Weiwei Wang¹, Zhanguo Sun¹, Yueqin Chen¹, Laimin Zhu¹, Zhe Zhou¹, Hao Yu¹, and Weiqiang Dou^2
1Department of Medical Imaging, the affiliated hospital of Jining medical university, Jining,China, jining, China, ²GE Healthcare, MR Research China, Beijing, China, beijing, China

It is essential to accurately preoperatively predict genotypes and prognostic factors for patients with breast cancer in clinic treatment. Combined diffusion weighted imaging (DWI), Intravoxel incoherent motion (IVIM) and diffusion kurtosis imaging (DKI) were developed to comprehensively assess tumors at the cellular and molecular levels. In this study we aimed to explore whether the combination of these three diffusion techniques can help to comprehensively evaluate breast cancer.

Yurong zheng¹, Li Li¹, Rui Wang¹, Tiejun Gan¹, Pengfei Wang¹, Jing Zhang¹, and Kai Ai^2
1Department of Magnetic Resonance, LanZhou University Second Hospital, Lanzhou, China, ²Philips Healthcare, Xi’an, China

Intravoxel incoherent motion (IVIM) combined with Dynamic Contrast Enhanced MRI (DCE-MRI) are meaningful MRI techniques applied to breast cancer. This study uses DCE-derived parameters (voiume translocation constant, Ktrans and rate constant, Kep) and IVIM-derived parameters (diffusion coefficient, D and perfusion fraction, f) to perform correlation analysis with prognosis of breast cancer indexes (ER, PR, her-2, Ki-67). The results show that IVIM and DCE-MRI can distinguish benign and malignant breast lesions. Therefore, there are correlation between Ktrans, Kep, D and prognostic factors of breast cancer. Our research may provide more important clinical evidence for the treatment and prognosis of breast cancer.

Yuanqiang Xiao¹, Wenying Chen¹, Mengsi Li¹, Jun Chen², Meng Yin², Richard L. Ehman², and Jin Wang^1
1Department of Radiology, The third affiliated hospital of Sun Yat-sen University, Guangzhou, China, ²Department of Radiology, Mayo Clinic College of Medicine, Mayo Clinic, Rochester, MN, United States

Preoperative prediction of aggressiveness (histologic subtype, grade of differentiation, Federation International of Gynecology and Obstetrics (FIGO) stage) in cervical cancer (CC) using a noninvasive method remains a challenge. 3D MR Elastography (MRE) is a novel functional MRI technique which can quantitatively characterize the mechanical properties of tumors. We retrospectively analyzed 24 CC patients undergoing 3D MRE examinations and found that tumor stiffness (TS) in adenocarcinoma and FIGO stage III/IV was significantly higher than that in squamous cell carcinoma and FIGO stage I/II. TS based on 3D MRE could serve as a potential noninvasive marker to assess the aggressiveness in CC.

Anubhav Datta^1,2, Michael Dubec^1,3, David Buckley^3,4, Damien McHugh³, Amal Salah⁵, Ross Little¹, Michael Berks¹, Susan Cheung¹, Catharine West¹, Ananya Choudhury^1,6, Lisa Barraclough⁶, Peter Hoskin^1,6,7, and James P. B. O'Connor^1,2,8
1Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom, ²Clinical Radiology, The Christie NHS Foundation Trust, Manchester, United Kingdom, ³Christie Medical Physics and Engineering, The Christie NHS Foundation Trust, Manchester, United Kingdom, ⁴School of Medicine, University of Leeds, Leeds, United Kingdom, ⁵Proton Beam Therapy Dept, The Christie NHS Foundation Trust, Manchester, United Kingdom, ⁶Clinical Oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom, ⁷Mount Vernon Cancer Centre, Northwood, United Kingdom, ⁸Division of Radiotherapy and Imaging, Institute of Cancer Research, London, United Kingdom

Hypoxia is a ubiquitous negative prognostic factor in solid tumours. Oxygen-enhanced MRI can spatially map regions refractory to an oxygen challenge and, when combined with a perfusion measurement, has the potential to quantify hypoxia in vivo. We developed the technique in healthy volunteers before successfully translating into a longitudinal patient study of patients with cervical carcinoma. We present initial data to support OE-MRI quantifying and mapping hypoxia modification following therapy in this clinical dataset.

Ross A Little¹, Geoff JM Parker^2,3, and James PB O'Connor^1
1Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom, ²Centre for Medical Image Computing, University College London, London, United Kingdom, ³Bioxydyn Limited, Manchester, United Kingdom

OE-MRI is an emerging technique for identifying, mapping and quantifying tumour hypoxia. Current analysis is based on combining data with a perfusion map and categorising each voxel absolutely as hypoxic, normoxic or necrotic. In this study we use bootstrap analysis to map the uncertainty on the biomarker pOxy-R. We investigate how this performs in synthetic tumour data before applying the method to data from 9 patients with rectal cancer undergoing chemoradiotherapy. Bootstrapping enabled estimates of confidence intervals for change, thus identifying those patients who exhibited hypoxia modification on therapy. 

Huizhen Song¹, Jiao Bai¹, Yu Wang¹, Juan Xie¹, Mengping Huang¹, Yunzhu Wu², Shaoyu Wang³, and Jian Shu^1
1Department of Radiology, Affiliated Hospital of Southwest Medical University, Luzhou,SiChuan, China, ²MR Scientific Marketing, Siemens Healthineers, Shanghai, China, ³MR Scientific Marketing, Siemens Healthineers, Xi’an, Shaanxi, China

 This study compared the image quality of single-shot echo-planar imaging (ss-EPI) and readout-segmented echo-planar imaging (rs-EPI) in cervical cancer (CC). ADC values derived from these two sequences were considered as diagnostic capabilities for CC’s lymph-vascular space invasion (LVSI) and lymph node metastasis (LNM). The results showed that rs-EPI images of cervical cancer had higher subjective image quality scores, lower SNR, but no difference in CNR and ADC values. ADC was able to predict the CC’s LNM status，but couldn’t identify the LVSI status. ADC of rs-EPI sequence was superior to diagnose CC’s LNM status. 

Mihaela Rata^1,2, Nina Tunariu^1,2, Yun Jiang³, Julie Hughes¹, Georgina Hopkinson¹, Erica Scurr¹, Jessica M Winfield^1,2, Vikas Gulani³, Dow-Mu Koh^1,2, and Matthew R Orton^1,2
1Radiology/MRI Unit, Royal Marsden NHS Foundation Trust, Sutton/London, United Kingdom, ²Division of Radiotherapy and Imaging, Institute of Cancer Research, Sutton/London, United Kingdom, ³Radiology, University of Michigan, Ann Arbor, MI, United States

Magnetic resonance fingerprinting (MRF) generates fast, co-registered quantitative maps from a single acquisition. This prospective study evaluates MRF-derived measures of treatment-induced T₁ and T₂ changes in prostate cancer patients with metastatic bone disease, by comparison with existing quantitative T₁ and T₂ measurements. This study demonstrated a good correlation of MRF-derived T₁ and T₂ changes with existing quantitative methods, supporting the use of MRF for faster measurements in bone lesions.

Changjun Ma¹, Ailian Liu¹, Shifeng Tian¹, Lihua Chen¹, Nan Wang¹, Qingwei Song¹, and Zhiwei Shen^2
1Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian, China, ²Philips Healthy(China), Beijing, China

 Testing of Microsatellite Instability (MSI) is used to evaluate the prognosis of endometrial cancer (EC) to make the optimal treatment, and plays an important role to screen for Lynch syndrome. MSI had been detected by the traditional technology, such as PCR, IHC and Next Generation Sequencing（NGS）, however, MSI also could be assessed using magnetic resonance imaging with the advantages of non-invasion and low-cost. This study aimed to investigate the clinical value in assessing the status of EC MSI with amide proton transfer weighted (APTw) imaging and intravoxel incoherent motion (IVIM) diffusion MR imaging.