Fangfang Fu¹, Meng Nan², Yaping Wu¹, Zhun Huang³, Yan Bai¹, Pengyang Feng³, Ting Fang², Jianmin Yuan⁴, Yang Yang⁵, Haiyan Gao¹, and Meiyun Wang^1
1Henan Provincial People's Hospital & People's Hospital of Zhengzhou University, Zhengzhou, China, ²Zhengzhou University People's Hospital & Henan Provincial People’s Hospital, Zhengzhou, China, ³Henan University People's Hospital & Henan Provincial People’s Hospital, Zhengzhou, China, ⁴Central Research Institute, Beijing, China, ⁵Beijing United Imaging Research Institute of Intelligent Imaging, Beijing, China

It is meaningful to predict lymph node status of lung cancer before surgery. In the study, 18F-FDG PET/MRI were used to obtain PET metabolic parameters, multi-model DWI and APTWI parameters for predicting LNM of lung cancer. Our results showed that multiparametric PET/MRI is helpful in predicting lymph node status before surgery. 18F-FDG hybrid PET/MRI enables a robust diagnosis ability of LNM of lung cancer when several multi-model DWI parameters, PET metabolic parameters and APT parameter are combined. Thus, integrated PET/MRI can help to characterize LNM before surgery.

Yoshiharu Ohno^1,2, Masao Yui³, Kaori Yamamoto³, Daisuke Takenaka⁴, Takeshi Yoshikawa⁴, Saki Takeda⁵, Akiyoshi Iwase⁵, Yuka Oshima¹, Nayu Hamabuchi¹, Satomu Hanamatsu¹, Yuki Obama¹, Hiroyuki Nagata¹, Takahiro Ueda¹, Hirotaka Ikeda¹, Kazuhiro Murayama², and Hiroshi Toyama^1
1Radiology, Fujita Health University School of Medicine, Toyoake, Japan, ²Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Japan, ³Canon Medical Systems Corporation, Otawara, Japan, ⁴Diagnostic Radiology, Hyogo Cancer Center, Akashi, Japan, ⁵Radiology, Fujita Health University Hospital, Toyoake, Japan

Whole-body MRI and co-registered or integrated PET combined with MRI (PET/MRI) using 1.5 T or 3T MR systems has been suggested as equal to or more accurate than PET/CT or conventional staging or recurrence surveillance methods in thoracic oncologic patients.  We hypothesize that whole-body MRI and co-registered PET/MRI for SCLC patients have equal to or superior potential for VALSG and TNM stage assessments than PET/CT and conventional staging method.  The purpose of this study was to prospectively compare the capabilities for assessing VALSG and TNM stages among whole-body MRI, PET/MRI, PET/CT and conventional staging method in SCLC patients.    

Yoshiharu Ohno^1,2, Masao Yui³, Daisuke Takenaka⁴, Takeshi Yoshikawa⁴, Kaori Yamamoto³, Masato Ikedo³, Saki Takeda⁵, Akiyoshi Iwase⁵, Satomu Hanamatsu¹, Yuki Obama¹, Hiroyuki Nagata¹, Takahiro Ueda¹, Hirotaka Ikeda¹, Kazuhiro Murayama², and Hiroshi Toyama^1
1Radiology, Fujita Health University School of Medicine, Toyoake, Japan, ²Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Japan, ³Canon Medical Systems Corporation, Otawara, Japan, ⁴Diagnostic Radiology, Hyogo Cancer Center, Akashi, Japan, ⁵Radiology, Fujita Health University Hospital, Toyoake, Japan

We hypothesize that CEST imaging has a potential for therapeutic effect prediction in NSCLC patients treated with chemoradiotherapy and may be at least as valuable as DWI and FDG-PET/CT.  Moreover, combined predictors may improve therapeutic effect prediction capability, when compared with single predictor from MRI or PET/CT.  The purpose of this study was to compare the capability of therapeutic effect prediction for chemoradiotherapy among CEST imaging, DWI, FDG-PET/CT and combined predictors from MRI and PET/CT in NSCLC patients.

Robert R Edelman^1,2, Bradley Allen², Nondas Leloudas¹, Jianing Pang³, and Ioannis Koktzoglou^1,4
1Radiology, NorthShore University HealthSystem, Evanston, IL, United States, ²Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States, ³Siemens Medical Solutions USA, Chicago, IL, United States, ⁴Radiology, Pritzker School of Medicine, University of Chicago, Chicago, IL, United States

We recently described the feasibility of using a prototype 3D unbalanced steady-state free precession (3D uSSFP) pulse sequence for dark blood imaging.  We sought to determine whether this technique could be adapted for dark blood, susceptibility-insensitive imaging of the lungs.  A breath-hold, ECG-gated version of 3D uSSFP was implemented for a pilot study of healthy volunteers and patients.  Initial results suggest that 3D uSSFP allows efficient volumetric imaging of the lungs and can demonstrate even small lung nodules without artifacts.  With further development, the technique could provide a radiation-free alternative to low-dose CT for lung cancer screening.

Efe Ilicak¹, Safa Ozdemir¹, Lothar R. Schad¹, Jascha Zapp¹, and Frank G. Zöllner^1,2
1Computer Assisted Clinical Medicine, Heidelberg University, Mannheim, Germany, ²Mannheim Institute for Intelligent Systems in Medicine, Heidelberg University, Mannheim, Germany

Functional lung imaging is of great importance for diagnosis and follow-up of prevalent lung diseases. To this end, novel pulse sequences and post-processing techniques have been previously proposed to assess pulmonary functions. However, one overlooked aspect has been the parallel imaging reconstruction. Here, we propose the use of an advanced reconstruction scheme based on Low-Rank Modeling of Local k-Space Neighborhoods (LORAKS). In vivo results are provided to demonstrate the performance of LORAKS compared to commonly used GRAPPA reconstructions. Preliminary results indicate that LORAKS can be a viable option for improving reconstruction quality in pulmonary functional imaging.

Luis A. Torres¹, Nara S. Higano^2,3,4, Deep Gandhi⁴, Chamindu Gunatilaka², Jason C. Woods^2,3,4, and Sean B. Fain^5
1Medical Physics, University of Wisconsin-Madison, Madison, WI, United States, ²Division of Pulmonary Medicine, Cincinnati Children’s Medical Center, Cincinnati, OH, United States, ³Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States, ⁴Department of Radiology, Cincinnati Children’s Medical Center, Cincinnati, OH, United States, ⁵Department of Radiology, University of Iowa, Iowa City, IA, United States

Self-gating of free breathing pulmonary MR images remains challenging due to inconsistent tidal breathing and bulk motion especially in neonatal patients. We evaluate several conventional and advanced retrospective motion compensation techniques in neonatal subjects with lung disease of prematurity. Registration-based techniques show a significant improvement in signal to noise ratio and contrast to noise ratio relative to other motion compensation methods. There were no significant changes in sharpness across the cohort. We conclude that registration-based techniques could be used to improve image quality without loss of sharpness.

Zachary Peggs¹, Jonathan Brooke², Shahidehalsadat Safavi^3,4, Andrew Prayle^5,6, Christabella Ng^5,6, Jan Alappadan¹, Christopher Bradley¹, Andrew Cooper¹, Samal Munidasa^7,8, Brandon Zanette⁸, Giles Santyr^7,8, Helen Barr⁹, Alan R Smyth^5,6, Ian Hall², Susan Francis¹, and Penny Gowland^1
1Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, United Kingdom, ²The Nottingham Biomedical Research Centre (BRC), Respiratory Medicine Dept, School of Medicine, University of Nottingham, Nottingham, United Kingdom, ³The Toronto Lung Transplant Program, University Hospital Network, Toronto, ON, Canada, ⁴Respirology Medicine Dept, University of Toronto, Toronto, ON, Canada, ⁵School of Medicine, University of Nottingham, Nottingham, United Kingdom, ⁶Nottingham NIHR Biomedical Research Centre, Nottingham, United Kingdom, ⁷The Hospital for Sick Children, Toronto, ON, Canada; Dept. of Medical Biophysics, University of Toronto, Toronto, ON, Canada, ⁸The Hospital for Sick Children, Toronto, ON, Canada, University of Toronto, Toronto, ON, Canada, ⁹The Wolfson Centre for Adult Cystic Fibrosis, Nottingham City Hospital, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom

Phase resolved functional lung imaging (PREFUL) was carried out before and 12 weeks after commencement of Kaftrio^® therapy in a small Cystic Fibrosis (CF) group, and in healthy controls (HC). No significant differences were found in measures characterising the PREFUL signal between HC and CF, or before and after Kaftrio^® therapy. This could be explained by the small sample size or lack of age matching. It was found that fractional ventilation measures with PREFUL can be sensitive to subjective thresholding and the method of image registration. Also, the impact of irregular breathing patterns, especially in patients, should be further explored.

Mina Kim¹, Josephine H. Naish^2,3, Marta Tibiletti², Sarah H. Needleman¹, Adam Szmul¹, David M. Higgins⁴, James P. B. O’Connor^5,6, and Geoff J. M. Parker^1,2
1Centre for Medical Image Computing (CMIC), University College London, London, United Kingdom, ²Bioxydyn Limited, Manchester, United Kingdom, ³BHF Manchester Centre for Heart and Lung Magnetic Resonance Research (MCMR), Manchester University NHS Foundation Trust, Manchester, United Kingdom, ⁴Philips, Farnborough, United Kingdom, ⁵Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom, ⁶Division of Radiotherapy and Imaging, Institute of Cancer Research, London, United Kingdom

T₁-weighted dynamic lung OE-MRI is challenging at 3 T using gradient echo acquisitions due to decreased T₁ relaxivity of oxygen and substantial ∆R₂* contribution. We implemented a dual echo T₁-FFE-based method at 3 T and evaluated signal enhancement behaviour and ∆R₂*. The proposed method is shown to produce negative contrast on oxygen enhancement signal due to dominance of ∆R₂* at TE larger than 0.4 ms. We also demonstrated that the contrast property of the percentage signal enhancement (PSE) is TE dependent. Longer TE enables differentiation on PSE values between non-smokers and smokers.

Arnd Jonathan Obert^1,2, Marcel Gutberlet^1,2, Agilo Luitger Kern^1,2, Till Frederik Kaireit^1,2, Julian Glandorf^1,2, Tawfik Moher Alsady^1,2, Frank Wacker^1,2, Jens M. Hohlfeld^2,3,4, and Jens Vogel-Claussen^1,2
1Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany, ²Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany, ³Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany, ⁴Department of Clinical Airway Research, Fraunhofer Institute for Toxicology and Experimental Medicine, Hannover, Germany

Diffusion of fluorinated gas in the short-time regime was measured using multiple gradient echo sequences with a single pair of trapezoidal gradient pulses. Pulmonary alveolar surface-to-volume ratio (S/V) was calculated using a first-order approximation of the time-dependent diffusion in a study with 20 healthy volunteers and 22 patients with chronic obstructive pulmonary disease (COPD). Median surface-to-volume ratio is significantly decreased in COPD patients compared to healthy volunteers (P<.0001). No significant difference was found between measurements within 7 days. Linear correlations were found with S/V from hyperpolarized ¹²⁹Xe MRI (r=0.85, P=.001) and the forced expiratory volume in one second (r=0.68, P<.0001).

Robin A. Müller^1,2, Filip Klimeš^1,2, Andreas Voskrebenzev^1,2, Lea Behrendt^1,2, Till F. Kaireit^1,2, Cristian Crisosto^1,2, Maximilian Zubke^1,2, Martin R. Prince^3,4, Christopher C. Cooper⁵, R. Graham Barr⁶, Jens M. Hohlfeld^7,8, and Jens Vogel-Claussen^1,2
1Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany, ²Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany, ³Department of Radiology, Weill Cornell Medical College, New York, NY, United States, ⁴Department of Radiology, Columbia College of Physicians and Surgeons, New York, NY, United States, ⁵Exercise Physiology Research Laboratory, Departments of Medicine and Physiology, David Geffen School of Medicine, UCLA, Los Angeles, CA, United States, ⁶Division of General Medicine, Department of Medicine, New York-Presbyterian/Columbia University Irving Medical Center, New York, NY, United States, ⁷Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany, ⁸Fraunhofer Institute of Toxicology and Experimental Medicine, Hannover, Germany

Metronome-paced tachypnea (MPT) is a technique where a patient breathes with a fixed frequency (40 breaths / minute). MPT induces dynamic hyperinflation and allows investigation of potential stress-driven effects on ventilation parameters. Fourteen patients with chronic obstructive pulmonary disease (COPD) underwent phase-resolved functional lung (PREFUL) MRI with 2D coronal lung MR images acquired during normal tidal breathing (NTB) and MPT. Compared to NTB, ventilation defect percentages increased in COPD patients during MPT. Thus, MPT in conjunction with PREFUL-MRI will be further investigated as a possible sensible ventilation test for COPD patients.

Marta Tibiletti¹, James A Eaden², Jo Naish^1,3, Paul JC Hughes², John C Waterton^1,4, Matthew J Heaton¹, Nazia Chaudhuri⁵, Sarah Skeoch⁶, Ian N Bruce^7,8, Stephen A Bianchi⁹, Jim M Wild^2,10, and Geoff JM Parker^1,11
1Bioxydyn Ltd, Manchester, United Kingdom, ²POLARIS, University of Sheffield MRI unit, The University of Sheffield, Sheffield, United Kingdom, ³MCMR, Manchester University NHS Foundation Trust, Manchester, United Kingdom, ⁴Centre for Imaging Sciences, University of Manchester, Manchester, United Kingdom, ⁵North West Lung Centre, Manchester University NHS Foundation Trust, Manchester, United Kingdom, ⁶Royal National Hospital for Rheumatic Diseases, Royal United Hospitals Bath NHS Foundation Trust, Bath, United Kingdom, ⁷NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester, United Kingdom, ⁸Centre for Musculoskeletal Research, University of Manchester, Manchester, United Kingdom, ⁹Academic Directorate of Respiratory Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom, ¹⁰nsigneo Institute for in silico Medicine, Sheffield, United Kingdom, ¹¹Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom

Interstitial lung diseases (ILD) are a heterogeneous group of conditions exhibiting inflammation and scarring of the lung parenchyma. Here, we compare imaging biomarkers from hyperpolarised ¹²⁹Xe ventilation MRI and oxygen-enhanced MRI (OE-MRI) with standard pulmonary function tests in cohorts of ILD patients with mixed origins. We also evaluated whether disease resolution or progression could be detected over two visits. None of the imaging biomarkers considered completely differentiated ILD subtypes. OE-MRI biomarkers are feasible in ILD patients and do not correlate strongly with PFT. Both OE-MRI and ¹²⁹Xe MRI revealed spatially heterogeneous ventilation in patients with DI-ILD and IPF.

David Thomas Goodhart¹, Justin Grenier¹, Rob Stobbe¹, Peter Seres¹, and Richard Thompson^1
1The Department of Biomedical Engineering, University of Alberta, Edmonton, AB, Canada

We aim to describe the dynamic response of the distribution of lung water to the change in position from standing to supine. An efficient UTE MRI trajectory (Yarnball) provided 3D images (free-breathing, 74 seconds acquisition) in 3 volunteers, with 10 repeated scans over ~14 minutes. Lung water density (LWD) increased over time but total lung water content remained constant, consistent with a measured decrease in lung volume over time. LWD increased by a larger extent towards the back, suggesting a larger lung volume reduction in gravity dependent regions (the back) over time. Steady-state LWD was not achieved in 14 minutes.