Peng Zhao¹, Yongqing Yang², Yu Wang², Wenjing Ma¹, Xiangtao Lin², Liu Mengxiao³, Lu Zu², Tao Yang², Letian Yuan¹, Yani Cheng², Shanshan Sun¹, Shuo Cai¹, and Wei Zhang^2,4
1Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China, ²Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China, ³MR Scientific Marketing,Diagnostic Imaging, Siemens Healthineers Ltd., Shanghai, China, ⁴The People's Hospital of LaoLing, LaoLing, China

Chest scans were performed on 42 lung cancer patients using MRI and CT scanners to calculate ECV. Using one-way analysis of variance, the ECV calculated based on CT is statistically different between SCLC and NSCLC, there is no statistical difference between squamous cell carcinoma and adenocarcinoma, and the ECV calculated based on MRI is statistically different among the three.It can be seen that ECV can be accurate and non-invasive assessment of the pathological type of lung cancer, and MRI-ECV has a higher diagnostic efficiency than CT-ECV, can provide some help for the choice of clinical treatment options.

Qiuxi Lin¹, Yu Deng¹, Xinchun Li¹, Weiyin Vivian Liu², Lei Zhang², Ziyi Zhang³, Qun Luo³, Qi Wan¹, and Chongpeng Sun^1
1Department of Radiology, The first affiliated hospital of Guangzhou Medical University, Guangzhou, China, ²GE Healthcare, Beijing, China, ³Department of Respiratory and Critical Care Medicine, The first affiliated hospital of Guangzhou Medical University, Guangzhou, China

Pulmonary MRI provides qualitative structural and quantitative functional images of the lungs without ionizing radiation. In this study, free-breathing 3D isotropic high-resolution pulmonary zero echo time (ZTE) imaging was applied to detect pulmonary abnormalities and make diagnosis of interstitial lung diseases (ILDs). The pulmonary interstitial abnormalities including ground-glass opacity, reticular opacity, honeycombing, traction bronchiectasis and consolidation can be well depicted. The diagnosis performance of ZTE in ILDs is comparable with HRCT. ZTE might assist long-term follow-ups in ILDs evaluation without radiation exposure.

Taku Tajima^1,2, Hiroyuki Akai³, Koichiro Yasaka⁴, Akira Kunimatsu¹, Masaaki Akahane², Naoki Yoshioka², Osamu Abe⁴, Kuni Ohtomo⁵, and Shigeru Kiryu^2
1Department of Radiology, International University of Health and Welfare Mita Hospital, Tokyo, Japan, ²Department of Radiology, International University of Health and Welfare Narita Hospital, Chiba, Japan, ³Department of Radiology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan, ⁴Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan, ⁵International University of Health and Welfare, Tochigi, Japan

Single-shot fast spin echo (single-shot FSE) sequence is an accelerated T2-weighted imaging (T2WI) in pancreatic MRI. Fast advanced spin echo (FASE) is one of similar modalities. However, single-shot FSE suffers from image blurring and relatively low tissue contrast. We hypothesized that denoising approach with deep learning-based reconstruction (dDLR) would facilitate accelerated breath-hold thin-slice single-shot FSE MRI. We assessed the image quality of respiratory-triggered FSE T2WI (Resp-FSE) and breath-hold FASE with and without dDLR (BH-dDLR-FASE and BH-FASE, respectively) at 1.5 T. The image quality of BH-dDLR-FASE was superior to BH-FASE and Resp-FSE, and BH-dDLR-FASE had a shorter acquisition time than Resp-FSE.

Juan Li¹, cheng jingliang¹, and Lin Liangjie^2
1Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China, ²Philips Healthcare, Beijing, China

This study explored the application of APT and IVIM in evaluation of prognostic factors for rectal adenocarcinoma. Parameters of APT signal intensity (APT SI), pure diffusion coefficient (D), pseudo-diffusion coefficient (D*), perfusion fraction (f), and apparent diffusion coefficient (ADC) were measured. The results showed that APT SI was significantly lower in low- than high-grade adenocarcinoma. The D value was significantly higher in low- than high-grade adenocarcinoma. The D value was significant lower in positive than in negative extramural vascular invasion (EMVI). This suggests that APT and IVIM were helpful to assess rectal adenocarcinoma, including histopathological grade and the EMVI status.

Jie Yuan¹, Mengxiao Liu², Songhua Zhan¹, Zhigang Gong¹, and Qiang Shen^1
1Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China, ²MR scientific Marketing, Diagnostic Imaging, Siemens Healthineers Ltd, Shanghai, China

It is important to combine histopathological and non-invasive imaging measurements to assess tumor components and predict tumor invasiveness to define disease treatment and prognostic assessment. In this study, we assessed the relationships between DKI and IVIM parameter measurements and the corresponding tumor tissue composition, regardless of the status of the malignant tumor. To this end, we selected a range of tissue parameters informative for important biological properties of the tumor, such as Ki-67, the tumor: stroma ratio, CD34 etc.

Juan Li¹, Marcel Dominik Nickel², cheng jingliang¹, and Zhu Jinxia ^3
1Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China, ²MR Application Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany, ³MR collaboration, Siemens Healthcare Ltd., Beijing, China

This study evaluated the clinical significance of using native T1 mapping for distinguishing histopathologic subtypes, grades, and stage of rectal adenocarcinoma by measuring parameters such as T1 relaxation time and apparent diffusion coefficient (ADC). The results showed that T1 and ADC values were significantly higher in rectal mucinous adenocarcinoma (MC) compared to non-mucinous rectal adenocarcinoma (AC). In the AC group, T1 values were significantly lower in the low-grade AC than in the high-grade AC. Our findings suggest that native T1 mapping can distinguish histopathologic subtypes of renal adenocarcinoma. Moreover, T1 values distinguish different grades of AC more accurately than ADC values.

Jing Cheng¹, Jiansen Li², Jun Yang², Huimao Zhang³, Guobin Li², Xin Liu¹, and Dong Liang^1
1Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China, ²United Imaging Healthcare, Shanghai, China, ³Department of Radiology, the First Hospital of Jilin University, Changchun, China

T2-weighted MR imaging is the standardized protocol in clinical evaluation of rectal cancer and anatomic structures. Usually, spasmolytic agent injection is required before the examination to reduce the imaging artifacts caused by the rectum peristalsis. In this work, we propose a novel dynamic imaging approach that with a complementary k-space sampling strategy and deep learning-based image reconstruction method to illustrate the anatomical structures of the rectum without any agent injection. Experimental results demonstrate the superior performance of the proposed approach.

Fengxian Fan¹, Yanli Jiang¹, Jing Zhang¹, Jie Zou¹, and Jialiang Ren^2
1Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, China, ²GE Healthcare, Shanghai, China

The purpose of this study is to compare the diagnostic accuracy of histogram analysis–derived parameters from intravoxel incoherent motion (IVIM) and diffusion kurtosis imaging (DKI) for staging of liver fibrosis (LF). The correlations between different histopathologic stages and histogram parameters were determined. The results showed that the histogram metrics of DKI maps demonstrate significant correlation with fibrosis stage, while there was no correlation between histogram metrics of IVIM and fibrosis stage. In conclusion, histogram analysis of DKI may serve as a valuable and robust tool for the staging of LF.

Hong Wei¹, Hanyu Jiang¹, and Bin Song^1
1Radiology, West China Hospital, Sichuan University, Chengdu, China

A total of 214 patients with pathologically confirmed Hepatocellular carcinoma (HCC) who underwent gadoxetic acid-enhanced magnetic resonance imaging (EOB-MRI) before curative resection between July 2015 and November 2020 were retrospectively included in this study. The preoperative model integrating EOB-MRI findings and serum AFP and AST levels achieved accurate recurrence prediction in HCC, with similar performance to that of the postoperative clinical-radiologic-pathologic model. Moreover, the preoperative model yielded superior predictive performance to four widely used clinical staging systems for HCC recurrence prediction. This model offered a potential noninvasive and reliable approach for individualized recurrence risk estimation before hepatectomy.

Zhijun Geng^1,2, Botong Wu^3,4, Tiantian Liu³, Niange Yu³, Dandan Zheng³, Hua Guo⁴, and Chuanmiao Xie^1,2
1The department of medical imaging, Sun Yat-sen University,Cancer Center, Guangzhou, China, ²States key laboratory in South China, Guangzhou, China, ³Shukun (Beijing) Technology Co., Ltd, Beijing, China, ⁴Center for Biomedical Imaging Research, Department of Biomedical Engineering,School of Medicine, Tsinghua University, Beijing, China

Subtraction images are an important part of routine multi-phase contrast-enhanced MRI for characterizing enhancement of lesions which are intrinsically hyperintense on T1-weighted imaging. Successful subtraction MRI is dependent on precise 3D co-registration of the pre- and contrast-enhanced source data. However, there still lack a robust, convenient, time efficient and labor free method for automatically image subtraction. This study developed a deep learning based nonrigid registration algorithm, measure the improvement in displacement after registration using anatomic landmarks and automatically generate the subtraction liver images.

Wang Nan¹, Jiazheng Wang², Peng Sun², Lihua Chen¹, Qingwei Song¹, and Ailian Liu^1
1Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian, China, ²Philips Healthcare, Beijing, China

Cirrhosis of the liver not only increases the risk of liver cancer but also causes portal hypertension, leading to gastrointestinal bleeding, hepatic encephalopathy, ascites, and other complications. The opening of collateral circulation caused by portal hypertension plays an important role in the occurrence and progress of diseases. Therefore, precise diagnosis of collateral circulation (CC) in cirrhotic patients is important for clinical practice. Hereby, we compared quantitative parameters from multiparametric MRI (4D flow, APT, IVIM, T1/T2 mapping) between the CC and non-CC groups in cirrhotic patients, which showed significant differences.

Fei Xing¹ and Xiance Zhao^2
1the Third People’s Hospital of Nantong, Nantong, China, ²Philips Healthcare, Shanghai, China

The purpose of this study was to compare the diagnostic performance of the LI-RADS v2017 and v2018 for HCC in patients with cirrhosis using Gd-EOB-DTPA. We retrospectively analyzed Clinical data of 213 patients（246 observations）with cirrhosis who underwent Gd-EOB-DTPA from October 2015 to July 2020 were retrospectively collected. MRI major features were reviewed by two radiologists. The LI-RADS categories were assigned according to v2017 and v2018. Our study showed that Updated LR-5 criteria on Gd-EOB-DTPA, the diagnostic performance of LI-RADS v2018 for diagnosing HCC is superior to v2017, particularly in small HCC (10–19 mm), with a greater sensitivity and similar specificity.

Xiaonan Wang¹, Tongtong Sun¹, Jinxia Zhu², Stephan Kannengiesser³, and Hongyan Ni^4
1Tianjin Medical University, Tianjin, China, ²Siemens Healthineers Ltd., Beijing, China, ³Siemens Healthcare GmbH, Erlangen, Germany, ⁴Tianjin First Central Hospital, Tianjin, China

We used R2* mapping to assess iron overload in multiple organs of patients with transfusion-dependent diseases and related the R2* values to transfusion volumes and serum ferritin (SF) levels. The organs assessed included the liver, spleen, pancreas, vertebral bone marrow, and myocardium. The results showed a correlation between the R2* values of multiple organs and between the R2* values of some organs and transfusion volumes. This study revealed differences in the distribution of iron overload in various organs and suggested that transfusion volumes could be used to predict the degree of liver iron overload in patients with transfusion-dependent diseases.

Shuang Zheng¹, Lei Zhang¹, Huimao Zhang¹, Zhuo Wang¹, Yuejiao Sun¹, Yi Zhu², and Ke Jiang^2
1The First Hospital of Jilin University, Changchun, China, ²Philips Healthcare, Beijing, China

3D-isotropic volumetric data acquisition provides higher spatial resolution and signal-to-noise ratios, and facilitates multi-planar reformations. But the application was limited due to long scan time. Recently, compressed sensing (CS) has been proposed as a new method for reducing the number of k-space samples. However, one of the drawbacks of CS is a relatively lower SNR than for PI (parallel imaging). Artificial intelligence reconstruction has been introduced for improving imaging quality. The aim of this study is to investigate the feasibility of 3D-isotropic T1 weighted imaging (T1WI) with compressed sense AI reconstruction in the liver magnetic resonance imaging.  

Siya Shi¹, Yanji Luo¹, and Liqin Wang^1
1The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China

Tomoelastography, a newly emerging imaging modality, is a multi-frequency magnetic resonance elastography technique using noise-robust data post-processing. The aim of our study was to investigate the assessment of stiffness and fluidity of pancreas in healthy volunteers with tomoelastography. Tomoelastography derived pancreatic stiffness and fluidity were near-perfect reproducible in healthy volunteers. There was no stiff or fluidic difference among different groups of sex, age, BMI or pancreatic anatomical region. Tomoelastography can provide stable and promising stiffness and fluidity measurements throughout the pancreas. Our results provide data that will enable pancreatic studies of tomoelastography as a potential clinical tool in future.

Pengyang Feng¹, Nan Meng², Zhun Huang¹, Ting Fang², Ziqiang Li³, Fangfang Fu⁴, Wei Wei⁴, Yan Bai⁴, Yang Yang⁵, Jianmin Yuan⁶, and Meiyun Wang*^1
1Department of Radiology, Henan University People’s Hospital & Henan Provincial People’s Hospital, Zhengzhou, China, ²Department of Radiology, Zhengzhou University People’s Hospital & Henan Provincial People’s Hospital, Zhengzhou, China, ³Xinxiang Medical University & Henan Provincial People's Hospital, Xinxiang, China, ⁴Department of Radiology, Henan Provincial People’s Hospital, Zhengzhou, China, ⁵UIH Group, Central Research Institute, Beijing, China, ⁶UIH Group, Central Research Institute, Shanghai, China

Amide proton transfer-weighted imaging (APTWI) primarily reflects the protein content and acidity information of tissue structures. Stretch index diffusion imaging includes α, DDC values, these parameters reflect the heterogeneous characteristics of tumors. Ki67 is a good indicator to evaluate the proliferative activity of tumor cells. The results showed that APTWI and stretch index diffusion imaging had similar diagnostic performance in the diagnosis of lung cancer staging，and there was a certain correlation between the parameters and Ki67.