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Hengjie Chen¹, Jaime F Mata², Y. Michael Shim², John P. Mugler², Xiaoping Hu¹, Li Zhao³, An Liu⁴, and Kun Qing^1,4
1University of California, Riverside, Riverside, CA, United States, ²University of Virginia, Charlottesville, VA, United States, ³Zhejiang University, Hangzhou, China, ⁴City of Hope National Medical Center, Duarte, CA, United States

Keywords: Lung, Hyperpolarized MR (Gas)

In this work, a 2-point Dixon-based method is developed to provide separation of the hyperpolarized xenon-129 dissolved-phase magnetic resonance imaging (MRI) components for pulmonary applications. Based on analysis of data from 6 healthy volunteers and 20 patients with lung disease, the separated tissue and red blood cell (RBC) components obtained from this method are highly consistent with those from the previously-described 3-point Dixon method. The 2-point Dixon based method has the potential to greatly improve the signal-to-noise ratio for dissolved-phase MRI while still maintaining accurate tissue/RBC separation.

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Marta Tibiletti¹, Paul JC Hughes², James A Eaden², Josephine H Naish^1,3, Helen A Marshall⁴, John C Waterton^1,5, Stephen A Bianchi⁶, Jim M Wild^4,7, and Geoff JM Parker^1,8
1Bioxydyn Ltd, Manchester, United Kingdom, ²POLARIS, University of Sheffield MRI unit, The University of Sheffield, Sheffield, United Kingdom, ³MCMR, Manchester University NHS Foundation Trust, Wythenshawe, United Kingdom, ⁴POLARIS, The University of Sheffield, Sheffield, United Kingdom, ⁵Centre for Imaging Sciences, University of Manchester, Manchester, United Kingdom, ⁶Academic Department of Respiratory Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom, ⁷Insigneo Insititute for in silico medicine, Sheffield, United Kingdom, ⁸Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom

Keywords: Lung, Perfusion

Quantitative pulmonary perfusion can be derived from MR imaging with injection of contrast agent (CA). Tracer-kinetic theory yields physiological parameters such as pulmonary blood flow (PBF), blood volume (PBV) and mean transit time (MTT) but relies on accurate calculation of CA concentration. Previous studies have used ‘subtraction’ or ‘normalisation’ methods without T₁-mapping. Using both simulations and data from interstitial lung disease patients, we demonstrate how the ‘subtraction’ method weights PBV by local lung density. This causes likely spurious correlations with hyperpolarised ¹²⁹Xe biomarkers linked to lung ventilation, microstructure and density, potentially obscuring information of diagnostic interest.

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Guilhem Jean Collier¹, Ho-Fung Chan¹, Graham Norquay¹, Neil J. Stewart¹, Ryan S. Munro¹, Oliver Rodgers¹, Rolf F. Schulte², and Jim M. Wild^1
1POLARIS, University of Sheffield, Sheffield, United Kingdom, ²GE Healthcare, Munich, Germany

Keywords: Lung, Hyperpolarized MR (Gas)

Four-echo 3D radial spectroscopic imaging of hyperpolarised ¹²⁹Xe in the lung is implemented at 3T to measure ratios of xenon gas and dissolved xenon in blood (RBC) and lung tissues (M). Thanks to an interleaved acquisition of the echo times and the choice of a 0.32ms echo time spacing, data acquisition is possible within the short relaxation time of dissolved ¹²⁹Xe (T₂^*~1ms).  11 healthy volunteers have been imaged at both 1.5 and 3T after the inhalation of a 1L dose of hyperpolarised ¹²⁹Xe. Results show comparable images at both field strengths and a significantly reduced (p=0.02) RBC:M at 3T.

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Mami Iima^1,2, Kazuki Tsuji³, Ryosuke Mizuno⁴, Toshiki Yamazaki³, Masako Kataoka¹, Maya Honda^1,5, Rie Ota^1,6, Aika Okazawa⁷, Keiho Imanishi⁸, Masakazu Toi⁹, and Yuji Nakamoto^1
1Kyoto University Graduate School of Medicine, Kyoto, Japan, ²Kyoto University Hospital, Institute for Advancement of Clinical and Translational Science (iACT), Kyoto University Hospital, Kyoto, Japan, ³Kyoto University Faculty of Medicine, Kyoto, Japan, ⁴A.I.System Research CO.,Ltd., Kyoto, Japan, ⁵Diagnostic Radiology, Kansai Electric Power Hospital, Osaka, Japan, ⁶Diagnostic Radiology, Tenri Hospital, Nara, Japan, ⁷Kyoto University Graduate School of Medi, Kyoto, Japan, ⁸e-Growth Co., Ltd., Kyoto, Japan, ⁹Breast Surgery, Kyoto University Graduate School of Medi, Kyoto, Japan

Keywords: Breast, Breast

348 women suspected of breast tumors were enrolled, and  206 breast lesions (139 malignant, 67 benign) were further analyzed. Breast 5b-value-DWI was performed, and a deep learning model dedicated to this breast DWI dataset was established. Several comparative experiments were performed; comparison of data augmentations, small network VS. large network, 2DCNN VS. 3DCNN, and analysis in 5b-DWI VS. ADC maps.  Augmentations using elastic deformation, affine transform, and Gaussian noise improved diagnostic performance up to AUC=0.90. The use of small CNN and without ADC map also showed higher diagnostic performance (AUC=0.88-0.90), showing AI potential to improve breast DWI diagnostic performance.  

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Kalina Polet Slavkova¹, Eric A Cohen¹, Rhea Chitalia², Snekha Thakran¹, Walter C Mankowski¹, Alex Nguyen², Hannah Horng², Elizabeth S McDonald³, Michael D Feldman⁴, Angela DeMichele^5,6, and Despina Kontos^7
1Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States, ²Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, United States, ³Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA, United States, ⁴Division of Surgical Pathology, Hospital of the University of Pennsylvania, Philadelphia, PA, United States, ⁵Division of Hematology Oncology, Perelman Center for Advanced Medicine, Philadelphia, PA, United States, ⁶Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, United States, ⁷Radiology, University of Pennsylvania, Philadelphia, PA, United States

Keywords: Breast, Breast, radiomics, DCE-MRI

Our objective is to predict pathological complete response (pCR) outcome to neoadjuvent chemotherapy in breast cancer patients. We combine radiomic features with background parenchymal enhancement -- computed from standard-of DCE-MRI data from the ISPY-2 trial -- and model treatment outcome via multivariable logistic regression. During training and testing, we demonstrate that models including BPE alongside radiomic and clinical covariates yielded the highest AUC values among all tested regression models, thus improving the prediction of pCR outcome.

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Shan Cai^1,2, Jens Tellman^1,2, Christian Simonsson^1,2,3, Wolf Bartholomä^1,4, Jonatan Eriksson^1,2, Nils Dahlström^1,4, Stergios Kechagias⁵, Patrik Nasr⁵, Mattias Ekstedt⁵, Ralph Sinkus⁶, and Peter Lundberg^1,2
1Center for Medical Imaging Science and Visualization, Linköping University, Linköping, Sweden, ²Department of Medical Radiation Physics, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden, ³Department of Biomedical Engineering, Linköping University, Linköping, Sweden, ⁴Department of Radiology in Linköping, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden, ⁵Department of Gastroenterology and Hepatology, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden, ⁶School of Biomedical Engineering and Imaging Science, King’s College London, London, United Kingdom

Keywords: Liver, Elastography, 3D MRE

Magnetic resonance elastography (MRE) is a powerful tool that can grade liver fibrosis non-invasively. In comparison with 2D MRE, 3D MRE can provide additional biomechanical tissue parameters for evaluating liver fibrosis. However, there is a great need to develop a quality assurance protocol for 3D MRE measurements. In this study, we have investigated quality assurance parameters for a 3D MRE research system and identified the cut-off values of the quality parameters to assign the 3D MRE data into three quality categories. A confidence map was constructed based on the evaluation of these quality parameters.

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Yikun Wang¹, Jiahao Zhou¹, Huimin Lin¹, Fuhua Yan¹, and Ruokun Li^1
1Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China

Keywords: Liver, Liver, MR elastography

Differentiating fibrosis and inflammation is vital important clinical distinction in patients with chronic liver disease (CLD). Liver histopathology is the worldwide reference standard for staging fibrosis and inflammation. Therefore, there is urgent need to develop non-invasive and low risk methods for staging liver fibrosis and inflammation. Current researches has been demonstrated that three-dimensional MRE allows showed higher diagnosis accuracy for staging liver fibrosis even inflammation than 2D MRE. Here, we prospectively evaluate the diagnosis efficacy of the parameters 3D MRE-derived for staging liver fibrosis and grade of inflammation in real clinical situations.

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Yurui Qian¹, Vincent Wai-Sun Wong², Jian Hou¹, Baiyan Jiang^1,3, Xinrong Zhang², Grace Lai-Hung Wong², Zhigang Wu⁴, Queenie Chan⁵, Simon Chun Ho Yu¹, Winnie Chiu-Wing Chu¹, and Weitian Chen^1
1Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, Hong Kong, ²Medical Data Analytics Centre (MDAC), Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Hong Kong, Hong Kong, ³Illuminatio Medical Technology Limited, Hong Kong, Hong Kong, ⁴Philips Healthcare, Shenzhen, China, ⁵Philips Healthcare, Hong Kong, Hong Kong

Keywords: Liver, Liver

Non-alcoholic fatty liver disease (NAFLD) is often associated with abnormal metabolic syndrome. In this study, we investigated dynamic glucose enhanced imaging of the liver using T1rho MRI after glucose ingestion. We hypothesize this approach can be used to assess metabolic activities in the liver. Sixteen young volunteers and four patients with NAFLD were recruited in this study. The preliminary results suggest that the proposed approach has the potential to detect metabolic variations between normal subjects and subjects with fatty liver. 

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Timothy J Allen¹, Srijyotsna Volety¹, Rianne A van der Heijden², Greg Simchick², and Diego Hernando^1,2
1Medical Physics, University of Wisconsin-Madison, Madison, WI, United States, ²Radiology, University of Wisconsin-Madison, Madison, WI, United States

Keywords: Liver, Diffusion/other diffusion imaging techniques

Liver DWI using M1-optimized diffusion imaging (MODI) minimizes motion-induced signal dropout while suppressing lesion-mimicking vessel signal. However, early MODI implementations have been confined to 3.0T MR systems with high-performance gradients. The feasibility and reproducibility of MODI DWI on 1.5T systems and systems with conventional gradient performance remains untested. In this work, liver DWI was acquired using conventional and MODI acquisitions in 8 healthy human subjects on 3 separate MR systems with different field strength and gradient performance. ADC estimation with MODI achieved smaller coefficients of variation and reproducibility coefficients across MR systems in comparison to conventional Stejskal–Tanner (monopolar) DWI. 

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Xiaodong Zhong¹, Marcel D Nickel², Stephan A.R. Kannengiesser², Brian M Dale³, Holden H Wu⁴, and Vibhas Deshpande^5
1MR R&D Collaborations, Siemens Medical Solutions USA, Inc., Los Angeles, CA, United States, ²MR Application Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany, ³MR R&D Collaborations, Siemens Medical Solutions USA, Inc., Cary, NC, United States, ⁴Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States, ⁵MR R&D Collaborations, Siemens Medical Solutions USA, Inc., Austin, TX, United States

Keywords: Liver, Quantitative Imaging, Fat, R2*, Iron

Respiratory motion compensation is necessary for free-breathing stack-of-radial liver fat and R₂^* quantification. While self-gating is a valid approach, it may lead to degraded quality of images and quantitative maps and possible prolonged acquisition. A 3D XD-GRASP stack-of-radial technique was developed and evaluated in a motion phantom and in vivo subjects. Results demonstrated PDFF and R₂^* agreement of the proposed method compared to reference methods. Improved image and map quality and PDFF and R₂^* quantification agreement of the proposed method using an acceleration factor of 4 (equivalent to 105 seconds of time saving) were observed compared to the self-gating method.

Liyun Zheng^1,2,3, Chun Yang^1,2, Yongming Dai⁴, and Mengsu Zeng^1,2
1Shanghai Institute of Medical Imaging, Shanghai, China, ²Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China, ³Shenzhen United Imaging Research Institute of Innovative Medical Equipment, Shenzhen, China, ⁴MR Collaboration, Central Research Institute, United Imaging Healthcare, Shanghai, China

Keywords: Liver, Liver

Most solid tumors have increased interstitial fluid pressure (IFP), and the increased IFP is an obstacle to treatment. This study applied a non-invasive dynamic contrast-enhanced magnetic resonance imaging-based model to acquire IFP and interstitial fluid velocity (IFV). Based on the IFP and IFV maps, histogram analysis was applied to evaluate the spatial distributions of pixel gray levels with reduced sampling bias. IFP- and IFV-derived parameters have proven to be significant predictors of microvascular invasion status. Therefore, this optimal model, together with histogram analysis, offers a new way for in vivo and non-invasive assessment of hepatocellular carcinoma.

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Yanli Jiang^1,2,3, Fengxian Fan^1,3, Jie Zou^1,2,3, Pin Yang^1,3, Pengfei Wang^1,3, Jing Zhang^1,3, and Shaoyu Wang^4
1magnetic resonance imaging department, Lanzho u university second hospital, LANZHOU, China, ²Lanzhou university, LANZHOU, China, ³Gansu Province Clinical Research Center for Functional and Molecular Imaging, LANZHOU, China, ⁴Siemens Healthineer, ShangHai, China

Keywords: Liver, Diffusion/other diffusion imaging techniques

DWI has been broadly used in clinical practice, which can provide quantitative parameters. Several DWI models have been used for liver fibrosis staging but diagnostic performance variance in different research because their acquisitions are different and normally difficult to be compared in one study. In this study, we compared 6 DWI models, including 14 parameters in detecting significant liver fibrosis using date from one acquisition. The results showed that the DWI models were similarly valuable in detecting significant liver fibrosis in patients with liver disease. The combined index with the three parameters of CTRW model had the highest AUC.

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Yujin Jung¹, Hyun-Seo Ahn¹, and Sung-Hong Park^1
1Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Korea, Republic of

Keywords: Kidney, Oxygenation

Measuring the renal oxygenation level is important because it is related to the progress of kidney diseases such as chronic kidney disease. In this study, we noninvasively quantified and mapped the renal metabolic rate of oxygen (RMRO₂) using quantitative susceptibility mapping and pseudo-continuous arterial spin labeling and evaluated the results using the caffeine challenge. The results demonstrated higher renal oxygenation in the medulla than the cortex, and lower renal oxygenation on the caffeine day compared to the control day, as expected. This technique can be applied to identifying patients at risk of kidney diseases with no contrast agent.

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Akira Yamamoto¹, Tsutomu Tamada¹, Yu Ueda², Ayumu Kido¹, Atsushi Higaki¹, Akihiko Kanki¹, and Yoshihiko Fukukura^1
1Kawasaki Medical School, Kurashiki, Japan, ²Philips Japan, Tokyo, Japan

Keywords: Kidney, fMRI

This study suggests the possibility that MRI using the values of CMD on optimal TI on SSFP with IR pulse with multi TI, which can sensitively capture fibrotic changes in the renal cortex of NADKD, can be a new parameter to evaluate NADKD non-invasively and in a short period of time.

Xiwei Li¹, Shifeng Tian¹, Changjun Ma¹, Nan Wang¹, Jiazheng Wang², and Ailian Liu^1
1The First Affiliated Hospital of Dalian Medical University, Dalian, China, ²Philips Healthcare,Beijing, Beijing, China

Keywords: Cancer, Body

Endometrial cancer (EC) is one of the three major malignant tumors in women, and its commonly used treatment is mainly surgery,  radiotherapy, chemotherapy and hormone therapy . However, some patients still have low response to the above treatments. However, molecular therapy targeting Her-2 gene has significant value in the clinical diagnosis and improving the prognosis. Amide proton weighted imaging (APTw) and diffusion kurtosis imaging （DKI）can be used for the diagnosis of diseases by reflecting the level of molecular metabolism and cellular microstructure. This study explored the value of the above two sequences in quantitative prediction of HER-2 gene expression levels.

Xilong Liu¹, Chantao Huang¹, Wentao Hu², Jie Feng¹, Wenjun Qiao¹, Sijin Chen¹, Bo Liu¹, Yongming Dai², and Yikai Xu^1
1Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou, China, ²MR Collaboration, Central Research Institute, United Imaging Healthcare, Shanghai, China

Keywords: Placenta, Diffusion/other diffusion imaging techniques

Currently, antenatal noninvasive imaging techniques to directly evaluate placental function remains challenge. The objective of this study was using diffusion-relaxometry correlated spectrum imaging (DR-CSI) as a tool to probe the possible placental composition changes over gestation in normal pregnancy. Four to five peaks were visible in the D-T2 spectrum for most subjects. DR-CSI compartments were defined according to peak distribution. Significant correlation between DR-CSI compartment volume fractions and GA was found. We suggested that the DR-CSI technique could be used to reveal features of placental composition.

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Han Jiang¹, Nan Meng², Ziqiang Li¹, Bo Dai², Pengyang Feng³, Yu Luo², Zhiwei Shen⁴, and Meiyun Wang*^2
1Department of Medical Imaging, XinxiangMedical University & Henan Provincial People's Hospital, Zhengzhou, China, ²Department of Medical Imaging, Zhengzhou University People's Hospital & Henan Province People's Hospital, Zhengzhou, China, ³Department of Medical Imaging, Henan University People’s Hospital & Henan Provincial People’s Hospital, Zhengzhou, China, ⁴Philips healthcare, Beijing, China

Keywords: Pelvis, CEST & MT, rectal cancer

What are the values of glucose-chemical exchange saturation transfer (glucoCEST) and amide proton transfer (APT) imaging in WHO grading and T staging of rectal cancer? We performed 3D-glucoCEST, 3D-APT, and DWI scans in 21 rectal adenocarcinoma cases. GlucoCEST signal intensity (SI) and 3D-APT SI could distinguish high-grade from low-grade, and T3 stage from T2 stage rectal adenocarcinoma, and both had comparable diagnostic efficacy. In addition, 3D-glucoCEST SI and 3D-APT SI were positively correlated with tumor grade.

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Jhimli Mitra¹, Chitresh Bhushan¹, Soumya Ghose¹, David Mills¹, Heather Chan¹, Matthew Tarasek¹, Shane Wells², Sydney Jupitz³, Chris Brace⁴, Bryan Bednarz³, Thomas Foo¹, James Holmes⁵, and Desmond Yeo^1
1GE Research, Niskayuna, NY, United States, ²Depts. of Radiology and Urology, University of Wisconsin-Madison, Madison, WI, United States, ³Dept. of Medical Physics, University of Wisconsin-Madison, Madison, WI, United States, ⁴Depts. of Radiology and Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, United States, ⁵Dept. of Radiology, University of Iowa, Iowa City, IA, United States

Keywords: Liver, Multimodal, Real-time multimodal alignment, image-guided intervention, MRI-US deformable fusion

Multimodal MRI-US image fusion in image-guided therapy such as liver microwave ablation aids in correct placement of the applicator device. Significant tissue deformation due to breathing motion requires alignment of pre-interventional MRI on real-time interventional US to compensate for the motion. In this work, we present a hybrid framework (conventional and deep learning) for multimodal deformable registration to provide higher accuracy and retain the low latency required for real-time interventions.

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Matthew Gibbons¹, Janet E Cowan², Peter R Carroll², Matthew R Cooperberg², and Susan M Noworolski^1
1Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States, ²Department of Urology, University of California, San Francisco, San Francisco, CA, United States

Keywords: Prostate, Cancer

This study’s objective was to determine whether automated mpMRI cancer risk maps could identify prostate cancer progression during active surveillance. Derived lesion masks were used to analyze factors for progression. A decision tree model for progression was generated with sensitivity = 0.84, specificity = 0.56, and ROC AUC 0.75. The identification results indicate the potential of mpMRI and MRI cancer risk maps to assist in identifying progression during prostate cancer active surveillance.

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Zhaohuan Zhang¹, Shu-Fu Shih¹, Kyunghyun Sung¹, Steven Raman¹, and Holden H. Wu^1
1Department of Radiology, University of California, Los Angeles, Los Angeles, CA, United States

Keywords: Prostate, Microstructure

Diffusion-Relaxation Correlation Spectroscopic Imaging (DR-CSI) has shown promises for quantifying prostate microscopic tissue compartments for prostate cancer characterization, but in vivo DR-CSI faces challenges such as lower signal-to-noise ratio (SNR), and signal averages could lead to prolonged scan time. This work investigated the combination of DR-CSI with random matrix theory-based denoising to take advantage of the large number of TE-b values contrast encodings to improve SNR, and enables rapid in vivo prostate microstructure MRI in <6min at 3T.