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Leo Ling Cheng^1,2, Xiaoyu Wang^3,4, Zehan Liu^3,4, Jessica Duffy⁴, Abner Louissaint, Jr.^2,4, and Panteleimon Takis^5
1Radiology, Massachusetts General Hospital, Boston, MA, United States, ²Harvard Medical School, Boston, MA, United States, ³Nanjing University, Nanjing, China, ⁴Molecular Pathology, Massachusetts General Hospital, Boston, MA, United States, ⁵Imperial College London, London, United Kingdom

Keywords: Screening, Spectroscopy, Gelified Biofluids

Currently, blood metabolomics analysis has to choose between serum and plasma: the former leaves blood in room temperature and therefore causing metabolic alterations; and the latter has interfering chemicals added during acquisition of samples, which make results complicated. Here, using HRMAS MRS, we studied gel samples of whole mouse blood by mixing them with silica powder. The obtained spectra agreed, in general, with the correlating serum samples, which proved the robustness of this method. Taking advantage of tiny amounts of samples (μl) and simple and rapid pretreatment, our new technique demonstrates a novel approach to metabolomic analysis and clinical applications. 

Pradeep Kumar¹, Rajeev Kumar², Sanjay Thulkar³, Sanjay Sharma⁴, Maroof Ahmad Khan⁵, and Virendra Kumar^1
1NMR and MRI Facility, AIIMS, New Delhi, India, ²Urology, AIIMS, New Delhi, India, ³Radiology , IRCH, AIIMS, New Delhi, India, ⁴Radiadiagnosis,RPC, AIIMS, New Delhi, India, ⁵Biostatistics, AIIMS, New Delhi, India

Keywords: Prostate, Blood, Metabolomics

Prostate cancer (PCa) with metastases remains incurable diseases requiring early diagnosis and effective treatments. To investigate and integrate the blood plasma metabolomic profiles with clinical parameters to distinguish PCa patients with metastasis from those without bone metastasis using 1H-NMR spectroscopy for establishing potential biomarker/s. Significant changes in liver enzyme ALP, ALT, and AST levels were observed in metastatic PCa. Pathway analysis revealed dysregulation of nitrogen and carbon metabolism. The discovery of metabolites in blood associate with clinical parameters for understanding PCa related pathophysiological mechanisms of bone and liver metastases.

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Longjiang Fang¹, Wenjing Zhao¹, Yujing Chu¹, Qi Wang¹, and Dmytro Pylypenko^2
1Department of Radiology, Weifang People's Hospital, Weifang, China, ²GE Healthcare, Beijing, China

Keywords: Lung, Diffusion/other diffusion imaging techniques

This study aims to compare multiplexed sensitivity encoding (MUSE) and single-shot diffusion-weighted echo planar imaging (SS DWEPI) techniques in lung MRI. A total of 22 patients with lung lesions were recruited in the study. Qualitative parameters included anatomic details, suscepti-bility artifacts, and diagnostic confidence; quantitative parameters included SNR and ADC of the lesions. The statistical studies demonstrated results that prove MUSE can provide better anatomic detail, lower susceptibility artifacts, higher diagnostic confidence, and improved SNR of the lung. MUSE is a promising technique for both clinical MRI diagnosis and treatment planning for lung lesions.

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Seokwon Lee¹, Ho Yun Lee^2,3, Hye Yun Park⁴, Hongseok Yoo⁴, Jinil Park⁵, Hyonha Kim⁵, and Jang-Yeon Park^1,5
1Biomedical engineering, Sungkyunkwan University, Suwon, Korea, Republic of, ²Radiology and Center for Imaging Science, Samsung Medical Center, Seoul, Korea, Republic of, ³Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea, Republic of, ⁴Pulmonary and Critical Care Medicine, Samsung Medical Center, Seoul, Korea, Republic of, ⁵Intelligent Precision Healthcare Convergence, Sungkyunkwan University, Suwon, Korea, Republic of

Keywords: Lung, Lung

Idiopathic pulmonary fibrosis (IPF) is a specific form of idiopathic interstitial pneumonia of unknown cause, the most common and fatal of these interstitial lung diseases. A study on the quantitative assessment of IPF severity based on signal intensity in hyperpolarized MRI lung imaging has recently been proposed. In this preliminary study, it was shown that non-contrast-enhanced 3D ultrashort echo-time (UTE) MRI could diagnose ventilation defects in lesions in patients with IPF using UTE-based 3D ventilation maps and histograms in combination with 3D UTE structural images.

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Siqiang Lv^1,2, Zhanguo Sun³, and Xiuzheng Yue^4
1Jining Medical University, Jining, China, ²Affiliated Hospital of Jining Medical University, jining, China, ³Affiliated Hospital of Jining Medical University, Jining, China, ⁴Philips Healthcare, Beijing, China

Keywords: Lung, Data Acquisition, SPLs

Intravoxel incoherent motion diffusion-weighted imaging (IVIM) could obtain parameters of pure water molecule diffusion and microcirculatory perfusion-related diffusion and more accurately reflects the complexity of the microstructure of the tumor tissues. Gradient-and-spin echo (GRASE), incorporating the gradient echo and spin echo techniques, is a fast-imaging sequence with potential for improved IVIM examinations. The aim of the study was to evaluate the feasibility and image quality of the GRASE-IVIM sequence in evaluating solitary pulmonary lesions (SPLs) by comparing with the EPI-IVIM and TSE-IVIM sequences. Our data showed GRASE-IVIM sequence could be a fast and stable alternative technique to evaluate the SPLs.

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Saleem Yousf¹, Kristine Glunde^1,2, Dalton R. Brown¹, Caitlin Tressler¹, Michael G. Goggins^3,4,5, and Zaver M. Bhujwalla^1,2
1Division of Cancer Imaging Research, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, United States, ²Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, United States, ³Departments of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, United States, ⁴Departments of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, United States, ⁵Departments of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States

Keywords: Cancer, Metabolism, PDAC

Metabolic imaging techniques such as mass spectrometry imaging (MSI) complement magnetic resonance spectroscopy and colocalize metabolite profiles with immunohistological evaluation of tissue sections.  Here we have performed matrix-assisted laser desorption/ionization (MALDI)-MSI of normal pancreatic tissue, intraductal papillary mucinous neoplasm (IPMN), and pancreatic ductal adenocarcinoma (PDAC) to characterize the spatial distribution of PDAC metabolites in tissue sections.  Our preliminary data with MALDI-MSI identifies significantly increased taurine and significantly decreased creatine, both of which can also be detected with ¹H MRS, in PDAC compared to normal tissue.  The spatial heterogeneity of metabolite distribution in PDAC tissue can be related to immunohistochemical evaluation.

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Jose Santiago Enriquez^1,2, Rian M Howell^2,3, Olivereen Le Roux³, Shivanand Pudakalakatti¹, Prasanta Dutta¹, Florencia McAllister^2,3, and Pratip Bhattacharya^1,2
1Cancer System Imaging, UT MD Anderson Cancer Center, Houston, TX, United States, ²UT MD Anderson Cancer Center UT Health Science Center Houston Graduate School of Biomedical Sciences, Houston, TX, United States, ³Clinical Cancer Prevention, UT MD Anderson Cancer Center, Houston, TX, United States

Keywords: Cancer, Pancreas, Metabolism, Metabolic Imaging, Hyperpolarized MR (non-gas)

There is an unmet need for the early diagnosis of pancreatic cancer. Diagnosis is difficult due to the asymptomatic nature of pancreatic cancer. One way to detect the early stages is to monitor the altered metabolism in premalignant pancreatic lesions in vivo with hyperpolarized metabolic imaging. Here we demonstrate how genetically engineered mouse models were used to detect early stages of pancreatic cancer as we see an increase in the altered metabolism in the pancreatic cancer models compared to control mice. Simultaneously we observe changes in hypoxia levels in these models using electron paramagnetic resonance imaging.

Minge Zhang¹, Jichen Xie¹, Jinbiao Huang¹, Yan Chen¹, Jingjing Wang¹, Liqi Yi², Youmao Zheng², Shilin Gu², Runyu Tang³, Yunfei Zhang³, Yongming Dai³, and Hai Yang^1
1Department of Radiology, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, China, ²Department of Hand and Foot Surgery, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, China, ³Central Research Institute, United Imaging Healthcare, Shanghai, China

Keywords: Screening, Visualization, Lymphoedema Imaging

Surgical intervention should be considered when extremity lymphedema reached clinical stage II, and the identification of lymphatic vessels from nearby veins is critical for surgery planning. In this study, we reviewed the MRL examinations of patients with secondary lymphedema. The results showed that MRL could be used to characterize the secondary lymphedema pre-operatively, and predefine treatment planning for patients who suffer secondary lymphedema.

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Fengleng Yang¹, Huaibo Jing², Xiaodan Wang², and Zhigang Wang^1
1Radiology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China, ²Gynecology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China

Keywords: Urogenital, Urogenital, Cesarean scar pregnancy; Magnetic resonance imaging (MRI); Curettage; Massive hemorrhage; Risk factors

Cesarean scar pregnancy is a special type of ectopic pregnancy for which dilatation and curettage (D&C) is one of the main treatment modalities, and uncontrollable hemorrhage is a more dangerous complication during D&C. Accurate preoperative prediction of the risk of intraoperative hemorrhage will help gynecologists draw up precise treatment. The aim of this study is to develop an MRI scoring model for predicting intraoperative hemorrhage during D&C. The study found that cesarean section diverticulum area, uterine scar thickness and gestational sac diameter were independent risk factors for intraoperative hemorrhage. A scoring model was developed, The model possessed decent prediction performance.

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Cheng Meiying¹, Tan Shifang¹, Zhang Lingjie¹, Ren Tian², Zhang Chunxiang¹, Wang Kaiyu³, Li Haiyang⁴, Shang Honglei¹, Chang Hui⁵, Yang Zhexuan¹, Cao Jing⁶, and Zhao Xin^1
1Department of Radiology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China, ²Department of Information, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China, ³MR Research China, GE Healthcare, Beijing, China, ⁴Department of Medical Equipment, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China, ⁵Department of Research, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China, ⁶Department of Pathology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China

Keywords: Urogenital, MR Value

Most of ovarian sex cord stromal tumors (OSCSTs) are benign with good prognosis, but low-grade malignant OSCSTs need special treatment. Correct preoperative diagnoses and accurate classification remain challenging. We retrospectively analyze the clinical and imaging characteristics of OSCSTs and found significant biomarkers such as maximum enhancement ratio (ER_max) and apparent diffusion coefficient (ADC) for the preoperative diagnosis and classification of common OSCSTs. It’s more helpful for preoperative diagnosis by combining of MRI and ultrasound together than by ultrasound alone, and MRI has the similar diagnostic accuracy as the combination.

Jinsong Bai¹, Haitao Zhang¹, and shaoyu wang^2
1Shanxi Hanzhong People's Hospital, Hanzhong, China, ²DI MR SMK, Siemens Healthineers, Shanghai, China

Keywords: Pelvis, Cancer, Ovarian cancer

The aim of our study was to compare the differential diagnostic efficacy of dynamic contrast enhanced magnetic resonance imaging (DCE-MRI), apparent diffusion coefficient (ADC), serum carbohydrate antigen 125 (CA125), human epididymal secretory protein 4 (HE4) and their combined application in benign and malignant ovarian tumors, and to explore the best method for the diagnosis of ovarian tumors.

Ma Changjun¹, Tian Shifeng¹, Liu Ailian¹, Chen Lihua¹, Lin Liangjie², Zhang Xiaoxiao³, Guo Yinghua⁴, and Wang Jiazheng^4
1Department of Radiology,, The First Affiliated Hospital of Dalian Medical University, Dalian, China, China, ²Clinical & Technical Support, Philips Healthcare, Beijing, China, China, ³Clinical & Technical Support, Philips Healthcare, Wuhan, China, China, ⁴Clinical & Technical Support, Philips Healthcare, Shanghai, China, China

Keywords: Placenta, Quantitative Imaging

HIF-1α is a major transcriptional factor regulating gene expression under hypoxic conditions. The identification of HIF-1α expression is very helpful for the quantitative assessment of tumor hypoxia, on which the therapeutic response is predicted or regimens are adjusted .

Yuru Zhong¹, jiao bai^1,2, Jian Shu¹, Fugang Han¹, Jun Li¹, Dongmei Zhao¹, and Yunzhu Wu^3
1Radiology Department, The Affiliated Hospital of Southwest Medical University, LuZhou, China, ²Radiology Department, The affiliated Hospital of Southwest Medical University, LuZhou, China, ³SIEMENS Healthineers Ltd.Shanghai, Shanghai, China

Keywords: Pelvis, Diffusion/other diffusion imaging techniques

To assess the image quality of anal fistula by RESOLVE DWI compared to SS-EPI DWI, and explore the value of RESOLVE DWI for diagnosis and classification of anal fistula. Qualitative and quantitative evaluation of image quality showed that RESOLVE DWI group was superior than SS-EPI DWI group.The accuracy of RESOLVE DWI sequence in the diagnosis of the internal orifice, branch fistula, and classification was higher than in SS-EPI DWI for anal fistula. RESOLVE DWI can provide higher quality images of anal fistula than SS-EPI DWI.

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Jie YUAN¹, Mengxiao Liu², Songhua Zhan¹, and Wenli Tan^1
1Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China, ²Siemens Healthineers Ltd, Shanghai, China

Keywords: Digestive, Cancer

Dynamic contrast-enhanced (DCE) MRI incorporates arterial input function and pharmacokinetic models to assess tissue perfusion, vasculature, capillary permeability, and interstitial space volume. It can be used to assess tumor vascularization, which can help determine tumor aggressiveness and the degree of angiogenesis and monitor therapy. However, the relationship between pathological characteristics of rectal cancer and the quantitative analysis of DCE remains unclear. 

Ying Qiu¹, Yi Zhu², Dandan Guo¹, and Ke Jiang^2
1Department of radiology, First Hospital of Jilin University, ChangChun, China, ²Philips Healthcare, BeiJing, China

Keywords: Urogenital, Pelvis

Rectal MRI examination requires high resolution three-dimensional (3D) sequences to observe the morphology, structure and the location of the lesions. However, 3D sequences may lead to longer scan time ，patient discomfort and image quality problem. In this study, we investigated the use of a deep learning-based reconstruction algorithm (CS-AI) to highly accelerate 3D rectum MRI. The result showed that CS-AI reconstruction can use the same scan time with sufficient image quality compared to SENSE and might be clinically useful in assessment of rectum cancer.

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Bohong Cao¹, Qing Li¹, Shuai Jiang¹, Yunfei Zhang², Yongming Dai², and Jianjun Zhou^1
1Zhongshan Hospital, Fudan University, Shanghai, China, ²MR Collaboration, Central Research Institute, United Imaging Healthcare, Shanghai, China

Keywords: Urogenital, Bladder

Bladder cancer pathology grading is currently obtained mainly by invasive cystoscopic biopsy or surgical pathology. This study aimed to investigate the effectiveness of Vesical Imaging Reporting and Data System (VI-RADS) in the diagnosis of high-grade bladder cancer (HG-BC) and explore a new preoperative non-invasive grading prediction system. We demonstrate that most bladder cancers with a VI-RADS score ≥3 are high-grade and that the decision tree model is a good predictor of pathological grading in patients with VI-RADS ≤2. Thus, VI-RADS can be a grouping imaging biomarker for noninvasive prediction of bladder cancer grade.

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yujiao zhao¹, cong you¹, cheng zhang¹, feifei qu², jinxia zhu², and Thomas Benkert^3
1The First Central Clinical College of Tianjin Medical University, tianjin, China, ²MR collaborations, Siemens Healthcare, beijing, China, ³MR Application Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany

Keywords: Urogenital, Bladder, bladder cancer

This study investigated the image quality and lesion characterization of bladder lesions on integrated slice-specific dynamic shimming (iShim) diffusion-weighted imaging (DWI) compared with single-shot echo-planar imaging (ss-EPI) DWI. The qualitative and quantitative image quality analyses were compared between the 2 DWI techniques. The diagnostic agreements of lesion characterization, including submucosal stalk and myometrial invasion, were also evaluated on DWI images compared with pathologic results. The results indicated that iShim-DWI provided better bladder tumor detection and image quality than ss-EPI DWI, suggesting that iShim-DWI might serve as a competent technique in bladder imaging.

Xiangyu Wang¹, Fan Lin¹, and Kan Deng^2
1Shenzhen Second People's Hospital, Shenzhen, China, ²Philips Healthcare, Guangzhou, China

Keywords: Pelvis, Tumor

The VI-RADS criterion was reported to have limitations, particularly for tumors location. So we evaluated the diagnostic performance of Vesical Imaging-Reporting and Data System (VI-RADS) scoring and diagnostic accuracies based on tumor locations. VI-RADS had superior diagnostic performance for detecting MI, especially in tumors located at the bladder lateral, posterior walls and ureteric orifices.

Guanglei Tang¹, Wenhao Fu¹, Kan Deng², and Jian Guan^1
1The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China, ²Philips Healthcare, Guangzhou, China

Keywords: Urogenital, fMRI

In this study, we determined APT of normal testes possible variations with age, and to assess the feasibility of APT in testicular spermatogenic function evaluation. Our results showed that APT of normal testicular tissue decrease with advancing age, and could be promising in evaluation of male infertility.

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Carlijn Tenbergen¹, Angeliki Stamatelatou¹, Sahar Nassirpour², Paul Chang², and Tom Scheenen^1,3
1Department of Medical Imaging, Radboud University Medical Center, Nijmegen, Netherlands, ²MR Shim, Reutlingen, Germany, ³Erwin L. Hahn Institute, Essen, Germany

Keywords: Prostate, Shims, Diffusion, Spectroscopy

B0-field inhomogeneities can influence (spectroscopic) image quality of the prostate, causing geometric distortion in diffusion weighted EPI images as well as line broadening in MRSI voxels. We added a 16-element external local shim array around the pelvis to improve B0-field homogeneity within the prostate and evaluated its effects compared to standard shimming in 9 healthy volunteers. Resulting B0-maps showed a comparable or reduced frequency variation across subjects, with a significant decrease of MRSI citrate line widths. DWI did not show a robust effect over the group of subjects.