Yifei Su¹, Jinxia Guo², Junhao Wang¹, Rui Cheng³, Chunhong Wang³, Liangliang Hao⁴, Hongming Ji³, Yexin He⁴, and Cheng Xu^4
1The Fifth Clinical Medical College of Shanxi Medical University, Taiyuan, China, ²GE Healthcare, MR Research, Beijing, China, ³Department of Neurosurgery, Fifth Hospital of Shanxi Medical University, Taiyuan, China, ⁴Department of Radiology, Fifth Hospital of Shanxi Medical University, Taiyuan, China

Keywords: Tumors, Cancer, high grade glioma, solitary brain metastasis

We aim to explore the value of intravoxel incoherent motion (IVIM) in differentiating high-grade glioma (HGG) and solitary brain metastasis (SBM) by using histogram and first-order texture analysis in combination with the structural lesion feature. Results showed there were significant higher skewness (Dfast, f) and kurtosis (Dslow, f), and significant lower entropy (Dslow, f) and mean (f) in HGG solid tumor region as well as significant lower mean (f) in HGG peritumoral edema zone. Clear tumor margin in T2-weighted imaging help improve the differentiation when integrated with the IVIM parametric values.

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Toshiaki Taoka^1,2, Rintaro Ito^1,2, Rei Nakamichi², Toshiki Nakane², Kazushige Ichikawa³, Mayuko Sakai⁴, Nobuyasu Ichinose⁴, Masanori Ozaki⁴, Takaya Mori⁴, Yoshiki Tanaka⁵, and Shinji Naganawa^2
1Department of Innovative Biomedical Visualization (iBMV), Nagoya University, Nagoya, Japan, ²Radiology, Nagoya University, Nagoya, Japan, ³Division of Radiology, Nagoya University Hospital, Nagoya, Japan, ⁴Canon Medical Systems Corporation, Otawara, Japan, ⁵SORD Corporation, Chiba, Japan

Keywords: Tumors, Diffusion/other diffusion imaging techniques, OGSE

The characteristics of tissue structures can be estimated by comparing images with different diffusion times acquired using the OGSE and PGSE methods. However, for multiple images, it is difficult to make pixel-by-pixel comparison. We attempted a method for integrating the pixel values of these images using ternary plotting for malignant glioma cases. Tumor areas with abnormal enhancement, peritumoral abnormal signal areas, and distant edematous areas were evaluated. The ternary plot provided immediate visual information. It also highlighted similarities in the tissue characteristics of the tumor, with enhancement to the peritumoral area showing abnormal signals.

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Peng Wang^1,2, Yanhao Liu¹, Qiong Wu¹, Shaoyu Wang³, Huapeng Zhang³, Yang Song³, Xu Yan³, and Yang Gao^1
1Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China, ²Inner Mongolia Medical University, Hohhot, China, ³Siemens Healthineers, Shanghai, China

Keywords: Tumors, Diffusion/other diffusion imaging techniques

Glioma composition is complicated, making whole-tumor investigation with traditional pathological analysis typically challenging. It is possible to demonstrate intratumor heterogeneity using habitat analysis in radiography, a technique analogous to biological environmental analysis with individualized descriptions and quantitative expression of subregions inside the region of interest. Therefore, our goal was to create an integrated model for the habitat analysis-based diffusion kurtosis imaging diagnosis of adult-type diffuse glioma grade. According to the findings, diffusion kurtosis imaging based on habitat analysis accurately predicted adult-type diffuse gliomas grade, which may help to resolve some "intermediate situations" that are challenging to diagnose clinically.

Chao Zhang¹, Ruohan Li¹, Jingyun Sha¹, Lulu Cai¹, Peng Wu², and Kai Xu^1
1Department of Radiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China, ²Philips Healthcare, Shanghai, China

Keywords: Tumors, Diffusion Tensor Imaging, edema

We evaluated the function of the human glymphatic system (GS) in patients with glioma using diffusion tensor imaging analysis along with the perivascular space (DTI-ALPS). Thirty-seven patients with glioma and 34 healthy controls (HCs) were recruited for analysis. We found that DTI-ALPS index on the ipsilateral lesion side was significantly decreased, but not on the contralateral side in glioma when compared with HCs. The decreased DTI-ALPS index was significantly correlated with the volume of peritumoral edema (PTBE), but not the volume of tumor. This study suggested the PTBE may be an independent factor that affects the GS in glioma patients.

Hui Zheng¹, Zongmeng Wang¹, Lingmin Zheng¹, Rufei Zhang¹, Yang Song², and Lin Lin^1
1Fujian Medical University Union Hospital, Fuzhou, China, ²MR Scientific Marketing, Siemens, Healthineers Ltd., Shanghai, China

Keywords: Tumors, Diffusion/other diffusion imaging techniques

The natural history of meningioma remains unclear and a simple, practical method is needed to identify fast growth tumors. This study evaluated correlations between clinical parameters, tumor growth rate (TGR), tumor volume doubling time (VDT), Ki-67 and relative apparent diffusion coefficient (rADC) derived from diffusion weighted imaging (DWI). The results showed that rADC was an independent predictive parameter of meningioma growth and baseline rADC had a good predictive ability for differentiating slow growth from fast growth meningioma. This suggests that in asymptomatic meningiomas, DWI might be a valuable predictive imaging method.

Dejun She^1,2,3, Hao Huang^1,2, Xiance Zhao⁴, and Dairong Cao^1,2,3,5
1Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, China, ²Department of Radiology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China, ³Key Laboratory of Radiation Biology of Fujian higher education institutions, First Affiliated Hospital, Fujian Medical University, Fuzhou, China, ⁴Philips Healthcare, Shanghai, China, ⁵Department of Radiology, Fujian Key Laboratory of Precision Medicine for Cancer, First Affiliated Hospital of Fujian Medical University, Fuzhou, China

Keywords: Tumors, Diffusion/other diffusion imaging techniques, Meningiomas; Diffusion-weighted MRI

An accurate assessment of the World Health Organization grade is vital in meningiomas. While many studies have investigated the usefulness of conventional DWI and DTI for noninvasive grading intracranial meningiomas, there are neither any studies comparing three advanced diffusion model including DKI, MAP and NODDI with DTI for predicting meningioma grade. Thus, it is vital to evaluate whether these advanced models derived from diffusion spectrum imaging can also be beneficial in grading meningiomas. Our results suggested that whole tumour histogram analyses of the diffusion metrics from multiple diffusion models are promising methods in grading meningiomas. 

Qi Lin¹, Langlang Tang¹, Yongzhou Xu², and Peng Wu^3
1Department of Radiology, Longyan First Hospital, Longyan, China, ²Philips Healthcare, Guangzhou, China, ³Philips Healthcare, Shanghai, China

Keywords: Tumors, Cancer

To further evaluate the efficacy of MRI in the differential diagnosis of glioblastoma (GBM) and primary cerebral lymphoma (PCL), this study retrospectively analysed rCBV and mADC-related data from patients with GBM and PCL and performed a quantitative comparison. The rCBV and mADC values were found to be significantly higher in the GBM group than in the PCL group. We diagnosed GBM when rCBV >23.2900 ml/100g or mADC >0.6550×10-3mm²/s, and the corresponding sensitivity, specificity, and predictive values were all high. This demonstrates the important clinical value of the combined application of mADC and rCBV for the definitive diagnosis of brain tumours.

Tao Han¹, Junlin Zhou¹, and Xianwang Liu^1
1Lanzhou University Second Hospital, LanZhou, China

Keywords: Tumors, Diffusion/other diffusion imaging techniques

This study evaluated the feasibility of the model combining conventional MRI features and apparent diffusion coefficient (ADC) histogram parameters for predicting recurrent meningioma. The results showed that tumor shape and ADCp1 were independent risk factors for predicting meningioma recurrence after removing confounding factors by single and multiple logistic regression analysis. The logistic regression model nomogram constructed based on the above two risk factors for predicting meningioma recurrence, which had a higher predictive effect than a single risk factor. In conclusion, logistic regression model nomogram have important value in predicting meningioma recurrence and helping patients achieve the greatest survival benefit.

Ruirui Lv¹, Wenfu Ma¹, Yuhui Xiong², Peng Yong¹, Jiarui Zheng¹, Xuhong Yang¹, and Xiaodong Wang^3
1Ningxia Medical University, Yinchuan, China, ²GE Healthcare MR Research, Beijing, China, ³General Hospital of Ningxia Medical University, Yinchuan, China

Keywords: Tumors, Brain

This work sought to investigate the performance of synthetic MRI(Sy-MRI) and MUSE-DWI in differentiating progressive disease (PD) from pseudo-progression (PsP). It was concluded that the pre-contrast T1(T1-pre) and post-contrast T1(T1-Gd) from synthetic MRI can be used as novel quantitative imaging biomarkers for discriminating PD from PsP. The combination of T1-pre, T1-Gd and ADC may explore as an effective strategy to improve the ability for discriminating PD from PsP, and provide a basis for clinical follow-up diagnosis and treatment.

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Lijuan Qian¹, Jie Yu², Yuan Liu³, Peng Sun⁴, Manman Chen⁵, Xin Li⁵, and Fan Yang^5
1Radiology, Union Hospital Tongji Medical College Huazhong University of Science and Technology, Wuhan, China, ²Union Hospital Tongji Medical College Huazhong University of Science and Technology, Wuhan, China, Wuhan, China, ³Union Hospital Tongji Medical College Huazhong University of Science and Technology, Wu, China, ⁴Philips healthcare,Beijing, Beijing, China, ⁵Union Hospital Tongji Medical College Huazhong University of Science and Technology, Wuhan, China

Keywords: Tumors, Head & Neck/ENT

TSE-DWI-IVIM as a new and feasible  method for predicting the early response to Induction Chemotherapy(IC) for NPC patients.Diffusion-related IVIM parameters (pre-D) might be and perfusion-related parameters (pre-f) can be helpful as potential imaging biomarkers of the therapeutic response to IC in NPC patients.  

 

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Liam S. P. Lawrence¹, Rachel W. Chan¹, James Stewart², Mark Ruschin², Aimee Theriault², Sten Myrehaug², Jay Detsky², Pejman J. Maralani³, Chia-Lin Tseng², Hany Soliman², Mary Jane Lim-Fat⁴, Sunit Das⁵, Greg J. Stanisz^1,6, Arjun Sahgal², and Angus Z. Lau^1
1Physical Sciences, Sunnybrook Research Institute, Toronto, ON, Canada, ²Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada, ³Medical Imaging, Sunnybrook Health Sciences Centre, Toronto, ON, Canada, ⁴Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada, ⁵Department of Surgery, St. Michael's Hospital, Toronto, ON, Canada, ⁶Department of Neurosurgery and Paediatric Neurosurgery, Medical University, Lublin, Poland

Keywords: Tumors, Radiotherapy

Hyperintense regions on high b-value DWI (HRDs) may reflect hypercellular tumour and are of interest for radiotherapy dose escalation. However, the extent to which diffusion restriction versus prolonged T₂ creates these hyperintensities is not known. Additionally, the dynamics of HRDs during radiotherapy are not fully characterized. In 35 glioblastoma patients treated on a 1.5T MR-Linac, we found HRDs shrank during treatment and extended beyond the gross tumour volume. Apparent diffusion coefficient was reduced and T₂ was elevated in HRD compared to the remainder of the clinical target volume, implying that both diffusion restriction and prolonged relaxation are responsible for HRDs.

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Xiaoxiao Ma¹, Kun Cheng¹, Chenyang Zhao², Jianxun Qu³, Chenxi Li¹, Runze Li¹, Caohui Duan¹, Xiangbing Bian¹, Danny JJ Wang^2,4, and Xin Lou^1
1Department of Radiology, Chinese PLA General Hospital, Beijing, China, ²Mark & Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States, ³MR Collaboration, Siemens Healthineers Ltd., Beijing, China, ⁴Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States

Keywords: Tumors, Perfusion

The goal of this study was to assess the feasibility of pseudo-continuous arterial spin labeling (pCASL) at 7T on patients with intracranial tumors. We found that 7T ASL imaging was feasible and had a higher resolution than 3T ASL imaging and therefore, may enable in vivo assessment of subtle changes and provides a valuable tool for early detection and mechanism investigation of neurovascular function impairments in patients with intracranial tumors.

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Sarah M Jacobs¹, Evita C Wiegers¹, Zahra Shams¹, Jannie P Wijnen¹, Peter W.A. Willems², Pierre A Robe², Angelika Mühlebner^3,4, Wim Van Hecke³, Maeike Zijlmans^2,5, Dennis WJ Klomp¹, and Anja G van der Kolk^1,6
1Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, Netherlands, ²UMC Utrecht Brain Center, Department of Neurology and Neurosurgery, University Medical Center Utrecht, Utrecht, Netherlands, ³Department of Pathology, University Medical Center Utrecht, Utrecht, Netherlands, ⁴Department of Pathology, Amsterdam University Medical Center, location AMC, Amsterdam, Netherlands, ⁵Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, Netherlands, ⁶Department of Medical Imaging, Radboud University Medical Center, Nijmegen, Netherlands

Keywords: Tumors, Tissue Characterization

We combined metabolic magnetic resonance imaging (MRI) sequences at 7 Tesla (7T) to characterize glioma tissue and discover metabolic MRI profiles that could help delineate the extent of disease spread and determine molecular tumor subtypes preoperatively. Here we show the first preliminary results of three different diffuse glioma subtypes imaged with ¹H MR spectroscopy (MRS), ³¹P 3D chemical shift imaging (CSI), glutamate chemical exchange saturation transfer (GluCEST) and quantitative susceptibility mapping (QSM).

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Xin Ge^1,2, Yuhui Xiong³, Min Li⁴, Xiaodong Wang⁵, and Jing Zhang^2
1Second Clinical School, Lanzhou University, Lanzhou, China, Lanzhou, China, ²Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, China, Lanzhou, China, ³GE Healthcare MR Research, Beijing, China, Beijing, China, ⁴GE Healthcare MR Enhancement Application, Beijing, China, Beijing, China, ⁵Department of Radiology, General Hospital of Ningxia Medical University, Yinchuan, China, Yinchuan, China

Keywords: Tumors, Tumor

The main work of our research was to investigate the difference of quantitative MR metrics from synthetic MRI and 3D-pCASL including T₁, T₂, PD, CBF, and the multiparametric strategies that contained more than one of the metrics between high-grade gliomas (HGGs) from solitary brain metastases (SBMs) in the peritumoral edema. We found that the T₁, T₂, and CBF were useful metrics for differentiating HGGs from SBMs which were easily confounded with HGGs in daily diagnosis. Furthermore, combining T₁, T₂, and CBF further improved their diagnostic performance.

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Mengqiu Cao¹, Xiaoqing Wang², Fang Liu², Ke Xue³, and Yongming Dai^3
1Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China, ²Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China, ³MR Collaboration, Central Research Institute, United Imaging Healthcare, Shanghai, China

Keywords: Tumors, Diffusion/other diffusion imaging techniques

Evaluation of the degree of malignancy of gliomas, including the histopathological and molecular features, is of great importance for neurosurgeons in making individualized operation plans before surgery. In our study, the clinical value of a three-component diffusion model in characterizing gliomas malignancy and IDH-1 mutation status was evaluated. Our results showed that the three-component diffusion model exhibited great potential in evaluating the phenotype and genotype of gliomas by providing more complex microstructural information and showed significantly optimal diagnostic performance than the mono-exponential, bi-exponential and DKI models.

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Hao Wu¹, Zhenwei Yao¹, Bobin Chen², Hui Kang², Huaping Sun¹, Yan Ren¹, Shuguang Chu³, Na Lu¹, Xianjing Zhao¹, Jie Wu¹, Yan Ma², Yan Yuan², Tianling Ding², Zhiguang Lin², Jingjing Ma², Qing Li², Xianjin Zhou⁴, Yiqian Zhu⁵, Tianyong Xu⁶, and Yong Zhang^6
1Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China, ²Department of Hematology, Huashan Hospital, Fudan University, Shanghai, China, ³Department of Radiology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China, ⁴Eye Institute, Eye and ENT Hospital, College of Medicine, Fudan University, Shanghai, China, ⁵Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China, ⁶GE Healthcare, Shanghai, China

Keywords: Tumors, Arterial spin labelling, primary CNS lymphoma, cerebral blood flow, prognostic factor

PCNSL is a heterogeneous and aggressive non-Hodgkin lymphoma with poor prognosis. The present study revealed that 3D-ASL MR perfusion imaging-derived rCBF values pre- and posttreatment can be used as predictors for patients with newly diagnosed PCNSL. Furthermore, this is the first study identifying rCBFmean as an independent predictor for overall survival. Different from the traditional prognostic scoring system, the study provided a noninvasive MRI technique that requires no contrast agent or radiation exposure. Inclusion of the 3D-ASL sequence in routine MRI protocols is highly recommended to help to optimize individualized treatment and improve prognosis.

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Xiaoqing Wang¹, Mengqiu Cao¹, Yang Song², Guang Yang³, and Yan Zhou^1
1Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China, ²MR Scientific Marketing, Siemens Healthineers Ltd. Shanghai, China, Shanghai, China, ³Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, China

Keywords: Tumors, Brain, Diffusion weighted MRI

This study investigated the feasibility of spatially explicit analysis based on IVIM MRI to identify hypoxia-related habitats with higher-grade glioma, and to predict progress-free survival in patients. The results showed that spatial explicit analysis on IVIM MRI could be an appropriate method for distinguishing different hypoxic subregions in glioma. In addition, the volume percentage of less hypoxic habitats can effectively predict progress-free survival in higher-grade glioma. 

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Xianwang Liu^1,2,3, Tao Han^1,2,3, Hong Liu^1,2,3, and Junlin Zhou^1,2,3
1Department of Radiology, Lanzhou University Second Hospital, lanzhou, China, ²Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, lanzhou, China, ³Key Laboratory of Medical Imaging of Gansu Province, lanzhou, China

Keywords: Tumors, Quantitative Imaging, Solitary fibrous tumor, Transitional meningioma, Magnetic resonance imaging, Apparent diffusion coefficient, Histogram analysis

This study investigates the value of whole volume apparent diffusion coefficient (ADC) histogram analysis in distinguishing intracranial solitary fibrous tumor (SFT) and transitional meningioma (TM). The method was to compare the differences between ADC histogram parameters in them and explore the relationships between these parameters and Ki-67 expression. Our research demonstrates that SFT with higher variance, lower AP1, and AP10. Significant correlations were observed between these parameters and Ki-67 expression. The best diagnostic performance was obtained by variance. Therefore, we consider that the whole volumetric ADC histogram analysis is a feasible tool for non-invasive distinguishing between SFT and TM.

Lingmin Zheng¹, Zongmeng Wang¹, Danjie Lin¹, Yang Song², Lin Lin¹, and Yunjing Xue^1
1Fujian Medical University Union Hospital, Fuzhou, China, ²MR Scientific Marketing, Siemens, Healthineers Ltd, Shanghai, China

Keywords: Tumors, Diffusion/other diffusion imaging techniques

The consistency of Intracranial tumors is crucial to determine the required surgical instruments as well as affecting the outcome of surgery, but no specific feature of conventional MRI is reliable in predicting the consistency of tumors. Histogram analysis of diffusion parameters has been successfully used in predicting the grade, subtype, and proliferative activity of meningiomas. This study prospectively evaluated and compared the potential of various diffusion metrics obtained from the mono-exponential model (MEM), bi-exponential model (BEM), and stretched exponential model (SEM)-based diffusion-weighted imaging (DWI) in predicting consistency of meningiomas. It was found that different models of DWI (MEM, BEM, and SEM) are useful in the differentiation between soft and hard meningiomas. However, Alpha obtained from SEM and fast-ADC from BEM are more promising diffusion parameters for predicting the consistency of meningiomas.

Yifan Yuan¹, Shin Tai Chong², Sanford Pin-Chuan Hsu³, Ying-Hua Chu⁴, Yi-Cheng Hsu⁵, Yu-Ting Ko², Kuan-Tsen Kuo², Ching-Po Lin^2,6, and Jianping Song^1
1Department of neurosurgery, Huashan Hospital Fudan University, Shanghai, China, ²Institute of Neuroscience, National Yang Ming Chiao Tung University, Hsinchu, Taiwan, Hsinchu, Taiwan, ³Department of neurosurgery, Taipei Veterans General Hospital, Taipei, Taiwan, ⁴MR Collaboration, Siemens Healthineers Ltd, Shanghai, China, ⁵MR Collaboration, Siemens Healthineers Ltd, shanghai, China, ⁶Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, shanghai, China

Keywords: Tumors, Diffusion Tensor Imaging

Novel fiber tracking technology, based on diffusion imaging, can objectively reveal and visualize three-dimensional white matter tracts; through the cooperation of intraoperative navigation, it can help achieve maximum resection under the premise of ensuring function. We used an in-house developed software (DiffusionGo) specially designed for neurosurgeons. The fiber tracking result using DiffusionGo showed robust consistency with the surgical findings. We believe that this fully automatic processing pipeline provides the neurosurgeon with a solution that may reduce time costs and operating errors and improve care and surgical procedure quality across different neurosurgical centers.