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Manuel Kolb¹, Ferdinand Seith¹, Isabella Mack¹, Thomas Küstner¹, Rolf Pohmann², and Petros Martirosian^3
1Department of Diagnostic and Interventional Radiology, University Hospital of Tübingen, Tübingen, Germany, ²High-Field MR Center, Max Planck Institute for Biological Cybernetics, Tübingen, Germany, ³Section of Experimental Radiology, Department of Radiology, University Hospital of Tübingen, Tübingen, Germany

Keywords: Lung, Arterial spin labelling, Pulmonary blood flow, Lung perfusion

PCASL can quantitively measure pulmonary blood flow and detect pulmonary embolism. However, patients suffering from lung embolisms are usually unable to follow breathing commands required for optimal imaging. In this study, the influence of respiratory states on pulmonary perfusion measured with PCASL was investigated. Nineteen healthy volunteers were studied with an ECG-triggered PCASL sequence in a test-retest design. It was found that mean perfusion was highest during expiration, followed by free breathing and lowest in inspiration. A significant difference was observed between the maximal inspiration and expiration breath-hold conditions. Perfusion values acquired by PCASL in the lung parenchyma showed high reproducibility.

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Aditya Jhajharia¹, Salaheldeen Elsaid¹, Minjie Zhu¹, Joshua Rogers¹, Youngshim Choi², Liqing Yu², Sui Seng Tee¹, and Dirk Mayer^1
1Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, United States, ²Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, United States

Keywords: Liver, Hyperpolarized MR (Non-Gas), NASH

This study applied metabolic imaging of hyperpolarized [1-¹³C]pyruvate to a genetic mouse model of nonalcoholic steatohepatitis (NASH). Histology of the NASH (livKO) mice showed different levels of liver injury that were categorized into mild, moderate, and severe. NASH mice with severe liver injury had significantly higher Lac-to-Pyr and Ala-to-Pyr ratios in liver ROIs than that in control animals . These results suggest that hyperpolarized MRSI can be a promising method to differentiate liver injury based on severity in NASH. We also discussed several sources for variability of the MR data and how to potentially address them.           

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Junhao Zha¹, Yang Song², and Shenghong Ju^1
1Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China, ²MR Scientific Marketing, Siemens Healthineers Ltd, Shanghai, China

Keywords: Liver, Radiomics, liver fibrosis

To our knowledge, this is the first study developing a multi-task hybrid models incorperating conventional MR tissue texture and routine clinical biomarkers with both good accuracy and explainability in detecting fibrosis and necroinflammation. Our study used an interactive deep learning approach to automatedly segment the entire volumetric liver contours more effectively. Our CoRC models outperformed routine clinical fibrotic scores (FIB-4, APRI), and TE-LSM by discrimination, calibration in the large multicenter cohorts. Our CoRC models could be as a potential alternative when biopsy, hepatobiliary phase (HBP) images, liver stiffness measurement (LSM) are unavailable. 

Yidi Chen¹, Hanyu Jiang¹, and Bin Song^1
1Radiology, West China Hospital, Sichuan University, Chengdu, China

Keywords: Liver, Tumor

Hepatocellular carcinoma (HCC) with stem cell phenotype is characterized by activating classic cell proliferation pathways and altering intrinsic regulators, it can stimulate HCC tumor proliferation, make the tumor more prone to recurrence, metastasis and therapy resistance. In this study, we developed an easy-to-use and noninvasive risk score integrating preoperative clinical indicators and enhancement magnetic resonance imaging (MRI) to predict stem cell phenotype HCC.

Ying Xu¹, Lu Li¹, Yi Yang¹, Feng Ye¹, Sicong Wang², Lizhi Xie², Yanan Wang³, and Xinming Zhao^1
1Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China, ²GE Healthcare, China, Beijing, China, ³Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zheng Zhou, China

Keywords: Liver, Radiomics, Cholangiocarcinoma; colorectal liver metastases; nomogram; differential diagnosis.

 A total of 133 patients in training cohort (64 IMCC and 69 CRLM) and 57 patients in validation cohort (29 IMCC and 28 CRLM) were included. Radiomics features were extracted from the DCE-MR images and selected by the least absolute shrinkage and selection operator algorithm to establish the radiomics model.The radiomics nomogram was constructed combining the radiomics model and clinical model.The radiomics nomogram combining radiomics signatures based on DCE-MRI with clinical factors (serum CEA level and tumor diameter) may provide a reliable and noninvasive tool to discriminate IMCC from CRLM, which could help guide treatment strategies and prognosis prediction preoperatively.

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Sirisha Tadimalla¹, Tim Wang², Val Gebski³, Sheryl Foster^4,5, Vincent Lam⁶, Jonathan Sykes², Robert Finnegan^1,7,8, Jacob George⁹, Verity Ahern², Steven Sourbron¹⁰, and Annette Haworth^1
1Institute of Medical Physics, The University of Sydney, Sydney, Australia, ²Sydney West Radiation Oncology Network, Western Sydney Local Health District, Westmead, Australia, ³NHMRC Clinical Trials Centre, The University of Sydney, Sydney, Australia, ⁴Faculty of Medicine and Health, The University of Sydney, Sydney, Australia, ⁵Department of Radiology, Westmead Hospital, Westmead, Australia, ⁶Acute Surgical Unit, Westmead Hospital, Westmead, Australia, ⁷Ingham Institute of Applied Medical Research, Liverpool, Australia, ⁸Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards, Australia, ⁹Department of Gastroenterology and Hepatology, Westmead Hospital, Westmead, Australia, ¹⁰Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom

Keywords: Cancer, Radiotherapy

Quantitative imaging biomarkers of liver function offer a potential opportunity to optimize radiation dose distributions for personalized treatment of patients with liver cancers using radiation therapy. The PRISM clinical study aims to determine if radiation treatment plans guided by liver function maps from MRI can increase the therapeutic dose to tumours. We have developed a dedicated multi-parametric MRI protocol for the quantitative assessment of liver composition, structure and function. Details of the protocol and pilot data are presented here.

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Ehsan Tasbihi¹, Thomas Gladytz¹, Ludger Starke^1,2, Jason M. Millward¹, Erdmann Seeliger³, and Thoralf Niendorf^1,4
1Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany, ²Hasso Plattner Institute for Digital Engineering, University of Potsdam, Potsdam, Germany, ³Institute of Translational Physiology, Charité – Universitätsmedizin, Berlin, Germany, ⁴Experimental and Clinical Research Center, a joint cooperation between the Charité Medical Faculty and the MAX Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany

Keywords: Kidney, Preclinical

Increased incidence of kidney diseases is a concern, for which rapid biomarkers are lacking. Changes in tubule volume fraction (TVF) is a potential biomarker for kidney disease. T₂-mapping may be useful to asses TVF in noninvasive manner. To study this, we developed a protocol tailored for T₂-mapping of the rat kidney, and determined a suitable numerical solution for multi-exponential decomposition of the T₂-decay. Evaluation and validation of these algorithms using synthetic data and phantom showed an accuracy of 98%. This demonstrates that our approach is promising for research into quantitative assessment of renal TVF in in vivo applications.

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Songlin Guo¹, Peng Wu², Lu Han², Liang Pan ¹, and Wei Xing^1
1Third Affiliated Hospital of Soochow University, Department of Radiology, Changzhou, China, ²Philips Healthcare, Shanghai, China, Shanghai, China

Keywords: Kidney, Transplantation

Although 4D-Flow MRI is capable of detecting hemodynamic abnormalities, it is rarely employed in transplanted kidneys. Using 4D-Flow MRI, we assessed total volume, net flux, maximum flow, and mean flow rate and performed a statistical analysis of the correlation in this study. Total volume, net flux, maximum flow, and mean flow rate were shown to be inversely linked to the degree of stenosis in the transplanted renal artery. As a result, 4D-Flow MRI may be applied to study the hemodynamic changes of the transplanted renal artery noninvasively.

Shuang Wang¹, Tuo Ji², Jingdong Zhang ¹, Dan YU³, Yongming Dai³, and Lin Liu^1
1The Radiology Apartment of China-Japan Union Hospital of Jilin University, Changchun, China, ²The first Urology Apartment of China-Japan Union Hospital of Jilin University, Changchun, China, ³Central Research Institute, United Imaging Healthcare, Shanghai, China

Keywords: Kidney, Diffusion/other diffusion imaging techniques

The multimodal apparent diffusion (MAD) is a new approach with a predefined number of components associated with microstructure. In this work, the performance of quad-modal apparent diffusion in the kidney was assessed with simulation for different conditions. In-vivo demonstration and comparison with other models showed an explicable parametrization and improved fitting performance.

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Yan Deng¹, Xiao ming Zhang², and Bin Song^1
1Radiology, West China Hospital, Sichuan University, Chengdu, China, ²Affiliated Hospital of North Sichuan Medical College, Nanchong, China

Keywords: Pancreas, Cancer

Individualized management of pancreatic ductal adenocarcinoma (PDAC) is difficult and understanding it underlying biology is important. Radiomics model based on MRI was developed to predict status of KRAS and TP53 in PDAC, univariate analysis, MRMR and LASSO were applied for feature selection and multivariable logistic regression used for modeling. The classification metrics were applied to assess these models discrimination. Results suggested radiomics model based on MRI outperformed clinical model for predicting gene mutations of PDAC. This study confirmed that radiomics model based on MRI had a potentiality to predict the KRAS and TP53 mutation in PDAC.

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Jiaxin Yuan¹, Siya Shi¹, Liqin Wang¹, Xuefang Hu¹, Jinhui Yu¹, Tingting Wen¹, Shiting Feng¹, Zhenpeng Peng¹, and Yanji Luo^2
1The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China, ²The First Affiliated Hospital, Sun Yat-Sen University, Guanghzou, China

Keywords: Pancreas, MR Value, Magnetic resonance elastographies,SPNs,pNENs

This prospective study enrolled patients with pathologically confirmed solid pseudopapillary tumors (SPNs) and pancreatic neuroendocrine tumors (pNENs) who underwent preoperative tomoelastography examinations at our hospital. Sixty-four patients were included (18 patients with SPNs; 46 patients with pNENs). SPNs showed significantly lower stiffness (P<0.001) and fluidity (P=0.001) than pNENs. Both stiffness and fluidity allowed distinguishing SPNs from pNENs. AUCs were 0.899 for stiffness, 0.760 for fluidity. Tomoelastography is a novel multi-frequency MRE technique that can facilitate the differentiation between SPNs and pNENs.

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Yajing Zhang¹, Zhigang Wu², Wengu Su³, Jiazheng Wang⁴, Yan Zhao⁵, and Marc Van Cauteren^6
1MR Clinical Science, Philips Health Technology, Suzhou, China, ²Philips Healthcare (China), Shenzhen, China, ³MR Application, Philips Health Technology, Suzhou, China, ⁴Philips Healthcare (China), Beijing, China, ⁵MR R&D, Philips Health Technology, Suzhou, China, ⁶Philips Healthcare, Tokyo, Japan

Keywords: Pancreas, Data Acquisition

Pancreas imaging remains challenging because of its small size and motion, and conventional diffusion weighted imaging (DWI) suffers from poor image quality due to low signal-to-noise (SNR) and image blurring. This study performs several schemes to achieve high resolution high image quality pancreas DWI with reduced FOV using Compressed SENSE.

Feng Zhang¹, Yu Xin Yang², Lei Jiang³, Liang Zhao¹, Yongming Dai⁴, and Jiong Zhu^1
1Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China, ²United Imaging Research Institute of Intelligent Imaging, Beijing, China, ³Ningbo Hangzhou Bay Hospital, Ningbo, China, ⁴Central Research Institute, United Imaging Healthcare, Shanghai, China

Keywords: Lung, Lung

This preliminary study investigates the utility of high-resolution 3D-UTE to assess patients with CTD-ILD and their pulmonary function, including both pulmonary parenchyma and lesions, using OE-UTE-MRI. Our results suggest that high-resolution 3D UTE and OE-UTE MRI could potentially be as useful as thin-section CT for lesion detection of CTD patients with ILD and provide additional pulmonary functional loss assessment.

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Lili Xu¹, Gumuyang Zhang¹, Li Mao², Xiuli Li², Hao Sun¹, and Zhengyu Jin^1
1Peking Union Medical College Hospital, Beijing, China, ²Deepwise AI Lab, Beijing, China

Keywords: Prostate, Machine Learning/Artificial Intelligence, Multicenter study

Zonal segmentation is important in the management of prostatic diseases. Many studies have demonstrated the feasibility of training CNN models for zonal segmentation. However, they lack validation in non-public datasets and consideration of the patients’ characteristics. In this study, we validated the model’s utility for prostate zonal segmentation on T2WI in different external testing datasets. The model yielded good performance regardless of the variations in the patients’ clinicopathological characteristics. The model showed higher performance than the junior radiologist in PZ segmentation. Prostate morphology and MR scanner parameters, especially CG volume and vendor, impact zonal segmentation performance.

Xiwei Li¹, Lihua Chen¹, Nan Wang¹, Jiazheng Wang², and Ailian Liu^1
1The First Affiliated Hospital of Dalian Medical University, Dalian, China, ²Philips Healthcare,Beijing, Beijing, China

Keywords: Prostate, Cancer

Perinerval infiltration (PNI)  is closely related to the degree of radical operation and postoperative recurrence. Pathological examination is the gold standard for PNI diagnosis, but it is an invasive examination. The APTw imaging can be used for disease diagnosis and therapeutic evaluation by detecting the content of protein and polypeptide in tissues and cells. In this study, APTw was used to evaluate the PNI  in prostate cancer. The results showed that the APT values of PNI （+） group was higher than other one group. Therefore, APTw is of great value in  differentiation of perinerval invasion from prostate cancer.

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Xiaoxian Zhang¹, Chunmiao Xu¹, Zhiwei Shen², Ke Jiang², and Xuejun Chen^1
1Henan tumor hospital, Zhengzhou, China, ²Philips healthcare，Beijing，China, Beijing, China

Keywords: Cancer, Diffusion/other diffusion imaging techniques

Bloodstream metastasis to the liver, lung, and bone is the most prevalent mechanism of rectal cancer metastasis. However, there are currently no good indications for diagnosing heterochronic hematogenous metastases at the early stage. Therefore, this study aimed to explore whether ADC histograms might predict new heterochronic hematogenous metastases before and after neoadjuvant radiation for rectal cancer. Results showed that the first-order histogram feature ADC5% derived from post-treatment ADC maps might be utilized as an imaging biomarker and an independent predictor of new heterochronic hematogenous metastases after surgery following neoadjuvant chemotherapy for rectal cancer.

Xiaoling Gong¹, Yu Shen², Daguang Wen³, Xiaoxiao Zhang⁴, Xiaoyong Zhang⁵, Ziqiang Wang², and Bing Wu^3
1Department of Radiology, West China Hospital, Sichuan University, Cheng du, China, ²Colorectal Cancer Center，Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China, ³Department of Radiology, West China Hospital, Sichuan University, Chengdu, China, ⁴Philips Healthcare, China, Beijing, China, ⁵Philips Healthcare, China, Chengdu, China

Keywords: Cancer, fMRI, rectal cancer

Early imaging prediction of neoadjuvant chemotherapy (NACT) response would enable a personalized treatment approach to improve therapeutic response and avoid treatment morbidity in rectal cancer. Morphological changes base on T2 weighted MRI and free dispersion limitation of water molecules in tumor have limited value in evaluating efficacy after NACT. Amide proton transfer (APT)–weighted MRI, indirectly detecting the concentration of tissue macromolecular proteins, could help to inform us of the proliferation and biological status of tumor cells. The aim of this study is to determine if APT MRI is useful in early assessment of treatment response in persons with rectal cancer.

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Yassine N Azma^1,2, Nada Boci¹, Katarzyna Abramowicz¹, Matthew R Orton^1,2, Nina Tunariu^1,2, Dow-Mu Koh^1,2, Geoff Charles-Edwards^1,2, David J Collins^1,2, and Jessica M Winfield^1,2
1MRI Unit, The Royal Marsden NHS Foundation Trust, London, United Kingdom, ²Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom

Keywords: Fat, Whole Body, Dixon

Dixon-derived fat fraction (FF) has proven to play a pivotal role in whole-body MRI examinations for assessment of bone marrow disease in advanced prostate cancer. However, Dixon sequences are known to be subject to multiple sources of bias compared to the proton-density fat fraction (PDFF) gold standard. In this study, FF within the pelvis was measured for healthy tissues, active lesions and treated lesions with six different Dixon sequences. All sequences demonstrated good repeatability in scan-rescan studies of healthy volunteers. Statistically significant differences were observed between T₁w-FF and PDFF for both active and treated lesions which requires further investigation.

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CHETNA BANGA¹, DR. PREETI BHOSLE¹, DR. DUSHANT KUMAR¹, PROF. K.K DEEPAK², DR. DINU CHANDRAN³, and PROF. RAMA JAYASUNDAR^4
1NUCLEAR MAGNETIC RESONANCE, ALL INDIA INSTITUTE OF MEDICAL SCIENCES, NEW DELHI, NEW DELHI, IN, India, ²PHYSIOLOGY, ALL INDIA INSTITUTE OF MEDICAL SCIENCES, NEW DELHI, NEW DELHI, India, ³PHYSIOLOGY, ALL INDIA INSTITUTE OF MEDICAL SCIENCES, NEW DELHI, NEW DELHI, IN, India, ⁴NUCLEAR MAGNETIC RESONANCE, ALL INDIA INSTITUTE OF MEDICAL SCIENCES, NEW DELHI, NEW DELHI, India

Keywords: Screening, Quantitative Imaging, MR body composition analysis, phenotyping, subcutaneous fat, resting state fMRI

Phenotyping individuals are gaining importance in personalized medicine. This MR based body composition analysis and resting state (R-fMRI) along with autonomic functions (AFT) evaluation have determined parameters for physical, functional and physiological phenotyping in healthy volunteers (n=30). MR studies (at 3T) were R-fMRI using EPI sequence, subcutaneous fat evaluation by mDIXON sequence and AFT included parasympathetic (deep breathing, HUT) and sympathetic (HUT, hand grip test, cold pressor test). Increased functional activation, higher abdominal fat and fall in Baroreflex independent sympathetic reactivity were observed in volunteers having BMI ≥25 Kg/m2 compared to those with BMI <25Kg/m2.

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Sam Keaveney^1,2, Georgina Hopkinson¹, Julia Markus³, Andrew N Priest^4,5, Erica Scurr¹, Julie Hughes¹, Cheryl Richardson¹, Simon J Doran², David J Collins^1,2, Christina Messiou^1,2, Dow-Mu Koh^1,2, and Jessica M Winfield^1,2
1MRI Unit, Royal Marsden NHS Foundation Trust, Sutton, United Kingdom, ²Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom, ³Centre for Medical Imaging, University College London, London, United Kingdom, ⁴Department of Imaging, Addenbrookes Hospital, Cambridge University Hospital NHS Foundation Trust, Cambridge, United Kingdom, ⁵Department of Radiology, University of Cambridge, Cambridge, United Kingdom

Keywords: Whole Body, Cancer, Quality Assurance / Quality Control

A short quality control (QC) acquisition and analysis process was developed previously to detect faulty RF coil elements and coil positioning errors in whole-body (WB) MRI. This work demonstrates the feasibility of this process on systems from three manufacturers and reports on the evaluation of this approach following its addition to the clinical WB-MRI protocol for all examinations over a period of six months on six scanners, providing on-going monitoring of image quality across 450 examinations. Two previously unidentified broken RF coil elements were detected, which were affecting clinical image quality, demonstrating the value of this active detection approach.