Lei Ye¹, Xiaoyong Zhang², Yuntian Chen¹, and Hui Xu^1
1Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China, ²Clinical Science, Philips Healthcare, Chengdu, Sichuan, China

There are different opinions about the importance of dynamic contrast enhancement (DCE) in VI-RADS among patients with bladder cancer (BCa), for the limited contribution for identifying muscle invasiveness and gadolinium-related toxicity. This study head-to-head compared the diagnostic accuracy between simplified VI-RADS excluding DCE sequence and conventional VI-RADS including DCE sequence. Our results showed that the diagnostic performance was comparable between these two MRI protocols.

Wenjuan Liu¹, Weili Xie^2,3, and Zhenchang Wang^1
1Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing, China, ²School of Clinical Medicine, Jining Medical University, Jining, China, ³Jining No. 1 Peoples’ Hospital, Jining, China

The study evaluated the accuracy of MRI in the diagnosis of 22 angular pregnancy cases and 37 interstitial pregnancy cases retrospectively during the first trimester. Two senior obstetrics radiologists reviewed the MR images and analyzed several features. The study found two key features were useful to diagnose angular pregnancy, namely, “medial free edge” and “medial free edge plus above-cutoff endometrial thickness”. One key feature to diagnose interstitial pregnancy was “intact lateral junctional zone”. MRI is a novel imaging approach to make the precise differential diagnosis of angular pregnancy and interstitial pregnancy.

Haijie Wang¹, Yida Wang¹, Lei Ling², Jue Wang³, Xiaotian Li³, Hao Zhu³, He Zhang², and Guang Yang^1
1Shanghai key lab of magnetic resonance, East China Normal University, Shanghai, China, ²Department of Radiology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China, ³Department of Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China

Placenta accrete spectrum (PAS) disorders may lead to common complication like catastrophic perinatal hemorrhage. T2W is the most useful MRI sequence for identification of PAS disorders, but the diagnosis of PAS is often difficult and highly subjective. To overcome this problem, we automatically segmented the placental regions by nnU-Net and used radiomics features extracted from the segmented region to build a radiomics-clinical model for identification of placenta invasion. 512 pregnant women were enrolled in this study. Our segmentation model achieved a mean Dice coefficient of 0.890 and the classification model achieved an AUC of 0.849 on the independent validation cohort.

Haijie Wang¹, Yida Wang¹, Tianping Wang², Xuefen Liu², Lei Ling², Guofu Zhang², He Zhang², and Guang Yang^1
1Shanghai key lab of magnetic resonance, East China Normal University, Shanghai, China, ²Department of Radiology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China

To compare radiomics-clinical nomograms based on various sequence MR images in predicting epithelial ovarian tumor prognosis status. A total of 186 patients with epithelial ovarian cancer pathologically proven by invasive procedure were enrolled. The single-sequence and paired-sequence radiomics signatures were constructed for T2W, T1W, DWI and CE-T1W images. And the T2W radiomic-clinical nomogram achieved a favorable prediction performance in the validation cohort with an AUC of 0.818. And it was also found the T2W radiomic-clinical nomogram was better than other models with a greater clinical net benefit.

Xianglin Guo¹, Qinglin Song¹, Ye Li¹, Yulin Chen¹, and Ailian Liu^1,2
1The First Affiliated Hospital of Dalian Medical University, Dalian, China, ²Dalian Engineering Research Center for Artificial Intelligence in Medical Imaging, Dalian, China

Symptoms of ovarian cancer are concealed, it is difficult to diagnose early, and the mortality rate is very high. DKI imaging can sensitively detect microstructure changes in tumor tissue and help preoperative assessment of Ki67 expression. This paper aims to study the correlation between Ki67 expression and DKI in ovarian cancer. The results show that the MK, Ka, Kr, MD, Da and Dr values in the DKI parameters have obvious correlation with Ki-67 expressions, and that the MK, Ka, and Kr values in DKI parameters were positive correlation with Ki-67 expression levels, and the difference was statistically significant.

hui zhang^1,2 and hui zhang^1
1Beijing Hospital, Beijing, China, ²Nanjing Meishan Hospital, Nanjing, China

The accurate diagnosis of malignant SCSTs is still a challenge. We retrospectively analyzed the MRI texture features of 69 cases, and used t-test, one-way ANOVA, the Mann-Whitney U-test and ROC curve to evaluate these parameters. The results showed that the derived texture parameters may be valuable tool in predicting malignant SCSTs.

Jiajun Guo¹, Ye Li¹, Ailian Liu¹, and Yulin Chen^1
1Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian, Dalian, China

Ovarian cancer (OC) behaves more aggressively and has a worse prognosis than any other cancer involving the female genital tract. WT-1 was significantly upregulated in human OC tissues and closely associated with OC type, grade and FIGO stage. This worked aimed at exploring the value of Intravoxel incoherent motion (IVIM) quantitative parameters for diagnosis of WT-1 positive OC. The results showed that D value provided a promising performance (AUC = 0.740, sensitivity= 88.2%, specificity= 70.6 %) in quantitatively evaluating WT-1 positive OC.

Jiahui Zhang¹, Lili Xu², Gumuyang Zhang², Hao Sun², and Zhengyu Jin^2
1Department of Radiology, Peking Union Medical College Hospital, Beijing, China, ²Peking Union Medical College Hospital, Beijing, China

This study aimed to compare and analyse the diagnostic value of PI-RADS v2.1 when used with bpMRI versus mpMRI, DWI versus T2WI to detect peripheral-zone prostate cancer (pzPCa) and clinically significant prostate cancer (csPCa). The diagnostic efficiencies of mpMRI and bpMRI as well as DWI and T2WI in pzPCa and csPCa were compared using a PI-RADS score of ≥4 as the positive threshold and pathologic results as the gold standards. MpMRI and bpMRI as well as DWI and T2WI using PI-RADS v2.1 exhibited similar diagnostic efficiency in pzPCa and csPCa, whereas bpMRI demonstrated increased diagnostic specificity compared with mpMRI.

Atsushi Nakamoto¹, Hiromitsu Onishi¹, Takahiro Tsuboyama¹, Takashi Ota¹, Hideyuki Fukui¹, Kazuya Ogawa¹, Keigo Yano¹, Kengo Kiso¹, Toru Honda¹, Mitsuaki Tatsumi¹, and Noriyuki Tomiyama^1
1Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, Suita, Japan

The image quality and diagnostic performance of diffusion weighted imaging (DWI) using multiplexed sensitivity encoding (MUSE) and DWI using reduced field-of-view (rFOV) technique in detecting prostate cancer were compared. Visual scores of MUSE-DWI regarding the visibility of prostate anatomy and overall image quality were significantly higher than those of rFOV-DWI. The diagnostic performance in detecting prostate cancer was not significantly different between MUSE-DWI and rFOV-DWI. MUSE yielded high quality DWI without reducing FOV and is expected to be more useful than rFOV technique for evaluation of the prostate including lymph node metastasis.

Takahiro Ueda¹, Yoshiharu Ohno^1,2, Kaori Yamamoto³, Masao Yui³, Masato Ikedo³, Saki Takeda⁴, Akiyoshi Iwase⁴, Yuka Oshima¹, Nayu Hamabuchi¹, Satomu Hanamatsu¹, Yuki Obama¹, Hiroyuki Nagata¹, 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, ⁴Radiology, Fujita Health University Hospital, Toyoake, Japan

We hypothesize that CEST is at least as valuable as DWI and may have a potential to improve differentiation capability of malignant from benign prostatic areas as one of the combined quantitative discriminators on prostatic MR imaging.  The purpose of this study was to compare the capability for distinguishing malignant from benign areas among CEST, DWIs at standard and super high b values and combined quantitative discriminator in suspected prostatic cancer patients.

Yu Ueda¹, Tsutomu Tamada², Hiroyasu Sanai², Kazunori Moriya², Ayumu Kido², Makoto Obara¹, Tetsuo Ogino¹, and Marc Van Cauteren^3
1Philips Japan, Ltd., Tokyo, Japan, ²Department of Radiology, Kawasaki Medical School, Okayama, Japan, ³Philips Healthcare, Asia Pacific, Tokyo, Japan

Diffusion-weighted imaging (DWI) with shorter echo time (TE) could be exploited to improve diffusion contrast by minimizing T2 shine-through due to longer T2 in normal prostate. However, clinical magnetic resonance imaging (MRI) scanner has limitation in shortening TE in conventional DWI. It would be beneficial to generate additional DWI with short TE from DWIs with two different TE, in addition to short repetition time (TR) which improvement of diffusion contrast has been reported. The synthetic DWI with shorter TR (1000 ms) and TE (1 ms) tended to show better diffusion contrast than real-acquired DWI with conventional TR and TE.

Masami Yoneyama¹, Takashige Yoshida², Jihun Kwon¹, Yasutomo Katsumata³, Shuo Zhang⁴, and Marc Van Cauteren^3
1Philips Japan, Tokyo, Japan, ²Tokyo Metropolitan Police Hospital, Tokyo, Japan, ³Philips Healthcare, Best, Netherlands, ⁴Philips GmbH Market DACH, Hamburg, Germany

DWI is a key component of the prostate MRI examination, but current prostate DWI images acquired with high b-value DWI using SENSE often suffer from increased noise artifacts. We propose to utilize a deep learning constrained Compressed SENSE (CS-AI) for reducing the noise artifacts in single-shot DW-EPI images. CS-AI DWI clearly reduces noise-like artifacts, boosts the overall SNR and significantly improves the accuracy and robustness of ADC values in rapid high b-value prostate DWI compared with conventional SENSE- and CS-DW-EPI, without any penalty for scan parameters.

Jihun Kwon¹, Takashige Yoshida², Masami Yoneyama¹, and Marc Van Cauteren^3
1Philips Japan, Tokyo, Japan, ²Tokyo Metropolitan Police Hospital, Nakano, Japan, ³Philips Healthcare, Best, Netherlands

T2-weighted (T2W) imaging is used to depict prostate anatomy. However, T2W imaging with high spatial resolution, which is required by PI-RADSv2, is not always performed because of the long scan time. In this study, we investigated the use of Compressed SENSE AI (CS-AI) reconstruction to accelerate high-resolution T2W imaging of the prostate. The image quality of CS-AI reconstruction, conventional Compressed-SENSE (C-SENSE), and SENSE were compared qualitatively and quantitatively. Clinical cases demonstrated a significant noise reduction in accelerated CS-AI. CS-AI also showed a significantly higher contrast-to-noise ratio in CS-AI compared to SENSE and C-SENSE.