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Chris R Bradley^1,2, Eleanor F Cox^1,2, and Susan T Francis^1,2
1University of Nottingham, Nottingham, United Kingdom, ²NIHR Biomedical Research Centre, Nottingham, United Kingdom

Keywords: Liver, Liver

Most complications in liver cirrhosis arise from portal hypertension. Using a vendor-specific fat suppressed spin-echo echo planar imaging T₁ mapping method along with measures of flow within the superior mesenteric artery, we previously validated MRI as a surrogate measure of portal pressure at 1.5 and 3T. Here we translate this work to three MR vendors (GE, Philips and Siemens) using commercially available sequences allowing multi-site studies of assessment of portal pressure. Importantly, this could provide a non-invasive measure of portal pressure for clinical use to replace current invasive gold standard measures.

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Jihun Kwon¹, Kohei Yuda², Masami Yoneyama¹, Yasutomo Katsumata³, and Marc Van Cauteren^3
1Philips Japan, Tokyo, Japan, ²Tokyo Metropolitan Police Hospital, Nakano, Japan, ³Philips Healthcare, Best, Netherlands

Keywords: Liver, Diffusion/other diffusion imaging techniques

Diffusion-weighted imaging (DWI) in liver plays a significant role for lesion characterization and staging of fibrosis. Single-shot echo-planar imaging (ssh-EPI) readout is typically used; however, spatial resolution of ssh-EPI-DWI is limited by acquisition time. In this study, we investigated the use of prototype AI-based reconstruction technique (SmartSpeed Precise Image) to improve the image quality of liver ssh-EPI-DWI images. The image quality was compared between conventional Compressed-SENSE (C-SENSE), SmartSpeed AI, and SmartSpeed Precise Image. Volunteer data demonstrated a significant improvement of sharpness in DWI images and ADC map, and reduction of ringing artifact compared with C-SENSE and SmartSpeed AI reconstruction.

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Stephen Bawden^1,2, Astrid Horstman³, Abi Spicer², Noura Darwish³, Denis Breuille³, Penny Gowland², Ian Macdonald⁴, and Liz Simpson^4
1NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK, University of Nottingham, Nottingham, United Kingdom, ²Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, United Kingdom, ³Nestle Institute of Health Sciences, Lausanne, Switzerland, ⁴David Greenfield Human Physiology Unit, MRC/ARUK Centre for Musculoskeletal Ageing Research, University of Nottingham School of Life Sciences, University of Nottingham, Nottingham, United Kingdom

Keywords: Liver, Metabolism

The aim of this study was to use ¹³C MRS to compare hepatic glycogen levels before and after an overnight fast and following a small breakfast of varying carbohydrate quantities (0, 15.5 and 31g CHO) in children . Liver glycogen concentration decreased overnight from 378 ± 141 to 277 ± 107 mmol l^-1 with a between visit coefficient of variation of 21 ± 15 %. There was also a significant difference in the postprandial AUC (P < 0.005) with a linear CHO ‘dose’ response (R=0.51, P < 0.001). This study expands knowledge of normative glycogen storage in children. 

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Abi Spicer¹, Stephen Bawden^1,2, Penny Anne Gowland¹, Susan Francis¹, Douglas Morrison³, Guruprasad Aithal⁴, and Gary Frost^5
1University of Nottingham, Nottingham, United Kingdom, ²NIHR Nottingham Biomedical Research Centre, Nottingham University hospitals NHS trust, Nottingham, United Kingdom, ³Scottish Universities Environmental Research Centre (SUERC), University of Glasgow, Glasgow, United Kingdom, ⁴Nottingham Biomedical Research Centre NUH, University of Nottingham, Nottingham, United Kingdom, ⁵Section for Nutrition, Faculty of Medicine, Imperial College London, London, United Kingdom

Keywords: Liver, Spectroscopy, Multinuclear

Propionate is a short chain fatty-acid absorbed in the colon and metabolised in the liver with some evidence showing that consumption can increase energy homeostasis. Three healthy participants have been studied to date with ³¹P saturation transfer experiments performed pre and 180 minutes post consumption of an inorganic-propionate ester using 1D-slice-selective-ISIS. The exchange rate constant (k) was calculated to be higher than previous studies despite similar methodologies. Whilst at this time no conclusions can be drawn about the effect of consuming Inorganic Propionate Ester thus far, this study shows the applicability of using ³¹P saturation transfer in simpler intervention studies. 

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Abi Spicer¹, Stephen Bawden^1,2, Zachary Peggs¹, Alexander J Daniel¹, Andrew Peters¹, Susan Francis¹, and Penny Anne Gowland^1
1University of Nottingham, Nottingham, United Kingdom, ²NIHR Nottingham Biomedical Research Centre, Nottingham University hospitals NHS trust, Nottingham, United Kingdom

Keywords: Liver, Spectroscopy

Multinuclear spectroscopy requires the use of free breathing acquisitions to achieve acceptable SNR. Here proton spectroscopy is used as an analogue for multinuclear MRS along with dynamic phase imaging to characterise the effect of respiration. Consistent agreement was seen between the respiratory bellows trace and the timeseries of the water peak frequency and imaging field offset, with overlapping primary frequencies on respective Fourier transforms. On free breathing a maximum frequency shift of 31Hz was measured, this equates to a 0.24ppm shift which could cause significant line broadening in the spectra of multinuclear ³¹P and ¹³C liver experiments.

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Hailong Li¹, Jinzhao Qian¹, Ziang Chen¹, Wen Pan¹, Scott B. Reeder², David T. Harris², William R. Masch³, Anum Alsam³, Krishna P. Shanbhogue⁴, Anas Bernieh¹, Sarangarajan Ranganathan¹, Nehal A. Parikh¹, Jonathan R. Dillman¹, and Lili He^1
1Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States, ²University of Wisconsin-Madison, Madison, WI, United States, ³Michigan Medicine, University of Michigan, Ann Arbor, MI, United States, ⁴NYU Langone Health, New York, NY, United States

Keywords: Liver, Liver, Liver fibrosis, biopsy

Chronic liver diseases can lead to variable amounts of liver fibrosis, which impacts patient management and outcomes. Percutaneous liver biopsy is the clinical reference standard for assessment of liver fibrosis. However, biopsy is subject to sampling errors and poor patient acceptance. The aim of this study is to develop machine learning models to stratify the severity of biopsy-derived liver fibrosis using MR radiomic data and clinical data. Using clinical, routinely collected MRI and clinical data, our machine learning was able to stratify the severity of liver fibrosis with an AUROC of 0.71, demonstrating the feasibility of the machine learning approaches.    

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Christian Simonsson^1,2,3, Nils Dahlström^1,3, Markus Karlsson¹, Shan Cai¹, Simone Ignatova⁴, Patrik Nasr⁵, Mattias Ekstedt^3,5, Stergios Kechagias^3,5, and Peter Lundberg^1,3
1Department of Radiation Physics, Radiology, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden, ²Department of Biomedical Engineering, Linköping University, Linköping, Sweden, ³Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden, ⁴Department of Clinical Pathology and Clinical Genetics, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden, ⁵Department of Gastroenterology and Hepatology, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden

Keywords: Liver, Contrast Agent, NAFLD,NASH, Gd-DPTA-EOB, Pharmacokinetic Modeling

Due to the increased global prevalence of non-alcoholic fatty liver disease (NAFLD), there is a significant need for precise and non-invasive clinical methods to detect early stages of non-alcoholic steatohepatitis (NASH), which can progress to cirrhosis. We investigate the possibility of using the hepatocyte specific contrast agent Gd-EOB-DPTA based DCE-MRI in combination with mathematical modelling to assess hepatobiliary influx, as a possible biomarker for early NASH detection. We show a tentative correlation between increased portal inflammation and decreased hepatic Gd-EOB-DPTA uptake in a cohort of prospectively included patients with suspected chronic liver disease.

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Justin Yu¹, Alvin C Silva¹, Annelise Silva², Matthew Doan¹, and Anshuman Panda^1
1Mayo Clinic Arizona, Phoenix, AZ, United States, ²Wright State University, Fairborn, OH, United States

Keywords: Liver, Elastography

MR elastography (MRE) derived liver stiffness measurements (LSMs) require manual drawing of ROIs on elastogram images. These ROIs may differ in size, and some clinicians suggest that reporting mean stiffness weighted by ROI area is more accurate than the unweighted mean. In this study the unweighted and weighted mean liver stiffness were calculated for 161 patients undergoing liver MRE exams using various scanning hardware/field strengths, and the statistical significance of the difference between the two sets of LSMs was tested using a paired two-tailed t-test. No statistically significant differences were found between weighted and unweighted LSMs.

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yimei Lu¹, qianfeng Wang², and dengbin Wang^3
1Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China, ²Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, shanghai, China, ³Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine, shanghai, China

Keywords: Liver, Diffusion/other diffusion imaging techniques

As a common pathological feature of chronic liver diseases, liver fibrosis is a significant cause of global morbidity and mortality. An accurate assessment of the fibrosis stage and early detection of hepatic fibrosis are essential for preventing further adverse consequences. Our study suggests diffusion metrics are useful tools for noninvasively staging liver fibrosis. Among them, MK is a more valuable imaging biomarker for evaluating the degree of liver fibrosis, and f is less consistent in our two fibrosis models.

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Tae-Hoon Kim¹, Chang-Won Jeong¹, ChungSub Lee¹, SiHyeong Noh¹, DongWook Lim¹, Youe Ree Kim², and Young Hwan Lee^2
1Medical Convergence Research Center, Wonkwang University, Iksan, Korea, Republic of, ²Radiology, Wonkwang University School of Medicine and Hospital, Iksan, Korea, Republic of

Keywords: Liver, Quantitative Imaging

Sarcopenic obesity is a disease which associates both sarcopenia and obesity and may trigger worse clinical outcomes including hepatic manifestation of fat accumulation and musculoskeletal disabilities. It is likely that sarcopenia and obesity share common physiological pathways and are interconnected through the muscle-liver-adipose tissue axis. Assessment of muscle mass is a key for the whole-body insulin-mediated glucose metabolism and energy homeostasis. However, it is little known the interconnection between hepatic fibrosis and sarcopenic obesity. This study compared body composition contents in non-obese and sarcopenic obese patients using abdominal MRIs and investigated the relationship between hepatic fibrosis and sarcopenic obesity factors.

Jing Zhang¹, Zhiyang Lu¹, Kaifan Yang¹, 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

Early characterization of liver fibrosis has great clinical significance as it allows monitoring of treatment response to antifibrotic agents in patients with chronic liver disease. Most recently, high b-values diffusion-weighted imaging (DWI) based on the continuous-time random-walk (CTRW) model has been introduced. Compared to the healthy control group, the mean D, α, and β values were significantly lower in the hepatic fibrosis group. Spatial diffusion heterogeneity β showed the best diagnostic performance. This non-invasive method has the potential to realize efficient evaluation and improve clinical treatment decision-making.

Yunfei Zhang¹, Yongming Dai², and Mengsu Zeng^3
1MR Collaboration, Central Research Institute, United Imaging Healthcare, Shanghai, China, ²MR Collaboration, Central Research Institute, United Imaging Healthcare, Shanghai, China, ³Zhongshan Hospital of Fudan University, Shanghai, China

Keywords: New Devices, Diffusion/other diffusion imaging techniques

Recently, the 5.0 T whole-body MRI scanner was developed. This study aims to evaluate the feasibility of 5.0 T high field DWI and assess the agreement of the apparent diffusion coefficient (ADC) with that from 3.0 T DWI. The results showed that 5.0 T DWI displayed an increase in subjective image quality score. Both the inter-field and inter-observer agreements of ADC values were substantial to excellent. The substantial to excellent agreements between the ADC values measured with 3.0 T and 5.0 T DWI for liver, pancreas, spleen and kidney suggested that 5.0 T DWI can be applied for abdominal imaging.
 

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Bo-Ting Chen^1,2, Cheng-Ya Yeh², Yi-Chen Chen², Chia-Wei Li³, Charng-Chyi Shieh³, Chien-Yuan Lin³, and Kao-Lang Liu^1,2
1Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan, ²Department of Medical Imaging, National Taiwan University Cancer Center and National Taiwan University College of Medicine, Taipei, Taiwan, ³GE Healthcare, Taipei, Taiwan

Keywords: Liver, Machine Learning/Artificial Intelligence, Deep learning reconstruction, Abdomen diagnosis

We have previously validated the SNR improvement of abdominal MRI by Deep Learning Reconstruction (DLRecon).  In this study, we further investigate the improvement of image quality and diagnostic performance when trading the SNR with higher spatial and temporal resolution imaging setting. In the result, the clinical scoring of images with high-speed or high-resolution settings in DLRecon was superior to that of the images with conventional setting and reconstruction.

Li Wang¹, Xinzhong Ruan¹, and Mengxiao Liu^2
1Department of Radiology, Ningbo First Hospital, Ningbo, China, ²Siemens healthineers, Shanghai, China

Keywords: Liver, Fat

This study investigated the fat quantitative Q-DIXON sequence to evaluate intra-organ fat content and visceral adipose tissue (VAT) to find the association with metabolic syndrome (MetS) in adults with overweight and obesity suspected with NAFLD.

The results showed that the cut-off level of 9.15mm of perirenal fat thickness (PRFT) and 14.68% of liver fat fraction (LFF) can effectively predict MetS, and the combination of PRFT and LFF predict MetS better. Moreover, ectopic fat levels in pancreas and lumbar spines are positively associated with PRFT.

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Dominick Jon Romano¹, Mert Şişman^2,3, Qihao Zhang^1,3, Thanh Nguyen³, Pascal Spincemaille³, Martin Prince^3,4, and Yi Wang^1,3
1Biomedical Engineering, Cornell University, Ithaca, NY, United States, ²Electrical & Computer Engineering, Cornell University, Ithaca, NY, United States, ³Radiology, Weill Cornell Medical College, New York, NY, United States, ⁴Radiology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States

Keywords: Liver, Vessels

We have developed a methodology of preparing explant livers for perfusion and vessel size imaging. Off-label use of ferumoxytol is known to provide high quality vessel size maps in vivo; however, known adverse reactions to ferumoxytol may hinder adoption into the clinical workflow. In this case, gadolinium may be more attractive. VSI experiments on a gadolinium perfused liver provide a proof of concept that Gadolinium may be used as an alternative contrast for vessel size imaging.

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Hongyan Qi^1,2, Jianxiu Lian³, Jiang Nan², Xuan Wang², and Junqiang Lei^2
1First School of Clinical Medicine ,Lanzhou University, Lanzhou, China, ²Department of Radiology, the First Hospital of Lanzhou University, Lanzhou, China, ³Philips Healthcare, Beijin, China

Keywords: Liver, Quantitative Imaging, pdff-mapping

Non-alcoholic fatty liver disease (NAFLD) is a serious threat to human health, and the investigation for non-invasive biomarkers to quantify hepatic fat content appears to be crucial. In the study, PDFF was used to quantify liver fat content, assess the grade and degree of hepatic steatosis. PDFF was found to be effective in assessing fat content in NAFLD, which is expected to be used as a biomarker to assess the grading of steatosis in patients with NAFLD.

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Marjola Thanaj¹, Nicolas Basty¹, Ramprakash Srinivasan², Madeleine Cule², Elena Sorokin², Jimmy Bell¹, Elizabeth Louise Thomas¹, and Brandon Witcher^1
1Life Sciences, University of Westminster, London, United Kingdom, ²Calico Life Sciences LLC, South San Francisco, CA, United States

Keywords: Liver, Data Analysis, PDFF, R2*

MRI measures specific to the liver such as proton density fat fraction (PDFF) and R2* are proven biomarkers for assessing hepatic fat and iron content. There is an interest in using radiomics to extract additional information relating to spatial heterogeneity from images and apply these to clinical data. Here, we extracted radiomics features from liver PDFF and R2* and selected reproducible features and features that provide independent information to that derived from median liver PDFF and R2*. Additionally, we show that most radiomics features are negatively correlated with age and positively correlated with body mass index (BMI).

Chen Lihua¹, Song Qingwei¹, Nan Wang¹, Yongming Dai², Dan Yu², Guobin Li², and Ailian Liu^1
1The First Affiliated Hospital of Dalian Medical University, Dalian, China, ²MR Collaboration,Central Research Institute, United Imaging Healthcare, Shanghai, China

Keywords: Liver, MR Value

To investigate the effects of different united compressed sensing (uCS) acceleration factors (AFs) on three-dimensional magnetic resonance cholangiopancreatography (3D-MRCP) image quality and to compare the quality with that using conventional parallel imaging (PI).

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Dong Cheol Woo¹, Hwon Heo¹, Yeon Ji Chae¹, Joongkee Min¹, Do-Wan Lee¹, Sang Tae Kim¹, Monica Young Choi¹, Yu Sub Sung¹, Kyung Won Kim¹, Yoonseok Choi², and Chul-Woong Woo^1
1Asan Medical Center, Seoul, Korea, Republic of, ²Gangneung Asan Hospital, Gangneung, Korea, Republic of

Keywords: Liver, Ischemia, reperfusion, aryl hydrocarbon receptor, L-kynurenine

Recent studies suggest that aryl hydrocarbon receptor (AhR) act as an important mediator of ischemic injury in brain. In particular, pharmacological inhibition of AhR activation after ischemia has been shown to attenuate cerebral ischemia-reperfusion (IR) injury. In this study, we investigated whether AhR antagonist administration after ischemia was also effective in ameliorating hepatic IR injury. Our results indicate that treatment with the AhR antagonist after ischemia alleviate liver damage, as evidenced by serum ALT and AST levels, MRI-based liver function indices, and histologic and molecular analysis. Thus, adequate AhR antagonist activity is a potential therapeutic approach for hepatic IR injury.

Xue Ren¹, Ying Zhao¹, Qingwei Song¹, Geli Hu², Jiazheng Wang², and Ailian Liu^1
1The First Affiliated Hospital of Dalian Medical University, Dalian, China, ²Clinical and Technical Support, Philips Healthcare, Beijing, China

Keywords: Liver, Liver

Gadobenate dimeglumine (Gd-BOPTA) is a novel contrast agent for hepatobiliary specific magnetic resonance imaging.At present, there is no exact and recognized turning Angle and delay time for Gd-BOPTA enhanced MRI scanning, and no relevant research reports have been reported at home and abroad. This study intends to analyze the image quality of the liver and biliary system in the hepatobiliary stage of Gd-BOPTA enhanced MRI by using the combination of different rotation angles and delay time.