ISMRM22 - 2D-4D Flow & Perfusion in the Body: Methods & Clinical Applications

Joint Annual Meeting ISMRM-ESMRMB & ISMRT 31st Annual Meeting • 07-12 May 2022 • London, UK

2D-4D Flow & Perfusion in the Body: Methods & Clinical Applications

Weekday Course

ORGANIZERS: Jeffrey Maki, Masako Kataoka, Steven Sourbron

Tuesday, 10 May 2022

ICC Capital Suite 10-11

16:45 - 18:45

Moderators:
Blood Flow & Perfusion in the Body: Applications: Min Lee

Skill Level: Basic

Session Number: Tu-05

Session Number: Tu-05

Overview
Measurement of blood flow in large blood vessels, or perfusion in the microvasculature, is challenging in body organs due breathing and other motion, but also due to the often-atypical and complex anatomy and physiology of body organs and their feeding or draining blood vessels. At the same time, a reliable characterization of blood flow and perfusion in the body opens up a wide range of clinical applications in areas such as metabolic disease, diabetes, drug effects, pulmonary hypertension, cancer treatment response, and more.

The aim of this course is twofold: 1) to identify specific challenges and recent advances in methods for measuring 3D/4D flow and perfusion in the body; 2) present potential clinical applications of flow and perfusion in two selected organs: liver and lungs.

Target Audience
Basic MRI scientists, clinicians, radiographers, and clinicians with an interest in methods and applications of blood flow and perfusion in the organs of the body.

The course will review current methods and recent developments in a way that is accessible for a broader audience. Prior technical knowledge of advanced MRI methods is not assumed.

Educational Objectives
As a result of attending this course, participants should be able to:
- Describe the main challenges in measuring blood flow and perfusion in the organs of the body;
- Explain the ideas underlying current technological solutions for measuring blood flow and perfusion in the body;
- Recall the specific challenges of measuring and interpreting blood flow and perfusion methods in liver and lungs; and
- Describe the current and potential clinical applications of blood flow and perfusion measurement in the liver and lungs.

	Blood Flow & Perfusion in the Body: Methods
16:45		Current Methods for 2D, 3D & 4D Flow in Body Organs View the Presentation Hideki Ota Clinical application of flow imaging has been accepted, and various MR acquisition techniques are applied for imaging vessels of body organs. Depending on clinical purposes, blood flow should be visualized as static images for vascular morphology and/or measured for hemodynamic evaluation. In this talk, the following will be introduced: 1) basic knowledge of associations between flow and signals, 2) non-contrast-enhanced inflow-dependent MR angiography and contrast-enhanced MR angiography for qualitative flow visualization, and 3) principles of 2D PC and 4D flow MRI for flow visualization and measurement. Future directions of 4D flow MRI to overcome time-consuming process will also be discussed.
17:15		Current Methods for Perfusion & Permeability MRI in Body Organs View the Presentation Octavia Bane Dynamic contrast-enhanced (DCE-)MRI uses the unique physiology of liver perfusion (dual input from the hepatic artery and the portal vein) to characterize diffuse liver disease, and conditions arising from end-stage liver disease such as portal hypertension and hepatocellular carcinoma. By attending this lecture, course participants will be introduced to: 1) the conceptual difference between perfusion and vascular permeability, and why it is impossible to measure both at the same time; 2) acquisition protocol requirements for DCE-MRI; 3) the main pharmacokinetic models used with DCE-MRI in diffuse and focal liver disease; 4) examples of clinical applications of DCE-MRI in the liver.
	Blood Flow & Perfusion in the Body: Applications
17:45		Clinical Applications of 4D Flow MRI in the Portal Venous System View the Presentation Thekla Oechtering Assessment of hemodynamics in the portal venous system is essential for the diagnosis of many liver pathologies. 4D flow MRI offers a comprehensive approach for understanding pathophysiological mechanisms. It simultaneously and noninvasively acquires time-resolved flow and anatomic information in a 3D imaging volume. Although promising, it is particularly challenging in the portal venous system because of small vessel calibers, slow flow velocities, and respiratory motion. This presentation will describe how to perform and evaluate 4D flow MRI exams of the portal venous system. Moreover, it will discuss potential clinical applications and promising quantitative parameters that could help diagnose various pathologies.
18:15		Clinical Applications of cardiac & Lung MRI - a focus on pulmonary hypertension Video Permission Withheld Andy Swift This talk covers a number of the clinical applications of blood flow and perfusion imaging in the lungs. There will be a focus on pulmonary hypertension and parenchymal lung diseases of emphysema and interstitial lung disease. The use of several MRI sequences will be discussed, non contrast approached phase contrast MRI, arterial spin labelling and PREFUL, in addition contrast enhanced approaches such and dynamic contrast enhanced angiography and magnetic resonance angiography. The feasibility of these approaches and their diagnostic and prognostic value will be discussed.