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Pien E.J. Jellema^1,2, Fredy Visser², Niels Blanken³, Alberto de Luca^2,4, Eelco W. Hoving^1,5, Kirsten M. van Baarsen^1,5, Maarten H. Lequin^1,3, and Jannie Wijnen^2
1Pediatric Neuro-Oncology, Princess Máxima Centre, Utrecht, Netherlands, ²Centre for Image Sciences, University Medical Centre Utrecht, Utrecht, Netherlands, ³Department of Radiology, University Medical Centre Utrecht, Utrecht, Netherlands, ⁴Department of Neurology, University Medical Centre Utrecht, Utrecht, Netherlands, ⁵Department of Neurosurgery, University Medical Centre Utrecht, Utrecht, Netherlands

Keywords: Tumors, Surgery

Advanced intraoperative MRI (io-MRI) could provide additional guidance during pediatric neurosurgery. Currently, io-MRI sequences are acquired with two surface coils when using the DORO head-frame. We investigated if the addition of two surface coils and higher SENSE-factors would increase signal- and contrast-to-noise ratios (SNR & CNR), image quality, and decrease artefacts. The four coils set-up resulted in higher T1w SNR and CNR that was more homogeneously distributed. Image quality of T1w, T2w, and fiber-tracks did improve with four coils. Higher SENSE factors with four coils of most ASL and diffusion MRI images did not reduce EPI artefacts or improve image quality. 

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Siqi Cai^1,2, Yuchao Liang³, Yinyan Wang³, Yufei Liu⁴, Fanfan Chen⁴, Chunxiang Jiang^1,2, Lei Wang³, and Lijuan Zhang^1,2
1Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China, ²University of Chinese Academy of Science, Beijing, China, ³Beijing Tiantan Hospital of Capital Medical University, Beijing, China, ⁴Shenzhen Second People's Hospital, Shenzhen, China

Keywords: Tumors, fMRI (resting state)

This study investigated the temporal features of the brain network activity with dynamic fractional amplitude of low-frequency fluctuation (dfALFF) and sliding window approach. The time-varying brain activity was clustered into two distinct states. Patients’ brains featured high occurrence of the weak state, low occurrence of the strong state, and network dALFF that decreased but spatially extended with the tumor malignancy. The dfALFF variance of networks was attenuated in HGGs but not LGGs. These malignancy-specific alterations  indicate a diverse neuropathological profile of gliomas, and highlight the importance of temporal features of brain activity in the disease characterization of glioma.

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Chenxi Li¹, Kun Cheng¹, Jianxun Qu², Xiaoxiao Ma¹, and Xin Lou^1
1Department of Radiology, Chinese PLA General Hospital, Beijing, China, ²MR Collaboration, Siemens Healthineers Ltd., Beijing, China

Keywords: Tumors, Brain

With the advent of the 7T device meeting the need for ultra-high resolution, we planned to explore the advantages of 7T over 3T in terms of the internal detail display of gliomas. Seventeen patients with glioma were individually rated for internal tumor structure and feeding artery by 6 radiologists at 7T and 3T MR, and the DCS score was calculated. 7T revealed better details of internal tumor structure and higher diagnostic confidence than 3T.

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Anna Lavrova¹, John Kim¹, Remy Lobo¹, Maria Masotti², Jacob Richardson¹, Pedro Itriago-Leon³, Vikas Gulani¹, Katherine Wright¹, Ashok Srinivasan¹, and Nicole Seiberlich^1
1Radiology, University of Michigan, Ann Arbor, MI, United States, ²Biostatistics, University of Michigan, Ann Arbor, MI, United States, ³Siemens Medical Solutions USA Inc., Houston, TX, United States

Keywords: Tumors, Low-Field MRI

This study aims to compare the image quality of clinical brain imaging on an FDA-approved commercial low-field 0.55T MRI scanner and conventional higher field 1.5/3T MRI systems. The image quality of 205 compatible image series in 30 patients acquired at 0.55T and 1.5T/3T MRI systems was rated by two neuroradiologists. Despite significant differences in image quality ratings between low- and higher-field scanners, all brain sequences performed at 0.55T received ratings indicating that they were acceptable for diagnostic use.  This work indicates that the commercial 0.55T system can be used for routine brain imaging in clinical practice.

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Marco Essig¹, Frank A Giordano², and Gustavo Sarria^3
1Radiology, University of Manitoba, Winnipeg, MB, Canada, ²Radiation Oncology, University of Mannheim, Mannheim, Germany, ³Radiation Oncology, University of Bonn, Bonn, Germany

Keywords: Tumors, Contrast Agent, Brain Tumor, Relativity

New gadolinium-based contrast agents (GBCAs) with high relaxivity could have an impact on decision making and treatment planning of brain metastases (BM). In this post-hoc analysis , patients with BM who underwent two separate magnetic resonance imaging (MRI) examinations, one with gadopiclenol and one with gadobenate dimeglumine, both at 0.1 mmol/kg, were included. This study showed that gadopiclenol at the dose of 0.1 mmol/kg improved detection and characterization of BM, and led to a change in treatment decisions in 2 of 13 patients.

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Cheng Cheng¹, Shengzhang Ji², Rui Zhao¹, Chen Zhang³, and Guang hui Huo^1
1Radiology Department, Mesclor Medical Imaging Diagnostic Center, Tianjin, China, ²Medical Imaging Department, Tianjin Fourth Central Hospital, Tianjin, China, ³MR Scientific Marketing, Siemens Healthineers, Beijing, China

Keywords: Tumors, Tumor, pituitary, T1w SPACE

By compared the images quality and diagnostic efficacy of enhanced 3D T1w SPACE and 2D T1w TSE, this study aims to investigate the value of Contrast-Enhanced submillimeter slice 3D T1w SPACE sequence in hormone-producing pituitary microadenoma.

Xiaoyu Wang¹, Jianxun Qu², Tomi-Tricot Raphael³, Shaihan J Malik⁴, Song Wang¹, Xiangbing Bian¹, and Xin Lou^1
1Department of Radiology, Chinese PLA General Hospital, Beijing, China, ²Siemens Healthineers Ltd, Beijing, China, ³Siemens Healthineers Ltd, United Kingdom, United Kingdom, ⁴King's College London, United Kingdom, United Kingdom

Keywords: Tumors, Data Acquisition, direct signal control

This was a clinical application study of direct signal control (DSC) technology on 7T MRI. The result suggests that DSC-T2w provides good-quality for whole-brain imaging. When imaging region is restricted, we can also use static B1 shimming with a dedicated shimming region. This study demonstrated that DSC technology can improve the image quality in 7T brain scan.

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Huijing Xiang¹, Yi Li², Yuqi Duan¹, Xiaoyun Liang², Feng Huang², Peian Hu³, Dongbing Zhang¹, Zhengrong Zhou¹, and Lei Chen^1
1Department of Radiology, Minhang Branch, Fudan University Shanghai Cancer Center, Shanghai, China, ²Neusoft Medical Systems Co.Ltd., Shanghai, China, ³Department of Radiology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China

Keywords: Tumors, Tumor, Brain metastases, Reliability, Quantitative maps

As the first choice to identify brain metastases (BM), the anatomical, functional and metabolic information extracted by various MR sequences is the basis. However, synthetic MR technique mostly relies on expensive equipment and high field strength, which is challenging for primary institutions to implement. In this study, we assessment the reliability and diagnostic value based on BM of Strategically Acquired Gradient Echo (STAGE) at 1.5T. Enhanced T1W map of STAGE showed better GM/WM CNR compare with T1MPRAGE for BM identification. Reliable values and inconspicuous physiological variability were observed in the quantitative maps for various brain tissues.

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Laiz Laura de Godoy¹, Gaurav Verma², Donald M O’Rourke³, MacLean P Nasrallah⁴, Steven Brem³, Arati Desai⁵, Laurie A Loevner¹, Suyash Mohan¹, and Sanjeev Chawla^1
1Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States, ²Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States, ³Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States, ⁴Clinical Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States, ⁵Medicine, University of pennsylvania, Philadelphia, PA, United States

Keywords: Tumors, Spectroscopy, IDH mutant; gliomas; 2-hydroxyglutarate; SVS; 1H-MRSI

IDH mutation has become one of the most important prognostic biomarkers in glioma management, regardless of histopathological features. The oncometabolite 2HG has been proposed as a biomarker for IDH-specific genetic profiles for gliomas. We report clinical utility of SVS and ¹H-MRSI using a long TE (97 ms) in assessing IDH-mutant gliomas by detecting the characteristic resonances of 2HG. Our results from 25 patients showed sensitivity and specificity of 77% and 83%, respectively. In conclusion, ¹H-MRS with optimized TE can accurately detect 2HG levels, which has significant clinical implications for determining prognosis and evaluating therapeutic efficacy for targeted and/or alternative therapies.

Hui Ma¹, Zuliwei Ma¹, Shanmei Zeng¹, Mengzhu Wang², Yang Song², Chengxiu Zhang³, Zhiyun Yang¹, and Jing Zhao^1
1Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China, ²MR Scientific Marketing, Siemens Healthineers Ltd., Guangzhou, China, ³Shanghai Key Laboratory of Magneitc Resonance, East China Normal University, Shanghai, China

Keywords: Tumors, Brain, high-grade gliomas, tumor habitats, habitat imaging

We developed spatial habitats based on multiparametric MRI and evaluated associations between features in these habitats and survival time in patients with high-grade gliomas. The voxels in MR images were grouped into 2 clusters using the K-means clustering algorithm of in-house software nnFAE (V.0.0.10). Structural MRI habitats were defined on CE-T1WI and T2-Flair images, and physiologic MRI habitats were defined on MK derived from DKI and Ktrans derived from DCE imaging. Results showed physiologic habitats weighed more than structural ones, and suggested low vascular-permeability-and-tissue-complexity habitats may play an important role in distinguishing long- and short-term survival of high-grade gliomas patients. 

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Banu Sacli-Bilmez¹, Ayça Erşen Danyeli^2,3, Cengiz Yakicier⁴, M.Necmettin Pamir^3,5, Koray Özduman^3,5, Alp Dinçer^3,6, and Esin Ozturk-Isik^1,3
1Institute of Biomedical Engineering, Boğaziçi University, İstanbul, Turkey, ²Department of Medical Pathology, Acıbadem University, İstanbul, Turkey, ³Brain Tumor Research Group, Acıbadem University, İstanbul, Turkey, ⁴Department of Molecular Biology and Genetics, Acıbadem University, İstanbul, Turkey, ⁵Department of Neurosurgery, Acıbadem University, İstanbul, Turkey, ⁶Department of Radiology, Acıbadem University, İstanbul, Turkey

Keywords: Tumors, Brain

The 2021 central nervous system tumor classification has suggested that isocitrate dehydrogenase wildtype (IDH-wt) WHO grade-2/3 astrocytomas with molecular features of glioblastoma should be designated as “Glioblastoma, IDH-wildtype, WHO grade-4”. In this study, we explored metabolic correlates of patient survival in tumors fulfilling the criteria for “Glioblastoma, IDH-wildtype, WHO grade-4” using short echo time (TE) single voxel ¹H-MRS. The results of this study suggest that higher ratios of glutamine and glutamate complex (Glx) to total creatine (tCr) and glutathione (GSH) to tCr were associated with a shorter survival.

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Jordi de Leeuw¹, Junghun Cho², Eva van Grinsven³, Jeroen Siero⁴, Marielle Philippens⁴, and Alex Bhogal^4
1Imaging Division, UMC Utrecht, Utrecht, Netherlands, ²SUNY Buffalo, Buffalo, NY, United States, ³Brain Department, Radiotherapy, UMC Utrecht, Utrecht, Netherlands, ⁴Radiology Department, UMC Utrecht, Utrecht, Netherlands

Keywords: Tumors, Metabolism

Radiotherapy might have an influence on the ratio of deoxygenated versus oxygenated blood in the venous blood vessels (OEF) in the brain. The relationship between delivered dose and the OEF may be a more direct measure of tissue damage or recovery. Preliminary results suggest that there is a marginal significant increase in OEF values after radiotherapy. This indicates that OEF can be of valuable use in determining the effects of radiotherapy. Additionally, CMRO2 maps show an identical increase or decrease in cerebral metabolic activity.

Keywords: Oxygen extraction fraction Cerebral metabolic rate of oxygen extraction Radiotherapy Brain tumor

Yang Yu¹, Yan Ren¹, Qi Yue², and Zhenwei Yao^1
1Radiology, Fudan University, Huashan Hospital, Shanghai, China, ²Neurosurgery, Fudan University, Huashan Hospital, Shanghai, China

Keywords: Tumors, Tumor, H3 G34-mutant, glioma

Diffuse hemispheric glioma, H3 G34-mutant (H3G34-DHG) is a rare newly proposed entity in 2021 WHO classification of central nervous system tumors. We retrospectively analysis characteristics of 10 cases of H3G34-DHG and found some certain characteristics in clinical and radiological manifestations in this entity. In most cases, absent or focally faint contrast enhancement initially suggested another diagnosis than a high-grade glioma. However, increased tumor vessels still suggested abundant tumor blood supply. Moreover, hyperintensity on CT and restricted diffusion reflected high density of tumor cells. MRS also showed extremely high metabolism active in the tumor. 

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Bárbara Schmitz-Abecassis^1,2, Linda Dirven^3,4, Janey Jiang ⁵, Jasmin A. Keller¹, Robert J.J. Croese^3,4, Daniëlle van Dorth¹, Ilse M. J. Kant ^6,7, Martin J.B. Taphoorn^3,4, Matthias J.P. van Osch^1,2, Johan A.F. Koekkoek^3,4, and Jeroen de Bresser^1
1Department of Radiology, Leiden University Medical Center, Leiden, Netherlands, ²Medical Delta Cancer Diagnostics 3.0, South-Holland, Netherlands, ³Department of Neurology, Leiden University Medical Center, Leiden, Netherlands, ⁴Department of Neurology, Haaglanden Medical Center, The Hague, Netherlands, ⁵Department of Radiology, HagaZiekenhuis, The Hague, Netherlands, ⁶Clinical Artificial Intelligence Implementation and Research Lab (CAIRELab) and Department of Information Technology & Digital Innovation, Leiden University Medical Center, Leiden, Netherlands, ⁷Department of Digital Health, University Medical Center Utrecht, Utrecht, Netherlands

Keywords: Tumors, Tumor, Perfusion

Despite multimodal anti-tumor treatment, glioblastomas typically progress, yet identifying true tumor progression on MRI-scans is challenging. We aimed to establish brain MRI phenotypes of glioblastomas by combined analysis of radiological scoring of structural and perfusion tumor characteristics 3-months post-radiotherapy. Hierarchical clustering analysis method was applied to group patients by similar tumor characteristics and it was analyzed whether these groups showed differences in tumor progression and overall survival outcome. Four distinct MRI phenotypes of glioblastoma were established and showed between-group differences in median overall survival time.

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Aliya Anil¹, Ashley M Stokes¹, Lea Alhilali², John P Karis², Laura C Bell³, Leland S Hu⁴, Jerrold L Boxerman⁵, Kathleen M Schmainda⁶, and C Chad Quarles^7
1Division of Neuroimaging Research and Barrow Neuroimaging Innovation Center, Barrow Neurological Institute, Phoenix, AZ, United States, ²Neuroradiology, Southwest Neuroimaging at Barrow Neurological Institute, Phoenix, AZ, United States, ³Early Clinical Development, Genentech, San Francisco, CA, United States, ⁴Department of Radiology, Division of Neuroradiology, Mayo Clinic Arizona, Phoenix, AZ, United States, ⁵Department of Neuroradiology, Rhode Island Hospital, Providence, RI, United States, ⁶Department of Biophysics, Medical College of Wisconsin, Milwaukee, WI, United States, ⁷The University of Texas MD Anderson Cancer Center, Houston, TX, United States

Keywords: Tumors, DSC & DCE Perfusion

Early differentiation of tumor recurrence from post treatment radiation effects (PTRE) in glioblastoma patients would improve patient management. The purpose of this study is to identify the optimal standardized relative cerebral blood volume (sRCBV) threshold for generating fractional tumor burden (FTB) maps derived from the new consensus protocol, single-dose, low-flip angle data. To establish the threshold, low-flip angle data was compared to well-validated, double-dose, moderate-flip angle data. In summary, with the optimized threshold, the single-dose, low-flip angle approach yielded FTB maps that strongly agreed with the reference standard, providing a compelling option for clinical use.

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Eryuan Gao¹, Guohua Zhao¹, Huiting Zhang², Xiaoyue Ma¹, Peipei Wang¹, Jie Bai¹, Xu Yan², Guang Yang³, and Jingliang Cheng^1
1Department of Magnetic Resonance, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China, ²MR Scientific Marketing, Siemens Healthcare, Shanghai, China, ³Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, China

Keywords: Tumors, Diffusion/other diffusion imaging techniques, mean apparent propagator

Atypical high-grade glioma (HGG) (with no or little necrosis) and primary central nervous system lymphoma (PCNSL) are difficult to distinguish in routine MR images but their treatment strategies are totally different. Therefore, it’s important to distinguish between them before treatment. This study aimed to investigate the diagnostic efficiency of quantitative analysis based on mean apparent propagator-MRI in discriminating atypical HGG from PCNSL. Through quantitative analysis of MAP parameters, we found that MAP-MRI performed well in differentiating between atypical HGG and PCNSL.

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Jing Liu¹, Angela Jakary¹, Duan Xu¹, Javier Villanueva-Meyer¹, Nicholas Butowski¹, Jennifer Clarke¹, Jennifer Taylor¹, Nancy Ann Oberheim Bush¹, and Janine Lupo^1
1University of California San Francisco, San Francisco, CA, United States

Keywords: Tumors, Cancer

Multiple brain MRI sequences are routinely applied for tissue characterization and lesion detection, by acquiring multi-contrast anatomical images. We developed a single continuous data acquisition to generate multi-contrast images with high acquisition efficiency, which allows automatic brain tissue segmentation and lesion detection without contrast injection. Multi-compartment model-based dictionary searching method was developed to derive multi-parametric mapping, including T1, T2 and macromolecular proton fraction mapping. This short imaging acquisition (6 mins versus conventional ~30 mins scan time) without use of contrast injection and the efficient processing pipeline (automatic segmentation and quantitative mapping) can provide great potentials for imaging brain tumor patients.
 

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Aaron Rulseh¹, Zuzana Ryznarova¹, and Josef Vymazal^1
1Dept. of Radiology, Na Homolce Hospital, Prague, Czech Republic

Keywords: Tumors, Tumor, Metastasis

We compared standard T1-weighted thin-slice SE and T1-weighted SPACE sequences in the detection of metastatic brain lesions at 1.5 and 3 Tesla in 56 patients. Three raters evaluated the presence of lesions in 2 sessions minimally 6 weeks apart. Our results show that T1-weighted SPACE is not inferior to standard thin-slice SE sequences in the detection of brain metastases. All three experienced raters reached excellent consistency between SE and SPACE and agreement with ground truth.

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Sanghoon Kim¹, Changho Choi², Natasha Najam¹, and Alexander Lin^1
1BWH, Boston, MA, United States, ²Vaderbilt University Institute of Imaging Science, Nashville, TN, United States

Keywords: Tumors, Spectroscopy, 2HG detection

2HG is the specific biomarker for the IDH mutation in tumors. In this study, we utilized two different 2HG basis sets, one using a 4.8ms refocusing pulse duration and another with 5.8ms. Using the two different basis sets, we analyzed the same data and found large differences in the sensitivity and specificity results.

LUO XIAO¹, JIANG HONG², LIU XIAJING¹, LIN FAN¹, DENG KAN³, JIANG JUN¹, ZHANG ZHU², WANG YULI¹, and YU JUAN^1
1Medical Imaging Department, Shenzhen The Second People's Hospital, Shenzhen, China, ²Zhuhai People’s Hospital (Zhuhai hospital affiliated with Jinan University), Zhuhai, China, ³Philips Healthcare, Guangzhou, China

Keywords: Tumors, PET/MR, WHO grade

Should the BIOB meningiomas be classified as WHO grade 1 or WHO grade 2 atypical meningiomas, the core issue that scholars have questioned about the guidelines from an imaging perspective.In this study, we used BIOB as the entry point to comprehensively compare and analyze the MRI imaging characteristics of BIOB between WHO grade 1 and 2 meningiomas. Comparative analysis of multiple groups of MRI characteristics showed that BIOB and WHO grade 2 meningiomas were more similar in clinical and imaging features than grade 1 meningiomas. Therefore, it is reasonable to classify BIOB as WHO grade 2 meningiomas in the guidelines.