Qianyun LIU¹, Zhichao Feng², Wenming Zhou¹, and Weiyin Vivian LIU^3
1Medical Imaging, Yueyang Central Hospital, Medical Imaging, Yueyang Central Hospital, Yueyang, Hunan, China, China, ²Department of Radiology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China, Department of Radiology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China, Changsha, Hunan, China, China, ³GE Healthcare, MR Research China, Beijing, Beijing, China, China

The feasibility of zero echo time MR lung imaging in the assessment of pulmonary nodules or masses: a prospective head-to-head comparison with CT.

Jiejun Chen¹, Yixian Guo¹, Shujie Zhang¹, Wei Sun¹, Yinglong Guo¹, Yunfei Zhang², Yongming Dai², Dongmei Wu³, and Xiuzhong Yao^1
1Zhongshan Hospital affiliated to Fudan University, Shanghai, China, ²Central Research Institute, United Imaging Healthcare, Shanghai, China, ³Shanghai Key Laboratory of Magnetic Resonance, School  of  Physics and Electronics Science, East China Normal University, Shanghai, China

Diffusion-weighted imaging (DWI) is a powerful functional MRI technique. However, scarcely has the DWI been used to identify the expression of Cytokeratin 19 (CK19) in hepatocellular carcinoma (HCC). In this study, we aim to differentiate CK19 positive and negative HCC with diffusion parameters derived from different DWI techniques. Our results showed that diffusion parameters can be used as noninvasive quantitative imaging markers for preoperatively predicting the CK19 expression of HCCs. More importantly, the integration of different diffusion parameters could better describe the characteristics of tumor tissues，thus reaching better diagnostic performance.

Qihao Xu¹, Ying Zhao¹, Wenjing Qi², Xue Ren¹, Tao Lin¹, Qingwei Song¹, and Ailian Liu^1,3
1Department of Radiology, The First Affiliated Hospital, Dalian Medical University, Dalian, Liaoning, China, China, ²Department of Pathology, The First Affiliated Hospital, Dalian Medical University, Dalian, Liaoning, China, China, ³Dalian Engineering Research Center for Artificial Intelligence in Medical Imaging, Dalian, Liaoning, China

In hepatocellular carcinoma (HCC) patients, high Ki-67 was closely related with tumor size, vein invasion, histological grade and the metastasis. This worked aimed at investigating the value of intravoxel incoherent motion (IVIM) diffusion-weighted magnetic resonance (MR) imaging and enhanced T2star weighted angiography(ESWAN) for predicting tumor Ki-67 status in HCC. The results showed that Standard ADC, DDC, R2*, T2* and combine had promising performances in predicting Ki-67 status. This research suggested that the IVIM and ESWAN held great potential in predicting the Ki-67 status of HCC, which is valuable for noninvasively, preoperatively and accurately predicting the prognostic factors during clinical practice.

Yihuan Wang¹, Ruokun Li¹, Jiahao Zhou¹, Jing Guo², Ingolf Sack², and Fuhua Yan^1
1Department of Radiology, Department of Radiology, Ruijin Hospital，Shanghai Jiao Tong University School of Medicine, Shanghai, China, ²Department of Radiology, Charité–Universitätsmedizin Berlin, Berlin, Germany, Berlin, Germany

Glypican-3 (GPC3) expression in hepatocellular carcinoma (HCC) is often associated with a poor prognosis. GPC3 is a promising target for tumor-specific immunotherapy in HCC. We investigated the diagnostic performance of viscoelastic properties quantified by tomoelastography, a multifrequency MR-elastography (MRE) technique, for the detection of GPC3-positive HCC. Preliminary results showed that reduced stiffness quantified by tomoelastography is a mechanical signature of positive GPC3 expression in HCC. Combining stiffness and serum alpha-fetoprotein (AFP) level could be considered as a viable biomarker for detecting GPC3-positive HCC as well as for predicting the outcome of GPC3-targeted immunotherapy.

Qihao Xu¹, Ying Zhao¹, Dahua Cui¹, Qingwei Song¹, Xue Ren¹, Tao Lin¹, Xin Li², Yan Guo², Tingfan Wu², and Ailian Liu^1,3
1Department of Radiology, The First Affiliated Hospital, Dalian Medical University, Dalian, Liaoning, China, ²GE Healthcare, Shanghai, China, ³Dalian Engineering Research Center for Artificial Intelligence in Medical Imaging, Dalian, Liaoning, China

Hepatocellular carcinoma (HCC) is a common malignant tumor with a high mortality. The higher the pathological grade represents lower the differentiation degree of HCC. Patients with low differentiation have a higher postoperative recurrence rate and the worse prognosis. Texture analysis is a post-processing method that highlights the difference between the brightness of pixel features and the intensity of background signals by analyzing the distribution and spatial relationship of gray values, and quantify and evaluate the heterogeneity of tumors at the pixel level. This research suggested that R2* maps texture analysis held great potential in evaluating the pathological grade of HCC.

Ying Zhao¹, Ailian Liu^1,2, Yu Yao^3,4, Han Wen^3,4, Qingwei Song⁵, Tao Lin¹, Xin Li⁶, Yan Guo⁶, and Tingfan Wu^6
1The First Affiliated Hospital of Dalian Medical University, Dalian, China, ²Dalian Engineering Research Center for Artificial Intelligence in Medical Imaging, Dalian, China, ³Chengdu Institute of Computer Application, Chinese Academy of Sciences, Chengdu, China, ⁴University of Chinese Academy of Sciences, Beijing, China, ⁵Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China, ⁶GE Healthcare (China), Beijing, China

This work aimed at exploring the role of radiomics assessment of hepatocellular carcinoma (HCC) intratumoral and peritumoral regions based on contrast-enhanced magnetic resonance imaging (CE-MRI) to predict treatment response to transarterial chemoembolization (TACE) in patients with HCC. The results showed that the radiomics approach based on intratumoral and peritumoral regions has potential to improve performance for response prediction using preoperative CE-MRI. 

Laiyang Ma¹, Yanli Jiang¹, Jie Zou¹, Fengxian Fan¹, Jing Zhang¹, and Shaoyu Wang^2
1Lanzhou University 2 Hospital, Lanzhou, China, ²MR Scientific Marketing, Siemens Healthineers, ShangHai, China

The purpose of this study was to evaluate the value of Multi-echo DIXON(6 echo) and HISTO techniques for staging of liver fibrosis in patients with chronic hepatitis B. We found that PDFF% value and R2* value had a certain correlation with liver fibrosis, Multi-echo DIXON and HISTO quantitative techniques may be helpful for staging liver fibrosis.

Jiejun Chen¹, Dingxia Liu¹, Shujie Zhang¹, Wei Sun¹, Yinglong Guo¹, Yunfei Zhang², Yongming Dai², and Xiuzhong Yao^1
1Zhongshan Hospital affiliated to Fudan University, Shanghai, China, ²Central Research Institute, United Imaging Healthcare, Shanghai, China

Magnetic resonance elastography (MRE) is an emerging functional MR technique. Pancreatic ductal adenocarcinoma (PDAC), as one of the most lethal diseases, accounts for 85–90% of all malignant pancreatic tumors. Histologically, PDAC is a hard mass characterized by a marked desmoplastic reaction and build-up of fibrotic tissues. In this study, we aim to evaluate the usefulness of 2D spin-echo echo-planar-imaging (SE-EPI) MRE for differentiation of solid pancreatic masses. Our results showed that compared with benign pancreatic masses, PDAC demonstrated higher mass stiffness and stiffness.

Zhigang Wu¹, Yajing Zhang², Xiuquan Hu¹, Jing Zhang¹, Guangyu Jiang³, Fei Zeng¹, Xiaofang Xu¹, Yan Zhao³, and Jiazheng Wang^1
1Philips Healthcare, Beijing, China, ²MR Clinical Science, Philips Healthcare (Suzhou), Suzhou, China, ³MR R&D, Philips Healthcare (Suzhou), Suzhou, China

Robust fat suppression remains essential in clinical MRI to improve tissue signal contrast, minimize fat-related artifacts, and enhance image quality. It’s still a challenge to suppress the fat signal when the FOV and coverage is large, especially for abdomen imaging, where uneven fat suppression become common owing to both B0 and B1 field inhomogeneity. We propose a new solution that combines the optimized gradient reversal technique and Spectral Presaturation with Inversion Recovery (SPIR) simultaneously to overcome these challenges. This framework allows to suppress the fat signal robustly in large FOV with whole liver and kidney coverage.

Jeong Hee Yoon¹, Joonsung Lee², Ersin Bayram³, and Jeong Min Lee^1
1Radiology, Seoul National University Hospital, Seoul, Korea, Republic of, ²GE Healthcare, Seoul, Korea, Republic of, ³GE Healthcare, Houston, TX, United States

Liver magnetic resonance imaging (MRI) has been widely performed for liver lesion detection and characterization. There have been attempts to improve the image quality of T1-weighted images at liver MRI. Recently, deep learning (DL)-based reconstruction gains attention as a tool for improving the image quality without substantial computational power or difficult sequence modification.

Qian Wan¹, Hao Peng ¹, Jianxun Lyu¹, Yi Wang², Feng Liu², Chuanli Cheng¹, Yangzi Qiao¹, Hairong Zheng¹, Xin Liu¹, and Chao Zou^1
1Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China, ²Peking University People's Hospital, Beijing, China

Detection of inflammation is important to the NAFLD patients. Liver biopsy is limited by the  sampling error. T1 quantification  from MRI is believed to be one of promising imaging method to detect inflammation. However, intracellular hepatocyte lipid is a confounding factor for the accurate T1 quantitation in the case of the NAFLD. This study established a variable flip-angle multi-echo GRE sequence to produce the T1 value of water component (wT1) in a NAFLD rat model who underwent biopsy. The results indicate that wT1 could discriminate between moderate and severe inflammation stages (G2 +G3) from the no and mild stages (G0+G1).

Jeong Woo Kim¹ and Chang Hee Lee^2
1Radiology, Korea University Guro Hospital, Seoul, Korea, Republic of, ²Korea University Guro Hospital, Seoul, Korea, Republic of

The aim of our study was to 1) provide spectrum of values of multi-echo mDixon MRI-PDFF, FF_MRS, and FFs measured by two different histopathologic methods (pathologist and automatic fat vacuole segmentation), and 2) to evaluate the correlation among them. The values of MRI-PDFF and FF_MRS were significantly higher than FF_AI and significantly lower than FF_pathologist. Except for one case (97.9%,46/47), FF_MRS always showed higher value than MRI-PDFF and the average difference was 2.06 %. MRS and MRI-PDFF showed strong correlation with each other and with each histopathologic method. MRI-PDFF or MRS could be used as an alternative non-invasive reference standard.

Petr Bulanov¹, Evelina Manzhurtseva², Petr Menshchikov³, Artem Tolkalov⁴, Dmitriy Kupriyanov³, Galina Tereshchenko², and Galina Novichkova^2
1Lomonosov Moscow State Univesity, Moscow, Russian Federation, ²Dmitry Rogachev National Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russian Federation, ³Philips Healthcare, Moscow, Russian Federation, ⁴National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Moscow, Russian Federation

The most common MRI sequence for iron overload assessment is Cartesian multiecho gradient-recalled echo (GRE) sequence typically measured in a single breath-hold. However, Breath-holding, is not possible for people who are sedated and is difficult for those who have difficulties with holding their breath for a long period. Ultrashort TE (UTE) imaging is one of the solutions for this challenge. In this method radial data acquisition utilized for free breath scanning. Thus, the main goal of this study is to compare the GRE and UTE sequences on a sample of patients with varying degrees of liver iron overload.

Nobuyuki Kawai¹, Yoshifumi Noda¹, Tetsuro Kaga¹, Kimihiro Kajita², and Masayuki Matsuo^1
1Gifu University, Gifu, Japan, ²Gifu University Hospital, Gifu, Japan

Rapid dynamic liver MRI with compressed-sensing sensitivity encoding (Compressed SENSE) can reduce respiratory motion artifacts. However, Since the central k-space filling is random or posterior half of the acquisition in Compressed SENSE, optimal acquisition timing is missed only using a conventional scan delay method for hepatic arterial dominant phase (HAP). We assessed a combination of Compressed SENSE with contrast enhanced robust angiography (CENTRA) for dynamic liver MRI.  CS-CENTRA sequence achieved significantly higher arterial enhancement with comparable CNR compared to CS-conventional one in HAP. CS-CENTRA contributed to optimal acquisition timing for HAP.

Shoma Eitoku¹, Yasuhiro Fujiwara², and Motohira Mio^3
1Graduate School of Health Sciences, Kumamoto University, Kumamoto, Japan, ²Department of Medical Image Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan, ³Department of Radiology, Fukuoka University Chikushi Hospital, Fukuoka, Japan

The purpose of this study was to clarify whether gadoxetic acid concentration in the hepatic focal area at hepatobiliary phase (C_Hep), normalized by dose (normalized C_Hep), could be used as an index for quantitative liver function assessment. In severe liver dysfunction, a moderate correlation was observed between gadoxetic acid concentration and dose. Normalized C_Hep with bias correction based on the dose of gadoxetic acid may be used as an index of liver function, especially in the stratification of severe liver dysfunction.

Solomon Yig-Joon Ka¹, Gladys Goh Lo¹, Christine Shing Yen Lo¹, and Cindy Xue^2,3
1Department of Diagnostic & Interventional Radiology, Hong Kong Sanatorium and Hospital, Hong Kong, Hong Kong, ²Research Department, Hong Kong Sanatorium and Hospital, Hong Kong, Hong Kong, ³Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, Hong Kong

The diagnoses of hepatocellular carcinoma (HCC) are mostly made at advanced stage, which is associated with unfavorable prognosis and suboptimal survival. While dual-tracer PET/CT (dt-PET/CT) and gadoxetic acid-enhanced MRI are effective in detecting liver lesions, diagnostic performance of gadoxetic acid-enhanced MRI in identifying small HCC lesions compared with dt-PET/CT remains unclear. Here, we compare the sensitivity and specificity of each imaging modality to diagnose HCC. Gadoxetic acid-enhanced MRI has higher sensitivity in detecting HCC lesions than using dt-PET/CT, especially in smaller HCC lesions. Thus, gadoxetic acid-MRI could provide clinical value in the early diagnosis of HCC.