Xiao-Li Song¹, Jialiang Ren², Kaiyu Wang³, and Bing Wu^3
1The Second Hospital of Shanxi Medical School, Taiyuan, China, ²GE Healthcare, Beijing, China, ³GE Healthcare, MR Research China, Beijing, China

Cervical cancer remains the most common gynecological cancers. Histological subtype and grade of differentiation determines the course of the disease, the therapeutic outcome and survival of patient. Low-grade cervical cancers are associated with more favorable outcomes and lower tumor recurrence rates when compared to the high-grade cervical cancers.The multiple quantitative maps derived from synthetic magnetic resonance imaging (MRI) might have potential applications in describing the characteristics of cervical cancer.

Mandi Wang¹, Yiang Wang¹, Chia-Wei Lee², Chien-Yuan Lin², and Elaine Y.P. Lee^1
1The University of Hong Kong, Hong Kong, Hong Kong, ²GE Healthcare, Taipei, Taiwan

T1 and T2 relaxation mapping of tissues could provide valuable information for pathologic characterization but is limited by long scan time and consequently hampered routine clinical integration. This study aimed to investigate the ability of T1 and T2 values derived from synthetic technique dubbed MAGnetic resonance image Compilation (MAGiC) in the characterization of cervical squamous cell carcinoma (SCC). Mean T2 value was significantly higher in FIGO stage III~IV than FIGO stage I~II which demonstrated that T2 value could be a potential imaging biomarker for FIGO staging in SCC.

Mayumi Takeuchi¹, Kenji Matsuzaki², and Masafumi Harada^1
1Department of Radiology, Tokushima University, Tokushima, Japan, ²Department of Radiological Technology, Tokushima Bunri University, Sanuki, Japan

Lobular endocervical glandular hyperplasia (LEGH) is considered as a precursor lesion of cervical adenocarcinomas with poor prognosis, and early diagnosis on MRI is important. MRI of 9 LEGH-associated adenocarcinomas (LEGH-ACs) and 10 LEGHs were retrospectively evaluated. Both LEGH-AC and LEGH appeared as multicystic masses with solid components. 4 of 9 LEGH-ACs (44%) showed diffusion restriction, whereas 5 of 9 LEGH-ACs (56%) and all LEGHs showed no diffusion restriction. On DCE-MRI, 4 of 4 LEGH-ACs (100%) and 2 of 6 LEGHs (33%) showed rapid and prolonged contrast-enhancement pattern, whereas 4 of 6 LEGHs (66%) showed gradual contrast-enhancement pattern suggesting their benignity.

Bin Shi¹ and Jiang-Ning Dong^1
1The First Affiliated Hospital of USTC, Anhui Provincial Cancer Hospital, Hefei, China

The study aimed to explore the diagnostic value of IVIM-DWI and texture analysis on T2WI for the tumor differentiation grade of cervical squamous cell carcinoma. Finally, we carried out a combined analysis of IVIM-DWI and T2WI-based texture analysis for four compared groups, the AUC of these regression model for four comparison was 0.797, 0.954, 0.795, 0.952, respectively; better than each parameters of IVIM-DWI and texture features alone (0.503~0.684, 0.547~0.805, 0.511~0.712, 0.636~0.792, respectively). Thus, the combination of IVIM-DWI biomarkers and texture features based on tumorous heterogeneity could develop a novel predictive paradigm for the formulation of operation or radiation therapy.

Mayumi Takeuchi¹, Kenji Matsuzaki², and Masafumi Harada^1
1Department of Radiology, Tokushima University, Tokushima, Japan, ²Department of Radiological Technology, Tokushima Bunri University, Sanuki, Japan

Uterine cervical cancer with urinary bladder invasion is classified as stage IVA with poor prognosis. Cystoscopy is a diagnostic procedure but relatively invasive examination. MRI can rule out the bladder invasion and skipping cystoscopy may be possible, however, high false positive rate may be problematic. The bladder mucosal invasion in 14 cases was evaluated with reduced FOV DWI (rFOV-DWI) and compared with cystoscopic findings. The diagnosis of invasion had a sensitivity of 100%, specificity of 50%, accuracy of 93%, PPV of 92%, and NPV of 100%. Addition of rFOV-DWI may improve the staging accuracy in assessing the bladder mucosal invasion.

Masamitsu Hatakenaka¹, Makoto Nozaki¹, and Koichi Onodera^1
1Diagnostic Radiology, Sapporo Medical University, Sapporo, Japan

Some texture features from ADC map show both significant correlation with histology (benign vs. malignant), lymph node metastasis and myometrial invasion (<1/2 vs. >1/2), acceptable AUC (>0.7) and high data reproducibility (ICC>0.8) in uterine endometrial lesions.

Xing Meng¹, Ailian Liu¹, Shifeng Tian¹, Qinhe Zhang¹, Qingwei Song¹, and Jiazheng Wang^2
1Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian, China, ²Philips Healthcare, Beijing, China

Accurate differential diagnosis of endometrial carcinoma (EC) and endometrial polyp (EP) determines the choice of surgical methods. Recent studies have separately applied Amide proton transfer (APT) and Intra-voxel-incoherent-motion (IVIM) imaging in diagnosing female pelvic system diseases including cervical carcinoma (CC) and EC. In this study, we investigated the combination of APTw and IVIM for differential diagnosis of EC and EP. The Results suggested that the combination of APTw and IVIM effectively aids in differentiating EC from EP.

Ye Li¹, Shifeng Tian¹, Ailian Liu¹, Jiazheng Wang², and Peng Sun^2
1The First Affiliated Hospital of Dalian Medical University, Dalian, China, ²Philips Healthcare, Beijin, China

Preoperative risk assessment of endometrial carcinoma (EC) is crucial to therapy planning. The present study explores the feasibility of the combination of APT and DCE in preoperative risk assessment of endometrial carcinoma. Compared with low-risk EC, the APT values and volume transfer constant (Ktrans) derived from DCE in high-risk EC increased significantly. Our results suggest that both APT and Ktrans can differentiate high-risk EC and low-risk EC. However, a combination of APT and DCE does not improve the AUC statistically significantly. 

yaling wang¹, Zhongshuai Zhang², Yuancheng Wang¹, and Shenghong Ju^1
1Zhongda Hospital，School of Medicine，Southeast University, NanJing, China, ²SIEMENS Healthcare, Shanghai, China

This prospective study aimed to investigate the value of GRASP（Golden-angle RAdial Sparse Parallel）on dynamic gadolinium-enhanced T1-weighted MRI (DCE-MRI) for the differentiation between benign and malignant lesions of endometrium on 88 patients. The results showed that the quantitative parameters include Kep and Ve of DCE-MRI have statistically significant difference between the benign and malignant endometrium lesions

Nan Meng¹, Zhun Huang², Pengyang Feng², Ting Fang¹, Fangfang Fu¹, Yaping Wu¹, Wei Wei¹, Xuejia Wang³, Kaiyu Wang⁴, and Meiyun Wang*^1
1Department of Radiology, Zhengzhou University People’s Hospital & Henan Provincial People’s Hospital, Zhengzhou, China, ²Department of Radiology, Henan University People’s Hospital & Henan Provincial People’s Hospital, Zhengzhou, China, ³Department of MRI, The First Affiliated Hospital of Xinxiang Medical University,, Weihui, China, ⁴GE Healthcare, MR Research China, BeiJing, China

Our results showed that both multimodel DWI and APTWI can estimate the histological grade and Ki-67 index of endometrial adenocarcinoma (EA), and the combination of a high MTRasym(3.5 ppm) and low D may be an effective imaging marker for predicting the grade of EA.

Xinliu He¹, Yulin Chen¹, Li Liu¹, Ye Li¹, Qingwei Song¹, and Ailian Liu^1
1The First Affiliated Hospital of Dalian Medical University, Dalian, China

Ki-67 is one of the prognostic marker which determines the growth fraction of a tumour and its over expression is associated with malignancy, tumour aggression, reserved prognosis and metastasis.  This worked aimed at exploring the correlation of Intravoxel incoherent motion (IVIM) quantitative parameters with ki-67 expression level in ovarian cancer. The results proved that there are correlation between D value and Ki-67 gene expression in ovarian cancer, P value is 0.039 and the r value is -0.454.

Wenjun JUN Hu¹, Ailian Liu¹, Ye Li¹, Hongkai Wang², Mingrui Zhuang², and Qingwei Song^1
1The First Affiliated Hospital of Dalian Medical University, Dalian, China, ²Dalian University of Technology, Dalian, China

Malignant ovarian tumor is characterized of high incidence, poor treatment outcomes and high treatment costs. The aim of this study was to explore the value of R2* and automatically quantitative ITSS in differentiating malignant ovarian tumor (MOTs) from other ovarian tumors (OOTs). Results of this study indicate the ITSS and R2* values of MOTs were significantly higher than those of OOTs. The combination of the two parameters can improve the differential diagnosis efficiency.

Daphna Link¹, Netanell Avisdris^1,2, Xingfeng Shao³, Liat Ben-Sira^4,5, Leo Joskowicz², Ilan Gull⁶, Danny J.J Wang³, and Dafna Ben-Bashat^1,5
1Sagol Brain Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel, ²School of Computer Science and Engineering, The Hebrew University of Jerusalem, Jerusalem, Israel, ³Laboratory of FMRI Technology (LOFT), USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States, ⁴Division of Pediatric Radiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel, ⁵Sackler Faculty of Medicine & Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel, ⁶Ultrasound Unit, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel

Early and accurate placental insufficiency assessment is of a great importance. Here we comprehensively assessed placental perfusion and structure, and fetal brain and body volumes, in normal fetuses and in cases with fetal growth restriction (FGR) caused by placental insufficiency, at late gestational ages (GA=31-34 weeks). Increased Placental Blood Flow and Arterial Transit Time were detected in normal cases compared to earlier GA reported previously. Significant differences were found in several placental and fetal characteristics between normal and FGR cases. This study emphasizes the importance of multi-parametric assessment of fetuses to enable identification of high risks for FGR.

liu xilong¹, Feng jie¹, Huang chantao¹, Mei Yingjie², and xu yikai^1
1Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guang Zhou, China, ²Clinical science, Philips Healthcare, Guangzhou, China

Early diagnosis of FGR is vitally important for the management of pregnancy and delivery planned accordingly. IVIM MRI is a non-invasive, in vivo techniques which can assess placental perfusion quantitatively, and be useful for evaluating placental microcirculation. In this study, the IVIM parameters of placental was measured and to investigate whether FGR pregnancies have different placental perfusion compared with normal pergnancies. The results show that perfusion fraction (f) have a significantly lower in FGR group. And f value moderately incresased with increasing gestational age in normal pregnancies.

Ruiming Chen¹, Ante Zhu², Jitka Starekova³, Daniel Seiter¹, Kevin M. Johnson^1,3, Scott B. Reeder^1,3,4,5,6, Dinesh M. Shah⁷, Oliver Wieben^1,3, and Diego Hernando^1,3,4,8
1Medical Physics, University of Wisconsin - Madison, Madison, WI, United States, ²GE Global Research, Niskayuna, NY, United States, ³Radiology, University of Wisconsin - Madison, Madison, WI, United States, ⁴Biomedical Engineering, University of Wisconsin - Madison, Madison, WI, United States, ⁵Medicine, University of Wisconsin - Madison, Madison, WI, United States, ⁶Emergency Medicine, University of Wisconsin - Madison, Madison, WI, United States, ⁷Obstetrics and Gynecology, University of Wisconsin - Madison, Madison, WI, United States, ⁸Electrical and Computer Engineering, University of Wisconsin - Madison, Madison, WI, United States

Maternal obesity is associated with negative pregnancy outcomes, potentially due to insufficient placental flow and oxygen delivery. Blood oxygen level-dependent (BOLD) based T2* measurements are associated with oxygenation and have shown to provide assessment of placental function. Here, we report placental T2* values in a cohort of 70 obese and non-obese subjects with normal and adverse gestational outcomes. Results show variation of T2* histograms between normal subjects and subjects with pregnancy complications at both 14 and 20 weeks, whereas no significant median T2* value differences were observed in between non-obese and obese groups.

Lindsay E Morris¹, Flavien Delhaes², Lanette Friesen Waldner¹, Trevor Wade¹, Lauren M Smith¹, Mary-Ellen ET Empey¹, Simran Sethi¹, Timothy RH Regnault^2,3,4, and Charles A McKenzie^1,4
1Medical Biophysics, Western University, London, ON, Canada, ²Physiology and Pharmacology, Western University, London, ON, Canada, ³Obstetrics and Gynaecology, Western University, London, ON, Canada, ⁴Division of Maternal, Fetal and Newborn Health, Children's Health Research Institute, London, ON, Canada

Effects of a life-long high fat and high sugar diet (Western diet: WD) in ~38-day gestation guinea pigs. Pregnant life-long WD or control diet (CD) fed sows underwent T1-weighted and IDEAL water-fat images on a 3T MRI at mid gestation. Regions of interest were segmented around key volumes. The maternal liver volume and median fat fraction were significantly higher in WD relative to CD sows while measures of other fat depots were unaltered between diet groups. The fetal and placental volumes were not significantly different between the diet groups. This research expands our understanding of metabolically unhealthy pregnancies. 

Bella Fadida-Specktor¹, Dafna Ben Bashat^2,3, Daphna Link Sourani², Netanell Avisdris^1,2, Elka Miller⁴, Liat Ben Sira^3,5, and Leo Joskowicz^1
1School of Computer Science and Engineering, The Hebrew University of Jerusalem, Haifa, Israel, ²Sagol Brain Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel, ³Sackler Faculty of Medicine & Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel, ⁴Medical Imaging, Children’s Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON, Canada, ⁵Division of Pediatric Radiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel

Weight estimation is of great importance in assessing fetal development, yet unavailable in routine fetal MRI. The aim of this study was to develop an automatic fetal body segmentation method and to create a large dataset of volumetric body measurements of normal fetuses. Automatic fetal body segmentation was performed on data obtained from two clinical sites, three MRI systems and two sequences. Using a neural network trained for each sequence, high performance was achieved for both of them. A database of normal fetal volumes with a wide range of gestational age was created and was consistent with ultrasound growth chart.