

To improve understanding of DWI features of complex renal cysts, and compare diagnostic performance of MRI and CT in discrimination of benign and malignant masses. Images of each lesion were analyzed, including size, thickness of wall, number of septum, enhancement of wall/septum, wall nodule, calcification, and cyst content. CT and MRI image characteristics were compared with pathology or follow-up results. The incidences of high signal intensity on DWI were significantly higher in malignant than in benign masses. MRI showed higher AUC than CT for differentiating benign from malignant masses. MRI could be useful in improving diagnosis of complex renal cysts.

Tatsuya Yamamoto¹ and Atsushi Kohno^1
1Department of Diagnostic Radiology, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan

Although the prognosis of chromophobe renal cell carcinoma (CHRCC) is more favorable than that of other RCC subtypes, it is a malignant tumor with possible metastasis. On the other hand, there is only one confirmed case of renal oncocytoma metastasis. This study assessed the apparent diffusion coefficient (ADC) value derived from diffusion-weighted imaging to differentiate renal oncocytoma from CHRCC according to cell grade. The ADC values were significantly different between low-grade and high-grade CHRCCs and between oncocytoma and high-grade CHRCC. Thus, the ADC value is useful for differentiating oncocytoma from high-grade CHRCC but not for differentiating oncocytoma from low-grade CHRCC.

Xinmiao Bu¹, Ailian Liu¹, Dahua Cui¹, Xin Li², and Qingwei Song^1
1The First Affiliated Hospital of Dalian Medical University, dalian, China, ²GE Healthcare, Beijing, China

To investigate the potential of ESWAN in differentiating renal clear cell carcinoma with different pathological grades, to help preoperative non-invasive prediction of renal clear cell carcinoma pathological grading.

Xinmiao Bu ¹, Ailian Liu¹, Lihua Chen¹, Weiping Yang¹, Yunsong Liu¹, Yaxin Niu¹, Qingwei Song¹, Renwang Pu¹, Jiazheng Wang², Zhiwei Shen², and Zhongping Zhang^2
1The First Affiliated Hospital of Dalian Medical University, dalian, China, ²Clinical Science, Philips Healthcare, Beijing, China

To evaluate the joint diagnosis value of T1 Mapping and amide proton transfer imaging in the chronic kidney disease and healthy volunteers.

Akira Yamamoto¹, Tsutomu Tamada², Yu Ueda³, Takeshi Fukunaga², Ayumu Kido², and Atsushi Higaki^2
1Radiology, Kawasaki Medical School, Kurashiki, Japan, ²Kawasaki Medical School, Kurashiki, Japan, ³Philips Japan, Minato-ku, Japan

The purpose of this study was to identify the changes in multiparametric magnetic resonance imaging (MRI) findings in early diabetic nephropathy. Measurements were made of the renal cortex and renal medulla T2 values, T2* values and R2* values, as well as optimal TI, inverted TI value in SSFP with ssIR pulse with multi TI. Also, renal cortical thickness and renal length were measured, representing morphological changes. Significant differences were seen between the healthy and early diabetic nephropathy groups in values of T2 and inverted TI. This study suggests the possibility that MRI using the T2 value and inverted TI of SSFP with an ssIR pulse can be used to evaluate early diabetic nephropathy non-invasively and in a short period of time.

Youzhen Feng¹, Zhongyuan Cheng¹, Xiaoqing Xiong¹, Qiting Lin¹, Dingkun SiTu¹, Pingkang Chen¹, Zhifei Liu², Long Qian³, and Xiangran Cai^1
1Medical Imaging Center, First Affiliated Hospital, Jinan University, Guangzhou, Guangdong, China, Guangzhou, China, ²Medical Imaging Center, First People's Hospital of Kashgar, Xinjiang, china., Xinjiang, China, ³MR Research, GE Healthcare, Beijing, 100176, China., Beijing, China

Multiparametric-MRI (mp-MRI) has shown promising results in the diagnosis of clinical disease. It provides us an approach to perform investigation from multiple dimension and avoids to ignore the worthwhile diagnosis information. Previous studies indicated that the perfusion and dispersion of renal parenchyma have been changed in diabetic mellitus (DM) without biochemical indicators of significant renal damage. However, the convergence and divergence of those diffusion and perfusion related MRI parameters in the evaluation of DM associated kidney damage is still unclear. To assess the renal functional changes in DM patients, three MRI modalities were applied in current study.

Hajime Tamura¹, Hideki Ota², Tatsuo Nagasaka³, and Eikan Mishima^4
1Division of Medical Physics, Tohoku University, Graduate school of medicine, Sendai, Japan, ²Department of Advanced MRI Collaboration Research, Tohoku University, Graduate school of medicine, Sendai, Japan, ³Department of Radiology, Tohoku University hospital, Sendai, Japan, ⁴Division of Nephrology, Endocrinology, and Vascular Medicine, Tohoku University, Graduate school of medicine, Sendai, Japan

Renal IVIM imaging taking account of water in the urinary tubules and relaxation times was performed in patients with renal-artery stenosis. Several estimated parameters were significantly correlated with the functional parameters obtained by renal scintigraphy (water fraction with the time to peak height (T_max) on the renogram curve of renal scintigraphy, parenchymal diffusion coefficient with the glomerular filtration rate (GFR), and transverse relaxation time of flowing blood with GFR).

Feng Wang^1,2, Tadashi Otsuka³, Keiko Takahashi³, Daniel C. Colvin¹, Hua Li¹, Raymond C. Harris³, Takamune Takahashi³, and John C. Gore^1,2,4
1Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, United States, ²Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, United States, ³Division of Nephrology and Hypertension, Vanderbilt University Medical Center, Nashville, TN, United States, ⁴Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, United States

Assessing the severity and progression of tubular dilation and fibrosis in kidneys are important clinical challenges. Here we evaluate spin-lock MR imaging with different locking fields for detecting tubular dilation and fibrosis in a mouse model of unilateral ureter obstruction. We fit the dispersion of spin-lock relaxation rates R_1ρ  at different locking fields (frequencies) to a model of exchanging water pools and assessed the sensitivity of the derived quantities for detecting tubular dilation and fibrosis in kidney. Histological scores for tubular dilation and fibrosis, based on luminal space and positive picrosirius red area in sections, were obtained for comparison.

Darya Morozov¹, Jennifer R. Charlton², Kimberly A. deRonde², and Kevin M. Bennett^1
1Radiology, Washington University in St. Louis, School of Medicine, Saint Louis, MO, United States, ²Pediatrics, University of Virginia Children's Hospital, Charlottesville, VA, United States

Tubular hypertrophy is an early feature of many renal pathologies. A direct, non-invasive measure of kidney morphology is lacking. Current diagnostics are primarily based on biopsy after suspected renal disease, which is prone to sampling error and is invasive. A robust non-invasive imaging tool to study tubular changes in vivo is greatly needed and would provide early tissue biomarker for initiation and progression of kidney injury. In this work, we used a single diffusion encoding MRI approach to study distribution of restricting tissue compartment sizes in kidney cortex as a potential noninvasive marker of tubule size in the intact kidney.

Yingjie Mei^1,2, Guixiang Yang³, Yihao Guo^1,4, Kaixuan Zhao^1,4, Chenggong Yan³, Yikai Xu³, and Yanqiu Feng^1,4
1Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guang Zhou, China, ²Philips Healthcare, Guang Zhou, China, ³Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou, China, ⁴School of Biomedical Engineering, Southern Medical University, Guang Zhou, China

Cases of Aristolochic acid nephropathy (AAN) have been reported worldwide, yet no serum or urinary biomarkers have been shown to have clinical utility in detection of AAN. In this study, we aim to detect renal changes in the early phase of AAN with T2 mapping. The results suggest that T2 mapping may be a valuable tool in experimental studies and clinical practice of acute phase of AAN.

Zhongyuan Cheng¹, Qiting Lin¹, Xiaoqing Xiong¹, Dingkun Situ¹, Pingkang Chen¹, Zhifei Liu², Long Qian³, Youzhen Feng¹, and Xiangran Cai^1
1Medical Imaging Center, First Affiliated Hospital, Jinan University., Guangzhou, China, ²Medical Imaging Center, First People's Hospital of Kashgar, Xinjiang, china., Xinjiang, China, ³MR Research, GE Healthcare., Beijing, China

The aim of this study was to investigate the feasibility of diffusion tensor imaging (DTI) and blood oxygenation level dependent imaging (BOLD) in assessing early renal function changes in hyperuricemia.

Lihua Chen¹, Ailian Liu¹, Jiangzheng Wang², Zhiwei Shen², Qingwei Song¹, Renwang Pu¹, and Nan Wang^1
1The First Affiliated Hospital of Dalian Medical University, Dalian, China, ²Philips Healthcare, Beijing, China

3D amide proton transfer weighted (APTw) MR imaging is a novelcontrast-agent-free MRI technique for detection of amide protons in mobile cellular proteins and peptides 1-3.On the other hand, 3D pseudo-continuous arterial spin labeling (3D-pCASL)is amethod to measure renal blood supply and hence potentially a metric for renal function. This study reveals a close association between the vascularity and concentration of mobile cellular proteins in kidney.

Hanjing Kong^1
1Peking University, Beijing, China

Renal embolization is part of a multisystemic disease and has attracted enhanced attention in recent years for its increasing incidence in the elderly.It is a significant cause of renal loss in patients who suffer from valvular cardiopathy, aortic atheromatosis, and hypercoagulable states. In this study, we attempt to investigate the feasibility of compressed sensing (CS) based DCE-MRI in the assessment of AERD in animal models.

Gang Zheng¹, Michael de Veer¹, Hongxin Wang¹, Shenpeng Li¹, and Gary Egan^1
1Monash Biomedical Imaging, Monash University, Clayton, Australia

The detection of adipose tissue (AT) is of great importance in studying obesity. Isoflurane is a common fluorinated anesthetic with an excellent safety record in preclinical studies, which has a high blood–gas partition coefficient in adipose tissue. This abstract demonstrates that 19F-isoflurane can be used as an MR contrast agent for noninvasive imaging of AT in a mouse body.

Wan Dong¹, Ailian Liu¹, Qinhe Zhang¹, Liangjie Lin², and Jiazheng Wang^2
1Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian, China, ²Philips Healthcare, Beijing, China

It has been reported that pancreatic volume is closely related to pancreatic function. The 3D mDixon Quant MRI can achieve accurate water and fat images. Here, two measurement methods, including the single-layer region-of-interest (ROI) based and the 3D volume extraction methods, were compared for determination of pancreatic volume on the 3D mDixon Quant images. Results showed that pancreatic volumes measured by the two methods were with favorable consistency (ICC=0.971) and strong stability (P=0.169).

Wan Dong¹, Ailian Liu¹, Qinhe Zhang¹, Liangjie Lin², and Jiazheng Wang^2
1Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian, China, ²Philips Healthcare, Beijing, China

Functions of pancreas are associated with its volume and fat fraction. 3D mDixon Quant has been proved to be valuable in measuring fat fraction, which was employed in this study for determination of volume and fat content of pancreas. Then the correlations of pancreas volume and fat content to age, gender and BMI were examined. Results showed a significant negative correlation of age to the pancreas volume, while positive to the fat fraction. Therefore, 3D mDixon Quant is helpful in assessing pancreas volume and fat fraction. As age increases, the pancreas tends to shrink and its fat fraction to increase.

Paul Kennedy^1,2, Sara Lewis³, Octavia Bane^1,2, Stefanie Hectors^1,2,4, Edward Kim⁵, and Bachir Taouli^1,2
1BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States, ²Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States, ³Radiology, Icahn School of Medicine at Mount Sinai, NY, NY, United States, ⁴Department of Radiology, Weill Cornell Medicine, New York, NY, United States, ⁵Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, NY, NY, United States

In this study we assess early changes following ⁹⁰Y radioembolization (RE) in hepatocellular carcinoma and liver parenchyma using MR elastography and predict response at 6 weeks/6 months. Tumor stiffness (TS) and liver stiffness (LS) adjacent to the tumor were significantly increased 6w following RE. Baseline TS and LS adjacent to the tumor were significantly lower in patients who achieved complete response. Baseline TS correlated with necrosis at 6w and was a significant predictor of partial response or stable disease based on mRECIST criteria following RE. MR elastography may be a useful tool for predicting necrosis and tumor response to RE.

Ruiqi Geng^1,2, Yuxin Zhang^1,2, Matthias Robert Muhler¹, Jitka Starekova¹, and Diego Hernando^1,2
1Department of Radiology, University of Wisconsin-Madison, Madison, WI, United States, ²Medical Physics, University of Wisconsin-Madison, Madison, WI, United States

Diffusion weighted imaging (DWI) of the liver has multiple important applications in the assessment of liver disease, including cancer. However, liver DWI faces several major challenges including signal dropout due to cardiovascular pulsation, mis-registration due to respiratory motion, and low SNR. We have developed a DWI technique that addresses these challenges by combining motion-robust diffusion waveforms to address cardiovascular pulsation, high SNR from non-gated free-breathing acquisitions, and motion-corrected averaging for respiratory motion-correction. This technique was evaluated in patients with known or suspected liver metastases. The proposed technique has the potential to enable improved assessment of liver lesions.

Nathanael Kim¹, Shannan Dickinson², Maggie Fun³, Ersin Bayram³, Li Feng⁴, Ricard Do², and Ricardo Otazo^1,2
1Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, United States, ²Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, United States, ³GE Healthcare, Waukesha, WI, United States, ⁴Biomedical Engineering and Imaging Institute and Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States

Breath-hold post contrast T1-weighted liver MRI is limited by the patient’s ability to cooperate with breathing instructions. Free-breathing radial imaging and compressed sensing-based motion-resolved image reconstruction (XD-GRASP) has been specifically developed to resolve motion artifacts over standard cartesian techniques. In this work, we apply XD-GRASP to enable free-breathing MRI in the hepatobiliary liver phase, a clinically relevant problem. We demonstrate that the image quality of free-breathing XD-GRASP is equal to or superior to the one using standard breath hold acquisitions.

Yoshifumi Noda¹, Keita Fujimoto¹, Nobuyuki Kawai¹, Kimihiro Kajta¹, Yuta Akamine², Hiroshi Kawada¹, Yukichi Tanahashi¹, and Masayuki Matsuo^1
1Radiology, Gifu University, Gifu, Japan, ²Philips Japan, Tokyo, Japan

Intravoxel incoherent motion, a bi-exponential model of diffusion-weighted imaging with multiple b values, can represent pure molecular diffusion and perfusion, and be used in characterizing focal hepatic lesions. Recently, stretched exponential model has been used in several cancers. In this study, we evaluated the feasibility of stretched exponential model for differentiating hepatic hemangiomas and liver metastases. Our results showed that DDC value from a stretched exponential model was the highest diagnostic potential, so it could be a quantitative imaging biomarker for differentiating hepatic hemangiomas and liver metastases.

Yoshifumi Noda^1,2, Vinit Baliyan¹, Hamed Kordbacheh¹, and Avinash R Kambadakone^1
1Radiology, Massachusetts General Hospital, Boston, MA, United States, ²Radiology, Gifu University, Gifu, Japan

Gadoxetic acid is a liver-specific contrast agent and has been reported to be useful for the detection of liver metastases in patients with pancreatic ductal adenocarcinoma (PDAC). Recently, aberrant OATP expression has been reported in liver metastases from PDAC and is associated with poor prognosis. Our results show that patients with liver metastases demonstrating heterogeneous hypointensity on hepatobiliary phase images are associated with worse overall survival compared to those with homogeneous hypointensity.

Tao Lin¹, Ailian Liu ¹, Jiazheng Wang ², Nan Wang¹, Lihua Chen ¹, Dahua Cui¹, Ying Zhao ¹, Qingwei Song ¹, Yishi Wang², Renwang Pu ¹, and Bingbing Gao^1
1The First Affiliated Hospital of Dalian Medical University, Dalian, China, ²Philips Healthcare, Beijing, China

Our work aimed to explore the value of amide proton transfer-weighted (APTw) imaging in diagnosing liver lesions. The result showed that novel imaging tool had a high value in differentiating benign liver lesions from malignant liver lesions (AUC: 0.801; sensitivity: 76.9%; specificity: 83.3%).

Ying Zhao¹, Jiazheng Wang², Zhiwei Shen², Jianqing Sun², Nan Wang¹, Lihua Chen¹, Dahua Cui¹, Tao Lin¹, Qingwei Song¹, Renwang Pu¹, Bingbing Gao¹, and Ailian Liu^1
1The First Affiliated Hospital of Dalian Medical University, Dalian, China, ²Philips Healthcare, Beijing, China

In the current study, texture analysis of multiple high b-values DWI was demonstrated to be capable to identify primary hepatic cancer and hepatic metastases, which provided abundant quantitative information that may facilitate clinical management. The results showed that texture features based on b800 and b2000 DWI images was the optimal strategy to identify different types of hepatic malignant tumors (b800: sensitivity 92.0%, specificity 84.2%; b2000: sensitivity 84.0%, specificity 94.7%).

Sailong Zhang¹, Keith Wan-Hang Chiu¹, Siu Hin Mak², TSOUGENIS Efstratios³, and Peng Cao^1
1Diagnostic Radiology, The University of Hong Kong, Hong Kong, Hong Kong, ²The University of Hong Kong, Hong Kong, Hong Kong, ³Imsight Medical Technology Company (Hong Kong), Hong Kong, Hong Kong

Early detection of liver cancer is crucial for improving patient management outcome. However, liver lesions can be differencaited to be identified. In recent years,  the fully convolution neural network (FCNN)  has shown to be able to achieve commensurate and comparable performance of detecting various pathology on medical imaging. The goal of this study is to show the possibility of applying FCNN deep learning for training the hepatic lesion detection on dynamic contrast-enhanced Magnetic Resonance Imaging.

Yun Bian¹, Chao Ma¹, Xu Fang¹, Jin Li¹, Kai Cao¹, Li Wang¹, Jin Gang², Jianping Lu¹, and Hui Jiang^3
1Radiology, Changhai hospital, Shanghai, China, ²Pancreatic Surgery, Changhai hospital, Shanghai, China, ³Pathology, Changhai hospital, Shanghai, China

The uncinate process has unique anatomical characteristics, which may make cancers that develop there radiopathologically different from cancers that develope elsewhere in the pancreas. Previous studies on uncinate and non-uncinate process pancreatic head cancer have yielded conflicting results. Some investigators concluded that location of pancreatic head cancer did not correlate with prognosis. Meanwhile, other investigators demonstrated a significant association between tumor location and prognosis, showing that uncinate process pancreatic head cancer was associated with a higher mortality risk versus non-uncinate process pancreatic head cancer. However, it still remains unelucidated whether tumor location is an independent prognostic factor of overall survival (OS) of pancreatic head cancer patients. In addition, it is unclear whether tumor location could guide prognostic stratification of pancreatic head cancer patients. So, the primary objectives of our study were to investigate the relationship between uncinate and non-uncinate process pancreatic head cancer and overall survival (OS) and further explore prognostic stratification between the two tumor locations and OS in different subgroups of patients.