Selina Rupp¹, Mingming Wu¹, Jessie Han¹, Kilian Weiss², Johannes M Peeters³, Christina Holzapfel⁴, Marcus M Makowski¹, Daniela Junker¹, and Dimitrios C Karampinos^1
1Technical University of Munich, München, Germany, ²Philips GmbH Market Dach, Hamburg, Germany, ³Philips Healthcare, Best, Netherlands, ⁴Institute for Nutritional Medicine, School of Medicine, Technical University of Munich, München, Germany

With rising prevalence of obesity and metabolic syndrome comes an increasing demand of noninvasive detection of nonalcoholic fatty pancreas disease. Chemical shift encoding-based water-fat separation based on a multi-echo gradient echo acquisition enables pancreatic fat fraction (PDFF) mapping. The pancreas is a small organ and requires high spatial resolution which results in prolonged breath-hold duration for PDFF mapping. The present work aims to accelerate high-resolution single-breath-hold pancreas PDFF mapping using a methodology combining sparse sampled acquisitions with compressed sensing and deep learning reconstructions.

Felix N. Harder¹, Kilian Weiss², Eva Jung¹, Omar Kamal¹, Sean McTavish¹, Anh T. Van¹, Markus M. Graf¹, Ihsan E. Demir³, Veit Phillip⁴, Helmut Friess³, Roland M. Schmid⁴, Fabian K. Lohöfer¹, Marcus R. Makowski¹, Georgios A. Kaissis¹, Dimitrios C. Karampinos¹, and Rickmer F. Braren^1
1Institute of Diagnostic and Interventional Radiology, Technical University of Munich, School of Medicine, Munich, Germany, ²Philips GmbH Market DACH, Hamburg, Germany, ³Department of Surgery, Technical University of Munich, School of Medicine, Munich, Germany, ⁴Department of Medicine II, Technical University of Munich, School of Medicine, Munich, Germany

The incidence of intraductal papillary mucinous neoplasms (IPMN), which represent a potential precursor of pancreatic cancer, is increasing. We herein investigate the potential of computed high b-value diffusion-weighted imaging (cDWI) in detection and stratification of IPMN. cDWI at b = 1000 s/mm² increases lesion detection rates as well as diagnostic sensitivity and specificity regarding the presence of malignant imaging features. Combining cDWI and high-resolution reduced field-of-view imaging further increases diagnostic accuracy. cDWI seems particularly promising in view of the need for non-invasive lesion detection and characterization due to the recent paradigm shift from surgery to active surveillance of IPMN.

Archana Vadiraj Malagi¹, Sivachander Shivaji², Devasenathipathy Kandasamy², Pramod Garg³, Siddhartha Datta Gupta⁴, Shivanand Gamanagatti ², Raju Sharma², 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 Gastroenterology, All India Institute of Medical Sciences Delhi, New Delhi, India, ⁴Department of Pathology, All India Institute of Medical Sciences Delhi, New Delhi, India, ⁵Department of Biomedical Engineering, All India Institute of Medical Sciences Delhi, New Delhi, India

Tumor heterogeneity could be detected non-invasively utilizing textural indicators from IVIM-DKI, which have a high potential for early prognosis of pancreatic lesions. A novel technique was investigated for tumor prediction model utilizing IVIM-DKI with total variation penalty function, in which we employed combinations of texture characteristics from IVIM-DKI parameters. In this study, texture characteristics of the kurtosis(k) parameter had the high accuracy:93% and AUC:1, and combinations of all IVIM-DKI parameters' textural features after feature reduction had accuracy:84% and AUC:0.91 for classifying benign and malignant pancreatic lesions. Whole-volumetric texture analysis of IVIM-DKI can be employed for characterization of pancreatic lesions.

Antonella Meloni¹, Laura Pistoia¹, Massimiliano Missere², Riccardo Righi³, Antonino Vallone⁴, Ada Riva⁵, Vincenzo Positano¹, Luciana Rigoli⁶, Francesco Massei⁷, Valentina Carrai⁸, Gianna Alberini¹, Filippo Cademartiri¹, and Alessia Pepe^1
1Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy, ²Gemelli Molise SpA, Fondazione di Ricerca e Cura "Giovanni Paolo II", Campobasso, Italy, ³Ospedale del Delta, Lagosanto (FE), Italy, ⁴Azienda Ospedaliera "Garibaldi" Presidio Ospedaliero Nesima, Catania, Italy, ⁵Ospedale “SS. Annunziata” ASL Taranto, Taranto, Italy, ⁶Policlinico "G. Martino", Messina, Italy, ⁷Azienda Ospedaliero Universitaria Pisana, Pisa, Italy, ⁸Azienda Ospedaliero - Universitaria Careggi, Firenze, Italy

We systematically explored the link between pancreatic iron detected by the T2* Magnetic Resonance Imaging technique and cardiovascular complications in a cohort of 63 patients with sickle cell disease (SCD). Patients with cardiovascular complications (supraventricular arrhythmias, heart failure, pulmonary hypertension, myocardial infarction, deep vein thrombosis, leg ulcers) showed significantly lower global pancreas T2* values than patients free of cardiovascular complications but comparable global heart T2* values. Pancreatic iron overload (T2*<26 ms) was associated with 7.5 times higher odds of cardiovascular complications.

Jürgen Machann^1,2,3, Norbert Stefan^2,3,4, Andreas L Birkenfeld^2,3,4, and Fritz Schick^1
1Section on Experimental Radiology, Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany, ²2. Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Centre Munich at the University of Tübingen, University of Tübingen, Tübingen, Germany, ³3. German Center for Diabetes Research (DZD), Tübingen, Germany, ⁴4. Department of Internal Medicine, Division of Endocrinology, Diabetology and Nephrology, University Hospital Tübingen, Tübingen, Germany

¹H-MRS of bile was performed in 54 healthy subjects at increased risk for metabolic diseases. Additionally, intrahepatic lipids (IHL) were quantified. Concentration of main peaks of bile was calculated in relation to non-suppressed water signal. Large interindividual differences in concentration of the bile-peaks with significantly lower concentrations in subjects with increased IHL were detected. Males show a tendency towards higher concentrations in all bile-peaks as well as in IHL (n.s.). It remains speculative, whether or not these MRS-derived results might play a role in the pathogenesis of insulin resistance – further analyses with assignable metabolic and laboratory data are recommended.

Cemre Ariyurek¹, Onur Afacan¹, and Sila Kurugol^1
1Radiology, Boston Children's Hospital and Harvard Medical School, Boston, MA, United States

In MR enterography, diffusion-weighted MRI (DW-MRI) is commonly used to evaluate Crohn’s disease (CD). Echo-planar imaging (EPI) used in DW-MRI suffers from geometric distortion due to time-varying susceptibility field changes in the bowel. Hence, we implemented a DW-MRI sequence using a dual-echo EPI with opposing encoding polarities. Thus, the distortion field can be estimated dynamically and corrected retrospectively. The proposed method was evaluated in DW-MRI data acquired on suspected CD patients by visually and quantitatively assessing distortion corrected volumes based on anatomical similarity with T2-HASTE and uncertainty of estimated diffusion parameters of the intravoxel incoherent motion model.

Iyad Naim^1,2, Caroline Hoad^2,3, Gordon Moran^1,2, and Penny Gowland^2,3
1School of Medicine, University of Nottingham, Nottingham, United Kingdom, ²National Institute of Health Research, Nottingham Biomedical Research Centre (BRC) at Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, United Kingdom, ³School of Physics and Astronomy, University of Nottingham, Nottingham, United Kingdom

Crohn’s disease (CD) is an inflammatory bowel disease affecting 115k people in the UK. The ‘Comb Sign’ describes increased vascularity and arborization of vessels in the mesentery, due to intestinal inflammation. Radiologists observe this sign on cross-sectional imaging as an indication for CD, but it has never been quantified. We used time of flight MR angiography to visualize the vessels in the abdomen without using contrast agents. Images were analyzed using in-house developed software that traces vessels and counts branching points. Scans from 15 healthy volunteers(HV) and 6 CD patients showed patients had more vessel branching points compared to HV.

Wenjun Hu¹, Anliang Chen², Wan JUN Dong², Xiwei JUN Li², Yue Wang², Yuhui Liu², and Ailian Liu^1
1Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian, China, ²The First Affiliated Hospital of Dalian Medical University, Dalian, China

Tumor budding (TB) is a histopathologic characteristic which has led to a growing interest in the prognosis prediction of cancers of various sites. Preoperative prediction of TB status may help personalize treatment in rectal cancer cancer patients. Previous studies showed MRI-based and PET/CT based radiomics can predict TB status, however, the high cost and complex post-processing limit their clinical applications. Dynamic contrast-enhanced (DCE) MRI has been extensively evaluated aggressiveness of rectal cancer. Results of this study indicate Kep values can effectively differentiate high from intermediate-low grade TB.

Meshari T Alshammari^1,2, Luca Marciani¹, Gordon W. Moran¹, and Caroline L. Hoad^3,4
1Translational Medical Sciences and National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, United Kingdom, ²Department of Diagnostic Radiology, College of Applied Medical Sciences, University of Hail, Hail, Saudi Arabia, ³NIHR Nottingham Biomedical Research Centre (BRC), Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, United Kingdom, ⁴Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, United Kingdom

We aimed to investigate the temporal variation of the MR colonic tagging technique to measure mixing of colonic contents following a water based laxative drink by acquiring multiple scans on healthy participants. The study results indicate that time did not influence the measurement of colonic content mixing, however the scans were variable over the 10 minute acquisition window which suggests multiple scans are needed to accurately assess this parameter. Multiple measurements of this non-invasive technique can be used in future studies that aim to look at bowel motility and treatment response of IBD patients, using the same water-based laxative.

Hannah Askill ¹, Emily Gaudoin¹, Dipendra Jayantilal Mistry¹, Olivier Mougin¹, Caroline Hoad^1,2, Hayfa Sharif^1,2, Luca Marciani^1,2, and Penny A Gowland^1,2
1Sir Peter Mansfield Imaging Centre,, University of Nottingham, Nottingham, United Kingdom, ²Nottingham Biomedical Research Centre, Nottingham, United Kingdom

Gastric accommodation and gastric tone are key measure in functional diseases such as gastroparesis, dyspepsia, and even reflux. Whilst gastric accommodation has been assessed using conventional MRI such measures will have been be perturbed by the subject lying supine. Gastric tone is either assessed using a barostat or pressure sensors. This work investigate the gastric response to a meal in the upright position with the aim of analysing the data to study accommodation and markers of tone in future.

Raj Kumar Sharma¹, Santosh K. Bharti¹, Paul T Winnard¹, Marie-France Penet¹, and Zaver M. Bhujwalla^1,2,3
1Division of Cancer Imaging Research, The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, United States, ²Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine, Baltimore, MD, United States, ³Radiation Oncology and Molecular Radiation Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, United States

Analysis of organ metabolism with cancer growth can unravel systemic changes that occur with cancer and with cancer-induced cachexia.  Cancer-induced cachexia, commonly observed with pancreatic cancer, causes tissue wasting, intolerance to chemotherapy, and poor quality of life. Here, we identified alterations of metabolic pathways in the spleen, liver, pancreas, lung, heart, brain and kidney following growth of cachexia-inducing and non-cachexia inducing pancreatic cancer xenografts. These results highlight the systemic metabolic changes that occur with cancer and with cancer induced cachexia that  may lead to the development of organ-based early biomarkers as well to organ-based metabolic treatment strategies.