Dong Miao^1,2, Xue Ren^3,4, Ying Zhao^3,4, AiLian Liu^3,4, Yu Yao^1,2, Qihao Xu^3,4, and Qingwei Song^3,4
1Chengdu Institute of Computer Application, Chinese Academy of Sciences, Chengdu, China, ²School of Computer Science and Technology, University of Chinese Academy of Sciences, Beijing, China, ³Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian, China, ⁴Dalian Engineering Research Center for Artificial Intelligence in Medical Imaging, Dalian, China

Keywords: Liver, Liver, Couinaud segmentation

This study presents an effective framework for automatic Couinaud liver segmentation in Intravenous-Phase Enhanced MRI images, without the time-consuming delineation of each segment or identifying different branches of the vessel system. We define seven key points located at the bifurcations of the vascular system to divide liver into Couinaud segments II-VIII. We train a key point detection model to locate the coordinate of key point. The overall dice score is 81.17% and average surface distance is 2.35mm in test set.

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Atsushi Higaki¹, Yoshihiko Fukukura¹, Akihiko Kanki¹, Akira Yamamoto¹, kazunori Moriya¹, and Tsutomu Tamada^1
1Radiology, Kawasaki Medical School, Okayama, Japan

Keywords: Liver, Liver

This study focused on the feasibility of 4D flow MRI with low-velocity encoding sensitivity as a non-invasive tool for direct estimation of the left gastric vein and stratification of bleeding risk of esophageal varices. Our study showed that the development of esophageal varices was associated with decreased and increased net flow volumes in the left gastric and azygos veins, respectively. These results suggest the promise of 4D flow MRI with low-velocity encoding sensitivity as a non-invasive and accurate method for stratifying the bleeding risk of esophageal varices.

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Li Yang¹, Caixia Fu², and Mengsu Zeng^3
1Department of Radiology, Zhongshan Hospital,Fudan University, Shanghai, China, ²MR Application Development, Siemens Shenzhen Magnetic Resonance Ltd, Shenzhen, China, ³Zhongshan Hospitai,Fudan University, shanghai, China

Keywords: Liver, Diffusion/other diffusion imaging techniques

Recently, diffusion-weighted (DW) imaging–based elastography was proposed for noninvasive liver staging by converting a shifted apparent diffusion coefficient (sADC) to tissue elasticity on the basis of two b values (200 and 1500sec/mm²). We retrospectively calculated sADC from DW MRI and converted it to DW MRI–based virtual shear modulus (µ_Diff) for evaluating liver fibrosis in 90 patients. Our results showed the µ_Diff was significantly correlated with liver fibrosis stage, and the areas under the curves were 0.864 and 0.821 for significant and advanced fibrosis, respectively, indicating DW imaging–based elastography is a promising method for predicting liver fibrosis.

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Jonatan Eriksson^1,2, Wolf Bartholomä^2,3, Nils Dahlström^2,3, Jens Tellman^1,2, Stergios Kechagias⁴, Patrik Nasr⁴, Mattias Ekstedt^2,4, Peter Lundberg^1,2, and Johan Kihlberg^2,3
1Department of Medical Radiation Physics, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden, ²Center for Medical Imaging Science and Visualization, Linköping University, Linköping, Sweden, ³Department of Radiology in Linköping and Department of Health Medicine and Caring Sciences, Linköping University, Linköping, Sweden, ⁴Division of Diagnostics and Specialist Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden, Linköping, Sweden

Keywords: Liver, Elastography, MRE, Diffusion

A virtual manner of determining apparent stiffness values from diffusion images, so called ‘vMRE’, was evaluated in this study which included both healthy subjects and patients with Non-Alcoholic Fatty Liver Disease (NAFLD). No association was observed between true MR-Elastography (MRE) and vMRE. However, the difference between MRE and vMRE was more strongly correlated with T2*. Iron deposition is not uncommon in patients with NAFLD, and for that reason, a spin echo-MRE sequence was used, instead of the gradient-based sequence that has been used previously. Iron deposition in liver shortens T2*, which can also affect diffusion images and the vMRE. 

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Tomohiro Noda¹, Keitaro Sofue², Ryuji Shimada¹, Yu Ueda³, Yoshiko Ueno², Yuichiro Somiya¹, Shintaro Horii¹, Akiko Kusaka¹, and Takamichi Murakami^2
1Center of Radiology and Radiation Oncology, Kobe University Hospital, Kobe, Japan, ²Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan, ³Philips Japan MR Clinical Science, Tokyo, Japan

Keywords: Liver, Quantitative Imaging, T1mapping

We developed a free-breathing 3D Look-Locker sequence with radial sampling acquisition (3D-Radial LL) to acquire T1 map of the whole upper abdomen. To evaluate the quantitative accuracy, T1 values obtained from 3D-Radial LL and modified Look-Locker inversion recovery (MOLLI) in a phantom and volunteers were compared. The phantom study showed excellent correlation regarding T1 values between on the MOLLI and 3D-Radial LL. In the volunteer study, the difference in T1 values were within 6% for the liver, pancreas, spleen, and paraspinal muscle. The 3D-Radial LL enables accurate measurement of T1 values in the upper abdomen. 

Yeyu Cai¹, Jiayi Liu², Ziyi Zhou³, Tian Chai¹, Liyun Zheng⁴, and Yongming Dai^5
1Department of Radiology, Second Xiangya Hospital, Central South University, Changsha, China, ²Department of Oncology, Second Xiangya Hospital, Central South University, Changsha, China, ³Department of Radiology, Maternal and Child Health Hospital of Hubei Province, Wuhan, China, ⁴Shenzhen United Imaging Research Institute of Innovative Medical Equipment, Shenzhen, China, ⁵MR Collaboration, Central Research Institute, United Imaging Healthcare, Shanghai, China

Keywords: Liver, Animals

Liver fibrosis is a serious medical issue and noninvasive technique, such as magnetic resonance imaging (MRI), is required to identify and quantify liver fibrosis. Recently, several advanced diffusion MRI signal models that employ additional parameters to describe diffusion signals from complex microstructural compartments have been developed. The purpose of this study was to apply the multicompartmental restriction spectrum imaging (RSI) model to evaluate carbon tetrachloride (CCl₄)-induced liver fibrosis in mice. The optimal model to characterize liver fibrosis was the 4-compartment RSI model. Compared to control groups, mice with liver fibrosis exhibited significantly lower ADC and C₃, but higher C₁.

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Stephen Bawden^1,2, Louise Dexter², Tomoka Matsuda³, Mehri Kaviani², Penny Gowland², and Guruprasad P Aithal^1
1Nottingham Digestive Diseases Centre, NIHR Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, United Kingdom, ²Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, United Kingdom, ³Graduate School of Health and Sport Science, Nippon Sport Science University, Tokyo, Japan

Keywords: Liver, Metabolism

The aim of this study was to investigate the effects of hormonal changes throughout the menstrual cycle on moderate exercise induced liver glycogen changes in healthy women. Preliminary results show variation in hepatic glycogen stores and changes following exercise throughout the menstrual cycle.

Jing Zhang¹, Kaifan Yang¹, Yiyuan Zhu¹, Liyun Zheng², Yongming Dai³, and Yikai Xu^1
1Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou, China, ²Shenzhen United Imaging Research Institute of Innovative Medical Equipment, Shenzhen, China, ³MR Collaboration, Central Research Institute, United Imaging Healthcare, Shanghai, China

Keywords: Liver, Diffusion/other diffusion imaging techniques

This study evaluated the feasibility of the restriction spectrum imaging (RSI) model in the characterization and staging of liver fibrosis. The results demonstrated that the four-compartment model emerged as the best option and the C4 derived from the four-compartment model outperformed conventional apparent diffusion coefficient (ADC) values. Therefore, the four-compartment RSI model could be a noninvasive and in vivo diagnostic technique in the evaluation of chronic hepatitis, which is conducive to treatment decisions and patient management.

Tianzhu Liu¹, Lesheng Huang¹, Weiyin Vivian Liu², and Jun Chen^1
1Guangdong Hospital of Traditional Chinese Medicine, Zhuhai, China, ²MR Research China, GE Healthcare, Beijing, China

Keywords: Liver, Data Analysis

Grading liver fibrosis using intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) have been shown inconsistent results possibly for differences between liver segments and recruited types of patients. We systematically evaluated all measurements retrieved based on liver segments and classified by stage of liver fibrosis, and inconsistent repeatability and reliability of IVIM-derived values were found, attributing to inter- and intra- manual measurement bias and inhomogeneous distribution of tissue components such as fibrosis. ROC curve analysis showed moderate diagnostic efficiency between early hepatic fibrosis (EHF) and advanced HF (AHF), but not HCs from EHF based on IVIM-derived parameters with acceptable repeatability and reliability. 

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Maninder Singh¹, Owen T Carmichael¹, Adil Bashir², Anne M Russel³, Mark Bolding⁴, David T Redden³, Judd Storr⁵, William R Willoughby⁶, Candace Howard Claudio⁵, Daniel S Hsia⁷, Robert P Kimberly⁸, Meagan E Gray⁶, Eric Ravussin^7,9, and Thomas S Denny^2
1Biomedical Imaging Center, Pennington Biomedical Research Center, Baton Rouge, LA, United States, ²Auburn University, Auburn, AL, United States, ³University of Alabama, Birmingham, AL, United States, ⁴University of Alabama Medical Center, Birmingham, AL, United States, ⁵The University of Mississippi Medical Center, Jackson, MS, United States, ⁶The University of Alabama Medical Center, Birmingham, AL, United States, ⁷Pennington Biomedical Research Center, Baton Rouge, LA, United States, ⁸The University of Alabama School of Medicine, Birmingham, AL, United States, ⁹The University of Alabama, Birmingham, AL, United States

Keywords: Liver, Liver, Nonalcoholic Fatty Liver Disease; Magnetic Resonance Spectroscopy; Elasticity Imaging Techniques; Magnetic Resonance Imaging

 Non-alcoholic fatty liver disease (NAFLD) is a leading cause of end-stage liver disease. NAFLD diagnosis and follow-up relies on a combination of clinical data, liver imaging, and/or liver biopsy. However, inter-site imaging differences impede diagnostic consistency and reduce the repeatability of the multi-site clinical trials necessary to develop effective treatments. The goal of this pilot study was to harmonize commercially available 3T magnetic resonance imaging (MRI) measurements of liver fat and stiffness in human participants across academic sites and MRI vendors.

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Mayumi Higashi¹, Masahiro Tanabe¹, Masatoshi Yamane², Mahesh B. Keerthivasan³, Hiroshi Imai ⁴, Teppei Yonezawa², and Katsuyoshi Ito^1
1Department of Radiology, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan, ²Department of Radiological Technology, Yamaguchi University Hospital, Ube, Yamaguchi, Japan, ³MR R&D Collaborations, Siemens Medical Solutions USA Inc, New York, NY, United States, ⁴MR Research and Collaboration, Siemens Healthcare K.K., Tokyo, Japan

Keywords: Liver, Liver

The purpose of this study was to elucidate the clinical importance of T1 mapping of the liver with the water component only using the 2D DIXON Look-Locker sequence. T1 values of the liver were compared among T1 maps obtained by IP, OP and DIXON Look-Locker sequences. T1 values of the liver on the T1 maps obtained from IP- and OP-based sequences were significantly influenced by an increased fat component. In contrast, the T1 value of the liver on the T1 maps with the water component only calculated from DIXON water images was unlikely to be influenced by hepatic steatosis.

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Rajakumar Nagarajan¹, Andres Saucedo ², and M Albert Thomas^2
1Human Magnetic Resonance Center, University of Massachusetts, Amherst MA, Amherst, MA, United States, ²Radiological Sciences, University of California Los Angeles, Los Angeles, CA, United States

Keywords: Liver, Spectroscopy

In vivo magnetic resonance spectroscopy has the potential to provide information about both the quantity and composition of fat within the liver. We have demonstrated the feasibility of detecting cross peaks using the 2D L-COSY technique at 3T in a healthy liver. This can be used to study fatty liver to derive quantitative indexes.

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Zhongmiao Wang¹, Tingting Bo^2,3,4, Chen Chen⁵, Yuqin Min⁶, Xinxin Cai³, Huimin Lin³, Hongxia Lei¹, Renkuan Zhai¹, Jiqiu Wang², Fuhua Yan³, and Guang Ning^2
1Wuhan United Imaging Life Science Instrument Co., Ltd., Wuhan, China, ²Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China, ³Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China, ⁴Clinical Neuroscience Center, Ruijin Hospital Luwan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, China, ⁵United imaging healthcare, Shanghai, China, ⁶Institute for medical imaging technology, Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

Keywords: Liver, Liver

The feasibility of determination of fat in living mouse liver is demonstrated at 9.4T using gradient-echo sequence and the Fat Analysis and Calculation Technique (FACT)—Transition Region Extraction (TREE) algorithm. The proton density fat fraction map is obtained, which is positively correlated with steatosis. The proposed technique is a promising non-invasive tool for diagnosing fatty liver diseases.

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Arthur Peter Wunderlich^1,2, Holger Cario³, Stephan Kannengießer⁴, Veronika Grunau¹, Michael Götz², Meinrad Beer¹, and Stefan Andreas Schmidt^1
1Diagnostic and Intervnetional Radiology, Ulm University, Medical Center, Ulm, Germany, ²Section for Experimental Radiology, Ulm University, Medical Center, Ulm, Germany, ³Department of Pediatrics and Adolescent Medicine, Ulm University, Medical Center, Ulm, Germany, ⁴MRI Development, Siemens Healthcare GmbH, Erlangen, Germany

Keywords: Liver, Fat, segmental hepatic fat distribution

Purpose

To investigate the segmental distribution of hepatic fat fraction in hematologic patients.

Methods

The liver of 44 patients examined with 3D MR multi-echo gradient-echo was segmented semiautomatically and subdivided into nine segments. Segmental fat content was determined on PDFF maps and tested for statistically significant differences.

Results

Highly significant differences were detected. Segments 1 to 3 had the highest fat content, segments 7 and 8 the lowest.

Conclusions

Our results suggest that liver segments may represent functional aspects in fat metabolism and/or storage in addition to their anatomical significance. Fat distribution in hematologic patients was similar to living donors.

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Gavin Hamilton¹, Walter C Henderson¹, Danielle N Batakis¹, Lael Ceriani¹, Ashley L Louie¹, Yesenia Covarrubias¹, Celene Gonzalez¹, Michael S Middleton¹, Scott B Reeder², Kathryn J Fowler¹, and Claude B Sirlin^1
1Liver Imaging Group, Department of Radiology, University of California San Diego, San Diego, CA, United States, ²Department of Radiology, University of Wisconsin, Madison, Madison, WI, United States

Keywords: Liver, Spectroscopy

To permit simultaneous T1w, T1f, T2w, T2f and proton density fat fraction (PDFF) estimation, we developed a single-average, 21 s, single-breath-hold, Steady-state, Multi-Parameter MRS (SMP MRS) sequence. However, a 21 s breath-hold may be challenging especially children, such as pediatric subjects, so we simulated a shorter 12 s breath-hold sequence by removing the longer TR and TE values. We found good agreement for T1w, T2w and PDFF between the full 21 s SMP and simulated 21 s sequences, suggesting the shorter 12 s SMP MRS can be run instead of the full 21 s sequence. 

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Farid Hajibonabi¹, Sadhna Nandwana¹, Puneet Sharma¹, Patricia Balthazar¹, Amir Hossein Davarpanah¹, Courtney Coursey Moreno¹, and Melina Pectasides^1
1Radiology and Imaging Sciences, Emory University, Atlanta, GA, United States

Keywords: Liver, Quantitative Imaging, Quality Control

Liver fat/iron quantification with MRI is essential for detection of iron/fat overload that can lead to NAFLD and cirrhosis. The two widely used tools for this purpose are chemical shift-encoded MR sequences and HISTO. Both methods can fail due to various preventable technical factors. We analyzed various quality factors of technical acceptability for these studies and determined that >25% of all quantification studies performed over six months at our institution were technically unacceptable or had data handling errors. We then developed a checklist for MR technologists to confirm acceptability of the study and decrease potential errors before sending for interpretation.

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Jonatan Eriksson^1,2, Wolf Bartholomä^2,3, Nils Dahlström^2,3, Jens Tellman^1,2, Stergios Kechagias⁴, Patrik Nasr⁴, Mattias Ekstedt^2,4, Johan Kihlberg^2,3, and Peter Lundberg^1,2
1Department of Medical Radiation Physics, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden, ²Center for Medical Imaging Science and Visualization, Linköping University, Linköping, Sweden, ³Department of Radiology in Linköping and Department of Health Medicine and Caring Sciences, Linköping University, Linköping, Sweden, ⁴Division of Diagnostics and Specialist Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden, Linköping, Sweden

Keywords: Liver, Blood vessels, 4D Flow, 2D Flow, MRE, Spleen

A group of 6 healthy and 9 NAFLD-patients underwent a multi-parametric MRI examination, including 4D-, 2D-flow, MRE and relaxometry. 2D-flow results were successfully extracted from 4D-flow data, showing good match with 2D-flow, indicating that 4D-flow provides the opportunity to both provide regular flow values as well as additional information e.g. flow visualizations. Correlation between 4D-flow and spleen volume indicate that 4D-flow could provide markers for early portal hypertension.

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shuangshuang xie¹, caixin qiu¹, and wen shen^1
1Tianjin First Central Hospital, Tianjin, China

Keywords: Liver, Liver, liver regeneration

This study investigated the dynamic changes of residual right liver lobe after left lateral sectionectomy (LLS) and the potential value of IVIM and T2* mapping in evaluation of liver regeneration in living liver donors. All IVIM indexes of right liver lobe showed no obvious changes after surgery, but liver T2* values increased significantly at 2 weeks after surgery, and kept increasing gradually from week 2 to 8. Liver T2* values correlated moderately with liver volume, it may be a good substitute to liver volume in evaluating liver regeneration

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Chao Li¹, Jiahao Li², Jinwei Zhang², Pascal Spincemaille³, Thanh Nguyen³, and Yi Wang^3
1Applied and engineering physics, Cornell university, New York, NY, United States, ²Biomedical engineering, Cornell university, New York, NY, United States, ³Weill Cornell Medicine, New York, NY, United States

Keywords: Liver, Multi-Contrast

In this work, a 3D stack-of-spiral spoiled gradient echo sequence was implemented using T2 prepared single and multi-echo gradient echo acquisition for simultaneous R2, R2* and QSM mapping in a single breath hold within 24 secs.

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Stephan A.R. Kannengiesser¹, Arthur P. Wunderlich^2,3, Xiaodong Zhong⁴, Dominik Nickel¹, Holger Cario⁵, Michael Götz^2,3, Meinrad Beer³, and Stefan A. Schmidt^2
1MR Application Pevelopment, Siemens Healthcare GmbH, Erlangen, Germany, ²Department of Diagnostic and Interventional Radiology, Ulm University Medical Center, Ulm, Germany, ³Section for Experimental Radiology, Ulm University Medical Center, Ulm, Germany, ⁴MR R&D Collaborations, Siemens Medical Solutions, Inc., Los Angeles, CA, United States, ⁵Department of Pediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm, Germany

Keywords: Liver, Quantitative Imaging, R2*, iron content

Purpose: Preliminary liver R2* comparison in patients across field strengths and protocols.

 Methods: 3T R2* from 3D multi-gradient echo data with magnitude fitting was mapped to 1.5T R2*. Limits of agreement were calculated.

Results: Converted 3T R2* agreed well with 1.5T R2*. Best 95% limits of agreement were [-4.9% 7.6%] for 1.5T R2* [166s^-1 865s^-1] and [-34.5% 41.7%] for [49s^-1. 865s^-1].

Conclusion: 3T R2* agrees well with 1.5T R2* and can be used interchangeably for 3T R2* between 328s^-1 and 1699s^-1 with an optimized protocol. For low R2* values, protocols with longer echo times should be used.