Rui Wang¹, Xianchang Zhang², and Shaowu Li^1
1Beijing Neurosurgical Institute/Beijing Tiantan Hospital, Capital Medical University, Beijing, China, ²MR Collaboration, Siemens Healthineers Ltd., Beijing, China

Keywords: Tumors, Arterial spin labelling

This study investigated the feasibility of using local maximum cerebral blood flow (maxCBF) in tumor area measured with multi-inversion-time ASL (mTI-ASL) to preoperatively predict the 1p/19q status in patients with IDH1-mutant lower-grade glioma (LGG). Mann-Whitney U test showed that maxCBF in the tumor region was significantly higher in 1p/19q Non-Codeleted group than Codeleted group. ROC showed maxCBF achieved high sensitivity (0.7) and specificity (0.737) in differentiation of IDH1-mutant-LGGs with distinct 1p/19q status. This finding suggested that ASL-derived maxCBF has the potential as a tool for the noninvasive preoperative characterization of 1p/19q status, thus providing evidence for individualized treatment planning.

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Kiyohisa Kamimura¹, Tsubasa Nakano¹, Tomohito Hasegawa¹, Masanori Nakajo¹, Hiroyuki Uchida², Takashi Iwanaga³, Hiroshi Imai⁴, Thorsten Feiweier⁵, and Takashi Yoshiura^1
1Radiology, Kagoshima University, Kagoshima, Japan, ²Neurosurgery, Kagoshima University, Kagoshima, Japan, ³Radiological Technology, Kagoshima University Hospital, Kagoshima, Japan, ⁴Siemens Healthcare K.K., Tokyo, Japan, ⁵Siemens Healthcare GmbH, Erlangen, Germany

Keywords: Tumors, Diffusion/other diffusion imaging techniques

To investigate the utility of time-dependent DWI for differentiating between glioblastoma and brain metastasis, 65 patients with glioblastoma and 27 patients with brain metastasis were examined. ADC was not significantly different between the two tumor types neither at a short (7.1ms) nor at a long (44.5ms) diffusion time, whereas the ADC difference (ΔADCmean, ΔADC5, ΔADC95) and ADC change ratio (rADCmean, rADC5, rADC95) were significantly higher in brain metastasis than in glioblastoma. The ΔADCmean showed the best diagnostic performance. The ΔADCmean and rADCmean showed a significant negative correlation with ADC_44.5msmean, but not with extracellular extravascular space volume fraction derived from DCE-MRI.

Jinbo Qi¹, Xiaoyue Ma¹, Peipei Wang¹, Eryuan Gao¹, Guohua Zhao¹, Kai Zhao¹, Yang Song², Huiting Zhang³, Ankang Gao¹, Jie Bai¹, Yong Zhang¹, and Jingliang Cheng^1
1Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China, ²Magnetic Resonance Scientific Marketing, Siemens Healthineers Ltd., Shanghai, China, ³Magnetic Resonance Scientific Marketing, Siemens Healthineers Ltd., Wuhan, China

Keywords: Tumors, Diffusion/other diffusion imaging techniques, Neurite orientation dispersion and density imaging

We aim to explore the value of neurite orientation dispersion and density imaging (NODDI) maximum abnormal signal area histogram analysis for differentiation between glioblastoma Multiforme (GBM) and solitary brain metastasis (SBM). 50 patients with GBM and 50 patients with SBM confirmed by surgical pathology were enrolled and underwent MR examination. Result showed that multiple histogram parameters can significantly distinguish GBM from SBM, and the performance of logistic regression model is better than that of optimal single parameter.

Pei Dang¹, Xueying Huang², Zhihua Yang³, Aijun Wang², Lidong Wang⁴, Yuhui Xiong⁵, Xuhong Yang⁶, Minglei Wang², and Xiaodong Wang^7
1Radiology, General Hospital of Ningxia Medical University, yinchuan, China, ²General Hospital of Ningxia Medical University, Yinchuan, China, ³Radiotherapy, General Hospital of Ningxia Medical University, Yinchuan, China, ⁴Radiology, Yinchuan Hospital of Traditional Chinese Medicine, Yinchuan, China, ⁵GE Healthcare MR Research, Beijing, China, ⁶Ningxia Medical University, Yinchuan, China, ⁷Radiology, General Hospital of Ningxia Medical University, Yinchuan, China

Keywords: Tumors, Cancer, Glioma;True Progression;Pseudoprogression;DKI;IVIM

The differentiation of pseudoprogression from true progression remains a crucial diagnostic dilemma in glioma with postoperative radiation therapy.This work to explore the role of DKI combined IVIM in differentiating true progression and pseudoprogression in glioma. It was concluded that the MK and RK from DKI、D and D* from IVIM can be used as novel imaging biomarkers for Clinical and radiologists in differentiating glioma true progression from pseudoprogression. Combining MK, RK, D and D* may explore as an effective strategy to improve the ability for discriminating glioma true progression and pseudoprogression.

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Magdalena Sokolska¹, James K Ruffle², Meetakshi Gupta³, Julia Markus⁴, Michael Kosmin³, Hans Rolf Jäger ², Parashkev Nachev², and Harpreet Harpreet^4
1Medical Physics and Biomedical Engineering, University College London Hospitals, London, United Kingdom, ²Queen Square Institute of Neurology, University College London, London, United Kingdom, ³Radiotherapy, University College London Hospitals, London, United Kingdom, ⁴Imaging, University College London Hospitals, London, United Kingdom

Keywords: Tumors, Arterial spin labelling

Elevated tumour blood flow in treated gliomas t can be indicative of disease recurrence. TBF can be visualised and quantified with arterial spin labelling with quantification performed by scaling a perfusion-weighted image by a proton density image and a brain-blood partition coefficient, assuming mapping to a fully relaxed blood magnetisation signal. However, this assumption might not hold in T2/FLAIR hyperintense areas surrounding enhancing tumour  due to much higher water content. Therefore, this work investigates blood flow quantification in three tumour compartments, enabled by recent developments in AI-generated labels of tumour components. 

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Shanmei Zeng¹, Zuliwei Ma¹, Hui Ma², Dingxiang Xie², Yingqian Huang², Mengzhu Wang³, Wenting Zeng¹, Fangzeng Lin¹, Zhiyun Yang¹, Jianping Chu¹, and Jing Zhao^1
1Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China, ²Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China, ³MR Scientific Marketing, Siemens Healthineers Ltd., Guangzhou, Guangdong, China

Keywords: Tumors, Tumor

Currently, in diffuse glioma, in addition to histopathology, the molecular features have an important role in glioma diagnosis. As a new computing framework for diffusion spectrum imaging (DSI), mean apparent propagator (MAP) could investigate more subtle information of tumor microstructures than the Gaussian diffusion models, while MAP has not been studied much in glioma. Besides, the analysis of tumor habitat could reflect the glioma heterogeneity. Hence, we aim to analyze the tumor habitat-derived MAP metrics and further explore their clinical value in glioma evaluation, meanwhile, we introduce Diffusion-kurtosis imaging (DKI) as a reference to compare the diagnostic efficiency of DSI.

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Ching-Chung Ko^1,2, Lee-Ren Yeh³, and Jeon-Hor Chen^4
1Chi Mei Medical Center, Tainan, Taiwan, ²Department of Health and Nutrition, Chia Nan University of Pharmacy and Science, Tainan, Taiwan, ³Department of Radiology, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan, ⁴Department of Radiological Sciences, University of California, Irvine, CA, United States

Keywords: Tumors, Cancer

A subset of primary central nervous system lymphoma (PCNSL) may show early relapsed/refractory (R/R) disease after treatments. This study investigated the role of pretreatment apparent diffusion coefficient (ADC) values for the prediction of R/R in PCNSL. Total 52 patients with pathologically confirmed PCNSL were included, and 24 (46.2%) patients developed R/R (median time to relapse, 13 months) after treatment. The results showed female sex, complete response to first-line chemotherapy, and ADC value/ratio were significant predictors of R/R in PCNSL. Pretreatment ADC values/ratios offer objective and valuable evaluation for the treatment planning in PCNSL.

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Yeva Prysiazhniuk^1,2, Andres Server³, Øystein Bech-Aase³, Eirik Helseth⁴, David Kala^1,5, Roelant Sjouke Eijgelaar⁶, Elies Fuster-García⁷, Petter Brandal^8,9, Atle Bjørnerud³, Jakub Otáhal^1,2, Jan Petr^10,11, and Wibeke Nordhøy^3
1Department of Pathophysiology, the Second Faculty of Medicine, Charles University, Prague, Czech Republic, ²Laboratory of Developmental Epileptology, Institute of Physiology, Czech Academy of Sciences, Prague, Czech Republic, ³Department of Physics and Computational Radiology, Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway, ⁴Oslo University Hospital, Department of Neurosurgery, Oslo, Norway, ⁵Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University, Prague, Czech Republic, ⁶Department of Neurosurgery, Amsterdam University Medical Center, Amsterdam, Netherlands, ⁷Instituto Universitario de Tecnologías de la Información y Comunicaciones, Universitat Politècnica de València, Valencia, Spain, ⁸Department of Oncology, Oslo University Hospital, Oslo, Norway, ⁹Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo, Norway, ¹⁰Institute of Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany, ¹¹Department of Radiology and Nuclear Medicine, Cancer Center Amsterdam, Amsterdam University Medical Center, Amsterdam, Netherlands

Keywords: Tumors, Perfusion, Genetics

IDH genotype status is an important marker in glioma diagnostics. Given that IDH mutation affects the tumor vascularization pattern, perfusion imaging has the potential to become a non-invasive tumor histopathology assessor. In this study, two methods of perfusion MRI – Dynamic Susceptibility Contrast (DSC) and Arterial Spin Labeling (ASL) – were compared in their ability to assess IDH mutation status. DSC- and ASL-derived perfusion maps correlated significantly and were feasible parameters in the IDH classification task. Mean tumor CBF quantified with ASL had the highest AUC score, sensitivity, and specificity, supporting the feasibility of using ASL in clinical glioma diagnostics.

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susmita shrestha¹, Karuna Raya², Nian Wang³, and Surendra Maharjan^4
1Chitwan Medical College and Teaching Hospital, Chitwan, Nepal, ²Sharda University, Greater Noida, India, ³Indiana University School of medicine, Stark Neuroscience, IndianaPolis, IN, United States, ⁴Indiana University School of medicine, IndianaPolis, IN, United States

Keywords: Tumors, Brain

Meningioma as an extra-axial tumor of meninges is difficult to interpret within brain interface using normal Magnetic Resonance Imaging sequence protocol. Recently, Various advancement in diffusion Magnetic Resonance Imaging (dMRI) techniques such as DTI (Diffusion Tensor Imaging), DKI (Diffusion Kurtosis Imaging) and NODDI (Neurite Orientation Dispersion and Density Imaging) has been utilized as an emerging diagnostic tool to measure the degree of mobility of water molecules within biologic tissue and investigate micro-structural integrity of the brain tissue. Thus, we aim to differentiate meningiomas from normal brain parenchyma using DTI, DKI and NODDI metrics.

Yifan Sun¹, Zheting Yang¹, Yang Song², and Rifeng Jiang^1
1Fujian Medical University Union Hospital, Fuzhou, China, ²MR Scientific Marketing, Siemens Healthineers Ltd., Shanghai, China

Keywords: Tumors, Quantitative Susceptibility mapping, Glioma; Isocitrate dehydrogenase; WHO CNS5

Preoperative prediction of glioma histological features and biological behavior is clinically important. However, few studies reported the histogram analysis of QSM in the isocitrate dehydrogenase (IDH) genotype and subtype of gliomas. In this study, we explored the value of histogram features of QSM and ADC in predicting the IDH genotype and tumor subtype of adult-type diffuse gliomas based on the fifth edition of the World Health Organization Classification of Tumors of the Central Nervous System (WHO CNS5). We found that histogram parameters based on QSM and ADC are significantly related to the IDH genotype, tumor subtype, and proliferation of glioma.

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Jens Johansson¹, Kerstin Lagerstrand^2,3, Isabella M Björk-Burtscher^1,4, Mats Laesser^1,5, Hanna Hebelka^1,4, and Stephan E Maier^1,6
1Radiology, Clinical sciences,Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden, ²Medical Radiation Sciences, Clinical sciences,Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden, ³Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden, ⁴Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden, ⁵Sahlgrenska University Hospital, Gothenburg, Sweden, ⁶Radiology, Brigham and women's hospital, Boston, MA, United States

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

Clinical systems vary widely in their gradient performance. Accordingly, effective diffusion time and echo time, which are minimized by the system software according to available gradient performance, can differ significantly among systems. A major concern is that non-Gaussian diffusion in tissues can lead to significant variation of the measured apparent diffusion coefficient (ADC), which would clearly diminish its value as biomarker. This study evaluated if diffusion and/or echo time variations in pulsed gradient spin-echo (PGSE) sequences significantly influences the ADC measured in healthy brain and brain tumors.

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Guangyu Dan^1,2, Weiguo Li^2,3,4, Kaibao Sun¹, Qingfei Luo¹, Muge Karaman^1,2, and Xiaohong Joe Zhou^1,2,5
1Center for Magnetic Resonance Research, University of Illinois at Chicago, Chicago, IL, United States, ²Department of Biomedical Engineering, University of Illinois at Chicago, Chicago, IL, United States, ³Research Resource Center, University of Illinois at Chicago, Chicago, IL, United States, ⁴Department of Radiology, Northwestern University, Evanston, IL, United States, ⁵Departments of Radiology and Neurosurgery, University of Illinois College of Medicine, Chicago, IL, United States

Keywords: Tumors, Tumor, Glioma

Recently, diffusion-weighted MRI has emerged for probing intravoxel structural heterogeneity non-invasively as an alternative to gold standard histopathological analysis. A previous study demonstrated the correlation between the imaging- and histology-based tissue heterogeneities using a continuous-time random-walk (CTRW) model at a single diffusion time. In this study, we extended the study to multiple diffusion times and investigated the diffusion time dependence of the CTRW parameters and their correlation with histology-based heterogeneity on human glioma tissues. Significant time dependency was observed in the CTRW parameters, providing practical insights into the selection of diffusion time when assessing tissue heterogeneity.

Mengting Duan¹, Yi Zhu², Qi Wang¹, and Hui Liu^1
1The Fourth Hospital of Hebei Medical University, Hebei, China, ²Philips Healthcare, Beijing, China

Keywords: Tumors, Cancer, EPI-DWI, Compressed SENSE

It has been shown before that C-SENSE can improved the ss-EPI DWI image quality in higher spatial resolution. The aim of this paper is to achieve a high-resolution isotropic EPI DWI by CS and to investigate the impact of different acceleration factor(AF) on the diagnostic quality of brain metastases in comparison with SENSE EPI DWI.

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Sergio M. Solis-Barquero^1,2, Marta Calvo-Imirizaldu^1,2, Veronica Aramendia-Vidaurreta^1,2, Rebeca Echeverria-Chasco^1,2, Antonio Martinez-Simon³, Elena Cacho-Asenjo³, Marta Vidorreta⁴, Pablo D. Dominguez^1,2, Reyes Garcia de Eulate¹, and Maria A. Fernandez-Seara^1,2
1Department of Radiology, Clinica Universidad de Navarra, Pamplona, Spain, ²IdiSNA, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain, ³Department of Anesthesia, Perioperative Medicine and Critical Care, Clinica Universidad de Navarra, Pamplona, Spain, ⁴Siemens Healthcare, Madrid, Spain

Keywords: Tumors, Perfusion, Breath Holding

PCASL was used to measure cerebral blood flow (CBF) in eighteen patients with high-grade gliomas (III and IV) during normal breathing followed by a breath-holding task (ten periods of 21s interleaved with periods of normal breathing) to assess baseline CBF and cerebrovascular reactivity (CVR). All patients completed the task successfully and CBF and CVR maps were generated. CBF ratio in contrast-enhanced tumor area was higher in grade IV than grade III gliomas, as expected. CVR in tumor areas was decreased compared to GM CVR values. More studies are needed to assess the CVR heterogeneity in tumoral tissue. 

Ruiwen Geng¹, Yang Dong¹, and Lizhi Xie^2
1Radiology, The Second Hospital, Dalian Medical University, Dalian, China, ²GE Healthcare, MR Research China, Beijing, China

Keywords: Tumors, Arterial spin labelling

This study retrospectively analyzed the association between arterial spin labeling (ASL) and the molecular markers of isocitrate-dehydrogenase (IDH) mutation and hypoxia-inducible factor (HIF) -1α in glioma. The association of patients’ overall survival (OS) and progression-free survival (PFS) with quantization cerebral blood flow (CBF) from ASL, the imaging parameters from conventional MRI, clinical and pathological parameters were investigated in glioma.

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Paddy J. Slator¹, Rui V. Simoes^2,3, Rafael N. Henriques², Tânia Carvalho², Daniel C. Alexander¹, Noam Shemesh², and Andrada Ianus^2
1Centre for Medical Image Computing and Department of Computer Science, University College London, London, United Kingdom, ²Champalimaud Research, Champalimaud Foundation, Lisbon, Portugal, ³Institute for Research & Innovation in Health (i3S), University of Porto, Porto, Portugal

Keywords: Tumors, Microstructure

We characterise ex-vivo mouse brain tumours with combined T2-diffusion MRI and InSpect, a data-driven unsupervised learning technique that identifies distinct tissue components. We hence reveal heterogeneous tumour structures without imposing a biophysical model.

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Chuanshuai Tian¹, Wentao Hu², Yongming Dai², Sixuan Chen¹, Jianan Zhou¹, Xin Zhang¹, and Bing Zhang^1
1Department of Radiology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China, ²Central Research Institue, United Imaging Healthcare, Shanghai, China

Keywords: Tumors, Diffusion/other diffusion imaging techniques

Dozens of diffusion models have been created to describe the non-Gaussian nature of diffusion. Nevertheless, many of them imply assumptions that have not been rigorously confirmed, or includes abstract parameters. The purpose of this study was to observe the characteristics of varying diffusion curvature (VDC) indicators in several types of brain tumor. D₀ and D₁ distribution were obtained for each subject. This study illustrates the potential of applying a simple and pure empirical non-Gaussian diffusion model VDC on brain tumor imaging.

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Gülce Turhan¹, Ayşe İrem Çetin¹, Amnah Mahroo², Beatriz Padrela³, Simon Kanstandin^4,5, Daniel Christopher Hoinkiss², Nora Josefin Breutigam², Klaus Eickel^2,5, Jan Petr⁶, Henk Mutsaerts³, Ayca Ersen Danyeli⁷, Koray Ozduman⁸, Matthias Guenther^2,5, Alp Dincer^9,10, and Esin Ozturk-Isik^1,10
1Institute of Biomedical Engineering, Bogazici University, Istanbul, Turkey, ²Fraunhofer Institute for Digital Medicine MEVIS, Bremen, Germany, ³Amsterdam University Medical Center, Amsterdam, Netherlands, ⁴Fraunhofer Institute for Digital Medicine MEVI, Bremen, Germany, ⁵mediri GmbH, Heidelberg, Germany, ⁶Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany, ⁷Department of Pathology, Acibadem University, Istanbul, Turkey, ⁸Department of Neurosurgery, Acibadem University, Istanbul, Turkey, ⁹Department of Radiology, Acibadem University, Istanbul, Turkey, ¹⁰Brain Tumor Research Group, Acibadem University, Istanbul, Turkey

Keywords: Tumors, Arterial spin labelling

Subtle changes in BBB integrity might be missed by contrast-enhanced T1-weighted MRI. Blood-brain barrier arterial spin labeling (BBB-ASL) is a new technique to assess BBB disruptions. In this work, we measured the cerebral blood flow (CBF) and exchange time (Tex) values of the tumor, normal-appearing white matter, and normal-appearing gray matter regions in gliomas using BBB-ASL technique. Our results indicated higher CBF and leakier BBB in contrast-enhanced regions of gliomas than in the normal-appearing GM.

Xinying Li¹, Ke Xue², Xing Yang^1,3, Yongming Dai², Zhen Tian¹, and Yingwei Wu^1
1Shanghai Ninth People’s Hospital, affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai, China, ²MR Collaboration, Central Research Institute, Shanghai United Imaging Healthcare, Shanghai, China, ³Shanghai Pulmonary Hospital, Shanghai, China

Keywords: Head & Neck/ENT, Diffusion/other diffusion imaging techniques

Tumor heterogeneity occurred frequently in patients with SCC and associated with poor prognosis. Compared to clinic TNM stage or the histological grade, the histological heterogeneity has not been well addressed yet. Our results clearly demonstrated that higher incidence of CNM was observed in histological hetero-group than that in homo-group. whole-lesion ADC histogram metrics presented lower values in hetero-group and in CNM+ group. ADC75th and kurtosis were two independent prognostic factors for evaluating the CNM status. Whole-tumor ADC histogram offered an approach for detecting intra-tumoral heterogeneity and predicting cervical lymph node metastases status.

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Robert Shih¹, Ante Zhu², Raymond Huang³, J Kevin DeMarco⁴, H Douglas Morris¹, Maureen Hood¹, Nastaren Abad², Chitresh Bhushan², Thomas Foo², and Vincent Ho^1
1Uniformed Services University, Bethesda, MD, United States, ²GE Research, Niskayuna, NY, United States, ³Brigham and Women's Hospital, Boston, MA, United States, ⁴Walter Reed National Military Medical Center, Bethesda, MD, United States

Keywords: Tumors, Tissue Characterization

The MAGNUS ultra-high-performance gradient coil delivers simultaneous 200 mT/m and 500 T/m/s performance on each axis, with higher peripheral nerve stimulation thresholds than whole-body gradient coils, which is particularly useful for diffusion MRI-based microstructure imaging. We used MAGNUS-enabled OGSE to assess shorter diffusion times and length scales <10 µm in four brain tumor patients with gliomas. We measured differences in time-dependent diffusivity between high-grade glioma and low-grade glioma, as well as between recurrent glioblastoma and treatment effects. The malignant lesions demonstrated greater time-dependence of diffusivity. Further investigation with additional subjects and histopathologic correlation may lead to future clinical applications.