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Shengyong Li¹, Linying Guo², Jing Zhang¹, Yang Song³, Shengjian Zhang⁴, Rifeng Jiang⁵, Guang Yang¹, and Zuohua Tang^2
1Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, China, ²Department of Radiology, Eye & ENT Hospital of Shanghai Medical School, Fudan University, Shanghai, China, ³MR Scientific Marketing, Siemens Healthcare, Shanghai, China, ⁴Department of Radiology, Shanghai Cancer Center of Shanghai Medical School, Fudan University, Shanghai, China, ⁵Department of Radiology, Fujian Medical University Union Hospital, FuZhou, China

Keywords: Head & Neck/ENT, Multimodal

Sinonasal mucosal melanomas (SNMM) are clinically more aggressive than its cutaneous counterpart and presented markedly poor prognosis. To differentiate sinonasal melanomas from sinonasal lymphomas, a radiomics model was built using features from multi-parametric MRI, including T1-weighted imaging (T1WI), T2 weighted imaging (T2WI), DWI and C-T1WI. In this multicenter retrospective study, 189 patients diagnosed with SNMMs or sinonasal lymphoma were enrolled from three institutions. The proposed model achieved AUCs of 0.884 and 0.870 in the internal and external validation set, respectively.

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Hirotaka Ikeda¹, Yoshiharu Ohno^1,2, Kaori Yamamoto³, Maiko Shinohara³, Masato Ikedo³, Masao Yui³, Akiyoshi Iwase⁴, Minami Furuta¹, Yuki Obama¹, Hiroyuki Nagata², Takahiro Ueda¹, Yoshiyuki Ozawa¹, and Hiroshi Toyama^1
1Radiology, Fujita Health University School of Medicine, Toyoake, Japan, ²Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Japan, ³Canon Medical Systems Corporation, Otawara, Japan, ⁴Fujita Health University Hospital, Toyoake, Japan

Keywords: Cancer, Head & Neck/ENT

We hypothesize that RDC is useful for image quality and diagnostic performance improvements on DWI with b value at 1500 s/mm² in suspected prostatic cancer patients, although there was little influence of RDC on DWI at in vitro study.   The purpose of this study was to determine the influence of RDC for ADC measurement at in vitro study and its’ utility for improving image quality and diagnostic performance of malignant from benign head and neck tumors on DWI as in vivo study.   

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Shuichi Ito¹, Sachi Okuchi¹, Yasutaka Fushimi¹, Kanae Kawai Miyake², Koji Fujimoto³, Hitomi Numamoto², Satoshi Nakajima¹, Akihiko Sakata¹, Takuya Hinoda¹, Sayo Otani¹, Azusa Sakurama¹, Krishna Pandu Wicaksono¹, Hiroshi Tagawa¹, Yang Wang¹, Satoshi Ikeda¹, Miyuki Takiya¹, Hiroki Kondo⁴, Rimika Imai⁴, Tsuneo Saga², and Yuji Nakamoto^1
1Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan, ²Department of Advanced Medical Imaging Research, Graduate School of Medicine, Kyoto University, Kyoto, Japan, ³Department of Real World Data Research and Development, Graduate School of Medicine, Kyoto University, Kyoto, Japan, ⁴Canon Medical Systems Corporation, Otawara, Japan

Keywords: Head & Neck/ENT, Diffusion/other diffusion imaging techniques

Reverse encoding distortion correction diffusion-weighted imaging (RDC-DWI) is a novel on-console technique to reduce eddy current-induced distortion of motion probing gradient (MPG) images in addition to B0 field inhomogeneity. We compared RDC-DWI, B0-corrected-DWI, and original DWI in patients with unoperated non-functioning macroadenoma or residual pituitary macroadenoma after surgery. RDC-DWI had the best image quality regarding distortion, artifacts and overall tumor visualization, which suggested that RDC-DWI facilitates accurate visualization in the pituitary region on DWI.

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zijun Liu¹, baohong Wen¹, and yan Zhang^1
1The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China

Keywords: Head & Neck/ENT, Head & Neck/ENT, Parotid gland tumors

This study evaluates the usefulness of combined Diffusion kurtosis imaging (DKI) and dynamic contrast-enhanced MRI (DCE-MRI) in differentiating parotid gland tumors. DKI and DCE-MRI quantitative parameters were analyzed by using the Kruskal-Wallis H test and post hoc test with bonferroni correction or the one-way analysis of variance (ANOVA) with LSD method, and ROC curve. Our research shows that the significant parameters in stepwise diagnosing parotid gland tumors were K_ep, K^trans, and D value. Therefore, the combined use of DKI and DCE-MRI could be used to differentiate various parotid gland tumors, and it may be helpful for differentiating parotid gland tumors.

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Di Geng¹, Xiance Zhao², Yishi Wang³, Xiaoquan Xu¹, and Feiyun Wu^1
1Department of Radiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, China, Nanjing, China, ²Philips Healthcare, Shanghai, China, Shanghai, China, ³Philips Healthcare, Beijing, China, Beijing, China

Keywords: Head & Neck/ENT, Head & Neck/ENT

IMPULSED (Imaging Microstructural Parameters Using Limited Spectrally Edited Diffusion) imaging method based on time-dependent diffusion magnetic resonance imaging (MRI) could be used to quantify cell sizes. We found that several quantitative parameters derived from IMPULSED including Vin (intracellular volume fraction), d (volume-weighted mean cell size) and cellularity showed significant differences between polymorphic adenoma (PA) and Warthin’s tumor (WT) in the parotid gland. Our findings shed light on the role of IMPULSED-derived quantitative parameters in distinguishing PAs from WTs preoperatively.

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Rongli Zhang¹, Qi Yong H. Ai^1,2, Lun M. Wong¹, Qiao Deng¹, and Ann D. King^1
1Department of Imaging and Interventional radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, HongKong, China, ²Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong, China

Keywords: Cancer, Head & Neck/ENT

Parotid gland tumors (PGTs) are often asymptomatic and an incidental finding on MRI that can be overlooked. We constructed an accurate artificial intelligence (AI) tool trained on fat-suppressed T2-weighted MRI to automatically identify patients with PGTs with an accuracy of 94.3% (99/105), a sensitivity of 94.0% (47/50) and a specificity of 94.5% (52/55). For identified PGT patients, automatic segmentations of the tumor and gland were performed and achieved dices of 77.2% and 86.3%, respectively. The proposed AI tool may assist radiologists by acting as a second pair of eyes to ensure incidental PGTs on MRI are not missed.

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Yifen Zhou^1,2, Rui Chen^1,2, Huifen Ye^1,2, Zhigang Wu³, Yongzhou Xu³, Zaiyi Liu^1,2, and Guangyi Wang^1,2
1Department of Radiology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China, Guangzhou, China, ²Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China, Guangzhou, China, ³MSC Clinical & Technical Solutions, Philips Healthcare, China, Shenzhen, China

Keywords: Diffusion/other diffusion imaging techniques, Contrast Mechanisms, Turbo Spin-echo; Multivane-XD; Intravoxel Incoherent Motion; Contrast-enhanced imaging; Nasopharyngeal carcinoma

Diagnosis of Nasopharyngeal Carcinoma (NPC) remains challenge since the contrast-enhanced T1-weighted imaging (CE-T1WI) may lead to harmful impact by the accumulation of contrast agent in patients and its potential adverse reactions. TSE MVXD DWI based IVIM, a considerable alternative, was performed on 32 NPC patients with significant tumors to evaluate the relation with CE-T1WI. As the result showed, the TSE MVXD DWI based IVIM had significantly relation with CE T1WI. It is potentially a promising and valuable non-invasive method in the detection of NPC.

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Lixuan Huang¹, Zongxiang Yang¹, Hao Ren², Yao Hu¹, Cheng Tang¹, Huiting Zhang³, and Liling Long^1
1The First Affliated Hospital of Guangxi Medical University, Nanning, China, ²Guangxi Medical University Kaiyuan Langdong Hospital, Nanning, China, ³MR Scientific Marketing, Siemens Healthineers Ltd, Wuhan, China

Keywords: Head & Neck/ENT, Radiomics

This study aimed to develop radiomic models based on MRI to investigate the changes of temporal lobe heterogeneity in nasopharyngeal carcinoma (NPC) patients with radiation encephalopathy (REP) during the latent period, and to predict the temporal lobe REP early. Results showed that The AUC of radiomics-clinics combined model was higher than radiomics model and clinics model, with better accuracy. Our study suggested that the radiomics-clinics combined model may be an effective method for the noninvasive prediction of REP in NPC patients after radiotherapy.

Guixiao Xu¹, Chuanmiao Xie¹, Hui Li¹, Yun He¹, Liangru Ke¹, Haibin Liu¹, Liyun Zheng², and Yongming Dai^3
1Department of Radiology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, China, ²Shenzhen United Imaging Research Institute of Innovative Medical Equipment, Shenzhen, China, ³MR Collaboration, Central Research Institute, United Imaging Healthcare, Shanghai, China

Keywords: Head & Neck/ENT, Head & Neck/ENT

Nasopharyngeal carcinoma is cancer arising from the nasopharynx epithelium. The most widely researched etiological factor for nasopharyngeal carcinoma is the Epstein-Barr virus (EBV) infection. Elevated interstitial fluid pressure (IFP) is a significant biomarker for assessing head and neck malignant tumors. This study aimed to use the non-invasive dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI)-based IFP model to evaluate nasopharyngeal carcinoma and distinguish the differences between nasopharyngeal carcinoma patients with low and high EBV-infected levels. As a result, the non-invasive DCE-MRI-based IFP model could be used to evaluate nasopharyngeal carcinoma and differentiate patients with high- and low-level plasma EBV DNA.

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Lixuan Huang¹, Hao Ren², Zongxiang Yang¹, Yao Hu¹, Huiting Zhang³, and Liling Long^1
1The First Affliated Hospital of Guangxi Medical University, Nanning, China, ²Guangxi Medical University Kaiyuan Langdong Hospital, Nanning, China, ³MR Scientific Marketing, Siemens Healthineers Ltd., Wuhan, China

Keywords: Cancer, Diffusion/other diffusion imaging techniques

This study explored the vascular normalization induced by recombinant human endostatin (RHES) in nasopharyngeal carcinoma (NPC) based on IVIM, DKI, FROC and CTRW. Results showed that the DKI_D, CTRW_alpha, and FROC_D had a significant difference between prior-treatment and Day 5 in RHES group, FROC_mu in Day 5 and CTRW_alpha in post-treatment were statistically significant in two groups, and DKI_K with decreased trend with the progress of RHES + IC treatment. These results suggest that the four diffusion models can detect the noninvasively monitor the vascular normalization induced by RHES in NPC.

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TANG WEIQING¹, SONG YANG², YING YUAN¹, and TAO XIAOFENG^1
1Radiology, Shanghai Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicine, Shanghai, China, ²MR Scientific Marketing, Siemens Healthcare. Shanghai, China, Shanghai, China

Keywords: Head & Neck/ENT, Cancer

The aim of this retrospective study is to explore the value of histogram analysis of apparent diffusion coefficient (ADC) values for distinguishing different subtypes of adenoid cystic carcinoma (ACC) and prediction of survival. Receiver operating characteristic curve analysis was used to determine the best differentiating parameters. The ADC_10th percentile values achieved highest diagnostic efficacy with an AUC of 0.821. The multivariable Cox proportional hazards model found that radiomic signature and tumor stage were significant predictors in ACC patients. Histogram analysis of ADC values may be helpful for differentiating the subtypes of ACC, leading to improved targeted treatment and reduced morbidity.

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Jinye Li¹, Lixin Sun², Na Hu², Mengxiao Liu³, Linsheng Wang², and Chuanting Li^2
1shangdong provincial ENT hospital, Jinan, China, ²Shandong Provincial ENT Hospital, Jinan, China, ³Siemens healthineers, Shanghai, China

Keywords: Head & Neck/ENT, Head & Neck/ENT

In order to visualize endolymphatic hydrops in Ménière’s disease better, we compared the conventional 3D real IR and ZOOMit 3D real IR sequence. Results suggest that visualization of the endolymphatic space might be higher by zs-3D real IR compared with t-3D real IR, especially in the cochlea.

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Chenxi Lu¹, Qiqi Tong², Mantao Chen³, Xiujue Zheng³, Jianhui Zhong^1,4, and Hongjian He^1,5
1Center for Brain Imaging Science and Technology, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, China, ²Research Center for Healthcare Data Science, Zhejiang Lab, Hangzhou, China, ³Department of Neurosurgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China, ⁴University of Rochester, Rochester, NY, United States, ⁵School of physics, Zhejiang University, Hangzhou, China

Keywords: Nerves, Tractography & Fibre Modelling

Facial nerve tractography has recently been recognized as a valuable tool for predicting risk before vestibular schwannoma surgery to preserve function. Due to complexity of tissue structure, professional experience is usually required to manually adjust tracking parameters and place exclusion ROIs for optimal tractography. A pipeline for automatic facial nerve tractography will significantly lessen surgeons' workload. Here, we proposed a fiber growing method for adjusting the angle threshold adaptively and removed track outliers. Results show that the proposed method achieves good consistency with the manual method. The pipeline would have great potential for assisting clinic surgeries for vestibular schwannoma.

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Mengda Jiang¹, Yongchuan Chai², Yang Song³, and Xiaofeng Tao^1
1Department of Radiology, Shanghai Ninth People’s Hospital, affiliated to Shanghai Jiaotong Universit, ShangHai, China, ²Department of Otolaryngology, Head & Neck Surgery, Shanghai Ninth People’s Hospital, affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China, ³MR Scientific Marketing, Siemens Healthcare, Shanghai, China

Keywords: Head & Neck/ENT, Nerves, Geniculate Ganglion, Facial Nerve

To evaluate the CT and MRI findings to identify geniculate ganglion venous malformation (GGVM) and geniculate ganglion schwannoma (GGS). Clinical data, lesion size, involvement of facial nerve (FN) segment, signal intensity, homogeneity, the enhancement pattern on DCE-MRI, characteristics of bone destruction on HRCT were evaluated. Lesion size, involvement of FN segment, T1W and T2W intensity, and homogeneity on DCE-MRI were statistically different between them. For regression model, the “honeycomb” sign and “point-to-side” enhancement pattern were independent risk factor (AUC=0.975, accuracy=97.70%, sensitivity=95%, specificity=100%, PPV=100%, NPV=95.80%).

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Xiaoping Zhu¹, Daniel Lewis^2,3,4, Ka-Loh Li¹, William Lloyd¹, Mueez Waqar^2,3,5, Ibrahim Djoukhadar^3,6, David J Coope^2,3,4, Andrew T King^2,3, Timothy Cootes¹, and Alan Jackson^1
1DIIDS, University of Manchester, Manchester, United Kingdom, ²Dept. of Neurosurgery, Manchester Academic Health Science Centre, Manchester Academic Health Science Centre, Salford, United Kingdom, ³Geoffrey Jefferson Brain Research Centre, University of Manchester, Salford, United Kingdom, ⁴Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, United Kingdom, ⁵Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom, ⁶Dept. of Neuroradiology, Manchester Academic Health Science Centre, Manchester, United Kingdom

Keywords: Head & Neck/ENT, Tumor

In this study we sought to undertake histogram and habitat analyses of tumoural DCE-MRI derived microvascular kinetic parameters and quantitative relaxation rate changes (ΔqR1) in patients with  sporadic and neurofibromatosis type 2 (NF2) related vestibular schwannoma (VS). We demonstrate that within imaged VS tumours there is considerable intratumoural heterogeneity in DCE-MRI derived microvascular metrics and ΔqR1, with distinct intratumoural regions or habitats displaying high K^trans, v_p and ΔqR1 values respectively.  We furthermore demonstrate within a cohort of NF2-related VS undergoing anti-angiogenic (bevacizumab) therapy that both pre-treatment K^trans and ΔqR1 are predictive of later tumour volumetric response at 90 days post-treatment. 

Zhaopeng Tong¹, Chunhua Xing², Xiaomin Xu², Jin-Jing Xu², Yuanqing Wu², Richard Salvi³, Xindao Yin², Yu-Chen Chen², and Yuexin Cai^1
1Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China, ²Nanjing First Hospital, Nanjing Medical University, Nanjing, China, ³University at Buffalo, The State University of New York, Buffalo, NY, United States

Keywords: Head & Neck/ENT, fMRI (resting state), Brain Connectivity, Degenerative, Dementia, Neuroscience

Age-related hearing loss is generally associated with dementia. However, the underlying mechanisms and causal relationship linking ARHL to dementia are poorly understood. Based on resting-state fMRI, the study found that ARHL disrupts specific aspects of resting-state functional connectivity patterns across frontal-parietal regions of the central nervous system; these changes presumably reflect cortical reorganization resulting from auditory sensory deprivation and/or the long-term consequences of effortful listening. The ARHL disruption of network information processing presumably accelerates brain aging and contributes to cognitive decline.

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Rebecca Susan Dewey^1,2,3, Hannah Guest^4,5, Rebecca E Millman^4,5, Garreth Prendergast^4,5, Christopher J Plack^4,5,6, and Susan T Francis^1
1Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, United Kingdom, ²National Institute for Health and Care Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, United Kingdom, ³Hearing Sciences, Division of Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, United Kingdom, ⁴Manchester Centre for Audiology and Deafness (ManCAD), University of Manchester, Manchester, United Kingdom, ⁵National Institute for Health and Care Research (NIHR) Manchester Biomedical Research Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom, ⁶Department of Psychology, Lancaster University, Lancaster, United Kingdom

Keywords: Head & Neck/ENT, Nerves, Neurography, diffusion, DTI

Recent findings suggest that noise exposure can cause substantial damage to the auditory nerve, without damage to the sensory hair cells or loss of threshold sensitivity. It is unclear which physiological measures are most sensitive to neural damage. Here, a comprehensive MRI protocol (neurography, high-resolution DTI of the auditory nerve and brain, morphometry, T₁-myelination mapping, and resting-state functional connectivity) to study the ascending auditory pathway (auditory nerve, auditory brainstem, and cortex) is described. 200 participants will be recruited with varying noise exposure levels, with the aim of identifying diagnostic tests indicative of future hearing loss.

Dejun She^1,2,3, Hao Huang^1,2, Peiying You^1,2, Lu Li⁴, Xiance Zhao⁵, and Dairong Cao^1,2,3,6
1Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, China, ²Department of Radiology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China, ³Key Laboratory of Radiation Biology of Fujian higher education institutions, First Affiliated Hospital, Fujian Medical University, Fuzhou, China, ⁴The School of Medical Imaging, Fujian Medical University, Fuzhou, China, ⁵Philips Healthcare, Shanghai, China, ⁶Department of Radiology, Fujian Key Laboratory of Precision Medicine for Cancer, First Affiliated Hospital of Fujian Medical University, Fuzhou, China

Keywords: Nerves, Nerves, magnetic resonance neurography; trigeminal nerve

Visualization of the anatomy of extracranial the trigeminal nerve (TGN) is crucial to detect nerve pathological alterations and differentiate pathologic causes. As a novel and safe nerve imaging technique in magnetic resonance neurography (MRN), the iMSDE pulse could result in uniform vascular signal suppression without additional contrast agents, which has been demonstrated to improve the visualization of peripheral nerves in several anatomical regions. Our results suggested that the iMSDE 3DIRTSE is a viable alternative to conventional 3DIRTSE and contrast-enhanced 3DIRTSE for MRN of the extracranial branches of TGN in clinical practice. 

Miaoxin Yu¹, Dandan Yang², Runhua Zhang¹, Yong Jiang¹, Huiyu Qiao³, Xihai Zhao³, Gaifen Liu¹, and Yongjun Wang^1
1Department of Neurology, Beijing Tiantan Hospital, Beijing, China, ²Department of Radiology, Beijing Geriatric Hospital, Beijing, China, ³Tsinghua University, Beijing, China

Keywords: Head & Neck/ENT, Atherosclerosis

Intracranial atherosclerotic disease progression is associated with recurrent stroke risk. In the present study, we investigated the association between carotid plaque and intracranial atherosclerosis progression in stroke-free participants using MR vessel wall imaging. In 312 participants recruited from a community cohort, we found that carotid plaque was independently associated with intracranial atherosclerosis progression during around 3-years’s follow-up. Our findings suggest that carotid plaque may be an effective predictor for intracranial atherosclerosis progression.

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Gijs Heldens¹, Daphne Driessen², Tim Dijkema³, Anne Arens³, Patrik Zámecnik³, Sjoert Pegge³, Willem Weijs⁴, Adriana van Engen-van Grunsven⁵, Robert Takes¹, Johannes Kaanders², and Tom Scheenen^3
1Department of Otorhinolaryngology and Head and Neck Surgery, Radboud University Medical Center, Nijmegen, Netherlands, ²Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, Netherlands, ³Department of Medical Imaging, Radboud University Medical Center, Nijmegen, Netherlands, ⁴Department of Oral- and Maxillofacial Surgery and Head and Neck Surgery, Radboud University Medical Center, Nijmegen, Netherlands, ⁵Department of Pathology, Radboud University Medical Center, Nijmegen, Netherlands

Keywords: Cancer, Head & Neck/ENT

To clarify the amount, timing and optimal pulse sequence settings of using interstitial superparamagnetic iron oxide particles (SPIO) as a contrast medium to detect sentinel lymph nodes in head and neck radiology, we injected SPIO peritumorally in six patients with early-stage oral squamous cell carcinoma. Anatomical and T2*-weighted MR images were acquired, and dose was altered after every two patients. Images with different computed echo times were created to determine the signal attenuation effect of SPIO on the sentinel lymph nodes.