Sunitha B. Thakur1, David D. Dershaw2, Dilip Giri3, Junting Zheng4, Chaya Moskowitz, Jessica Ferrara2, Jason A. Koutcher1, Elizabeth A. Morris2
1Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, United States; 2Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, United States; 3Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, United States; 4Epidemiology-Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, United States
Treatment decisions and determination of breast cancer prognosis have traditionally been based on pathologic parameters such as tumorsize and axillary-nodal status, tumor-grade, and the results of tumor markers mainly ER/PR and HER-2/neu. Here we present the clinical usefulness of Diffusion-weighted MRI and measurement of apparent diffusion coefficients (ADCs) to correlate traditional markers such as histology and molecular markers such as ER, PR and HER-2. Mean tumor size is significantly higher in patients with positive lymph nodes. Although ADC values represent a valuable biomarker for detecting malignant lesions, the ADC cannot be a prognostic indicator for patients with breast cancer.
Frederick Kelcz1, Kendra S. Hain1
1Radiology, University of Wisconsin, Madison, WI, United States
We reviewed diffusion imaging results in post lumpectomy patients and preliminary results show a consisent ADC value in the benign range, despite persistent, occasionly concerning enhancement. DWI may be of great value in ruling in benignancy when differentiating enhancing scar from malignancy.
Sunitha B. Thakur1,2, David D. Dershaw2, Dilip Giri3, Junting Zheng4, Chaya Moskowitz, Jason A. Koutcher1,2, Elizabeth A. Morris2
1Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, United States; 2Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, United States; 3Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, United States; 4Epidemiology-Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, United States
Diffusion MRI is a noninvasive technique which provides information about early changes in morphology and physiology of tissues by monitoring changes in the local apparent diffusion coefficient (ADC) of water molecules. Recently, diffusion-imaging has demonstrated potential in discriminating malignant from benign breast tumors and in assessing progression of disease following therapy. In this work we present the clinical usefulness of DWI and ADC values. ADC measurements are useful to differentiate malignant lesions from benign lesions yielding 98.4 % specificity and 90.9 % sensitivity with ADC cut-off value of 1.28x10-3 mm2/s. ADC was less reliable for differentiating invasive and non-invasive carcinomas.
Wafaa Raafat Abdel Hamid1, Lobna Rashed Ezz El Arab, Mona Ahmed Mohamed2, Yasser Abdel Azim Abbas
1Radiodiagnosis, Ain Shams University, Cairo, Egypt; 2Johns Hopkins University school of medicine
Classic magnetic resonance imaging is based on the enhancement pattern of lesions in dynamic breast MRI and morphologic changes. However, there is an overlap of these criteria with benign lesions. Accordingly, problematic cases have always been subjected to biopsies and histopathological verification. In our work we are shedding light on the added value of Diffusion Weighted Imaging and ADC values in differentiating between benign and malignant breast lesions, with a major goal of sparing patients the invasiveness and complications of unneeded biopsies.
Lori R. Arlinghaus1,2, E. Brian Welch1,3, A. Bapsi Chakravarthy4, Jaime S. Farley5, John C. Gore1,2, Thomas E. Yankeelov1,2
1Institute of Imaging Science, Vanderbilt University, Nashville, TN, United States; 2Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN, United States; 3MR Clinical Science, Philips Healthcare, Cleveland, OH, United States; 4Radiation Oncology, Vanderbilt University, Nashville, TN, United States; 5Vanderbilt University Medical Center, Vanderbilt University, Nashville, TN, United States
Diffusion-weighted imaging (DWI) is a promising surrogate biomarker for the characterization of human breast cancer. However, DWI acquisition sequences are susceptible to artifacts induced by subject motion and eddy currents. DWIs acquired with echo planar imaging (EPI) techniques are also prone to nonlinear distortion induced by B0 field inhomogeneities, which worsen as field strength increases. We present evidence that image registration and B0 field map correction improve the quality of apparent diffusion coefficient (ADC) maps derived from the DWI data and improve the registration of the DWI data with anatomical images for comparison with other parametric maps.
Naomi R. Mraz1, Michael T. Nelson1, Jessica Kuehn-Hajder1, Greg John Metzger2, Patrick John Bolan2
1Radiology, University of Minnesota, Minneapolis, MN, United States; 2Radiology/CMRR, University of Minnesota, Minneapolis, MN, United States
In order for single-voxel MRS measurements to be a useful clinical tool for characterizing breast lesions, voxel placement must be accurate and consistent. This project tested the consistency of voxel placement between four different operators using a retrospective study to simulate voxel placement on a MR scanner. The relative geometric intersection was used as a measure of concordance between readers. Overall concordance was lower than expected (ranging 0%-82.5%, mean 31.2%). Concordance was higher for masses than for non-mass-like lesions. These results suggest that further training, guidance, or software support should be used to improve voxel placement consistency.
Hisashi Kawai1, Shinji Naganawa1, Hiroko Satake1, Satoko Ishigaki1
1Radiology, Nagoya University, Nagoya, Japan
The purpose of this study was to assess whether VOIs of MRS were located properly with non-contrast MRI and to compare the variability between pre- and post-contrast spectroscopic measurements at 3T-MRI.
Single-voxel MRS were performed in 92 breast cancer lesions. In 52 lesions, MRS was obtained before and after contrast-enhanced MRI. VOI were located in the lesion properly in 74 out of 92 breast cancers. The integral value of choline peak decreased significantly in post-contrast MRS compared to in pre-contrast MRS. MRS should be obtained before contrast administration not to be affected by Gadolinium contrast agents.
Patrick John Bolan1, Eva H. Baker2, Lance Jay DelaBarre1, Hellmut Merkle3, Doug Yee4, Michael T. Nelson5, Lenore Everson5, Michael Garwood1
1Radiology/CMRR, University of Minnesota, Minneapolis, MN, United States; 2Diagnostic Radiology Department, NIH Clinical Center, Bethesda, MD, United States; 3National Institute Neurological Disorders and Stroke, NIH, Bethesda, MD, United States; 4Masonic Cancer Center, University of Minnesota, Minneapolis, MN, United States; 5Radiology, University of Minnesota, Minneapolis, MN, United States
While 1H MRS is increasingly being used in clinical studies of breast cancer, there has been some evidence that the use of Gadolinium-based contrast agents prior to MRS can affect the spectra, broadening the choline resonance and reducing its area. This work describes a study performing 1H MRS at 4T before and after a bolus of Gd-DTPA. It was found that after the contrast injection there was a small negative impact on both the choline and water peaks, with an effect size of 10-15%.
Sungheon Kim1, Tess Clendenen2, Sherlin Lavianlivi1, Linda Moy1, Henry Rusinek1, Malcolm C. Pike3, Anne Zeleniuch-Jacquotte4
1Center for Biomedical Imaging, Radiology, NYU School of Medicine, New York, NY, United States; 2Epidemiology, NYU School of Medicine, New York, NY, United States; 3Preventive Medicine, USC Keck School of Medicine, Los Angeles, CA, United States; 4Environmental Medicine, NYU School of Medicine, New York, NY, United States
This study was to assess if Dixon water/fat images could be used to monitor breast volume and density changes during the menstrual cycle. Reproducibility of the volume and density measurement was assessed with data from four subjects. In addition, five healthy premenopausal women were scanned once a week for four weeks. The median breast volume was smallest in the ovulatory phase and largest in the late luteal phase. FG density was lowest at the follicular phase and highest in the late luteal phase. This result demonstrates the feasibility of using Dixon imaging to monitor the change in the breast.
Chen Lin1, Laurie Owens1, Hal Kipfer1, Helmuth Schultze-Haakh2, Brian Dale2
1Department of Radiology and Imaging Science, Indiana University School of Medicine, Indianapolis, IN, United States; 2Siemens Healthcare, Marlven, PA
Quantitative assessment of the quality of fat suppression in breast MRI with four different techniques, conventional quick fat (QFS), spectrally selective adiabatic inversion recovery (SPAIR), water only excitation (WE) and two point dixon (2PT DIXON) was made at 3.0T. The result demonstrates similar but inferior performance for QFS, SPAIR and WE. While 2PT DIXON is shown to provide superior fat suppression, further development is needed.
Martin D. Pickles1, Lindsay W. Turnbull1
1Centre for MR Investigations, University of Hull, Hull, East Yorkshire, United Kingdom
Theoretically breast MR examinations at 3.0T should be superior to 1.5T studies. However, breast imaging on higher field strength systems also pose problems such as larger chemical shift, susceptibility artefacts, B1 inhomogeneities and increased T1 relaxation times. The aim of this work was to compare the sensitivity and specificity achieved by a 3.0T MR breast screening programme against the published results of screening studies at 1.5T. In conclusion the diagnostic accuracy of MR breast screening at 3.0T does not seem to be adversely effected by high field strength related artefacts and the results are comparable to those published at 1.5T.
Martin D. Pickles1, Lindsay W. Turnbull1
1Centre for MR Investigations, University of Hull, Hull, East Yorkshire, United Kingdom
CADstream is a computer aided diagnosis package developed to aid in the interpretation of breast MR. Reports have demonstrated that CADstream provides quicker interpretation, increased specificity and greater correlation with histological size. However, these reports are based on the assessment of pre-treatment lesions and not post chemotherapy lesions where a treatment induced vascular shutdown is anticipated. The aim of this study was to assess CADstreams accuracy post chemotherapy. In conclusion this study demonstrated by reducing the enhancement and difference thresholds the sensitivity can be increased resulting in fewer false negative results.
Colin Morehouse Carpenter1,2, Rebecca Rakow-Penner3, Shudong Jiang2, Brian William Pogue2, Keith David Paulsen2, Gary H. Glover3
1Radiation Oncology, Stanford University School of Medicine, Stanford, CA, United States; 2Thayer School of Engineering at Dartmouth, Hanover, NH, United States; 3Radiology, Stanford University School of Medicine, Stanford, CA, United States
BOLD response in the breast was measured concurrently with MR-guided diffuse optical tomography (MRg-DOT) in 11 healthy volunteers during inspired gas changes. This approach utilized optical imaging to quantitatively identify the independent effects of oxy- and deoxyhemoglobin. A key factor in this study was characterization of the background physiological noise variations in individual subjects, which was measured via optical imaging during air breathing. The results from this work indicate that BOLD and optically-determined deoxyhemoglobin signals correlate significantly in the breast during an oxygen/carbogen respiratory stimulus, as long as only subjects that exhibit a significant response are included.
Jeon-Hor Chen1,2, Shih-Ting Chen2, Cheng-Ju Lin2, Daniel Chang1, Po-Pang Tsai2, Ke Nie1, Orhan Nalcioglu1, M-Y Lydia Su1
1Center for Functional Onco-Imaging, UC Irvine, Irvine, CA, United States; 2China Medical University Hospital, Taichung, Taiwan
Although breast density measurement showed high correlation using both anatomic landmarks, there was still an average of 20% difference for FV measurement. A significant number of women had the problem of being cut off of their fibroglandular tissue when the pectoris major muscle was used as the landmark. From our study, it was concluded that in women with dense breast such as the subjects included in this study, both anatomic landmarks, especially the one anterior to the pectoris major muscle, will have the problem of cut-off of the fibroglandular tissue, resulting in the acquired fibroglandular tissue underestimated.
Daniel Han-en Chang1, Jeon-Hor Chen1,2, Shadfar Bahri1, Hon J. Yu1, Ke Nie1, Orhan Nalcioglu1, Min-Ying Lydia Su1
1Tu & Yuen Center for Functional Onco-Imaging, University of California, Irvine, CA, United States; 2Department of Radiology, China Medical University Hospital, Taichung, Taiwan
Mammographic density is known to be strongly associated with the risk of breast cancer development, but using mammography to characterize breast density does not provide true volumetric information. MRI-based methods on the other hand provide promising alternatives, but may be affected by technical factors such as the choice of pulse sequences. We imaged breasts with two commonly used pulse sequences, fat-suppression and non-fat-suppression, and calculated their densities with an MRI-based method developed previously by our lab. We found that their densities are highly correlated and that fat-saturated images tend to have stronger relative tissue contrast.
Ke Nie1, Daniel Chang1, Jeon-Hor Chen1,2, Tzh-Ching Shih1,2, Chieh-Chih Hsu2, Orhan Nalcioglu1, Min-Ying Lydia Su1
1Tu & Yuen Center for Functional Onco-Imaging, University of California, Irvine, Irvine, CA, United States; 2Department of Radiology, China Medical University, Taichung, Taiwan
There is a great interest to correlate between the density measured on MRI and mammogram, so the established role for mammographic density may be extended to MRI-based density. One problem specific to volumetric MRI analysis is the inclusion of skin as the dense tissue. In contrast this effect could be ignored on projection mammogram. In this study, we investigated the correlation between the volume of the skin and the breast on 3D MRI. We further provided two correction models aiming to provide an estimation of the skin volume and its effect on MRI based density measurement.
14:00 4550. Contrast-Enhanced 1.5-T MR Imaging of the Breast: Association Between Asymmetric Increase of Whole Breast Vascularity and Ipsilateral Cancer on a Series of 384 Studies - not available
Luca Alessandro Carbonaro1, Nicola Verardi, Henrida Kule, Giovanni Di Leo, Francesco Sardanelli1
1Unit of Radiology, Università degli Studi di Milano, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
We estimated the value of the breast vascular map asymmetry (BVMA) as a marker of ipsilateral tumors. Three-hundred-eighty-four patients underwent a dynamic study. We looked for BVMA. Pathologic examination or follow-up served as a reference standard. Pathology revealed 173 malignant lesions and 211 benign lesions. BVMA showed high diagnostic performance. Sensitivity was 76% for invasive cancers and 39% for in-situ cancers (P<0.001). Breast vascular map asymmetry was associated with ipsilateral cancer in 76% of invasive tumors, only in 39% of DCIS. For ¡Ý20-mm tumors, a 90% association was found.
In Chan Song1, Nariya Cho1, Yong Sik Bang1, Woo Kyung Moon1
1Department of Radiology, Seoul National University Hospital, Seoul, Chongno-gu, Daehangno 101, Korea, Republic of
We evaluated a feasibility of the usage of internal mammary artery near chest wall as an artery input function in contrast enhanced dynamic MR study to obtain the permeability map in breast tumor. Ktrans and Kep were successfully measured using the internal mammary artery as an artery input function based on the Tofts model in all patients. In breast tumor, the good performance in fitting procedure and the acquired two parameters showed that the internal mammary artery may be used as an artery input function in pharmacokinetic analysis.
15:00 4552. Breast MRI Using a Balanced Steady-State Free Precession Imaging with a Two-Point Dixon Fat-Water Reconstruction Algorithm: Preliminary Experience and Comparison with 2D FSE
Christine Lee1, Manoj Saranathan2, Gina Hesley1, Robert Maxwell1, Kathy Brandt1
1Mayo Clinic, Rochester, MN, United States; 2Applied Science Lab, GE Healthcare, Rochester, MN, United States
Clinical evaluation of an ultrafast T2-like acquisition with near isotropic resolution in breast MRI is compared to more conventional 2D Fast Spin Echo.
Rolf Janka1, Evelyn Wenkel1, Christian Geppert2, Berthold Kiefer2, Michael Uder1
1Radiology, Universitity of Erlangen, Erlangen, Bavaria, Germany; 2Siemens Medical Solutions
The TWIST sequence divides k-space in two radial regions and samples it using a pseudo-stochastic trajectory at adjustable density. While the central region is sampled at the full temporal resolution, the periphery is sampled with reduced density. Its main field of application is an increase of temporal resolution in MR-angiography. But it can also be used to increase spatial resolution in the dynamic sequence of breast MRI. We tested the new sequence in 61 women and think it is a reliable and powerful tool in breast imaging which fulfil the requirements of both high temporal and spatial resolution.
13:30 4554. Using T2-Weighted MRI in the Automated Analysis of Breast Cancer Lesions - not available
Neha Bhooshan1, Maryellen Giger1, Li Lan1, Angelica Marquez2, Hui Li1, Gillian Newstead1
1University of Chicago, Chicago, IL, United States; 2Loyola University, Chicago, IL, United States
This studys purpose was to investigate the automated analysis of T2-weighted MR images in distinguishing malignant and benign breast lesions. Using 86 benign and 110 malignant lesions, our CADx scheme automatically performed lesion segmentation, feature extraction, and classification. T2 morphological features yielded an AUC of 0.78± 0.03 while T1 kinetic and morphological features achieved an AUC of 0.83± 0.03. When considering all features, two T2 features, three T1 features and one geometric feature were selected, giving an AUC of 0.85± 0.03. T2 MRI has the potential to improve the performance of CADx in distinguishing malignant and benign breast lesions.
14:00 4555. Incidental Enhancing Lesions Found on Preoperative Breast MRI: Management and Role of Second Look Ultrasound
Maria Laura Luciani1, Federica Pediconi, Valeria Dominelli, Marianna Telesca, Valeria Casali, Federica Vasselli, Carlo Catalano, Roberto Passariello
1of Radiological Sciences, "La Sapienza" University of Rome, Rome, Italy
We evaluated the role of second look US for the study of occasional lesions detected on preoperative breast MRI and we proved it can be an helpful way to localize and study lesions depicted only on preoperative breast MRI.
Nariya Cho1, In Chan Song1, Yong Sik Bang1, Woo Kyung Moon1
1Department of Radiology, Seoul National University Hospital, Seoul, Korea, Republic of
Transfer constant obtained from DCE-MRI are well correlated with tumor size and histologic grade of breast cancer, which shows its potential as a noninvasive prognostic parameter in the breast cancer patient.
15:00 4557. The Evaluation of the Disease Extent in Patient with Ductal Carcinoma in Situ: Comparison of Mammography, Sonography, and MRI - not available
Kyoung Eun Lee1, Hak Hee Kim1, Jeong-Hee Sohn1, Hee Jung Shin1, Gyungyub Gong2, Se Hyun Ahn3, Hyeon Sook Kim4, Eun Suk Cha4
1Radiology, Asan Medical Center, Seoul, Korea, Republic of; 2Pathology, Asan Medical Center, Seoul, Korea, Republic of; 3General Surgery, Asan Medical Center, Seoul, Korea, Republic of; 4Radiology, The Catholic University of Korea, Seoul, Korea, Republic of
We think that in patient with DCIS, complemented MRI may be best establish the presence and extent of disease.
Elizabeth O'Flynn1, Anna Kirby2, Maria Schmidt1, Ashutosh Nerurkar3, Veronica A. Morgan1, Erica Scurr1, John Yarnold2, Nandita M. deSouza1
1Cancer Research UK and EPSRC Cancer Imaging Centre, Institute of Cancer Research & Royal Marsden NHS Foundation Trust, Sutton, Surrey, United Kingdom; 2Clinical Academic Radiotherapy, Institute of Cancer Research & Royal Marsden NHS Foundation Trust, Sutton, Surrey, United Kingdom; 3Histopathology, Institute of Cancer Research & Royal Marsden NHS Foundation Trust, Sutton, Surrey, United Kingdom
This pilot study demonstrates the accuracy of dynamic contrast-enhanced (DCE)-MRI and diffusion-weighted (DW)-MRI in detecting and localising multifocal and multicentric disease in patients with breast cancer by correlating imaging with histopathology findings at mastectomy. DCE-MRI alone was most accurate in detecting satellite lesions (sensitivity of 89%), DW-MRI was least accurate (sensitivity 55%). Satellite lesions were found up to 22 mm from the edge of the index lesion. Accurate identification of satellite lesions with multifunctional MRI offers potential for monitoring the effects of local therapies on multifocal and multicentric disease, and in defining the target volume for partial breast irradiation.
14:00 4559. Magnetic Resonance Imaging for Axillary Staging in Breast Cancer Patients Receiving Neoadjuvant Chemotherapy: Comparison with Ultrasonography and Positron Emission Tomography - not available
Sun Mi Kim1, Chae Yeon Lyou1, Mijung Jang1
1Seoul National University Bundang Hospital, Seongnam-Si, Gyunggido, Korea, Republic of
The presence of axillary lymph node(LN) metastases in breast cancer is an important factor in assessing prognosis and determines management. Although surgical biopsy remains the gold standard for the diagnosis of axillary LN metastasis but standard for surgical biopsy in monitoring for chemotherapy response does not established yet. Comprehensive and sequential staging of axilla using noninvasive diagnostic modalities has been approached and which would represent an importance advance in the management of breast cancer patients. This presentation evaluate the accuracy of comprehensive pre- and post-neoadjuvant chemotheraphy axillary staging via MRI, ultrasound imaging and positron emission tomography.
Jae Jeong Choi1, Sung Hun Kim2, Eun Suk Cha3, Hyun Suk Kim4, Jae Young Byun2, Bong Joo Kang2, Ji Hye Lee2
1Radiology, Seoul St. Mary's Hospital, Catholic University of Korea , Seoul, Korea, Republic of; 2Radiology, Seoul St. Mary's Hospital, Catholic University of Korea, Seoul, Korea, Republic of; 3Radiology, St. Vincent's Hospital, Catholic University of Korea, Seoul, Korea, Republic of; 4Radiology, St. Paul's Hospital, Catholic University of Korea, Seoul, Korea, Republic of
We would like to submit our report titled ¡°MRI Findings of Triple Negative Breast Cancer: A Comparison with Non Triple Negative Breast Cancer¡¯¡¯. Triple negative breast cancer is a subtype with aggressive clinical behavior which currently lacks effective targeted therapies. MRI characteristics of triple negative breast cancer could assist pretreatment planning and prognosis assessment. We evaluated MRI and clinicopathologic features of triple negative breast cancer, and compared them with those of non triple negative breast cancer.
Sungheon Kim1, Linda Moy1, Malcolm C. Pike2, Anne Zeleniuch-Jacquotte3, Tess Clendenen4
1Center for Biomedical Imaging, Radiology, NYU School of Medicine, New York, NY, United States; 2Preventive Medicine, USC Keck School of Medicine, Los Angeles, CA, United States; 3Environmental Medicine, NYU School of Medicine, New York, NY, United States; 4Epidemiology, NYU School of Medicine, New York, NY, United States
The purpose of this study was to develop a multiparametric MRI method to investigate magnitude and timing of various breast changes during the menstrual cycle. Five healthy premenopausal women were scanned once a week for four weeks. T2, ADC, and magnetization transfer rate were measured. T2 gradually increased throughout the cycle and was 5% higher in the menstrual phase than the follicular phase. In contrast, the median ADC was highest in the luteal phase (15% greater than the follicular phase) and began to decline during menses. The MTR was about 4% lower in the menstrual phase than the follicular phase.
Dal Mo Yang1, Dong Ho Lee2, Dong Wook Sung2, Geon-Ho Jahng, Chang Woo Ryu
1Radiology, East-West Neo Medical Center, Kyung Hee University, Seoul, Korea, Republic of; 2Radiology, Kyung Hee University Hospital
The purpose of this study was to compare the diagnostic accuracy of time-resolved MR angiography with that of conventional angiography for detection of ovarian venous reflux, which aid for a diagnosis of pelvic venous congestion. Retrospective analysis was performed with 19 consecutive patients who underwent time-resolved MR angiography and conventional angiography. There was no significant difference between time-resolved MR angiography and conventional angiography for detection of ovarian venous reflux (P > 0.05). The sensitivity, specificity, and diagnostic accuracy of time-resolved MR angiography were found to be 93.5%, 66.7%, and 89.5%, respectively. Time-resolved MR angiography is helpful for diagnosis of pelvic venous congestion.
Michael R. Torkzad1, Katarina Bremme2, Margareta Hellgren3, Maria J. Eriksson4, Anna Hagman5, Trine Jörgensen2, Kent Lund4, Gunnel Sandgren6, Lennart Blomqvist7, Peter Kälebo8
1Radiology Department, Uppsala University Hospital, Stockholm, Sweden; 2Karolinska Institutet, Woman and Child Health, Stockholm, Sweden; 3The Sahlgrenska Academy, University of Gothenburg, Institute for the Health of Women and Children, Gothenburg, Sweden; 4Karolinska Institutet, Department of Clinical Physiology, Stockholm, Sweden; 5The Sahlgrenska Academy, Institute for the Health of Women and Children, Gothenburg, Sweden; 6Sahlgrenska University Hospital/Östra, Department of Clinical Physiology, Gothenburg, Sweden; 7Department of Diagnostic Radiology, Karolinska University Hospital Solna, Department of Diagnostic Radiology, Stockholm, Sweden; 8Sahlgrenska University Hospital/Östra, Department of Radiology, Gothenburg, Sweden
Purpose: The agreement between ultrasonography and magnetic resonance imaging (MRI) in diagnosing the extent of pelvic deep vein thrombosis (DVT) during pregnancy was measured. Materials and methods Pelvic veins of 27 pregnant women with DVT were examined with ultrasound and MRI. Results: Three cases (11.5%) of DVT in the pelvic veins were shown only on MRI. MRI was able to detect highr thrombus extension in 65% of cases. Proportion of agreement (ê) between ultrasound and MRI for DVT in individual veins was 0.33 (95% CI 0.27-0.40, i.e. fair agreement). Conclusion: MRI could be essential in diagnosis of pelvic DVT during pregnancy.
Loredana Sorina Truica1, Ian Cameron, 1,2, Leonard I. Avruch2, Andre Gruslin2
1Carleton University, Ottawa, ON, Canada; 2The Ottawa Hospital, Ottawa, ON, Canada
IVIM measurements of normal placenta at 1.5 T using a respiratory triggered DW_SS_EPI sequence are reported. Improvements in the acquisition and analysis techniques used in this study allowed us to obtain more consistent results for the perfusion fraction, f, the diffusion coefficient, D, and the pseudo-diffusion coefficient, D*, than previous studies. Parameter maps of D and f were reflective of placental structure and composition. Such maps can be useful tools in identifying tissue differences and give important insight into the placental hemodynamic systems. This technique could become instrumental in the assessment and management of abnormal pregnancies.
Junko Takahama1, Satoru Kitano1, Aki Takahashi1, Nagaaki Marugami1, Megumi Takewa1, Takahiro Itoh1, Toshiaki Taoka1, Kimihiko Kichikawa1
1Radiology, Nara Medical University, Kashihara, Nara, Japan
The aim of this study was to compare the quality of images obtained with 3D T2-weighted sequence with the quality of conventional 2D T2-weighted images on 3.0-T MRI. Thirty consecutively registered patients were reviewed and analyzed quantitative measures of contrast and image quality. Three-dimensional volumetric T2-weighted images on 3.0T MRI are of content quality and give better anatomical recognition than conventional 2D images and have the added advantage of multiplanar and postprocessing capabilities.
Xiao Hong Ma1, Chun Wu Zhou1, Fei Sun2, Xin Ming Zhao1, Han Ouyang1, Hong Mei Zhang1
1Diagnostic Radiology, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China; 2Shanghai Guided Medical Scientific Co. Ltd., Shanghai, China
Our study target to semi-quantify the perfusion parameters of normal pancreas and pancreatic carcinoma with three-dimension (3D) high spatial and time resolution dynamic contrast enhanced (DCE) MRI on a 3.0T MR system. 31 patients who need abdomen contrast enhancement scan but with normal pancreas and 34 pancreatic carcinoma patients underwent DCE-MRI on a 3.0T MR system with 8-channel body coil. The perfusion parameters were measure including signal enhancement ratio at 30 seconds and 90 seconds after injection (SER30, SER90), positive enhancement integral (PEI), time to peak (TTP) and maximum slope of increase (MSI). There is no regional perfusion difference between the head, body and tail of normal pancreas, while there is significant difference between lesion and non-lesion area of pancreatic carcinoma, and between normal pancreas and non-lesion area of pancreatic carcinoma.
Kyung Ah Kim1, Mi-Suk Park1, Eun Ju Kim2, Myeong-Jin Kim1, Jin-Young Choi1, Hye-Suk Hong1, Ki Whang Kim1
1Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea, Republic of; 2Clinical science, MR, Philips Healthcare, Seoul, Korea, Republic of
We investigated the effect of the oxygen inhalation on relaxation times of T1 in abdominal solid organs, including liver, pancreas, spleen, and kidney. The inhalation of oxygen caused T1 shortening in the pancreas, kidney and spleen, which have predominant arterial blood supply, whereas no significant effect was noted in the liver, which has predominant portal venous blood supply. Our results indicate that MRI is feasible to detect changes with oxygen inhalation, which differs considerably among organs, in a noninvasive fashion. As a clinical application, the effect of oxygen on various normal and pathologic tissues may be used as a biomarker of arterial flow, oxygen delivery to organs, and hypoxic status.
Idit Matot1, Miriam Katz2, Orit Pappo3, Nathalie Corchia4, Gregory Barshtein5, Shaul Yedgar5, Rinat Abramovitch, 6
1Department of Anesthesiology & Intensive Care, Tel Aviv, Sourasky Medical Center, Tel Aviv, Israel; 2Department of Anesthesiology, Rabin Medical Center, Petach Tiqva, Israel; 3Pathology, Hadassah Hebrew University Medical Center, Jerusalem, Israel; 4he Goldyne Savad Institute of Gene Therapy, Hadassah Hebrew University Medical Center, Jerusalem, Israel; 5Department of Biochemistry, Hebrew University, Jerusalem, Israel; 6MRI/MRS lab HBRC, Hadassah Hebrew University Medical Center, Jerusalem, Israel
Concerns have recently been raised about the safety of transfusing stored-blood. Several studies have suggested that the risk of complications increases when transfused blood has been stored for long period. The liver is a target for injury in low flow states associated with trauma and hemorrhage. We studied the effect of blood resuscitation (fresh vs. Stored-blood) on liver injury. In rats, transfusion of blood stored longer than 4 days increased liver injury. This was associated with significant changes in the viscoelastic characteristics of the stored-blood and unrelated to the oxygen-carrying-capacity, cytokines in the stored-blood or the RBC/endothelial cells adherence properties.
Chen-Te Chou1,2, Ran-Chou Chen2,3
1Radiology, Chang-Hua Christian Hospital, Chang-Hua, Taiwan; 2Biomedical Imaging and Radiological Science, National Yang-Ming Medical University, Taipei, Taiwan; 3Radiology, Taipei City Hospital, Taipei, Taiwan
The study was to evaluate the efficacy of hepatocyte-phase imaging in characterization of focal hepatic lesions among cirrhotic liver using gadoxetic acid enhanced MRI. Our results revealed SNRs/CNRs of HCC were significantly decreased in hepatocyte phase (P<0.05) and the benign DN showed no significant difference (P>0.05). Severe additional HCC were diagnosed by hepatocyte-phase imaging. The diagnostic performance is significantly higher in the imaging set with hepatocyte-phase imaging (P=0.016). In conclusion, combination of gadoxetic acid-enhanced dynamic study and hepatocyte-phase imaging could provide better diagnostic performance than dynamic study only in characterization of focal liver lesion among cirrhotic liver.
Atsushi Higaki1, Tsutomu Tamada1, Akihiko Kanki1, Yasufumi Noda1, Hiroki Higashi1, Takenori Yamashita1, Katsuyoshi Ito1
1Radiology, Kawasaki Medical School, Kurashiki, Okayama, Japan
We evaluated the relationships between enhancement effects of liver parenchyma in hepatobiliary phase of gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA) enhanced MR imaging and MR imaging findings of cirrhosis change. Hepatic parenchymal enhancement in the HP of Gd-EOB-DTPA enhanced MR imaging did not necessarily decrease according to the morphological severity of cirrhosis. This fact may suggest that the hepatic uptake of Gd-EOB-DTPA depends on the preserved hepatocytes function rather than the severity in morphologic changes in cirrhosis.
14:00 4571. Diffusion-Weighted MR Imaging Improves Sensitivity of Lesion Detection Compared with Gadolinium Enhanced T1-Weighted Imaging in Patients with Suspected Liver Metastases from Neuroendocrine Tumours.
Mark Ingram1, Toni Wallace2, Erica Scurr2, David J. Collins2,3, Val Lewington4, Dow-Mu Koh2
1Department of Radiology, St George's Healthcare NHS Trust, Tooting, London, United Kingdom; 2Department of Radiology, Royal Marsden NHS Foundation Trust, Sutton, Surrey, United Kingdom; 3CRUK-EPSRC Cancer Imaging Centre, Institute of Cancer Research, Sutton, Surrey, United Kingdom; 4Department of Nuclear Medicine, Royal Marsden NHS Foundation Trust, Sutton, Surrey, United Kingdom
In patients with neuroendocrine liver metastases, imaging determination of the size and distribution of metastatic disease is of value as it could influence the choice of therapy. We compared diffusion-weighted MR imaging (DW-MRI) and gadolinium-DTPA enhanced MR imaging for the detection of focal liver lesions in patients with suspected liver metastases arising from neuroendocrine tumours. DW-MRI was found to have a significantly higher diagnostic sensitivity (88%) compared with gadolinium-DTPA enhanced MR imaging (77%) for lesion detection in this patient population (p = 0.001, McNemar test).
Akihiro Tanimoto1, Nobuya Higuchi2, Akihisa Ueno2, Shigeo Okuda2
1Department of Diagnostic Radiology, School of Medicine, Keio University , Tokyo, Japan; 2Department of Diagnostic Radiology, School of Medicine, Keio University, Tokyo, Japan
So-called gringing artifactsh are often associated with Primovist-enhanced dynamic MR imaging, aggravating the diagnosis for focal hepatic lesions. To analyze the cause of this phenomenon, various scan and data acquisition parameters were tested using a newly created simulation software on the personal PC. The simulation study revealed that square matrices, short scanning time, slow infusion rate, and sequential view ordering were effective measures to reduce the artifacts. These results were confirmed in the clinical practice of Primovist-enhanced MR imaging.
Russell Norman Low1,2, Jingfe Ma3, Neeraj Panchal1,2
1Sharp and Children's MRI Center, San Diego, CA, United States; 2San Diego Imaging, San Diego, CA, United States; 3Department of Imaging Physics, The University of Texas MD Anderon Cancer Center, Houson, TX, United States
This study evaluates a prototype breath hold fast recovery fast spin echo (FSE) based Dixon pulse sequence that provides superior fat suppression less sensitive to magnetic field inhomogeneities.
Andrew Dean Hardie1
1Radiology, Medical University of South Carolina, Charleston, SC, United States
MRI is accurate for identifying hepatocellular carcinoma however gadolinium chelates are contraindicated in patients with severe renal dysfunction due to the risk of Nephrogenic Systemic Fibrosis. There is a need to develop clinically usefull non-contrast MRI techniques to image these patients. Diffusion-weighted imaging and T2* weighted imaging offer the ability to identify tumors in cirrhotic patients with an accuracy similar to gadolinium MRI.
Laurent Milot1, Kayan Ma2, Erin Efford1, Gal Sela2, Carolyn Maloney1, Susan Crisp1, Natalie Coburn3, Masoom Haider1, Cameron Piron2, Calvin Law3, Don Plewes4
1Department of Medical Imaging, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; 2Sentinelle Medical Inc, Toronto, Ontario, Canada; 3Department of Surgical Oncology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; 4Department of Imaging Research, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
Ultrasound and MRI provide complimentary information useful in pre-operative planning for surgical resection of hepatic metastases from colorectal cancer. This study investigates the value of real-time co-registration of preoperative MRI and ultrasound images to determine if this method improves the ability to localize suspicious targets under ultrasound, using MRI as a gold standard. Co-registered MRI/ultrasound imaging yielded a significant increase in the number of targets successfully localized compared to ultrasound examination alone. Co-registered imaging was particularly effective in localizing small lesions (less than 5 mm) which were difficult to identify under conventional ultrasound examination.
Gianpaolo Pirovano1, Mieczyslaw Pasowicz2, Miles A. Kirchin3, Ningyan Shen4, John R. Parker5, Alberto Spinazzi1
1Medical Affairs, Bracco Diagnostics Inc., Princeton, NJ, United States; 2Radiology, John Paul II Hospital, Kracow, Poland; 3Medical Communications, Bracco Imaging, Milan, Italy; 4Biometrics, Bracco Diagnostics Inc., Princeton, NJ, United States; 5Medical Communications, Bracco Diagnostics Inc., Princeton, NJ, United States
15 subjects aged 2-5 years were enrolled in a pharmacokinetic study and received 0.1 mmol/kg bw gadobenate dimeglumine. Pharmacokinetic parameters were calculated from the blood Gd concentration-time data using compartmental and noncompartmental techniques. At 6 hours after gadobenate dimeglumine administration, all subjects¡¦ residual Gd in blood was close to 1.0 Ýg/mL, indicating that Gd was successfully cleared from the blood. No differences in whole blood or urinary pharmacokinetic parameters were observed between pediatric subjects 2 to 5 years when compared to adult subjects studied in previously.
Bobby Kalb1, Douglas Vander Kooi2, Daniel Karolyi1, Bhavika Patel1, Khalil Salman1, Diego R. Martin1
1Radiology, Emory University, Atlanta, GA, United States; 2Radiology, Langley Airforce Base, Hampton, VA, United States
Infiltrative-type of HCC (I-HCC) is an incurable, less common growth pattern of HCC that may mimic fulminant CLD. Distinction of I-HCC on MRI is critical for optimal management and to avoid inadvertent transplantation of incurable disease, however imaging features may be atypical with poor visibility of tumor extent on postcontrast images. We have categorized MR imaging and pathologic features of I-HCC, and found tumor conspicuity to be most pronounced on T2-weighted images, with portal venous tumor thrombus present in all cases. These findings are important to help improved clinical application of MRI in the setting of CLD.
Stephanie M. George1, Diego R. Martin2, Don P. Giddens1
1Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, United States; 2Department of Radiology, Emory University School of Medicine, Atlanta, GA, United States
With the incidence of chronic liver disease (CLD) increasing the need for improved diagnostic measurements has increased. Magnetic resonance imaging (MRI) and phase-contrast MR offer noninvasive techniques which provide both high quality anatomical and hemodynamic data. The use of these data coupled with computational fluid dynamics (CFD) to provide detailed flow field information is a novel approach. This study examines a small number of normal subjects and patients comparing PC-MR measured portal venous hemodynamic parameters including velocity and flow rate and computational results. This work demonstrates the feasibility of coupling MRI and CFD to investigate the altered hemodynamics in CLD.
Jumpei Suyama1, Shouei Sai1, Masaaki Kawahara1, Yoshimitsu Ohgiya1, Noritaka Seino1, Masanori Hirose1, Takehiko Gokan1
1Department of Radiology, Showa University School of medicine, TOKYO, Japan
The purpose of this study is to evaluate relationship between Tc-99m-GSA scintigraphy and 3T-MRI using Gd-EOB-DTPA for quantitative liver function. Nineteen patients with liver tumor were included in this study. There was significant correlation between LHL15 and the increased ratio of signal intensity at 4min (r=0.80, p<0.00005), and the increased ratio at 20 min were also well correlated (r=0.67, p<0.0005). It could be possible to use Gd-EOB-MRI for quantitative liver function as well as Tc-99m-GSA scintigraphy.
Riikka J. Immonen1, Smaragda Lamprianou2, Laurent Lecomte1, Laurent Vinet2, Paolo Meda2, Rolf Gruetter1,3
1Laboratory for functional and metabolic imaging, Ecole Polytechnique Fédérale de Lausanne, Lausanne, CH-1015, Switzerland; 2Department of Cell Physiology and Metabolism, University of Geneva, Geneva, CH-1210, Switzerland; 3Department of Radiology, University of Geneva and Lausanne, Geneva/Lausanne, CH-1210/CH-1015, Switzerland
In vivo imaging of pancreas with high resolution is challenging. In diabetes pancreatic βcell mass and function are gradually lost. MRI methodology to monitor this in vivo is needed. We utilized 14.1T and manganese enhanced MRI to image the mouse gland in vivo, and to examine the changes in manganese signal during βcell stimulation by glucose. In multi-slice images with 50*50*300μm resolution, acquired <20min, we were able to distinguish pancreatic main vessels and exocrine ducts, and Mn highlighted spots, possibly pancreatic islets. We also demonstrated with T1-wt inversion recovery, lower resolution technique, the manganese enhancement before and after glucose stimulus.
April M. Chow1,2, Kannie W.Y. Chan1,2, Shu Juan Fan1,2, Jerry S. Cheung1,2, Ed X. Wu1,2
1Laboratory of Biomedical Imaging and Signal Processing, The University of Hong Kong, Pokfulam, Hong Kong SAR, China; 2Department of Electrical and Electronic Engineering, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
Hepatic ischemia/reperfusion injury (IRI) occurs during liver transplantation, tumor resection, hemorrhagic shock and veno-occlusive disease. Biochemical changes caused by hepatic IRI lead to hepatocellular remodeling, including cellular regeneration or irreversible programmed cell death. In this study, we demonstrated that the alteration in the metabolism of choline-containing compounds (CCC) accompanied with hepatic IRI could be monitored using 1H MRS. The CCC peak may be useful in evaluating the regeneration of hepatocytes upon hepatic IRI. 1H MRS has shown to be a potential tool for identify and quantify metabolic changes in liver in vivo noninvasively.
Natasha Wehrli1, Hersh Chandarana1, Ely Felker1, Bachir Taouli, 1,2
1NYU Medical Center, New York, NY, United States; 2Mount Sinai School of Medicine, New York, NY, United States
Gd-EOB-DTPA is a recently FDA approved liver-specific contrast agent which combines a dynamic and a delayed phase of enhancement, approved to be used at a lower dose compared to extracellular agents (0.025 vs. 0.1 mmol/kg). In this study, we compared hepatic vascular conspicuity obtained with single and double dose Gd-EOB vs. Gd-DTPA at the dynamic phase, and found significantly better liver-to-vessel contrast ratio with Gd-DTPA compared to single dose Gd-EOB-DTPA. The liver-to-vessel contrast ratio improved when using a double dose Gd-EOB-DTPA.
Steven Sourbron1, Wieland Sommer, Christoph Zech, Maximilian Reiser, Karin Herrmann
1Ludwig-Maximilian-University Munich, Munich, Bavaria, Germany
A dual-inlet one-compartment uptake model is developed for DCE-MRI with Gd-EOB-DTPA in the liver. The model generalizes the one-compartment model for the liver, providing one new parameter: the intracellular uptake rate (KI). Data in normal appearing liver tissue of 25 patients shows that the uptake model fitted all ROI curves accurately, and provided values in the expected range for all known parameters. The average value for KI was 1.7/100/min, with a relatively narrow range of normality. The method may present a new and practical paradigm in functional liver MRI, producing quantitative measures of both perfusion and hepatobiliary function.
Anja C.S. Brau1, Yuji Iwadate2, Moritz Kircher3, Shreyas Vasanawala3, Robert Herfkens3
1Applied Science Lab, GE Healthcare, Menlo Park, CA, United States; 2Applied Science Lab, GE Healthcare, Hino, Japan; 3Radiology, Stanford University, Palo Alto, CA, United States
Dynamic contrast-enhanced (DCE) 3D T1w MRI is routinely used in abdominal imaging for characterization of liver lesions. Each contrast-enhanced phase is typically acquired within a breath-hold; however, this multi-breath-hold requirement faces several drawbacks. In this work, navigator gating is combined with adaptive navigator correction (slab following) to prospectively adjust slab location based on measured motion, with the goal of improving the image quality and acquisition efficiency of navigated 3D DCE liver imaging. Initial contrast-enhanced clinical results with this method are presented.
Stella K. Kang1, Emma Robinson1, Ramya Srinivasan1, Bachir Taouli1,2, Hersh Chandarana1
1Radiology, NYU Langone Medical Center, New York, NY, United States; 2Radiology, Mount Sinai Medical Center, New York, NY, United States
In patients undergoing orthotopic liver transplantation, preoperative MR imaging characteristics in hepatocellular carcinoma were examined, including T1 and T2 signal intensity, diffusion weighted imaging, and dynamic contrast enhanced kinetics and their relationship with histopathologic grade was assessed. DynaCAD, commercially available software, was utilized to examine enhancement kinetics of each tumor. Poorly differentiated HCCs had lower time to peak and higher rate of enhancement. T1 hypointensity also showed correlation with poorly differentiated tumors. No other qualitative or quantitative feature including DWI was useful in predicting HCC differentiation.
Tsutomu Tamada1, Atsushi Higaki1, Akihiko Kanki1, Tomohiro Sato1, Kazuya Yasokawa1, Katsuyoshi Ito1
1Dept. of Radiology, Kawasaski Medical School, Kurashiki-city, Okayama, Japan
We assessed differences in enhancement effects of liver parenchyma and activity of biliary and renal excretion between normal and cirrhotic livers on Gd-EOB-DTPA-enhanced MR imaging. It will be important to know that hepatic enhancement effects in the HP are decreased in patients with severe cirrhosis, probably due to impaired uptake of Gd-EOB-DTPA by hepatocytes, and biliary excretion is impaired in cirrhotic livers in comparison with normal livers while renal excretion of Gd-EOB-DPTA can be increased, probably due to the compensatory mechanism.
Russell Norman Low1,2, Matthew J. Austin3, Lloyd Estkowski4, Richard Ehman5
1Sharp and Children's MRI Center, San Diego, CA, United States; 2San Diego Imaging, San Diego, CA, United States; 3Radiology, Universit y of California at San Diego, San Diego, CA, United States; 4General Electric Healthcare; 5Mayo Clinic
We present our intial clinical experience using MR elastography in oncology patients to depict peritoneal tumor. Peritoneal tumors in the upper abdomen demonstrated increased mean shear stiffness compared to the liver as was depicted on color encoded spatial maps. On a per patient basis MRE demonstrated a .87 sensitivity, .78 specifity, and .82 accurcy. In the quantitative anlysis the mean shear stiffness of peritoneal tumor was 4.43 kPA and the mean shear stiffness of the adjancent liver was 2.36 kPa.
Andrew B. Rosenkrantz1, Lorenzo Mannelli1, David Mossa1, James Babb1
1Radiology, NYU Langone Medical Center, New York, NY, United States
T2WI of the liver was performed in 28 patients at 3T using standard rectilinear and BLADE k-space trajectories. Compared with standard T2WI, BLADE demonstrated significant improvements in in-plane motion, other ghosting artifact, liver edge sharpness, vessel sharpness, and flow suppression, a trend toward improved B1-inhomogeneity artifact, and no difference in through-plane motion. BLADE demonstrated a significant improvement in specificity for liver lesion detection but no difference in sensitivity. ROI analysis showed significantly improved relative contrast between the liver and focal lesions with BLADE. We conclude that BLADE achieved significant improvements in artifacts, image quality, and specificity for liver lesion detection.
Peter Beddy1, Richard Black1, Lorenzo Mannelli2, Ilsa Joubert1, Andrew Priest1, David J. Lomas1
1Radiology, University of Cambridge and Addenbrookes Hospital, Cambridge, Cambridgeshire, United Kingdom; 2Radiology, University of Cambridge and Addenbrookes Hospital, Cambridge, Cambridgeshire, United Kingdom
BOLD MRI is a potential non-invasive method for assessing tissue oxygenation in a wide range of tissues. This work develops a method for oxygen challenge based BOLD imaging of the liver at 3T in a group of volunteers and demonstrates that acceptable results and low variability can be achieved using both breath-hold and respiratory triggered multi-echo gradient echo acquisitions.
Tedros Bezabeh1, Omkar B. Ijare1, Nils Albiin2, Annika Bergquist3, Urban Arnelo4, Matthias Löhr3, Johannes R. Hov5, Ian CP Smith1
1National Research Council Institute for Biodiagnostics, Winnipeg, Manitoba, Canada; 2Radiology, Karolinska Institutet, Stockholm, Sweden; 3Gastroenterology and Hepatology, Karolinska Institutet, Stockholm, Sweden; 4Surgery, Karolinska Institutet, Stockholm, Sweden; 5Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway
Conjugation of bile acids with amino acids glycine and taurine is an important phenomenon in bile formation. In healthy humans, the ratio of glycine- to taurine-conjugated bile acids is generally 3:1, and this ratio is altered in cholestatic conditions. We analyzed bile samples from patients with various cholestatic diseases and found that the median of the above ratio was 2.23:1. This alteration could be attributed to the elevation in the levels of taurine-conjugates or reduction in the levels of glycine-conjugates. Such alterations can be easily detected by 1H MRS and the technique could be valuable in the diagnosis of diseases related to bile acid synthetic defects.
Mi-Suk Park1, Myeong-Jin Kim2, Ki Whang Kim1
1Department of Diagnostic Radiology, Yonsei University Health System Severance Hospital, Seoul, Korea, Republic of; 2Severance hospital
In this abstract, we compared dynamic first-pass enhancement properties of gadoxetic acid with that of gadopentetate dimeglumine in the patients with HCC. Gadoxetic acid-enhanced MRI showed more rapid wash-out of HCC, stronger enhancement of hepatic parenchyma, and weaker enhancement of vessels than the standard Gd-chelate enhanced MRI.
Jeong-Sik Yu1, Jae-Joon Chung, Joo Hee Kim, Ki Whang Kim
1Radiology, Gangnam Severance Hospital, Seoul, Korea, Republic of
For the hepatocellular carcinomas, the presence of small satellite lesions is an important determinant of a patient¡¯s prognosis and therapeutic planning. Through the results of our study DWI is superior to dynamic MRI in the detection and characterization of subcentimeter lesions and can be added to strengthen the accuracy in the MRI assessment of intrahepatic metastases of HCCs. DWI could overcome the inherent drawbacks of dynamic MRI for the hypervascular pseudolesions or obscured tumoral vascularities by the perfusional changes in the background parenchyma serve as a complementary tool for patients examined by dynamic MRI.
Jesse L. Wei1,2, Kimiknu Mentore1, Martin P. Smith1,2, Neil M. Rofsky1,2
1Radiology, Beth Israel Deaconess Medical Center, Boston, MA, United States; 2Harvard Medical School, Boston, MA, United States
Administration of Gd-EOB-DTPA using the recommended dose for hepatobiliary imaging results in an unfamiliar "washed out" appearance of the liver on dynamic contrast enhanced (DCE) imaging. This likely results from increased background hepatic enhancement due to early hepatobiliary uptake. Injection of a combination of Gd-EOB-DTPA in conjunction with an extracellular contrast agent provides the 20-minute delayed hepatobiliary phase, while preserving the familiar vascular contrast and lesion conspicuity compared to background liver on DCE images.
Akiyoshi Yamamoto1, Riichiro Nagashima1, Kentaro Haraoka1, Katsumi Nakamura1, Mitsue Miyazaki2
1Radiology, Tobata Kyoritsu Hospital, Kitakyushu, Fukuoka, Japan; 2Toshiba Medical Research Institute, USA, Vernon Hills, IL, United States
Flow vector analysis using optical flow can provide the useful information to assess portal venous hemodynamics enhancement using Time-SLIP.
Sanaz Mohajeri1,2, Tedros Bezabeh1, Scott B. King1, Omkar B. Ijare1, Gerald Y. Minuk3, Jeremy Lipschitz4, Ian C.P. Smith1
1National Research Council Institute for Biodiagnostics, Winnipeg, Manitoba, Canada; 2Human Anatomy and Cell Science, University of Manitoba, Winnipeg, Manitoba, Canada; 3Hepatology, University of Manitoba, Winnipeg, Manitoba, Canada; 4Surgery, University of Manitoba, Winnipeg, Manitoba, Canada
Considering the key role of liver in body metabolism, the study of bile composition is of great importance. In vitro 1H MRS of bile samples have shown diagnostic value in detecting various hepatopancreatobiliary disorders. Given the invasive nature of this procedure, we considered the possibility of gathering in vivo data. We present here our initial efforts to obtain bile spectra from pigs using a 3T clinical scanner comparing the use of a Siemens body array coil with an optimized home-built receive array coil.
Lena M. Hallberg1, Annika Bergquist2, Nils Albiin1
1Radiology, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden; 2Gastroenterology and Hepatology, Karolinska University Hospital, Karolinska Insitutet, Stockholm, Sweden
Cholangiocarcinoma is a well known threat to patients with primary sclerosing cholangitis (PSC). Although, early diagnosis is crucial for curative surgical treatment, it is difficult to differentiate malignant strictures from benign. We wanted to see if excretion hepatobiliary contrast was inhibited in affected segments, as a sign of malignancy. Therefore, six patients with PSC and a histopathologically confirmed cholangiocarcinoma , were examined in a 1.5 T MRI and Gd-BOPTA i.v. administered. In five of these patients there was no sign of excretion in affected segments. Thus, inhibited hepatobiliary excretion is a sign of cholangiocarcinoma in patients with primary sclerosing cholangitis.
Tsutomu Tamada1, Atsushi Higaki1, Akihiko Kanki1, Satoko Okamoto1, Katsiyoshi Ito1
1Dept. of Radiology, Kawasaski Medical School, Kurashiki-city, Okayama, Japan
We assessed quantitatively and qualitatively the enhancement effects and the enhancement patterns of hepatic hemangioma and normal liver tissue on Gd-EOB-DTPA-enhanced MR imaging. It will be important to know that the dynamic enhancement pattern of hepatic hemangioma is similar to that of hepatocellular carcinoma, probably due to the washout of Gd-EOB-DTPA in the early stage after contrast media administration compared with extracellular Gd chelates.
F. William Hersman1,2, Jeff Ketel2, Iulian Constantin Ruset, 1,2, Stephen Ketel2, Isabel Dregely1, Walter Porter2, David W. Watt2, John P. Mugler, III3, Talissa A. Altes3, Kai Ruppert3, Jaime F. Mata3, Samuel Patz4, Hiroto Hatabu4, Mirko Hrovat5, Iga Muradian4, Mikayel Dabaghyan4, G. Wilson Miller3, Chengbo Wang3, James P. Butler6, Jan H. Distelbrink2
1University of New Hampshire, Durham, NH, United States; 2Xemed LLC, Durham, NH, United States; 3University of Virginia, Charlottesville, VA, United States; 4Brigham and Women's Hospital, Boston, MA, United States; 5Mirtech, Inc, Brockton, MA, United States; 6Harvard School of Public Health, Boston, MA, United States
Hyperpolarized xenon-129 is potentially the most viable contrast agent to be used for characterizing pulmonary function by MRI. Further improvements in polarizing technology yield production rates of up to 15 liters/hour with 50% polarization. This high production prototype polarizer was relocated to two clinical sites and demonstrated in pilot clinical studies. First fully engineered systems based on this design, XeBox-E10, will be available in 2010 for collaborative research.
Arnaud Comment1,2, Sami Jannin3, Jean-Noël Hyacinthe4, Pascal Miéville3, Riddhiman Sarkar3, Puneet Ahuja3, Paul Romeo Vasos3, Xavier Montet4, François Lazeyras4, Jean-Paul Vallée4, Joseph A. Konter5, Patrick Hautle5, Ben van den Brandt5, Jean-Philippe Ansermet2, Rolf Gruetter1,6, Geoffrey Bodenhausen3,7
1Laboratory for Functional and Metabolic Imaging, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland; 2Institute of Condensed Matter Physics, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland; 3Laboratory of Biomolecular Magnetic Resonance, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland; 4Department of Radiology, Université de Genève, Genève, Switzerland; 5Paul Scherrer Institute, Villigen, Switzerland; 6Departments of Radiology, Universités de Lausanne et Genève, Lausanne and Genève, Switzerland; 7Department of Chemistry, Ecole Normale Supérieure, Paris, France
A method to produce hyperpolarized gases by dynamic nuclear polarization and subsequent sublimation was designed. The method was illustrated by applications to 129Xe in xenon gas, leading to the enhancement of the nuclear magnetic resonance signal-to-noise by four orders of magnitude. The main advantage of this new hyperpolarization method lies in its ability to produce highly polarized gases with large throughputs, on the order of tens of several liters per hour.
Armin Purea1, Kevin Teh2, Michael Barlow2, Dominik Berthel1, Alexander Weisser1, Ian Hall3, Peter Morris2
1Rapid Biomedical GmbH, Rimpar, Germany; 2Sir Peter Mansfield Magnetic Resonance Centre, University of Nottingham, Nottingham, United Kingdom; 3IPSET, University of Nottingham, Nottingham, United Kingdom
Presented are preliminary results from a novel coil configuration for 129Xe lung imaging. A non-circular birdcage was used as a transmit coil and a 8 channel receive coil were proposed. The coils were designed to utilise the bore space as much as possible to enhance patient comfort whilst not compromising the image quality. Initial images obtained using a SPGR sequence shows great promise. Scan time for lung patients will potentially decrease with the use of parallel receivers which were designed for optimum signal as much as flexibility.
Jian-Xiong Wang1, Alexei V. Ouriadov2, Jeffrey A. Stainsby3, Grace E. Parraga2, Giles Santyr2,4
1Applied Science Laboratory, GE HEALTHCARE, London, ON, Canada; 2Robarts Research Institute, The University of Western Ontario, London, ON, Canada; 3Applied Science Laboratory, GE HEALTHCARE, Toronto, ON, Canada; 4Dept. of Medical Biophysics, The University of Western Ontario, London, ON, Canada
A true 3D isotropic spatial resolution imaging method for Hyperpolarized He-3 human lung imaging using 3D-cones sequence is presented. The isotropic voxel size improves accuracy for co-registration, lung volume measurement and analysis for abnormalities in the lung.
Yulin Chang1, Jaime F. Mata1, Talissa Altes1, John P. Mugler III1, Kai Ruppert1
1Radiology, University of Virginia, Charlottesville, VA, United States
Hyperpolarized xenon-129 dissolves into lung tissue and binds hemoglobin and the dissolved-phase (DP) xenon molecules exchange with the gas-phase molecules via diffusion. Therefore the initial rate of the signal replenishment of the DP xenon following a saturation is proportional to both square root of time and lung surface area. In this work we demonstrate the possibility of measuring lung surface-to-volume ratio using DP xenon signals at short delays after a complete saturation in a rabbit model.
Ignacio Rodriguez1,2, Laura Carrero-Gonzalez, 1,3, Thomas Kaulisch3, Detlef Stiller3, Jose Manuel Perez-Sanchez4, Jesus Ruiz-Cabello1,2
1Instituto de Estudios Biofuncionales, Universidad Complutense, Madrid, Spain; 2CIBER de Enfermedades Respiratorias, Madrid, Spain; 3Boehringer Ingelheim Pharma, Biberach an der Riss, Germany; 4Univ. Paris-Sud, CNRS, Orsay, France
Using long-range diffusion MRI, ADC of rats with induced emphysema in one lobe has been performed. The results show a statistically significant increase of ADC in the emphysematous lobe at breath-hold, whereas no significant difference is seen at end expiration. Collateral ventilation could play a role in these results. The increase seen at breath-hold agrees with the results found by other workers.
Hirohiko Imai1,2, Atsuomi Kimura2, Takuya Kitao2, Emi Okubo2, Yuki Hori2, Satoshi Iguchi2, Hideaki Fujiwara2
1Center for Advanced Research and Education in Drug Discovery and Development, Graduate School of Pharmaceutical Sciences, Osaka University, Suita, Osaka, Japan; 2Department of Medical Physics and Engineering, Division of Health Sciences, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
Several techniques in hyperpolarized 129Xe MRI and MRS were applied to spontaneously breathing mice for comprehensively evaluating pulmonary structures and functions in emphysematous mice. The abnormalities of pulmonary structure, perfusion and ventilation were successfully detected in emphysematous mice, while significant difference was not shown in gas exchange. Although further improvement was needed for evaluating gas exchange in spontaneous breathing condition, it was shown that the method described here could become useful for drug research and development using small rodents since this protocol was able to detect several important pathological changes non-invasively.
Ahmed F. Halaweish1, Daniel R. Thedens1, Jered P. Sieren1, Eric A. Hoffman1, Edwin J.R. vanBeek1
1University of Iowa, Iowa City, IA, United States
Hyperpolarized 3Helium MRI Apparent Diffusion Coefficient (ADC) measurements enable probing of the lung microstructure and evaluation of pathological processes that affect airspace size. We successfully evaluated ADC measurements as a function of lung volume in 12 never-smoker subjects across three different lung volumes (20%, 60% & 100%VC). Significant differences between each lung volume were observed, along with significant ventral-dorsal gradients at the 20%VC volume and a more homogenous left-right distribution at 100%VC only. Results suggest that patterns of ADC throughout the lungs in the never-smoker subjects follow proper distribution and ventilation patterns and emphasize the importance of controlled lung inflation.
13:30 4606. Dynamic O2-Enhanced MRI Vs. Quantitative Thin-Section MDCT: Capability for COPD Assessment in Smokers - not available
Yoshiharu Ohno1,2, Hisanobu Koyama1, Keiko Matsumoto1,3, Yumiko Onishi1, Daisuke Takenaka1, Munebu Nogami1, Nobukazu Aoyama2, Hideaki Kawamitsu2, Makoto Obara4, Marc van Cauteren4, Kazuro Sugimura1
1Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan; 2Radiology, Kobe University Hospital, Kobe, Hyogo, Japan; 3Radiology, Yamanashi University, Shimokatou, Yamanashi, Japan; 4Philips Healthcare, Tokyo, Japan
Direct assessment of signal intensity - time course curve on dynamic O2-enhanced MRI have suggested as having potential for airway abnormality and oxygen transfer assessments. However, the literature shows no publications dealing with direct comparison of the capability of quantitatively assessed thin-section MDCT and of dynamic O2-enhanced MRI for COPD assessment in smokers. We hypothesized that dynamic O2-enhanced MRI may have potential for COPD assessment, and be considered at least as valuable as MDCT in smokers. The purpose of this study was to compare the capability for COPD assessment in smokers between dynamic O2-enhanced MRI and quantitatively assessed thin-section MDCT.
Daniel Maxien1, Olaf Dietrich2, Sven Thieme2, Maximilian Reiser2, Konstantin Nikolaou2
1Department of Clinical Radiology, Ludwig Maximilian University, Munich, Germany; 2Department of Clinical Radiology, Ludwig Maximilian University Munich, Germany
Oxygen-enhanced MRI of the lung has proved its feasibility in studies with healthy volunteers, but till now there is only limited experience in circumscribed patient cohorts. We wanted to determine the value and feasibility of oxygen-enhanced MRI in patients with pulmonary arterial hypertension. Therefore we evaluated the sensitivity and specificity of oxygen-enhanced MRI versus ventilation and perfusion scintigraphy. Furthermore, we made a quantitative comparison of the relative signal enhancement in defect areas with the relative signal enhancement in the whole lung to determine which signal difference is needed for a reliable visual detection of diseased lung areas.
Francesco Molinari1,2, Grzegorz Bauman3, Monika Eichinger2, Bernhard Geiger4, Lorenzo Bonomo1, Hans-Ulrich Kauczor5, Michael Puderbach2
1Department of Bioimaging and Radiological Sciences, Catholic University of Rome, Rome, Italy; 2Department of Radiology, German Cancer Research Center, Heidelberg, Germany; 3Department of Medical Physics in Radiology, German Cancer Research Center, Heidelberg, Germany; 4Siemens Corporate Research, Princeton, United States; 5Department of Radiology, University of Heidelberg, Heidelberg, Germany
In oxygen-enhanced MRI, lung signal is measured repeatedly during different breathing cycles. Inconsistencies of respiratory phase may hamper the quality of the parametric O2-maps. In this study, fully automatic non-rigid registration was assessed as a postprocessing method to improve the quality of O2-MRI of the lung. This post-processing technique reduced spatial misalignment among images and signal variability within the lung. O2-induced signal enhancement was not influenced by image registration. Spatial heterogeneity of parametric O2-maps decreased significantly. As such, fully automatic non-rigid registration appears suitable for improving the quality of multislice O2-MRI of the lung.
Masaya Takahashi1, Osamu Togao1, Riki Tsuji1, Ivan Dimitrov1
1Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, United States
The utility of ultra-short TE (UTE) imaging in conjunction with projection acquisition of the free induction decay helps to acquire the MR signal from the lung parenchyma. We applied an UTE sequence for imaging of the murine lung at different positive end-expiratory pressures (PEEP) in a 3 T clinical MRI system. The signal intensity and T2* of the lung parenchyma measured with a UTE sequence reduced as the PEEP became higher where the lung volume increased. We found that both are highly correlated with the lung volume.
Piotr Alfred Wielopolski1, Pierluigi Ciet2, Gabriel Paul Krestin1, Martin H. Lequin1, Harm Tiddens3, Rashindra Manniesing4
1Radiology, Erasmus Medical Center, Rotterdam, Zuid-Holland, Netherlands; 2Department of Medical-Diagnostic Sciences and Therapies, Policlinico Universitario di Padova, Padova, Italy; 3Department of Pulmonology, Erasmus Medical Center, Rotterdam, Zuid-Holland, Netherlands; 4Department of Informatics and Radiology, Erasmus Medical Center, Rotterdam, Zuid-Holland, Netherlands
The purpose of this work was to provide: first, a suitable acquisition scenario including static and dynamic 3D MRI sequences with sufficient temporal and spatial resolution to provide good morphological information and visualization of dynamic events in the central airways and, secondly, to provide the means for an automatic analysis program suitable to segment the airway lumen and a dynamic evaluation of cross-sectional areas of the central airways down to the 2nd generation branching.
14:00 4611. MRI Assessment of Dynamic Lung Volume Changes in Subjects Using a Nasal Expiratory Positive Airway Pressure (NEPAP) Device - not available
Ding Xia1, Elan J. Grossman1, D M. Rapoport2, I Ayappa2, A V. Patel2, L Daugherty3, Jian Xu1, Kelly Anne Mcgorty1, Qun Chen1
1Center for Biomedical Imaging, Department of Radiology, NYU School of Medicine, New York, United States; 2Division of Pulmonary and Critical Care Medicine, NYU School of Medicine, New York, United States; 3Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States
The purpose of the current study is to use a real-time MRI technique for measuring lung volume changes caused by using a nasal expiratory positive airway pressure (nEPAP) device, a new treatment for obstructive sleep apnea (OSA). This may help us better understand the mechanism by which it treats OSA. Our results show there is an increase in functional reserve capacity (FRC) while using the nEPAP device. Since end-expiratory hyperinflation is likely to produce increased traction in the trachea, this suggests the main action of the nasal expiratory device may be to stiffen the upper airway through increased longitudinal traction.
Ding Xia1, Elan J. Grossman1, Ke Zhang1, Abram Voorhees2, K I. Berger3, R M. Goldring3, B W. Oppenheimer3, J Reibman3, W N. Rom3, L Rogers3, A Helwig3, L Daugherty4, Jian Xu1, Kelly A. Mcgorty1, Qun Chen1
1Center for Biomedical Imaging, Department of Radiology, NYU School of Medicine, New York, United States; 2Siemens Medical Solutions, Malvern, PA, United States; 3Department of Medicine, NYU School of Medicine, New York, United States; 4Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States
Clinical-pathologic correlation between patient illness and pulmonary disease is difficult to determine when airway abnormalities are localized only to distal airways of the lungs. The purpose of this study is to establish quantitative regional measurements of heterogeneity for distal airway dysfunction based on a tissue tracking MRI technique and apply them to early diagnosis of obstructive airway disease. Results show that in subjects with suspected distal airway disease MRI indicators of mean regional airflow are reduced despite presentation of normal spirometry. Thus, assessment of regional lung function by MRI may be a useful tool for early detection of airway disease.
Roberta Santarelli1, Xavier Maître1, Ralph Sinkus2, Luc Darrasse1
1Imagerie par Résonance Magnétique et MultiModalités (UMR8081), Univ Paris-Sud, CNRS, Orsay, France; 2Institut Langevin (UMR 7587), ESPCI, Univ Denis Diderot, CNRS, Paris, France
Viscoelastic properties of lungs participate in the organ basic function. Their exploration in vivo is not attainable. Hyperpolarised helium-3 MR-elastography on lungs has been demonstrated in vivo. This new technique ex vivo quantitatively evaluated the comparison between helium-3 and hydrogen MRE: the fluid/structure coupling was found to be strong, validating helium-3 lung MRE as a consistent tool for lung exploration. This work focuses on viscoelastic properties behaviour of hydrogen MRE, applied on the preserved pig lung inflated at different volumes: performance of wavelength, elasticity, and viscosity distribution is discernible throughout the inner area and the outer peripheries of the lungs
Min-Hui Cui1, Jong Hee Hwang1, Vlad Tomuta1, Daniel T. Stein1
1Albert Einstein College of Medicine, Bronx, NY, United States
Fifty-eight non-diabetic subjects with a wide range of BMI were studied to evaluate the regional differences of SAT and VAT distribution and the correlations of them with intrahepatic lipid, plasma triglyceride, glucose and FFA levels. Both lean and overweight/obese subjects have most SAT in lower abdomen. However, lean subjects have more VAT while overweight/obese subjects have less VAT in lower abdomen. The relationships between SAT and VAT from different abdominal regions in the lean and overweight/obese subjects with IHL, TG and glucose are also different. Thus conclusions based on one specific AT region should be interpreted with cautions.
E. Brian Welch1,2, Johan Berglund3, Heidi J. Silver4, Kevin D. Niswender5, Morten Bruvold6, Joel Kullberg3, Lars Johansson3, Malcolm J. Avison1
1Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, United States; 2MR Clinical Science, Philips Healthcare, Highland Heights, OH, United States; 3Department of Radiology, Uppsala University, Uppsala, Sweden; 4Vanderbilt Center for Human Nutrition, Vanderbilt University Medical Center, Nashville, TN, United States; 5Vanderbilt Diabetes Research and Training Center, Vanderbilt University Medical Center, Nashville, TN, United States; 6MR Clinical Science, Philips Healthcare, Best, Netherlands
The potential of whole body MRI for visualizing adipose tissue distribution has long been recognized. More recently, multi-gradient-echo MR acquisitions have been successfully used at 1.5 Tesla to quickly acquire whole-body data sets. Automated segmentation and quantification of such whole-body fat images into subcutaneous and visceral adipose tissue compartments shows great promise as a tool in studies of obesity and other metabolic syndrome diseases such as diabetes. Most whole-body fat-water imaging has been performed at 1.5 Tesla. However, the availability and prevalence of higher strength 3 Tesla scanners, especially in research settings, justifies the pursuit of robust multi-gradient-echo sequences designed to operate at 3 Tesla. Here we present initial results of a 3T multi-gradient echo whole-body fat-water sequence.
Peter Kellman1, Diego Hernando2, Saurabh Shah3, Z-P Liang2, David A. Bluemke1, Andrew E. Arai1
1National Institutes of Health, Bethesda, MD, United States; 2University of Illinois, Urbana, IL, United States; 3Siemens Medical Solutions, Chicago, IL, United States
A rapid multi-slice fat/water separated imaging protocol has been developed for mapping body fat with application to obesity studies. The method combines a 3-echo GRE acquisition and parallel imaging to scan the abdomen and chest in <30 sec. A recently developed joint estimation method for water/fat separation is able to perform robustly in the presence of large B0 field inhomogeneities.
Joel Kullberg1, Pär-Arne Svensson2, Ann-Katrine Karlsson3,4, Eira Stokland2, Jovanna Dahlgren3,4
1Department of Radiology, Uppsala University, Uppsala, N/A, Sweden; 2Department of Pediatric Radiology, The Sahlgrenska University Hospital, Göteborg, Sweden; 3Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden; 4The Queen Silvia Children's Hospital, Göteborg, Sweden
A method for assessment of adipose tissue distribution in children is presented. The method utilizes rapid water-fat imaging of 16 slices of the abdomen. A fully automated segmentation algorithm for assessment of visceral and subcutaneous adipose tissue volumes is described. The automatically measured results from 21 volunteer 5-year-olds are compared to those from semi-automated segmentation. Acceptable results were achieved despite the childrens young age and the relatively small adipose tissue volumes measured.
Ana Francisca Soares1,2, John Griffith Jones1, Francisco Veiga2, Rui Albuquerque Carvalho1
1Life Sciences, Faculty of Sciences and Technology and Center for Neurosciences and Cell Biology, University of Coimbra, Coimbra, Portugal; 2Pharmaceutical Technology, Faculty of Pharmacy, University of Coimbra, Coimbra, Portugal
The liver stores carbohydrate and lipid after a meal under insulin stimulation. Using deuterated water, we assessed hepatic glycogen synthesis and de novo lipogenesis in healthy and streptozotocin-induced diabetic rats feeding overnight. Hepatic glycogen and lipid content were analyzed by 2H-NMR. Healthy animals showed similar direct and indirect pathway contributions to glycogen. Following Diabetes induction we observed a progressive loss of direct pathway capacity compared to the indirect and also a reduction of de novo lipogenesis. These observations may serve as valuable markers for assessing alterations in hepatic glucose and lipid metabolism during the progress Diabetes.
14:00 4619. In Vivo Monitoring of Treatment Effect of Cryptotanshinone for Non-Alcoholic Fatty Liver Disease in Mice - not available
Hyeon Seung Lee1, Quan Yu Cai1, Ki Nam Min2, Jong Kook Park2, Tae Hwan Kwak2, Kyeong Hoon Jeong2, Kwan Soo Hong1
1MRI, Korea Basic Science Institute, Ochan-Eub, Chungcheonbuk-Do, Korea, Republic of; 2Advanced Biological Research, Mazence Inc, Suwon, Gyeonggi-Do, Korea, Republic of
Treatment of Non-Alcoholic Fatty Liver by Cryptotanshinone in Mouse Models for Hepatic Steatosis
14:30 4620. Functional Magnetic Resonance Imaging of Liver: Effect of Glucose - not available
muhammad E. Haque1, Ioannis Koktzoglou1, Wei Li1, Jo Ann Carbray1, Pottumarthi V. Prasad1
1Radiology, North Shore University Healthcare System, Evanston, IL, United States
One of the primary functions of insulin is disposal of glucose from the blood and inhibition of hepatic glucose production (HGP). Dysfunction of either of these processes can cause development of type II diabetes. Incomplete suppression of HGP is a strong indication of insulin resistance and may be an early marker for development of type II diabetes. Current methods to evaluate insulin resistance are complicated, invasive and hence not used in routine practice. Here we demonstrate feasibility of using BOLD MRI to monitor oxygenation changes in the liver following glucose which may be related to insulin sensitivity.
Patrick Antkowiak1, Moriel Vandsburger, Frederick Epstein
1University of Virginia, Charlottesville, VA, United States
The kinetics and mechanism of pancreatic β cell labeling with Mn2+ were investigated. Murine pancreatic T1 relaxation was measured in normals and after treatment with the Ca2+ channel blocker nifedipine. Two site water exchange analysis of pancreatic T1 relaxation provided the intracellular T1 and intracellular fraction, measures of β cell labeling. Increased intracellular T1 and lower intracellular fraction in nifedipine-treated mice confirmed Mn2+ enters β cells through Ca2+ channels. The timecourse of intracellular T1 and fraction in normal mice revealed 3 phases of Mn2+ kinetics: 1) labeling β cells, 2). washout from β cells, 3). nonspecific labeling of other cells.
Nathan S. Artz1, Rafael L. O'Halloran2, Mark Schiebler3, James H. Holmes4, Sean B. Fain1,3
1Medical Physics, University of Wisconsin-Madison, Madison, WI, United States; 2Radiology, Stanford University, Stanford, CA, United States; 3Radiology, University of Wisconsin-Madison, Madison, WI, United States; 4Applied Science Laboratory, GE Healthcare, Madison, WI, United States
Pulmonary perfusion was assessed in two healthy volunteers using a contrast-enhanced 3D stack-of-stars GRE sequence. Consecutive groups of 32 projection angles were reconstructed with IHYPR for a temporal resolution of ~1s. The signal vs. time curves demonstrate an expected trend with the pulmonary artery peaking first, followed next by the parenchyma and later the left atrium. Mean transit time, relative pulmonary blood volume and relative pulmonary blood flow maps demonstrate expected results with mean transit times from 3-5 s after the main pulmonary artery trunk and shorter MTTs in the posterior region due to gravity related effects.
Mona Salehi Ravesh1, Michael Puderbach2, Sebastian Ley3, Julia Ley-Zaporzhan3, Frank Risse1, Wilfried Schranz4, Wolfhard Semmler1, Frederik Bernd Laun1
1Department of Medical Physics in Radiology, German Cancer Research Center, Heidelberg, Germany; 2Department of Radiology, German Cancer Research Center, Heidelberg, Germany; 3Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany; 4Nonlinear Physics Group, Faculty of Physics, University of Vienna, Vienna, Austria
Lung perfusion is a crucial prerequisite for effective gas exchange. An accurate quantification of pulmonary perfusion is therefore important for diagnostic considerations and treatment planning in various diseases of the lungs.The assessment of pulmonary perfusion by Dynamic Contrast-Enhanced Magnetic Resonance Imaging requires deconvolution of the arterial input function. In the presence of noise this is an ill-posed problem which leads to strongly oscillating, unphysical solutions when it is solved without regularization. In this study a novel method to quantify the pulmonary perfusion is used and compared to the singular value decomposition and L-curve criterion based on simulated and patient data.
Nabil Saouti1, Anton Vonk Noordegraaf1, Michael Ingrisch2, J. Tim Marcus1
1VU University Medical Center, Amsterdam, Netherlands; 2Ludwig-Maximilian University, Munich, Germany
The aim is to visualise the perfusion of the lungs by the pulmonary and bronchial system separately, based on the fact that a contrast bolus injected intravenously will arrive later in the bronchial than in the pulmonary system. Included were 7 patients with whole left or right pulmonary artery atresia, and 6 chronic thromboembolic pulmonary hypertension patients. Using 3D dynamic contrast-enhanced MRI with 1 s temporal resolution, a 5 s signal-intensity onset delay was measured between open lung or lung region, and obstructed lung (region), providing evidence for bronchial arterial supply after a pulmonary artery obstruction.
Osamu Togao1, Marc van Cauteren2, Yoshiharu Ohno3, Ivan Dimitrov1,2, Masaya Takahashi1
1Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, United States; 2MR Clinical Science, Philips Healthcare, Best, Netherlands; 3Radiology, Kobe University Graduate School of Medicine, Kobe , Hyogo, Japan
We have demonstrated that an UTE sequence could bring inherent MR signal of the lung parenchyma that closely related to the parenchymal tissue anatomy. We hypothesize that the capability of the method to acquire inherent MR signal of the lung parenchyma should allow us to assess changes in SI due to inhalation of molecular oxygen or intravenous injection of gadolinium. In the present study, we tested the feasibility of a T1-weighted UTE sequence for assessment of regional pulmonary ventilation/perfusion which is essential for the evaluation of a variety of lung diseases in a 3T clinical MRI system.
Eric Frederick1,2, Mirko Hrovat3, Samuel Patz2
1Applied Physics, University of Massachusetts in Lowell, Lowell, MA, United States; 2Radiology, Brigham and Women's Hospital, Boston, MA, United States; 3Mirtech Inc, Brockton, MA, United States
Hyperpolarized noble gas imaging is a non-equilibrium imaging method where gas magnetization is depleted by RF excitations. Due to B_1 field inhomogeneities, this depolarization may not be uniform and therefore a B_1 flip angle map is required to correct the images. This process is typically performed by acquiring an additional set of images. We propose an alternative method where the flip angle map is obtained from one set of images. To do this, we break up a fully sampled image into two undersampled images that are then used for B_1 flip angle mapping. We demonstrate these methods with simulations.
Mohammadreza Heydarian1, Andrew Wheatley1, Grace Parraga1,2
1Robarts research Institute, London, Ontario, Canada; 2Medical Biophysics, University of Western Ontario, London, On, Canada
Hyperpolarized helium-3 MRI provides a way to visualize and quantify lung function based on segmentation of helium-3 ventilation images. Manual segmentation of 3He ventilation volumes is time consuming and prone to observer error. To address this limitation, we developed and applied a fully automated fuzzy c-mean (FCM) method for segmenting ventilated regions and observed significant associations between the automated and manual segmentation methods. FCM provides a fully automated, robust and efficient method for segmenting ventilated regions of hyperpolarized helium-3 images.
Lionel Martin1, Xavier Maître1, Mathieu Sarracanie1, Marlies Friese2, Ludovic de Rochefort1, Rose-Marie Dubuisson1, Emeline Boriasse1, Emmanuel Durand1
1Imagerie par Résonance Magnétique Médicale et MultiModalités (UMR8081), Univ Paris-Sud, CNRS, Orsay, France; 2Center for Magnetic Resonance, The University of Queensland, Brisbane, Queensland, Australia
MR flow measurement techniques have mostly been used in liquids. For coherent motion (flow), bipolar gradients induce a phase shift and a signal drop for incoherent motion (diffusion). This effect, negligible for liquids, cannot be neglected for gases. Competition between these two phenomena results in the existence of an optimal FOS that could be theoretically determined. 2D velocity maps of parabolic flows were acquired with different FOS and gases. Results show that velocity error is a function of the FOS and a different optimal FOS is reached for each gas. Thus, they validate our theoretical simulations.
Karl F. Stupic1, Nancy D. Elkins2, Galina E. Pavlovskaya3, John E. Repine2, Thomas Meersmann, 1,3
1Department of Chemistry, Colorado State University, Fort Collins, CO, United States; 2Health Science Center, Webb-Waring Institute, University of Colorado, Denver, CO, United States; 3School of Medicine, University of Nottingham, Nottingham, United Kingdom
Hyperpolarized (hp) 83Kr has been previously shown to provide T1 relaxation weighted MRI contrast that is highly sensitive to the surface chemistry in low surface-to-volume model surface systems In the present work 83Kr T1 relaxation in excised rat lungs is investigated as a function of lung inflation. Surprisingly, the relaxation in ex vivo lungs does not change with increased lung inflation (when the effects of airways are eliminated) despite the presumably changing surface to volume ratios in the alveoli. The measured relaxation times are long enough to permit future in vivo studies.
Geraldine Hye Won Kang1, Michael Schroeder1, Masoud Shiehmorteza1, Benjamin Johnson1, Tanya Wolfson1, Anthony Gamst1, Gavin Hamilton1, Mark Bydder1, Takeshi Yokoo1, Claude Sirlin1
1Radiology, University of California, San Diego, San Diego, CA, United States
As a result of the growing epidemic of obesity, fatty liver disease has become the most common liver condition in the United States. Thus, there is an increasing need for a noninvasive fat quantification technique. We have developed a T1-independent, T2*-corrected, spectral modeled chemical shift based fat quantification technique, which permits estimation of the proton density fat fraction (PDFF). Here we show that PDFF measured by this technique is reproducible across field strength and vendor and has high accurt5acy using spectroscopy as the reference.
Ely Felker1, Lorenzo Mannelli1, Emilio Vega1, Michael Bloom1, Hersh Chandarana1
1Radiology, NYU Langone Medical Center, New York, NY, United States
In addition to being associated with several metabolic disturbances, such as insulin resistance and diabetes mellitus, obesity causes fat infiltration of several organs, including the heart, liver, and skeletal muscle. The purpose of this study was to characterize the relationship between pancreatic fat infiltration and known markers of obesity. We showed that pancreatic fatty infiltration at MRI was significantly related to central fat volume, peripheral fat volume, and body mass index. Further study will enhance understanding of mechanisms that link obesity to its metabolic complications as well as, perhaps, provide an early marker for incipient insulin resistance and metabolic syndrome.
Khalil N. Salman1, Puneet Sharma2, Bobby Kalb1, Hiroumi Kitajima2, Christina Lurie1, Miriam Vos3, Diego R. Martin1
1Radiology, Emory University, Atlanta, GA, United States; 2Radiology, Emory Healthcare, Atlanta, GA, United States; 3Pediatrics, CHOA, Atlanta, GA, United States
Non Alcoholic Fatty Liver disease(NAFLD) has become a serious problem in the USA. biopsy procedures are invasive and pose a high risk of morbidity. MRS of the liver along with volumetric visceral and subcutaneous fat measurement have shown to be an independent measure of fatty liver. This study investigates the correlation between volumetric fat measurements and hepatic fat fraction using HISTO technique.
Jun Chen1, Deana Hoganson2, Meng Yin1, Kevin Glaser1, Jayant Talwalkar3, Eric Matteson2, Richard Ehman1
1Department of Radiology, Mayo Clinic, Rochester, MN, United States; 2Division of Rheumatology, Mayo Clinic, Rochester, MN, United States; 3Division of Gastroenterology, Mayo Clinic, Rochester, MN, United States
Methotrexate (MTX) has become the most frequently prescribed disease modifying antirheumatic agent (DMARD) for rheumatoid arthritis (RA), due to its efficacy, low cost and tolerability. An ongoing primary concern of MTX treatment is its potential hepatotoxicity. Guidelines published in 1994 by the American College of Rheumatology (ACR) suggest that serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), and albumin be monitored every 4-8 weeks for assessing hepatotoxicity in RA patients receiving MTX. If a patient develops 5 of 9 abnormal AST values within a 12 month time frame or if serum albumin decreases below the normal range, a liver biopsy is recommended. Because of the apparently low rate of clinically significance, MTX related hepatotoxicity, the usefulness and cost-effectiveness of such frequent monitoring, particularly in the absence of risk factors for liver disease have been brought into question. The unavailability of accurate non-invasive hepatic fibrosis detection methods other than biopsy has frustrated clinicians in addressing these important questions. Since its advent 15 years ago , Magnetic Resonance Elastography (MRE) has developed into a clinical useful diagnostic technology. This abstract reports interim results from a currently ongoing project using MRE to assess hepatic fibrosis in RA patients who are on MTX treatment seen at our institution.
James F. Glockner1, Christine U. Lee1, Richard L. Ehman1
1Radiology, Mayo Clinic, Rochester, MN, United States
Hepatic MR elastography and DWI with low and intermediate b-values were performed in 29 patients with suspected chronic liver disease. ADC measurements for both b-values demonstrated a negative correlation with hepatic stiffness as determined by MRE. The range of variation of in stiffness values is larger than that of ADC values, suggesting that MRE may be more sensitive to small variations in hepatic stiffness.
Wesley Calvin Chan1, Faisel Budhani1, Zahra Tejani1, Christine Massey2, Masoom A. Haider1
1Joint Department of Medical Imaging, University Health Network, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada; 2Dalla Lana School of Public Health, Princess Margaret Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
Monitoring hepatic iron concentration is an important clinical concern in thalassemia patients. The aim of this study is to demonstrate a correlation between R2* relaxation rate and liver iron concentration determined by the FDA approved Ferriscan® method. We found a very strong linear correlation between R2* values and Ferriscan® determined liver iron concentration with the Spearman correlation = 0.976 (95% CI: 0.963, 0.984). The prediction equation from regression analysis was ([Fe])=0.80(R2*)-44.1(r=0.968, r2 = 0.937, p < 0.0001). Determination of liver iron concentration by R2* methods may be helpful as a diagnostic surrogate for Ferriscan® iron measurements.
Yi Wang1, Frank H. Miller1, Robert McCarthy, Zongming E. Chen, Laura Sternick, Daniel Ganger, Richard Ehman2, Reed Omary1, Josh Levitsky, Bradley D. Bolster, Jr. 3, Saurabh Shah3, Sven Zuehlsdorff3, Paul Nikolaidis1, Vahid Yaghmai1
1Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States; 2Mayo Clinic; 3Siemens Healthcare
We proposed to evaluate the capability of MRE in detecting and distinguishing patients with inflammation and without fibrosis from patients without inflammation and fibrosis, and with various stages of fibrosis based on histopathologic analyses. Liver tissue with inflammation and without fibrosis can be seen with mildly elevated stiffness value on MRE, which was significantly higher than those that lack inflammation and fibrosis. Both mild hepatic fibrosis and inflammation was associated with mild elevation of stiffness, but a significant difference was not observed. Furthermore, tissue with moderate fibrosis and advanced fibrosis to cirrhosis showed significant increased stiffness values on MRE.
Jerry S. Cheung1,2, Shu Juan Fan1,2, Darwin Shan Gao1,2, Kwan Man3, Ed X. Wu1,2
1Laboratory of Biomedical Imaging and Signal Processing, The University of Hong Kong, Pokfulam, Hong Kong SAR, China; 2Department of Electrical and Electronic Engineering, The University of Hong Kong, Pokfulam, Hong Kong SAR, China; 3Department of Surgery, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
Early diagnosis of liver fibrosis could facilitate early interventions and thus alleviate its progression to cirrhosis and/or hepatocellular carcinoma. Several studies have shown that measurement of water diffusivity by diffusion-weighted imaging (DWI) was useful in the evaluation of liver fibrosis and cirrhosis. The aim of this study was to characterize longitudinal changes in diffusion properties of liver using diffusion tensor imaging (DTI) in an experimental model of liver fibrosis. The experimental results in this study demonstrated that DTI could detect longitudinal changes in diffusion properties of liver in an experimental model of liver fibrosis.
Andrew B. Rosenkrantz1, Pippa Storey1, Ben Niver1, Cristina Hajdu2, Vivian S. Lee1
1Radiology, NYU Langone Medical Center, New York, NY, United States; 2Pathology, NYU Langone Medical Center, New York, NY, United States
8 patients with liver cirrhosis and 8 volunteers underwent liver MRI at 1.5T that included repeated applications of an adjustable magnetization-transfer contrast (MTC) sequence, with the MT pre-pulse offset frequency varying from 1000Hz to 3000Hz and the MT pre-pulse flip angle varying from 100º to 900º. The magnetization transfer ratio measured over the right lobe showed substantial overlap between healthy and cirrhotic liver for all assessed MTC sequences, with none of the differences being significant (p-values from 0.092 to 0.819). Our data suggests that, unlike the results of previous studies, MTC imaging is unable to differentiate healthy and cirrhotic liver.
Russell Norman Low1,2, Huanzhou Yu3, Ann Shimakawa3, Lloyd Estkowski, Richard Ehman4
1Sharp and Children's MRI Center, San Diego, CA, United States; 2San Diego Imaging, San Diego, CA, United States; 3Applied Science Lab, General Electric Healthcare; 4Mayo Clinic
Quantification of diffuse liver disease adds a new dimension to hepatic MR imaging which can provide critical information for diagnosis and for monitoring response to therapy. We explore the implementation of a rapid breath-hold MR evaluation of liver fibrosis using MR Elastography combined with a new multiecho Dixon technique known as IDEAL Quant which quantifies liver iron assessed by R2* values and fat fraction. In five breath holds this exam assesses liver fibrosis, R2* correlated with iron content, and the percentage of fatty infiltration.
Yoon Ho Nam1, Hahnsung Kim1, Dong-Hyun Kim1,2
1Electrical & Electronic Engineering, Yonsei University, Seoul, Korea, Republic of; 2Radiology, Yonsei University College of Medicine, Seoul, Korea, Republic of
Accurate quantification of the liver fat content is an important factor in detecting hepatic diseases. A multi-echo approach can be used effectively for liver fat quantification. However, the presence of macroscopic field inhomogeneities shortens T2* values and can lead to underestimated T2* values of fat content in liver. This study propose correcting method for these macroscopic inhomogeneities to accurately quantify T2* values and fat, water content using multi-echo 2D liver imaging.
Tatsuyuki Tonan1, Kiminori Fujimoto1, Aliya Qayyum2, Takumi Kawaguchi3, Atsushi Kawaguchi4, Koji Okuda5, Shuji Nagata1, Michio Sata3, Naofumi Hayabuchi1
1Radiology, Kurume University School of Medicine, Kurume, Fukuoka, Japan; 2Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, United States; 3Internal Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan; 4Biostatistics Center, Kurume University School of Medicine, Kurume, Fukuoka, Japan; 5Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
MRI is sensitive to tissue iron overload because iron leads to a decline of magnetic resonance signal due to T2-shortening effect related to the paramagnetic properties, and recently has become suitable technique for quantifying hepatic iron overload noninvasively. The aim of this study is to assess the usefulness of echo-planar image based diffusion- weighted image (EPI-DWI) for quantifying subtle hepatic iron stores. We found a good correlation between EPI-DWI and hepatic iron concentration in patients with viral hepatitis, and demonstrated that EPI-DWI was more sensitive sequence for quantifying hepatic iron overload than gradient-recalled echo sequence.
Antonella Meloni1, Antongiulio Luciani2, Alessia Pepe1, Vincenzo Positano1, Gennaro Restaino3, Maria Chiara Dell'Amico1, Brunella Favilli1, Gianna Alberini1, Giovanni Palazzi4, Massimo Lombardi1
1MRI Lab, G. Monasterio Foundation and Institute of Clinical Physiology, CNR, Pisa, Italy; 2Istituto di Radiologia Az. Osp. "Garibaldi", Catania, Italy; 3Catholic University, Campobasso, Italy; 4Policlinico di Modena, Modena, Italy
The goals of our study were to set up a MRI acquisition technique for the detection of the iron burden in the whole liver of thalassemia major patients. Significant differences in the segmental T2* values were found. Specifically, the mean T2* values over the segments VI and VIII were significantly lower than the mean T2* values over the other segments. However, T2* variations in liver are low and likely due to the artefacts effects and measurement variability.
Robert D. O'Connor1, Gary Skolnick2, Nicole Nejedly2, Adil Bashir1, Samuel Klein2
1Radiology, Washington University, St. Louis, MO, United States; 2Geriatrics and Nutritional Science, Washington University School of Medicine, St. Louis, MO, United States
MRS protocols for hepatic lipid quantification are examined. It is concluded that an optimal protocol can achieve a CV of at least 5%.
Agus Priatna1, Vamsi Narra2
1MR R&D Collaborations, Siemens Healthcare, St Louis, MO, United States; 2Mallinckrodt Institute of Radiology, Washington University, St Louis, MO, United States
Three-dimensional two-point Dixon technique has been routinely used for liver imaging to provide opposed and inphase images, as well as fat only and water only images. Phase partial Fourier and strong echo asymmetry are often employed to reduce the scan time. However, echo asymmetry and phase partial Fourier with zero filling result in blurring artifacts in the in-plane view. This abstract describes the use of phase correction with projection onto convex sets (POCS) to the three dimensional two-point Dixon sequence in order to reduce blurring artifact and improve image quality at short scan times
Thierry Yzet1, Roger Bouzerar2, Eric Nguyen-Khac3, Brice Robert1, Denis Chatelain4, Hervé Deramond1, Marc-Etienne Meyer2, Olivier Baledent2
1Radiology, University Hospital, Amiens, France; 2Imaging and Biophysics, University Hospital, Amiens, France; 3Hepato-Gastroenterology, University Hospital, Amiens, France; 4Pathological Cytology, University Hospital, Amiens, France
Hepatic fibrosis is secondary to many etiologies and quantification of this fibrosis is a key point for the clinician. In this work, we wanted to appraise the potential links between elastometry data and parameters measured using PC-MRI in 17 subjects developing hepatic pathologies. Three distinct groups, probably representative of the stage of hepatic fibrosis, clearly appear A statistically significant linear correlation between the elasticity modulus and the vessel area variations DS or the portal congestion index IC is clearly highlighted. PC-MRI could be a useful and complementary tool for the understanding of evolution mechanisms involved in hepatic fibrosis.
14:00 4646. Absolute Quantification of Liver Fat by MRI Fat Volume Fractions in Comparison to Histopathology - not available
Michael Alexander Fischer1, Paul Stolzmann1, Daniel Nanz1, Cäcilia S. Reiner1, Stefan Breitenstein2, Matteo Montani3, Borut Marincek1, Hans Scheffel1
1Institute of Diagnostic Radiology, University Hospital Zurich, Zurich, Switzerland; 2Clinic of Visceral and Transplant Surgery, University Hospital Zurich, Zurich, Switzerland; 3Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland
A new approach for absolute quantification of liver fat content is presented by calculation of fat volume fractions (FVF-MRI) derived from a single-breathhold 3D spoiled dual gradient-echo MRI sequence yielding for in-/out-of-phase as well as fat-signal only images. Our results show that the absolute liver fat content equalling the actual weight per volume of liver lipid can be quantified accurately by FVF-MRI with surface-coil sensitivity correction compared to fat volume fractions derived from histopathology as the gold standard. Moreover fat-only images significantly reduce the measurement bias as compared to in/out-of-phase images.
sunder s. rajan1, David Thomasson2, Ronald Ouwerkerk3, songtao liu3, Ahmed m. Gharib3
1Div of physics, fda/cdrh/osel, Silver Spring, MD, United States; 2Radiology & Imaging Sciences, National Institutes of Health, MD; 3National Institute of Digestive and Diabetes and Kidney Diseases
Using a well characterized serial dilution lipid-water phantom we were able to simulate signal intensity results to determine the appropriate range of sequence parameter values over which we could experimentally validate measured lipid-water ratios on existing clinical 2D technique as well as using a recently available 3D Dixon technique.
Takayuki Masui1, Motoyuki Katayama1, Rie Takafuji2, T Natume1, S Nozawa2, Hiroki Ikuma1, Kimihiko Sato1, Kenji Asano3, Hasnine A. Haque3, M Sugimura1, S Imamura2, Atsushi Nozaki3
1Radiology, Seirei Hamamatsu General Hospital, Hamamatsu, Japan; 2Seirei Kenshin Center, Hamamatsu, Japan; 3GEHC-Japan, Hino, Japan
As one of criteria for metabolic syndrome, measurements of abdominal fat area using CT have been suggested. MEDAL or LAVA flex can provide in-phase and fat images and, modification of these images can be utilized to set threshold to make semiautomatic calculation of fat area. Purpose was with semiautomatic demarcation of fat areas on MR to evaluate correlations between MR and CT measurements for abdominal fat area in subjects having medical check-ups. Good correlation was observed between in MR and CT measurements. CT measurements of abdominal fat can be replaced by MR without irradiation in large population for medical-checkups.
Hero K. Hussain1, Marko K. Ivancevic, Frank J. Londy, Susan Rohrer, Elif A. Oral, Barbara McKenna, Thomas L. Chenevert
1University of Michigan, Ann Arbor, MI, United States
The dual-flip multi-echo MRI method at 3T is reliable to measure hepatic fat. It correlates well with MRS and quantitative histopathologic measures, though unlike MRS, offers full-liver mapping of fat content and heterogeneity.
13:30 4650. Multislice Multiecho T2* MRI Assessment of Regional Pancreatic Iron Overload and Correlation with Cardiac Biventricular Function and Myocardial Iron Overload in Thalassemia Major Patients.
Gennaro Restaino1, Antonella Meloni2, Alessia Pepe2, Vincenzo Positano2, Massimiliano Missere1, Pasquale Pepe2, Daniele De Marchi2, Giuseppina Secchi3, Antongiulio Luciani4, Giuseppina Sallustio1, Massimo Lombardi2
1Catholic University, Campobasso, Italy; 2MRI Lab, G. Monasterio Foundation and Institute of Clinical Physiology, CNR, Pisa, Italy; 3Azienda USL n° 1, Sassari, Italy; 4Istituto di Radiologia Az. Osp. "Garibaldi", Catania, Italy
The aims of this study were to describe the T2* values of the pancreas in patients with TM, to investigate the correlation between pancreatic and myocardial siderosis and to investigate the correlation between pancreatic iron overload and biventricular cardiac function. The mean T2* over the pancreatic head was significantly higher than the mean T2* value over the pancreatic body and tail. Significant positive correlations of the pancreatic T2* were demonstrated for global heart T2* value and number of segments with normal T2*. Moreover, pancreatic iron overload was negatively correlated to biventricular systolic function.
Keiko Miyazaki1, Matthew R. Orton1, James A. d'Arcy1, Val Lewington2, Dow-Mu Koh3, Martin O. Leach1, David J. Collins1
1CR-UK and EPSRC Cancer Imaging Centre, The Institute of Cancer Research and Royal Marsden Hospital, Sutton, Surrey, United Kingdom; 2Department of Nuclear Medicine, Royal Marsden NHS Foundation Trust, Sutton, Surrey, United Kingdom; 3Department of Radiology, Royal Marsden NHS Foundation Trust, Sutton, Surrey, United Kingdom
Dynamic contrast-enhanced (DCE-) MRI is a technique that enables non-invasive interrogation of tissue microvasculature environment. Different analysis approaches can be taken to quantify arterial and portal-venous hepatic perfusion from liver DCE-MRI data. In this study, two slope-ratio methods were used to quantify arterial and portal-venous perfusion from clinical MR data. Comparisons were made with perfusion quantified using a dual-input single compartment model. Perfusion quantified using the slope-ratio methods were found to be lower than those quantified using the dual-input model. High correlations were observed between the two approaches, especially in the estimates of arterial perfusion.
Chun-Jung Juan1, Hing-Chiu Chang2,3, Chih-Yung Yu1, Chang-Hsien Liou1, Cheng-Yu Chen1, Chun-Jen Hsueh1, Hung-Wen Kao1, Chih-Wei Wang1, Hsiao-Wen Chung1,3, Guo-Shu Huang1
1Department of Radiology, Tri-Service General Hospital, Taipei, Taiwan; 2Applied Science Laboratory, GE Healthcare Taiwan, Taipei, Taiwan; 3Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan
By simultaneous acquisition of all echoes in one TR interval, T2* IDEAL is superior to 3-pt IDEAL by allowing either larger spatial coverage or higher resolution. Whether the fat content measured by the T2* IDEAL method is influenced by the R2* effect of tissue or not is an important concern but remains ambiguous. In this study, we verify the fat content measurements of liver (lower R2* value) and vertebra (higher R2* value) in both methods compared to the MRS method. Our results show no statistical difference of liver and vertebral fat content in T2* IDEAL and 3-pt IDEAL methods.
Xiaoming Yin1,2, Saurabh Shah3, Andrew C. Larson1,2
1Radiology, Northwestern University, Chicago, IL, United States; 2Electrical Engineering and Computer Science, Northwestern University, Evanston , IL, United States; 3Siemens Medical Solutions, Chicago, IL, United States
R2* is typically estimated via mono-exponential fitting of signal decay within a series of GRE images combined by the root sum-of-square (RSS) approach. However, RSS approaches rectify and bias noise in later TEs, resulting in systematic fitting errors for R2* estimation. Our work investigated the accuracy of low SNR R2* measurements for RSS reconstructed data. Through phantom, ex vivo, and volunteer studies, we compared the accuracy of R2* measurement using SNR-weighted least-square regression and SNR-based truncation methods. We found SNR-weighted least-square regression to be a simple and reliable approach to reduce R2* measurement error.
13:30 4654. Differentiation of T1W Hyperintense Nodules Among Cirrhotic Liver: Comparison of Ferucarbotran-Enhanced MR Imaging with Accumulation Phase FS-T1WI and Gadolinium-Enhanced MR Imaging - not available
Ran-Chou Chen1,2, Chen-Te Chou3,4
1Biomedical Imaging and Radiological Science, National Yang-Ming Medical University, Taipei, Taiwan; 2Radiology, Taipei City Hospital , Taiwan; 3Radiology, Chang-Hua Christian Hospital, Er-lin branch, Chang-Hua, Taiwan; 4Department of Biomedical Imaging and Radiological Science, National Yang-Ming Medical University, Taipei, Taiwan
Our study was to evaluate ferucarbotran-enhanced MRI with accumulation-phase fat suppression T1-weighted imaging in comparison with gadolinium-enhanced MRI for characterization of T1W hyperintense nodules within cirrhotic liver. In the gadolinium-enhanced group, the MRI sensitivity, specificity and accuracy were 60%, 100% and 73%, respectively. In ferucarbotran-enhanced group, the sensitivity, specificity and accuracy were 100%, 83% and 94%, respectively. The ferucarbotran-enhanced MRI provided additional information of cellular function in differentiation of focal hepatic lesion and ferucarbotran-enhanced MRI is superior to gadolinium-enhanced MRI in characterization of T1W hyperintense nodules. T1W hyperintense nodule depicting hyperintense on ferucarbotran-enhanced accumulation-phase FS-T1WI should be investigated aggressively.
Tilina Hu1, Alvin Silva1, Leland Hu1, Richard Ehman2
1Radiology, Mayo Clinic, Scottsdale, AZ, United States; 2Radiology, Mayo Clinic, Rochester, MN, United States
To determine accurate biopsy-validated Magnetic Resonance Elastography threshold values that distinguish normal from abnormal liver (due to fibrosis and/or inflammation). We focus specifically on pre-operative evaluation of liver donors prior to transplant.
Rajakumar Nagarajan1, Manoj K. Sarma1, Charles Hinkin2, Steven Castellon2, Jason P. Smith3, Homayoon Khanlou4, Laveeza Bhatti4, Jonathan Truong5, Ann B. Ragin6, Elyse Singer7, M Albert Thomas1
1Radiological Sciences, University of California Los Angeles, Los Angeles, CA, United States; 2Department of Psychiatry & Biobehavioral Sciences, UCLA School of Medicine and VA Greater Los Angeles Healthcare System, Los Angeles, CA, United States; 3Veteran's Affairs Greater Los Angeles Healthcare Center; 4AIDS Healthcare Foundation, Westside Clinic, Los Angeles; 5Kaiser Permanente, Lancaster CA; 6Northwestern University, Chicago, Illinois, USA; 7Neurology, UCLA School of Medicine, Los Angeles, California, United States
Hepatitis C is a liver disease caused by the hepatitis C virus (HCV). HCV infection sometimes results in an acute illness, but most often becomes a chronic condition that can lead to cirrhosis of the liver and liver cancer. Hepatitis C may be detectable with MR diffusion tensor imaging (DTI), which is exquisitely sensitive to water diffusion and is used to quantify the magnitude of diffusivity and the orientation and linearity (that is, anisotropy) of water motility in microstructural level in brain. Combining two-dimensional (2D) localized correlated spectroscopic (L-COSY) technique with DTI provides more information about the cerebral metabolites, mean diffusivity and fractional anisotropy changes in patients with hepatitis C.
Arthur Peter Wunderlich1, Holger Cario2, Mathias Schmid3, Markus Juchems1
1Dept. for Diagnostic and Interventional Radiology, Univ.-Clinic Ulm, Ulm, Baden-Württemberg, Germany; 2Pediatrics, Univ.-Clinic Ulm, Ulm, Germany; 3Hematology, Univ.-Clinic Ulm, Ulm, Germany
To compare the liver iron content (LIC) determined by different MR methods, we investigated 93 patients with protocols according to three published methods, two using gradient echo (GRE) sequences and one working with spin echo (SE). The methods correlate moderately with r=0.82. Weakpoints are the bad performance of one GRE method near its upper limit and the sensitivity to liver steatosis of the GRE method addressing high LIC. The latter leads to reduced correlation of SE vs. GRE in the high LIC range. Although GRE generally tends to overestimate LIC, both methods are suitable for decisions concerning patient management.
Jean Luc Daire1, Ralph Sinkus2, Mathilde Wagner1, Nathalie Haddad1, Valerie Vilgrain1, Bernard van Beers1
1INSERM U773, CRB3 Centre de Recherches Biomédicales Bichat-Beaujon, Paris, France; 2Institut Langevin, ESPCI, Paris, France
Liver tumours are very frequent. They include benign lesions and malignant primary or secondary tumours (metastases). Currently, there is no established non-invasive imaging Goldstandard available in order to characterize malignancy for liver tumours. Very often, the enhancement characteristics of a bolus are used in order to differentiate benign from malignant tumours. Here, we intend to prospectively evaluate the complex shear modulus as measured via MR-elastography in the assessment of malignancy or benignity of liver lesions and compare its performance to those of three enhancement characteristics of the bolus passage.
Paige Nicole Hopewell1,2, Navin Bansal1,2
1Radiology, Indiana University School of Medicine, Indianapolis, IN, United States; 2Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, United States
Changes in signal intensity with disease progression in single quantum (SQ) and triple quantum-filtered (TQF) 23Na MRI are validated with shift reagent-aided SQ and TQF 23Na and 31P MRS studies in a nonalcoholic fatty liver disease model. Changes in intracellular Na+ concentration and fibrosis-associated macromolecule deposition in the extracellular space both contribute to an increased TQF 23Na MRI signal with advanced disease progression.
Edmund Mark Godfrey1, Anant S. Krishnan1, Susan E. Davies2, Nyree M. Griffin3, Graeme J. Alexander4, Mike E. Allison4, Alexander E. Gimson4, William H. Griffiths4, David J. Lomas1
1Department of Radiology, Addenbrooke's Hospital, Cambridge, Cambridgeshire, United Kingdom; 2Department of Histopathology, Addenbrooke's Hospital, Cambridge, Cambridgeshire, United Kingdom; 3Department of Radiology, St Thomas' Hospital, London; 4Department of Hepatology, Addenbrooke's Hospital, Cambridge, Cambridgeshire, United Kingdom
Standard imaging techniques are insensitive to liver fibrosis. Current clinical assessment of liver fibrosis requires a biopsy, which risks complications and sampling error. This work describes our experience with 2 new MR techniques: MR elastography and 31P spectroscopy. MR elastography was found to correlate with histological grade of fibrosis in contrast to 31P PME/PDE ratio. Our findings do not correlate with previous work. This may be because histological grade in our study was based on the original report, rather than review of the biopsy material. We plan to repeat the analysis of our results with this data.
Andrew B. Rosenkrantz1, Lorenzo Mannelli1, Sungheon Kim1, James Babb1
1Radiology, NYU Langone Medical Center, New York, NY, United States
In 30 consecutive patients at 1.5T, a breath-hold two-point Dixon VIBE acquisition was obtained of the liver immediately following a standard chemically-selective fat-suppressed VIBE acquisition, both performed during the equilibrium phase after intravenous contrast administration. Compared with the standard VIBE sequence, the Dixon VIBE sequence demonstrated significantly improved strength of fat suppression, homogeneity of fat suppression, vessel sharpness, and subjective overall image quality. There were no significant differences between the two sequences for sensitivity or PPV for focal liver lesion detection. We conclude that Dixon-VIBE achieved higher image quality with preserved diagnostic ability for post-contrast liver MRI.
Tobias Hahn1, Sebastian Kozerke1, Mark Fox2,3, Werner Schwizer2, Andreas Steingoetter, 1,4, Michael Fried2, Peter Boesiger1
1Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland; 2Division of Gastroenterology and Hepatology, University Hospital Zurich; 3Nottingham Digestive Diseases Centre and Biomedical Research Unit Queen's Medical Centre, University Hospital Nottingham; 4Institute of Radiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
3D tracking of small-sized 19F labeled capsules is studied using fast modified balanced FFE sequences for concurrent measurements of gastrointestinal function and morphology. Perfluoro-15-crown-5-ether and Hexafluorobenzene are proposed and studied for use as tracking mediums. The proposed imaging protocol is shown to be reliable in tracking small capsules through realistic abdominal phantoms and might therefore bear potential of being a valuable tool in detecting abnormal gastric function and at the same time posing the basis for creating a 3D anatomical model of the complex bowel geometry.
Owen John Arthurs1, Ilse Joubert1, Martin John Graves1, Pat Set1, David John Lomas1
1Department of Radiology, University of Cambridge and Addenbrooke's Hospital, Cambridge, Cambridgeshire, United Kingdom
Gut malrotation is a congenital disorder of abnormal intestinal rotation, for which the current diagnostic technique is an upper GI X-ray contrast study. This study evaluated the feasibility of interactive MR fluoroscopy for defining the gastro-intestinal tract anatomy in un-sedated children with suspected malrotation. We imaged 9 children using both X-ray fluoroscopy, FIESTA and interactive SSFSE MR imaging. We confidently identified the DJ flexure (7/9; 77%), orientation of the SMA / SMV (8/9; 88%) and the caecum (9/9; 100% using MRI. Interactive MR Fluoroscopy is feasible for gut imaging in un-sedated children.
Owen John Arthurs1, Erich Zammer2, David John Lomas1
1Department of Radiology, University of Cambridge and Addenbrooke's Hospital, Cambridge, Cambridgeshire, United Kingdom; 2Department of Orthopaedics, University of Cambridge and Addenbrooke's Hospital, Cambridge, Cambridgeshire, United Kingdom
Traditional X-ray fluoroscopy methods for upper gastro-intestinal (GI) tract imaging in children require postural alteration to help move contrast media to the required locations. In order to establish an equivalent MRI technique for imaging the paediatric gut, we have developed a custom-built coil insert which allows for gentle rotation of a child within a rigid surface coil. It has a Vitrothene polymer backing, with a Plastazote foam insert, which is currently for orthopaedic supports in our hospital. These materials are strong, non-ferromagnetic, easily cleanable, lightweight and breathable. This type of device should help facilitate MR fluoroscopy in small children.
Elisa Placidi1, C. L. Hoad1, L. Marciani2, R. C. Spiller2, P. A. Gowland1
1SPMMRC, School of Physics and Astronomy, University of Nottingham, Nottingham, United Kingdom; 2Nottingham Digestive Diseases Centre Biomedical Research Unit, University of Nottingham, Nottingham, United Kingdom
MRI was used to investigate the colonic response to two contrasting test meals: a readily absorbable glucose drink (control) and a non absorbable mannitol drink, which acts as a model of acute diarrhoeal disease. Eight healthy volunteers were imaged on a 1.5 T Philips Achieva scanner with several sequences up to 8 hours after the drink, to assess changes in the ascending colon in terms of water content, volume, and image signal intensity. Differences between the two conditions have been quantified. A scoring system based on subjective assessment of colonic contents has also been developed.
Ambreen Sattar1, J Zhu2, Y Yu2, L Hamm2, Y Ye2, Y Xuan2, J Hu2
1Radiology, Wayne State University, Detroit, MI, United States; 2WSU MR RESEARCH, Wayne State University, detroit, MI, United States
This study analyzes the abiltiy of 3.0 T MRI to better evaluate the activity of active vs remissive Crohn's disease over 1.0 T MRI.3.0 T magnet is better capable of detecting various signs of active Crohn's diseases such as Stenosis, bowel wall thickening and bowel wall enhancement. MRI is safer option because it does not uses ionizing radiation and provides better diagnostic outcome in staging disease which can significantly alter treatment options offered by the physician.
Srigouri Yalamanchili1, Michael Macari1, Rafael Rivera1, Danny Kim1, Alec Megibow1, James Babb1, Joseph Levy1, Kerry Zabriskie1, Sooah Kim2
1New York University; 2New York University, New York, NY, United States
Secific findings at MR imaging- mural T2 high signal intensity and contrast enhancement patterns- have been proposed as accurate markers of disease activity. The purpose of our study is to assess the performance using conventional non-contrast MR imaging sequences as a tool to localize and predict disease activity in Crohns disease in comparison to post-contrast images. Thirty patients referred for MR enterography were evaluated at 1.5 T using steady state free precession, single shot fast spin echo, fat suppressed T2, and pre- and post contrast enhanced T1-weighted sequences. Images were reviewed by two radiologists in two separate sessions; the readers interpreted non-contrast images of MRI during the first session and whole images including post-contrast sequences during the second session. The readers evaluated the presence or absence of disease in regard to the presence of active inflammation using a six-point grading system (0, No evidence of disease; 1, definite absence of active inflammation; 2, probable absence of active inflammation; 3, equivocal; 4, probable presence of active inflammation; and 5, definite presence of active inflammation). Reference standard was constructed by combining surgical, endoscopy, physical, and all available imaging findings. There were 34 bowel segments with active inflammation on reference standard in 18 subjects (proximal ileum, n=1, distal ileum, n=4; terminal ileum, n=16; cecum, n=6; ascending colon, n=1; rectosigmoid, n=2). Inter-reader agreement was significantly higher for whole imaging including post-contrast images relative to non-contrast images (Kappa 0.31 for non-contrast and 0.41 for whole images). Although there is no significant difference localizing abnormal bowel segment involved with Crohns disease using non-contrast images, inter-reader agreement, sensitivity, and accuracy are significantly higher in the assessment of active disease adding post-contrast images to non-contrast images for MRI interpretation.
Eleanor F. Cox1, Michael Mellows2, Susan E. Pritchard1, Mahamoud Hussein1, Caroline L. Hoad1, Carolyn Costigan3, Luca Marciani2, Robin C. Spiller2, Penny A. Gowland1
1SPMMRC, Physics & Astronomy, University of Nottingham, Nottingham, Nottinghamshire, United Kingdom; 2Nottingham Digestive Diseases Centre, NIHR BRU, Nottingham University Hospitals, Nottingham, United Kingdom; 3Brain & Body Centre, University of Nottingham, Nottingham, United Kingdom
The effect of a high fat (HF) meal and an equicaloric high carbohydrate (HC) meal on satiety, gastric volumes, small bowel water content (SBWC) and gallbladder contraction (as a marker of CCK release) was investigated using MRI. The HF meal resulted in increased fullness and decreased hunger and appetite compared with the HC meal. Gastric emptying was initially faster for the HF meal. After 90 minutes, SBWC was greater after the HF meal than after the HC meal. This delayed increase may reflect delayed emptying of fat which stimulates pancreatic secretions.
Hideto Kuribayashi1, Fanlai Cui2, Keiko Hirakawa2, Yoshimasa Kanawaku3, Youkichi Ohno2
1Varian Technologies Japan Limited, Minato-ku, Tokyo, Japan; 2Nippon Medical School; 3National Defence Medical College
Proton resonance frequency-shift based MR temperature imaging was introduced into the rectal temperature measurement in cooling dead bodies in order to estimate the time of death in legal medicine. A series of MR temperature difference maps in cooling dead rats could be obtained. Moreover, distribution of cooling rates among pelvic tissues was observed and shown to be related to body position.
Mayumi Takeuchi1, Kenji Matsuzaki1, Masafumi Harada1, Hiromu Nishitani1
1Department of Radiology, University of Tokushima, Tokushima, Japan
We evaluated 31 ovarian tumors including 8 mucinous tumors by 1H-MR spectroscopy at 3T. High to moderate 2 ppm peaks were observed in all 8 mucinous tumors, whereas low to slight 2 ppm peaks were observed in 14 of 23 non-mucinous tumors. The 2 ppm concentration in mucinous tumors (7.39+/-2.85 mM) was significantly higher than that in non-mucinous lesions (3.12+/-1.42 mM) (p<0.005). Using a cut off value of 4.45 mM for mucinous tumors had a sensitivity of 88%, specificity of 86%, PPV of 78%, and NPV of 92%.
Mayumi Takeuchi1, Kenji Matsuzaki1, Masafumi Harada1, Hiromu Nishitani1
1Department of Radiology, University of Tokushima, Tokushima, Japan
We evaluated 32 uterine corpus tumors (14 malignant including 11 endometrial carcinomas and 3 myometrial tumors; 18 benign including 5 endometrial and 13 myometrial masses) by 1H-MR spectroscopy at 3T. Choline peaks were observed in all 32 lesions, and tended to show higher peaks in malignant tumors. The choline concentration in malignancy (8.77+/-1.91 mM) was significantly higher than that in benign lesions (4.82+/-2.23 mM) (p<0.0001). Using a cut off value of 7.00 mM for malignant lesions had a sensitivity of 93%, specificity of 83%, PPV of 94%, and NPV of 81%.
14:30 4672. 23Na/1H MR Imaging of Female Pelvis at 7T Using a Dual-Tuned Multi-Channel Body Coil - not available
Kyongtae Ty Bae1, Jung-Hwan Kim1, Chan Hong Moon1, Alessandro Furlan1, Bumwoo Park1, JinHong Wang1
1University of Pittsburgh, Pittsburgh, PA, United States
For the first time, we were able to demonstrate MR imaging of the female pelvis and distribution of sodium signal intensities in the female pelvic organs in normal subjects at 7T with a multi-channel dual-tuned body RF coil. Future development of 23Na MR imaging will concentrate on the clinical application of sodium MR imaging of the female pelvis to assess various physiological and pathological conditions accompanied with changes in sodium concentration.
Jan Weis1, Kathrine Bjersand2, Anna Karin Wikström2, Mats Olovsson2, Johan Wikström3
1Department of Oncology, Radiology and Clinical Immunology, Uppsala University, Uppsala, Sweden; 2Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; 3Department of Oncology, Radiology and Clinical Immunology, Uppsala University , Uppsala, Sweden
31P image-selected in vivo spectroscopy (ISIS) with proton decoupling and nuclear Overhauser effect enhancement was used for measurement the spectra of placental tissue in vivo. Major metabolites of normal human placenta and placentas from women with preeclampsia were quantified. Our results demonstrate that the 31P MRS is able to measure spectra of the placenta with acceptable quality and measurement time. 31P MRS is a promising tool to detect in vivo changes of human placental metabolites.
13:30 4674. Pre- And Postoperative Dynamic MRI: Evaluation of Pelvic Organ Prolapse in Symptomatic Women - not available
Céline D. Alt1, Kerstin Brocker2, Florian Lenz2, Christof Sohn2, Hans-Ulrich Kauczor1, Peter Hallscheidt1
1Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany; 2Obstetrics and Gynecology, University Hospital Heidelberg, Heidelberg, Germany
Description: Evaluation of dynamic changes of pelvic organ prolapse by MRI. Method: Dynamic 1.5T MRI was performed preoperative and after surgery in women with pelvic organ prolapse. For measurement two referential lines and four anatomical landmarks were taken. Results: 77 women were yet included. Surgical treatment was anterior (43/62), posterior (15/62) and combined anterior/posterior mesh-repair (4/62). Median values of organ prolapse often showed significant changes (p<0,05) in short term follow-up compared to preoperative results. With posterior mesh-repair the changes weren´t significant. Conclusion: Dynamic MRI offers an accurate extent of prolapse and allows to evaluate the success after reconstructive surgery.
14:00 4675. Development of MR Visible Mesh for Soft Tissue Reinforcement in Surgical Treatment of Genital Prolapse. - not available
Sébastien Blanquer1,2, Olivier Guillaume1,2, Laurent Lemaire3,4, Florence Franconi5, Xavier Garric1,2, Jean Coudane1,2
1CNRS UMR 5247, Montpellier, France; 2UFR Pharmacie - Université Montpellier I, Montpellier, France; 3Université Angers, Angers, France; 4INSERM U646, Angers, France; 5PIAM, Université Angers, Angers, France
Mayumi Takeuchi1, Kenji Matsuzaki1, Hiromu Nishitani1
1Department of Radiology, University of Tokushima, Tokushima, Japan
We evaluated surgically proven 52 ovarian tumors (36 malignant; 6 borderline malignant; 10 benign). All 42 malignant/borderline malignant tumors showed homogeneous or heterogeneous high intensity on DWI, whereas 3 of 10 benign tumors (3 thecomas) showed high intensity. The ADCs in 42 malignant/borderline malignant tumors and in 10 benign tumors were 1.02 +/- 0.19 and 1.38 +/- 0.30, respectively (p<0.001). Using a cut off ADC of 1.15 had a sensitivity of 76%, specificity of 80%. The ADCs in high intense 3 thecomas on DWI were relatively low (1.08 to 1.20), possibly due to their abundant cellular nature as functioning tumors.
Srigouri Yalamanchili1, Genevieve L. Bennett1, Pippa Storey1, Andrew B. Rosenkrantz1
1Radiology, NYU Langone Medical Center, New York, NY, United States
5 female volunteers underwent pelvic MRI at 1.5T that included T2-mapping, diffusion-weighted imaging, and magnetization-transfer contrast imaging, each performed through the uterus in the sagittal plane with matching slice positions. There were trends toward a longer T2 time within the endometrium, a lower ADC within the junctional zone, and a lower magnetization-transfer ratio within the myometrium. There was a moderate positive correlation between T2 and ADC, but poor correlation between T2 and MTR as well as between ADC and MTR, suggesting that MTR may reflect a characteristic of tissue not measured by either ADC or T2.
Logan Dance1, Andrew Wentland2, Nathan Artz2, Sean Fain1,2, Arjang Djamali3, Elizabeth Sadowski1
1Radiology, University of Wisconsin, Madison, WI, United States; 2Medical Physics, University of Wisconsin, Madison, WI, United States; 3Nephrology, University of Wisconsin, Madison, WI, United States
Blood oxygen level dependent (BOLD) and arterial spin labeling (ASL) MR imaging can analyze the drug-specific effects of anesthetics on regional perfusion. Conflicting data currently exists regarding isoflurane's effect on renal perfusion. Using a swine model, we found that isoflurane decreased renal perfusion (ASL; microspheres) and renal oxygen bioavailability (BOLD MR) when compared to propofol. Isoflurane also caused a significant increase in heart rate and decrease in mean arterial pressure, compared to propofol. These effects should be considered when designing kidney perfusion studies.
14:30 4679. Blood Oxygen-Level Dependent (BOLD) MR Imaging of Diabetic Nephropathy-Preliminary Study - not available
Zhen Jane Wang1, Rahi Kumar1, Benjamin M. Yeh1, Suchandrima Banerjee2, Chi-yuan Hsu3
1Department of Radiology and Biomedical Engineering, University of California, San Francisco, San Francisco, CA, United States; 2Global Applied Science Laboratory, GE Healthcare, Menlo Park, CA, United States; 3Department of Medicine, Division of Nephrology, University of California, San Francisco, San Francisco, CA, United States
The preliminary data showed decreased medullary R2* values (corresponding to increased oxygen bioavailability) in patients with diabetic kidney disease compared to healthy volunteers; and the decrease in medullary R2* values appeared to be related to the degree of kidney disease.
Brendan Boyd1, Michael D. Noseworthy2
1School of Biomedical Biomedical Engineering, McMaster University, Hamilton, Ontario, Canada; 2Electrical and Computer Engineering, School of Biomedical Engineering, McMaster University, Hamilton, Ontario, Canada
Real time, free breathing, T2*-weighted (BOLD) images of the kidneys were retrospectively motion corrected and analyzed for physiologic spectral energies. Following induced diuresis a corresponding decrease in cardiac BOLD signal frequency energy was observed in the renal cortex. We hypothesize this corresponds to a decrease in O2 utilization due to decreased renal H2O reabsorption.
Jeff Lei Zhang1, Henry Rusinek1, Hersh Chandarana1, Pippa Storey1, Eric E. Sigmund1, Pierre Hugues Vivier1,2, Qun Chen1, Hua Guo1, Vivian S. Lee1
1Department of Radiology, New York University, New York, NY, United States; 2Rouen University Hospital, Rouen, France
In this study we used a Monte Carlo simulation approach to explore the mechanism of BOLD R2* contrast in kidney. Kidney pO2 levels predicted based on R2* values by the simulation were in agreement with literature values for a healthy volunteer, and correlated well with pO2 values measured by microprobe for diabetic rats of a previous study. The results indicate that the approach is a promising tool for quantifying kidney oxygenation level based on BOLD data.
13:30 4682. Effect of Octreotide on Intra-Renal Oxygenation as Estimated by BOLD MRI in Rats - not available
Lu-Ping Li1, Joann Carbray1, Pottumarthi V. Prasad1
1Radiology, Northshore University Healthsystem, Evanston, IL, United States
Previous observations have shown lower intra-renal oxygenation as early as two days after induction of type I diabetes. In order to test the hypothesis that this may be related to the direct effect of hyperglycemia, the infusion of glucose solution was used in healthy rats. However comparable levels of blood glucose levels and R2* values in diabetic rats were observed only in animals pretreated with an insulin inhibitor (octeotride). Because octeotride is associated with vasoconstriction, it is necessary to know the magnitude of any direct effect of octeotride on renal oxygenation. That was the motivation for the present study.
Iosif Alexandru Mendichovszky1, Constantina Chrysochou2, David L. Buckley3, Alan Jackson1, Phil A. Kalra2
1Wolfson Molecular Imaging Centre, The University of Manchester, Manchester, United Kingdom; 2Renal Department, Salford Royal Hospital, Salford, United Kingdom; 3University of Leeds, Leeds, United Kingdom
Atheromatous renovascular disease is a commonly encountered yet challenging disease to manage. The aim of the current study was to investigate renal parenchymal BOLD response to renal artery revascularization in patients with severe renal artery stenosis and correlate imaging findings with changes in SK-GFR (as measured by radioisotope techniques). No significant differences were found regarding baseline SK-GFR between kidneys that improved, remained stable, deteriorated or controls. R2* values were significantly higher in kidneys whose renal function subsequently improved vs. those who stayed stable, deteriorated or controls. In addition, the ratio of R2* to SK-GFR was significantly greater in improver kidneys.
14:30 4684. Long Term Follow-Up of Human Transplanted Kidneys by DWI and BOLD Imaging - not available
Peter Vermathen1, Tobias Binser1, Chris Boesch1, Ute Eisenberger2, Harriet C. Thoeny3
1Dept. Clinical Research, University Bern, Bern, Switzerland; 2Dept. of of Nephrology and Hypertension, University Hospital of Bern, Bern, Switzerland; 3Dept. of Radiology, University Hospital of Bern, Bern, Switzerland
Previously, we performed a DWI and BOLD MRI study in renal allograft recipients with good allograft function and determined short term reproducibility of diffusion and oxygenation parameters. In the current study, nine patients of our initial study were measured again 32±2 months after the initial scan to assess long term effects on diffusion parameters and on R2*. The functional parameters were markedly stable after 32 months with a slight tendency towards reduced oxygenation in eight of the nine patients, who still had good allograft function. In contrast, one subject with decreased GFR indicative of renal dysfunction demonstrated strongly altered MR-parameters.
15:00 4685. Performance of Generalized Factor Analysis of Dynamic Sequence (GFADS) in the Automated Characterization of Renal Function and Tissue Enhancement in Dynamic Magnetic Resonance Imaging (MRI)
Ruth Lim1, Jinsong Ouyang1, Matthew D. Schmitz1, Michael S. Gee1, Ranu Shailam1, Raul N. Uppot1, Georges El Fakhri1
1Department of Radiology, Massachusetts General Hospital / Harvard Medical School, Boston, MA, United States
We assessed the performance of a novel generalized factor analysis of dynamic sequences (GFADS) in dynamic, contrast-enhanced renal magnetic resonance imaging (MRI). By detecting unique time-intensity curves for each renal tissue/compartment type, this technique automates the creation of regions of interest (ROIs) around and within the kidneys, and obviates the need for manually-drawn ROIs. These time factor curves are computed from entire factor images and are significantly less affected by noise than time-intensity curves computed within regions of interest that span a few voxels. In this study, we found that GFADS software can successfully, semi-automatically, and rapidly identify the renal cortex, medulla, and collecting system on dynamic contrast-enhanced renal MRI studies while obviating the need to use manually-drawn regions of interest. This enables detailed quantitative assessment of cortical and medullary renal function in normal and abnormal kidneys.
Lale Umutlu1, Stephan Orzada2, Sonja Kinner, Stefan Maderwald2, Irina Brote2, Andreas K. Bitz2, Oliver Kraff2, Susanne C. Ladd2, Gerald Antoch, Mark E. Ladd2, Harald H. Quick2, Thomas C. Lauenstein
1Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen , Essen, Germany; 2Erwin L.Hahn Institute for Magnetic Resonance Imaging
Aim of this study was to assess the feasibility of contrast-enhanced kidney MRI at 7T. 8 healthy subjects were examined at a 7T whole-body MR system utilizing a custom-built 8-channel RF transmit/receive body coil. Qualitative analysis showed best overall image quality for T1w 2D FLASH imaging and strongest artifact impairment for T2w TSE imaging. Quantitative analysis showed continuous increase of SNR after iv. Gadolinium administration on T1w images and best corticomedullar differentiation in the arterial phase. This first attempt of 7T kidney imaging reveals the diagnostic potential, but also challenges of 7T abdominal MRI.
Joseph Abrams1, Timothy W. Clark1, Rahmin A. Rabenou2, Hersh Chandarana1
1Radiology, NYU Langone Medical Center, New York, NY, United States; 2Nephrology, NYU Langone Medical Center, New York, NY, United States
Transarterial embolization prevents hemorrhage of renal angiomyolipoma (AML) by decreasing the tumors angiogenic component. Our aim was to determine whether baseline AML lipid content, as estimated by AML-to-psoas signal ratio on T1 fat-saturated non-contrast acquisition, could help predict embolization response, as measured by changes in volume and enhancement on gadolinium contrast enhanced MRI (CE-MRI). Moderately good correlations were seen between baseline lipid content and change in volume and change in enhancement. These results suggest that AMLs with higher fatty components, as determined on MRI, are less likely to respond to embolization.
14:30 4688. MRI Characterization of Liver Involvement in Autosomal-Dominant Polycystic Kidney Disease
Wei Zhang1, Jon D. Blumenfeld2, Stephanie Donahue2, Honglei Zhang3, Martin R. Prince3
1Radioloty, Weill Cornell Medical College, new york, NY, United States; 2Internal Medicine, Weill Cornell Medical Center and The Rogosin Institute, new york, NY, United States; 3Radioloty, Weill Cornell Medical College, new york, NY, United States
135 ADPKD patients underwent abdominal MRI using a body array coil. Organ volumes and cyst volumes were measured on T2 images.RESULTS: There is significant correlation between HV and HCV, HV and HCF, HV and SPV, HCF and age, HCF and GFR, HCF and Sex, HCF and BRV, HCF and BECV, BRV and BCV at P=0.01 level. Hepatic cyst fraction was significantly higher in female.Discussion and Conclusion:Our research prove that hepatic cysts in ADPKD are more prevalent in women than men, and women experience a larger burden of hepatic cysts than men in a younger age, implicating gender-specific hormones works in the pathogenesis of hepatic cyst involvement in ADPKD.
15:00 4689. Intra-Observer and Inter-Observer Variability of Renal Volume Measurements in Polycystic Kidney Disease Utilizing a Semi-Automated MR Segmentation Algorithm with HASTE and TrueFISP Sequences
Benjamin A. Cohen1, Irina Barash2, Danny Kim1, Emilio Vega1, Matthew D. Sanger1, Michael Bloom1, Hersh Chandarana1
1Radiology, NYU Langone Medical Center, New York, NY, United States; 2Nephrology, NYU Langone Medical Center
In Polycystic Kidney Disease (PKD), total renal volume and changes in kidney volume have been identified as sensitive markers of disease progression and, perhaps, response to future novel therapeutics. The aim of this study was to assess the intra-observer and inter-observer variability of a semi-automated MR renal volumetric algorithm in PKD employing fluid sensitive pulse sequences emphasizing cyst conspicuity, specifically HASTE and TrueFISP. This algorithm provided excellent intra-observer (median agreement greater than 97-98%) and very good inter-observer (median agreement greater than 93%) reproducibility. Automated techniques, in development, will hopefully decrease inter-observer variability and processing time to support longitudinal analysis.
13:30 4690. Sodium MR Imaging of Kidney and Other Abdominal Organs Using a Dual-Tuned Body RF Coil at 7T - not available
Kyongtae Ty Bae1, Jung-Hwan Kim1, Chan Hong Moon1, Alessandro Furlan1, Bumwoo Park1, Tiejun Zhao2
1University of Pittsburgh, Pittsburgh, PA, United States; 2MR Research Support, Siemens Healthcare, Pittsburgh, PA, United States
We performed dual-tuned 23Na/1H MR imaging of human abdominal organs at 7T and demonstrated the spatial distribution of sodium in the kidney using sodium MR imaging. Future development of 23Na MR imaging will be focused on clinical application of sodium MR imaging in the abdomen to assess a variety of physiological and pathological conditions accompanied with changes in sodium concentration.
Akira Yamamoto1, Jeff Lei Zhang1, Henry Rusinek1, Hersh Chandarana1, James Babb1, Thomas Diflo2, Devon John2, Judith Benstein3, Pierre H. Vivier1, David Stoffel1, Vivian S. Lee1
1Radiology, New York University School of Medicine, New York, United States; 2Surgery, New York University School of Medicine, New York, United States; 3Medicine, New York University School of Medicine, New York, United States
60 patients (31 clinically normal-functioning transplanted kidney, 29 acute dysfunction transplanted kidney) were examined to assess quantitative low-dose 3D MR renography to diagnose acute transplant dysfunction. Acute rejection showed higher ratio of vascular mean transit time to whole kidney (MTT-A/K) and lower tubular transit time fraction (MTT-T/K) compared to ATN. In particular, the diagnostic test that classified patients as acute rejection when MTT-A/K 9.0% and as ATN otherwise achieved 100% diagnostic accuracy. Our method of MR renography is promising for the diagnosis of acute transplant renal dysfunction and can be performed as a component of routine anatomic imaging of the transplanted kidney.
Marica Cutajar1, Stephen D. Marks1, Jonathan D. Clayden1, Christopher A. Clark1, Isky Gordon1
1Radiology and Physics, UCL Institute of Child Health, London, United Kingdom
The aim of this study was to determine the reproducibility and robustness of Diffusion Tensor Imaging (DTI) in the kidney, to in turn justify the utility of this method in the clinical environment. DTI provides structural parameters relatively unstudied in kidney, the Apparent Diffusion Coefficient (ADC) and the Fractional Anisotropy (FA). The ADC gives an indication of the overall extent of diffusion, while the FA characterises the directionality of water diffusion in the tissue of interest. Initial studies have found a clear difference between the renal cortex and medulla for both ADC and FA values and both parameters were reproducible.
Wei Zhang1, Jon D. Blumenfeld2, Stephanie Donahue2, Honglei Zhang1, Martin R. Prince1
1Radiology, Weill Cornell Medical College, new york, NY, United States; 2Internal Medicine, Weill Cornell Medical Center and The Rogosin Institute, new york, NY, United States
Purpose: To assess how renal blood flow changes in autosomal-dominant polycystic kidney disease (ADPKD) and its correlation with renal parenchymal volume and function.Methods: 41 ADPKD patients underwent MRA of the renal arteries using 2D cine Phase Contrast besides routine abdominal MRI.Results: GFR to both kidneys correlated directly with total blood flow.Conclusion:Our research suggest that measuring total flow to bilateral kidneys may represent an effective way to monitor renal function in ADPKD patients.
Jean-Marc Idée1, Nathalie Fretellier1, Anne Dencausse1, Nicolas Poveda1, Gaëlle Jestin1, Claire Hollenbeck1, Marc Port1, Jean-Sébastien Raynaud1, Philippe Robert1, Claire Corot1
1Research, Guerbet, Roissy-Charles de Gaulle cedex, France
In rats with subtotal nephrectomy receiving single injections (2.5 mmol/kg) of gadodiamide (Omniscan) for 5 consecutive days, 62 +15% of the total plasma gadolinium concentration measured at sacrifice was found to be free while the free Gd3+ concentration in plasma was < limit of detection for gadoterate (Dotarem). Relaxometry study of the skin and the bone indicate gradual in vivo dechelation and release of free Gd3+ in rats receiving the linear GC gadodiamide (increase in the r1 relaxivity constant over time in the skin and higher r1 value vs. ex vivo matrix in skin and bone), while gadoterate remained stable.
Jean-Marc Idée1, Nathalie Fretellier1, Sylviane Guerret2, Marie-Christine De Goltstein1, Anne Dencausse1, Nicolas Poveda1, Claire Hollenbeck1, Walter Gonzalez1, Cécile Factor1, Claire Corot1
1Research, Guerbet, Roissy-Charles de Gaulle cedex, France; 2Novotec, Lyon, France
Rats with subtotal nephrectomy received a normal or high-phosphate diet and were allocated to single injections of 2.5 mmol/kg of gadodiamide (Omniscan) or saline for 5 consecutive days. Hyperphosphataemia enhanced histological lesions (increase in dermal cellularity, abnormalities in dermal collagen fibres and TGF-beta-1 immunostaining) and revealed macroscopic skin lesions. In the gadodiamide + high phosphate diet group, the total plasma gadolinium concentration was higher in the rats with skin lesions than in the rats without lesions as well as the free Gd3+ concentration.
Giles Roditi1, Tara Collidge2, Peter Thomson2, Jamie Traynor2, Patrick Mark3, Scott Morris2, Keith Simpson2
1Radiology, Glasgow Royal Infirmary, Glasgow, Scotland, United Kingdom; 2Nephrology, Glasgow Royal Infirmary, Glasgow, Scotland, United Kingdom; 3Nephrology, Western Infirmary Glasgow, Glasgow, Scotland, United Kingdom
Nephrogenic systemic fibrosis (NSF) mortality was compared to a matched renal replacement therapy (RRT) population. Records searched with NSF and GBCA exposure identified and onset of RRT with survival to death or census. 1826 patients with RRT, 1812 with outcome data. Total 17 cases of NSF. Survival for GBCA exposed and NSF cohort measured by RRT onset or post scan survival not significantly different between these groups. Frequency of NSF cases over years studied follows the number of CE-MRA scans performed suggesting GBCA exposure causally implicated in development of NSF
Giles Roditi1, Tara Collidge2, Peter Thomson2, Keith Simpson2, Scott Morris2, Brown Michaela2, Anirudh Rao2
1Radiology, Glasgow Royal Infirmary, Glasgow, Scotland, United Kingdom; 2Nephrology, Glasgow Royal Infirmary, Glasgow, Scotland, United Kingdom
NSF associates with the administration of gadolinium contrast in renal impairment. Of 481 patients who underwent renal CE-MRA 3 patients were identified as having NSF. 2 had AKI when imaged, third had deteriorating CKD (eGFR 16.1) and developed NSF three years later when on dialysis following further CE-MRA. All cases of gadodiamide-associated NSF from our unit (n=16) 13 were established on dialysis, 2 had AKI and one had eGFR of 8.3 ml/min. All patients developing NSF have AKI or stage 5 CKD, we found no NSF cases with an eGFR >15 ml/min.
Haiyi Wang1, Aitao Guo2, Dianjun Wang2, Yuangui Gao1, Xu Zhang3, Huiyi Ye1
1Radiology, PLA General Hospital, Beijing, China; 2Pathology, PLA General Hospital, Beijing, China; 3Urology, PLA General Hospital, Beijing, China
Renal cell carcinoma (RCC) is the most common malignant renal tumor in adults, with the three major subtypes, clear cell RCC, papillary RCC, and chromophobe RCC. Because of clincal needs for RCC subtypes differentiation, this study explores the ADC values of pathologically-proved clear cell, papillary, and chromophobe RCC subtypes, and the conclusion is drawn that they possess different diffusion characteristics that can be distinguished using DWI on the basis of the ADC, with high sensitivity and specificity, potentially improving the accuracy of pretreatment diagnosis and selection of clinical therapy.
Xiao-duo Yu1, Meng Lin1, Han Ouyang1
1Department of Diagnostic Imaging, Cancer Hospital,Peking Union Medical College,Chinese Academy of Sciences, Beijing, China
DWI and ADC value in 3.0T MRI has widely used in tumor, but applied to clinical practice limitedly for overlap between benign and malignant tumor. 51 cases with renal clear cell carcinoma proved by operation were studied. Set ADC value at 1.8×10-3mm²/s to divide the cohort into two groups. Significant differences were found between histological grade, clinical stage. After follow-up more than one year, tumor short-term control rate of the group with ADC value more than and equal to 1.8×10-3mm²/s was better than that of the group with ADC value less than 1.8×10-3mm²/s.Therefore DWI and ADC value help to evaluate prognosis potentially.
Hersh Chandarana1, Vivian S. Lee1, Elizabeth Hecht1,2, Bachir Taouli1,3, Eric E. Sigmund1
1Radiology, NYU Langone Medical Center, New York, NY, United States; 2Radiology, University of Pennsylvania, United States; 3Radiology, Mount Sinai Medical Center, New York, NY, United States
Movement of blood in microvasculature can be modeled as pseudo-diffusion also known as intravoxel incoherent motion. Perfusion effect can be separated if diffusion imaging is performed with low and high b values. The purpose of our study was to calculate perfusion fraction (fp) and tissue diffusivity (Dt) parameters obtained with biexponential analysis of multi-b DWI and determine if these parameters can distinguish enhancing from non-enhancing renal lesions. fp was higher and Dt lower in enhancing renal lesions; both these parameters had higher accuracy in detection of enhancing renal lesion compared to apparent diffusion coefficient (ADC) obtained with monoexponential fit.
Yu-Chun Lin1,2, Koon-Kwan Ng1, Tzung-Hai Yen3, Yu-Min Chen3, Hsiang-Yang Ma2, Jiun-Jie Wang4
1Department of Diagnostic Radiology, ChangGung Memorial Hospital, KweiShan, Taoyuan, Taiwan; 2Department of Electrical Engineering, ChangGung University, KweiShan, Taoyuan, Taiwan; 3Department of Nephrology, ChangGung Memorial Hospital, Taiwan; 4Department of Medical Imaging and Radiological Science, ChangGung University, KweiShan, Taoyuan, Taiwan
Diffusion Tensor Imaging in kidney for patients with chronic kidney disease indicated a significant reduction of diffusion anisotropy. Images from 6 CKD patients and 6 normal subjects were acquired in a 3 Tesla MR scanner. Regions of interest were located bilaterally in medulla and cortex. The results showed decreases in diffusion anisotropy and associated increase in radial diffusivity, noticeably in medulla in patients. We concluded that renal DTI is feasible in 3T MR scanner and furthermore, sensitive to changes in diffusivities in patients with chronic kidney disease.
Thomas Kwee1, Malou Vermoolen1, Erik Akkerman2, Henriëtte Quarles van Ufford1, Frederik Beek1, Inge Ludwig3, Marc Bierings4, Rob Fijnheer5, Marie-José Kersten6, Joseph Zsiros7, Willem Mali1, Rutger-Jan Nievelstein1
1Department of Radiology, University Medical Center Utrecht, Utrecht, Netherlands; 2Department of Radiology, Academic Medical Center, Amsterdam, Netherlands; 3Department of Hematology, University Medical Center Utrecht, Utrecht, Netherlands; 4Department of Pediatric Hematology, University Medical Center Utrecht, Utrecht, Netherlands; 5Department of Hematology, Meander Medical Center, Amersfoort, Netherlands; 6Department of Hematology, Academic Medical Center, Amsterdam, Netherlands; 7Department of Pediatric Hematology, Academic Medical Center, Amsterdam, Netherlands
This study aimed to assess the equivalence of whole-body MRI, including diffusion-weighted imaging (DWI), to computed tomography (CT) for the initial staging of malignant lymphoma. To that end, 66 consecutive patients with newly diagnosed malignant lymphoma prospectively underwent whole-body MRI (T1-weighted and short inversion time inversion recovery [n=66], and DWI [n=62]) at 1.5T and CT. Whole-body MRI (both with and without DWI) was equal to staging using CT in the majority of patients, while whole-body MRI overstaging occurs more frequently than whole-body MRI understaging (relative to CT).
Ananth J. Madhuranthakam1, Aya Yassin2,3, Jean H. Brittain4, David C. Alsop2,3, Neil M. Rofsky2,3
1MR Applied Science Lab, GE Healthcare, Boston, MA, United States; 2Radiology, Beth Israel Deaconess Medical Center, Boston, MA, United States; 3Harvard Medical School, Boston, MA, United States; 4MR Applied Science Lab, GE Healthcare, Madison, WI, United States
MRI has gained increased attention for whole-body screening of tumor metastasis. The commonly used sequences are STIR and DW-EPI. However, both are SNR limited and require multiple signal averages increasing the total scan time. In addition, DW-EPI images are also subject to distortion in larger FOVs, and are typically limited to low resolution, axial plane imaging. The primary objective of whole-body screening is to minimize the background tissue signal while simultaneously highlighting tumor signal in a rapid acquisition. Such a technique is presented in this work using SSFSE readout while suppressing signal from fat, fluid and blood vessels.
Matthew David Blackledge1, David J. Collins1, Toni Wallace1, Dow-Mu Koh1, Martin O. Leach1
1CR-UK and EPSRC Cancer Imaging Centre, Institute of Cancer Research and Royal Marsden Hospital, Sutton, Surrey, United Kingdom
We have demonstrated that the use of whole body DTI is feasible and practicable in the time required to obtain standard diffusion weighted whole body measurements of bone metastases without significant loss in image quality. Furthermore it is possible to measure useful biological parameters such as fractional anisotropy which may have direct clinical relevance in detecting spinal cord compression.
Thomas Kwee1, Inge Ludwig2, Cuno Uiterwaal3, Henriëtte Quarles van Ufford1, Marc Bierings4, Rob Fijnheer5, Taro Takahara1, Rutger-Jan Nievelstein1
1Department of Radiology, University Medical Center Utrecht, Utrecht, Netherlands; 2Department of Hematology, University Medical Center Utrecht, Utrecht, Netherlands; 3Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands; 4Department of Pediatric Hematology, University Medical Center Utrecht, Utrecht, Netherlands; 5Department of Hematology, Meander Medical Center, Amersfoort, Netherlands
This study aimed to investigate whether apparent diffusion coefficient (ADC) measurements allow discriminating normal lymph nodes from lymphomatous lymph nodes, and indolent lymphomas from aggressive lymphomas in patients with non-Hodgkin lymphoma (NHL). To that end, 18 healthy volunteers and 22 patients with newly diagnosed NHL (indolent: n=9; aggressive: n=13) prospectively underwent diffusion-weighted imaging at 1.5 T. Our results suggest that ADC measurements may be a highly specific method for discriminating normal lymph nodes from lymphomatous lymph nodes in patients with NHL. However, ADC measurements appear to be of no utility in differentiating indolent from aggressive lymphomas.
Jeff Lei Zhang1, Eric E. Sigmund1, Hersh Chandarana1, Henry Rusinek1, Hua Guo1, Pippa Storey1, Qun Chen1, Vivian S. Lee1
1Department of Radiology, New York University, New York, NY, United States
Synopsis: To improve precision of bi-exponential parameters of diffusion weighted imaging (DWI), we proposed a method for optimizing b values for DWI acquisition. Monte Carlo simulation was performed to explore whether the optimized b values would improve the bi-exponential parameters ability in differentiating benign and malignant renal lesions. Results showed that, using the optimized b values, the differentiability of perfusion fraction for the two types of lesions improved by 22%±7%, compared with uniformly distributed b values. The method should be applicable to DWI of any other tissues or organs where bi-exponential analysis is used.
Matthew David Blackledge1, David J. Collins1, Dow-Mu Koh1, Martin O. Leach1
1CR-UK and EPSRC Cancer Imaging Centre, Institute of Cancer Research and Royal Marsden Hospital, Sutton, Surrey, United Kingdom
AAn acquisition scheme optimized for computed Diffusion Weighted Imaging (cDWI) is discussed and a theoretical model for diffusion weighted image noise is presented. It is demonstrated through theory and experimental studies that noise is reduced in calculated high b-value images compared to conventional acquired high b-value DWI using this method.
14:30 4708. Comparison of Liver ADC Measurements Using Breath-Hold, Free Breath-Hold and Respiratory Gating Echoplanar Diffusion-Weighted Imaging Sequences Using Parallel Imaging Technique with Different Acceleration Factors
Chun-Jung Juan1, Hing-Chiu Chang2,3, Hsiao-Wen Chung1,3, Chi-Hong Chu4, Cheng-Chieh Cheng1,3, Su-Chin Chiu1,3, Hui-Chu Chiu5,6, Cheng-Hsien Hsu7, Cheng-Yu Chen1, Guo-Shu Huang1
1Department of Radiology, Tri-Service General Hospital, Taipei, Taiwan; 2Applied Science Laboratory, GE Healthcare Taiwan, Taipei, Taiwan; 3Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan; 4Section of General Surgery, Department of Surgery, Tri-Service General Hospital, Taipei, Taiwan; 5Department of Nuclear Medicine, Tri-Service General Hospital, Taipei, Taiwan; 6EMBA in Global Chinese Management, Department of Business Administration, College of Management, Tamkang University, Taiwan; 7Division of Software Design, Notebook Unit 5, Quanta Computer Inc., Taiwan
Inter-experimental comparison of the liver apparent diffusion coefficient (ADC) value remains challenging. In this study the effect of repetition time (TR) and acceleration factors on the liver ADC measurement is examined. Our study shows that free-breath method allows ADC measurement consistent with breath-hold method with the TR. The ADC values measured at a longer TR in both free-breath and respiration-triggered methods are significantly higher than breath-hold method. Our results also depict significant differences in liver ADC values when different acceleration factors are chosen. Our results highlight the important of TR and acceleration factors in liver ADC measurements for inter-experimental comparison.
Nina Tunariu1, James A. d'Arcy, Veronica A. Morgan1, Michael Germuska, Catherine G. Simpkin, Sharon L. Giles2, David J. Collins, Nandita M. deSouza
1 CR-UK and EPSRC Cancer Imaging Centre, Institute of Cancer Research and Royal Marsden Hospital, Sutton, Surrey, United Kingdom; 2CR-UK and EPSRC Cancer Imaging Centre, Institute of Cancer Research and Royal Marsden Hospital, United Kingdom
A major challenge for implementing diffusion-weighted magnetic resonance imaging (DW-MRI) as tumour response biomarker in multicentre clinical trials is in measuring changes in individual patients reliably and reproducibly. The delineation of the region of interest (ROI) has a great impact on final reproducibility. This study compares ADC values obtained using in-house computer ROI drawing software (Diffusion View) to segment tumour with those obtained from a manual drawing technique. Computer generated ROIs have the advantage of less variability, operator independence and significant time saving and support the feasibility of use of automated DWI measurements in clinical trials.
Lan Lu1, Jacob M. Haus2, John P. Kirwan2, Chris A. Flask1,3
1Department of Radiology, Case Western Reserve University, Cleveland, OH, United States; 2Department of Pathobiology, Cleveland Clinic, Cleveland, OH, United States; 3Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, United States
Recent studies suggest diffusion-weighted (DWI) and diffusion tensor MRI (DTI) as a promising tool in studying hepatic diseases including hepatitis and cirrhosis. Similarly, Non-Alcoholic Fatty Liver Disease (NAFLD) progresses from fatty liver (steatosis) to fibrosis (steatohepatitis), but diffusion MRI studies on NAFLD subjects are limited. In this study, we used DTI to investigate the diffusion parameters in obese, insulin resistant adults with fatty liver in comparison with healthy volunteers. Our results demonstrate diffusional changes indicative of hepatic adipocyte accumulation and not fibrosis. Therefore, hepatic lipids can complicate the utility of DWI/DTI in the study hepatic fibrosis associated with NAFLD/NASH.
Jiayin Gao1, Jinning Li1, Zhenghan Yang1, Yuan Fu1, Liang Xu1, Min Chen1, Cheng Zhou1
1Radiolgical Department, Beijing Hospital, Beijing, China
The aim of this study is to evaluate the reproducibility of ADC measurement in liver of healthy volunteers at 1.5T and 3.0T MR scanner. DWI of the liver was performed in 30 healthy volunteers with both 1.5T and 3.0T MR scanner in the same day. The mean ADC value of liver was 1.57¡Á10-3 mm2/s at 1.5T, while 1.35¡Á10-3 mm2/s at 3.0T (P<0.001). The result indicates that there is signiﬁcant variability of ADC measurement in hepatic parenchyma at between 1.5T and 3.0T.
Beena George1, Andriy Babsky1, George E. Sandusky2, Navin Bansal1
1Radiology, Indiana University, Indianapolis, IN, United States; 2Pathology and Laboratory Medicine, Indiana University, Indianapolis, IN, United States
The effect of hepatic fibrosis produced by diethylnitrosamine (DEN) was examined by fat and water MRI and diffusion weighted (DW) 1H MRI, separating water molecular diffusion and tissue perfusion. DEN caused an increase in liver water MRI signal intensity but no change in fat content. Fast apparent diffusion coefficient (ADC), which represents perfusion, was lower in DEN treated fibrotic livers compared to control livers. Slow ADC, which represents molecular diffusion, was same in both groups. Measurement of perfusion by DW 1H MRI may be a useful marker for diagnosis of liver fibrosis.
Jean-Luc Daire1, Ralph Sinkus2, Mathilde Wagner1, Nathalie Haddad1, Valérie Vilgrain1, Bernard Van Beers1
1CRB3 Centre de Recherches Biomédicales Bichat-Beaujon, INSERM U773, Paris, France, Metropolitan; 2Institut Langevin, ESPCI, Paris, 75005, France, Metropolitan
The aim of this project was to prospectively evaluate a DW MR imaging sequence combined with parallel acquisition to allow the calculation of pure molecular-based (D) and perfusion related (D*, f) diffusion parameters based on IVIM theory, in liver lesions according to their enhancement behaviour on 3D gradient-echo contrast-enhanced MR sequences. We have shown that D* and f values can reflect liver lesions perfusion since hypervascular liver lesions had significantly greater D* and f values than intermediate and non hypervascular lesions. A biexponential approach might be useful for the characterization of liver lesions and the assessment of tumour response.
Oliver Dudeck1, Christian Wybranski1, Martin Zeile1, David Löwenthal1, Frank Fischbach1, Maciej Pech1, Gero Wieners1, Jens Ricke1
1Radiology and Nuclear Medicine, Otto-von-Guericke University, Magdeburg, Sachsen-Anhalt, Germany
Forty colorectal liver metastases in 30 patients were evaluated with MRI including diffusion-weighted imaging (DWI) immediately before, 2 days after and 90 days following CT- and MR-guided brachytherapy. Tumor diameter (TD) and ADC were evaluated by two radiologists. On early postprocedural MRI, mean TD sligthly incresed while mean ADC decreased significantly (p<0,001). On follow-up MRI, a decrease in mean TD correlated with an increase of mean ADC (p<0,001 both; r=-0,565). In conclusion, changes in ADC can be assessed as soon as 2 days following brachytherapy. Early ADC decrease most likely reflected cell swelling, late increase reduction of tumor cell density.
14:00 4715. Diffusion Weighted Imaging in Differentiating Malignant from Benign Intraductal Papillary-Mucinous Neoplasm of the Pancreas - not available
Atsushi Nakamoto1, Tonsok Kim1, Masatoshi Hori1, Hiromitsu Onishi1, Takahiro Tsuboyama1, Mitsuaki Tatsumi1, Noboru Maeda1, Hiroki Higashihara1, Keigo Osuga1, Kaname Tomoda1
1Department of Radiology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
We retrospectively evaluated the diagnostic performance of diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) value for differentiating malignant intraductal papillary-mucinous neoplasm (IPMN) of the pancreas from benign IPMN. The mean minimum ADC value of malignant IPMN was lower than that of benign IPMN (P < 0.001). Mean Az value, sensitivity, specificity and accuracy of MR imaging with DWI were higher than those of MR imaging without DWI, although differences were not significant. We conclude that DWI and measurement of minimum ADC value would be helpful for differentiating malignant IPMN form benign IPMN.
Mamoru Takahashi1, Yasuo Takehara2, Takahiro Natsume3, Norihiro Tooyama, Katsutoshi Ichijo, Harumi Sakahara2, Atsushi Nozaki4
1Seirei Mikatabara General Hospital, Hamamatsu, Shizuoka, Japan; 2Hamamatsu University of Medicine; 3Seirei Hamamatsu General Hospital; 4GE Healthcare Japan
Problem: Tumor detection based on apparent diffusion co-efficient (ADC) is not always efficient and accurate on the high b-value diffusion weighted image (DWI). Method: The signal intensity ratio between lesions and spinal cord signal (LSR) were measured on DWI. The LSR was higher in malignant tumors than in other lesions. Tumor screening application gLSR maph was developed based on the signal intensity ratio between the lesions and the spinal cord signal on DWI. Results: With the cut-off of 0.45 for LSR, sensitivity for malignant tumor was 100%. Using the color map, effective and robust tumor screening was feasible on DWI.
Shonit Punwani1, Alan Bainbridge1, Stuart Taylor1, Steven Daw2, Ananth Shankar2, Paul Humphries1
1Radiology, University College London Hospital, London, United Kingdom; 2Paediatrics, University College London Hospital, London, United Kingdom
Cellular density should decrease following successful chemotherapy of lymphomatous tissue and a corresponding rise of ADC is expected. This study investigates the extent and nature of histographic post treatment ADC changes associated with a successful treatment outcome in childhood and adolescent patients with lymphoma.
Saori Mori1, Isao Muro1, Hisamoto Moriguchi1, Tomohiko Horie1, Masatoshi Honda1, Tesuo Ogino2, Makoto Obara2, Yutaka Imai1
1Radiology, Tokai university, Isehara, Kanagawa, Japan; 2Philips Healthcare Asia Pacific, Shinagawa, Tokyo, Japan
Significant distortion can often be observed in body diffusion weighted images using single shot EPI. In this study, we demonstrate that a B0 map obtained using three point-Dixon method is useful to correct for distortion. The correlation coefficients of corrected images were increased by 0.02 or greater from those of the uncorrected images. In this method, although prescan is required, it requires about a minute and a B0 map obtained from the prescan can be applied to 50 images. This method is quite useful in practice since a B0 map created using this method enables good distortion correction.
Tetsuo Ogino1, Tomohiko Horie2, Isao Muro2, Marc Van Cauteren3, taro takahara4
1Clinical Science , Philips Electronics Japan, LTD, Minato-ku, Tokyo, Japan; 2Tokai Univ. Hospital, Japan; 3Philips Healthcare Asia Pacific, minato-ku, Tokyo, Japan; 4Division of Radiology, Radiotherapy and Nuclear Medicine (RRN), University Medical Center (UMC) Utrecht, Utrecht, Netherlands
Respiratory and Cardiac motion affects DWI IQ on liver. A voxel deformation due to motion under Motion Probing Gradient(MPG) induces spin phase dispersion in a voxel and results signal loss. By replacing conventional MPG with a pair of bipolar gradient, the signal loss is reduced significantly. However, minimum TE and TR are prolonged due to low efficiency of such type of MPG. We propose a novel MPG method which is formed as hybrid of conventional MPG and bipolar MPG. Image quality of liver diffusion is significantly improved with slight scan time prolongation from conventional respiratory triggered DWI.
Andreas K. Bitz1,2, Irina Brote1,2, Stephan Orzada1,2, Oliver Kraff1,2, Stefan Maderwald1,2, Harald H. Quick3, Klaus Solbach4, Achim Bahr5, Hans-Peter Fautz6, Franz Schmitt6, Mark E. Ladd1,2
1Erwin L. Hahn Institute for MRI, University Duisburg-Essen, Essen, Germany; 2Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany; 3Institute for Medical Physics, Friedrich-Alexander-University, Erlangen-Nuernberg, Germany; 4High Frequency Technique, University Duisburg-Essen, Duisburg, Germany; 5IMST GmbH, Kamp-Lintfort, Germany; 6Siemens Healthcare Sector, Erlangen, Germany
The aim of this study was to compare RF shimming procedures based on RF simulations and measured B1+ maps for different ROIs in the thorax and abdomen of volunteers with varying physique. Simulation-based RF shims were computed by use of heterogeneous body models. In vivo B1+ mapping was performed during breath hold by utilization of a pre-saturation turboFLASH. ROIs in the heart, liver, and kidney were considered. Appropriate simulation-based shims could be derived which function in the majority of considered volunteers. If the numerical body model inadequately describes the subjects body, measured shims should be preferred to achieve higher image quality.
Matthew David Blackledge1, David Higgins2, Dow-Mu Koh1, Nandita M. deSouza1, Martin O. Leach1, David J. Collins1
1CR-UK and EPSRC Cancer Imaging Centre, Institute of Cancer Research and Royal Marsden Hospital, Sutton, Surrey, United Kingdom; 2Philips Healthcare, Guildford, Surrey, United Kingdom
A variety of fat suppression techniques including STIR, SPIR, SPAIR and SSGR used alone or in combination are investigated for use in large field of view Diffusion Weighted Imaging at 3.0T. We conclude that a combinatorial approach improves results. A combination of STIR and SPIR works well and can be further improved used in combination with SSGR. All methods would benefit from improved shimming over large field of view to reduce off-resonance attenuation effects.
Claudia Testa1, Laura Miglio2, David Neil Manners1, Caterina Tonon1, Emil Malucelli1, Bruno Barbiroli1, Andrea Pasini2, Giovanni Tani2, Raffaele Lodi1
1MR Spectroscopy Unit, Department of Internal Medicine, Aging and Nephrology, University of Bologna, Bologna, Bo, Italy; 2Paediatric Radiology Unit, Department of Woman, Child and Adolescent Health, University of Bologna, Bologna, Italy
DTI was used to evaluate renal damage in patients with chronic pyelonephritis. In 12 children affected by unilateral pyelonephritis as assessed by renal scintigraphy (Tc99-DMSA), axial DT images were acquired at b-values of 0, 100, 300, 600, 800 s/mm2. The mean diffusivity (D) and fractional anisotropy (FA) maps were generated for each b-value. We found that FA discriminated values from cortex and medulla better than D in healthy kidneys. D and FA decreased in affected kidneys at each b-values, in particular in the cortex of kidney poles. Changes of D and FA correlated with the degree of functionality damage found by scintigraphy.
Clifford R. Weiss1, Atilla Peter Kiraly2, Ralph Strecker3
1Department of Radiology, The Johns Hopkins Univeristy School of Medicine, Baltimore, MD, United States; 2Imaging and Visualization, Siemens Corporate Research, Princeton, NJ, United States; 3MR Oncology, Siemens Healthcare, Erlangen, Germany
Existing liver diffusion MR studies have moderate variability in computed ADC values. Reasons from transient changes in portal venous flow to noise have been attributed to this variability. However, the massive increase in splanchnic/portal blood flow after eating does not seem to be taken into account. We present a study comparing diffusion data before and after fasting that shows a large increase in ADC values after eating. Although it is a small study, results suggest that patient feeding state should be factored into future studies.
Ming-Cherng Wu1, Yu-Chun Lin1,2, Chung-Huang Hsieh1, YauYau Wai1,3, JiunJie Wang1,3
1Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, LinKou, Tao Yuan, Taiwan, Taiwan; 2Department of Electrical Engineering, Chang Gung University; 3Department of Medical Imaging and Radiological Sciences, ChangGung University
Renal cortex is the part of renal columns that contain the renal corpuscles and the renal tubules. The direction of water diffusion is consistent, which was properly reflected in the map of InterVoxel Diffusion Coherence. Diffusion Tensor Imaging in kidney were acquired from a 3T scanner. InterVoxel Diffusion Coherence detected high uniformity of the eigenvector distribution in the renal cortex. In the other hand, low Fractional Anisotropy in the corresponding regions suggested diffusion isotropy within cortex.
MRS - Body Applications
Jesper Lundbom1, Antti Hakkarainen1, Sanni Söderlund2, Nina Lundbom1, Marja-Riitta Taskinen2
1HUS Medical Imaging Centre, University of Helsinki, Helsinki, Finland; 2Department of Medicine, University of Helsinki
We used 1H-MRS to study adipose tissue fat composition and liver fat content in men with the metabolic syndrome. Adipose tissue methylene/methyl, an index of saturated fats, correlated negatively with liver fat content.
Gavin Hamilton1, Michael S. Middleton1, Takeshi Yokoo1, Mark Bydder1, Irene W. Mwangi1, Michael E. Schroeder1, Claude B. Sirlin1
1Department of Radiology, University of California, San Diego, San Diego, CA, United States
Accurate proton (1H) MRS fat quantification of liver fat requires determination of signal from fat peaks that are near or under the water peak. A theoretical triglyceride model was developed to characterize the liver fat spectrum, using number of -CH=CH- and -CH=CH-CH2-CH=CH- bonds, and average fatty acid chain length. In vivo, the relative areas of the different fat peaks are strongly correlated suggesting the fat profile is uniform regardless of the level of fat deposition in the liver. The model gives that 8.6% of the total liver fat underlies the water peak.
15:00 4727. Comparison of Liver Steatosis Quantification by MRS at 4.7 T and Histology on Ob/ob and Db/db Mice - not available
Fanny Noury1,2, Alain Fautrel3,4, Eric Hitti1,2, Pascale Bellaud3, Hervé Saint-Jalmes1,2, Bernard Fromenty4, Pierre-Antoine Eliat2
1LTSI - INSERM U642 - Université Rennes 1, Rennes, France; 2PRISM - IFR 140 BiogenOuest - Université Rennes 1, Rennes, France; 3Plate-forme dHistopathologie - IFR 140 BiogenOuest - Université Rennes 1, Rennes, France; 4FMC - INSERM U991 - IFR 140 - Université Rennes 1, Rennes, France
Murine models of obesity such as ob/ob (leptin deficient) and db/db (leptin receptor deficient) mice are extensively used in different scientific fields including pharmacology and toxicology. Besides increased body fatness, hyperlipidemia and insulin resistance these mice develop moderate (db/db) or massive (ob/ob) steatosis. In some studies a longitudinal follow-up of steatosis may be warranted, to assess the beneficial (or deleterious) effects of chronic drug administration. In this preliminary study, db/db and ob/ob mice were used to determine whether magnetic resonance spectroscopy could be a reliable non-invasive method to evaluate fatty liver, using statistical comparison with histological results.
Estee Fleischman1, Lauren Dutcher1, David Thomasson2, Adeline Louie2, Haresh Mani3, David Kleiner3, Caryn Morse1, Colleen Hadigan1
1National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States; 2Diagnostic Radiology Department, National Institutes of Health, Bethesda, MD, United States; 3National Cancer Institute, National Institutes of Health, Bethesda, MD, United States
There is growing interest in the application of 1H-MRS as a non-invasive approach to quantify hepatic triglyceride. This study was designed to establish the ability of 1H-MRS to accurately assess hepatic fat compared to histological scoring. Fifty subjects completed 1H-MRS of the liver within 30 days of diagnostic biopsy. The mean hepatic triglyceride content by 1H-MRS for each histologic grade was 9%, 23%, 40% and 56%, respectively. The correlation between the two methods was r=0.88, p<0.0001. With the phantom data we achieved an r=0.98 (p=0.02) over a range of fat-water fractions of 10 to 20 % using the standardized formula.
Giulio Gambarota1, Mark Tanner1, Johanna Berg2, Robert V. Mulkern3, Rex D. Newbould1
1GlaxoSmithKline, London, United Kingdom; 2Radiology, University Hospital of Malmö, Sweden; 3Radiology, Children's Hospital Boston, Boston, MA, United States
Magnetic resonance spectroscopy (MRS) is becoming the method of choice for non-invasive assessment of lipids in liver. To avoid artifacts due to liver motion, MRS is often performed with a breath-hold approach. Given the limited amount of time available to perform the acquisition, it is of interest to maximize the signal-to-noise ratio (SNR) of the lipid resonances. Here, we show that it is possible to substantially improve the SNR of the in liver, by choosing an appropriate TR. The current approach has the advantage of experimental simplicity and can be applied to all basic sequences routinely used in clinical settings.
Kannie W. Y. Chan1,2, April M. Chow1,2, Shu Juan Fan1,2, Ed X. Wu1,2
1Laboratory of Biomedical Imaging and Signal Processing, The University of Hong Kong, Pokfulam, Hong Kong SAR, China; 2Department of Electrical and Electronic Engineering, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
Post-operative diagnosis is important in partial hepatectomy (PHx) to determine the best time for interventions or therapeutic measures. We studied changes in unsaturated lipids verse saturated lipids as a mean to follow liver regeneration. The amount of unsaturated lipid at different time points showed a related trend with liver regeneration. A high level was found at 24h post-PHx, and was correlated with the maximum liver regeneration, and the saturated lipid stayed at a high level during the first day of regeneration. Thus, this pilot study shows that 1H-MRS could provide us with more information on the degree of regeneration.
14:30 4731. The Effect of Meal and Exercise on the in Vivo 31P-NMR Liver Spectrum: Initial Findings - not available
Antti Hakkarainen1, Jesper Lundbom1,2, Esa K.J. Tuominen1, Marja-Riitta Taskinen, Kirsi Hannele Pietiläinen3, Nina Lundbom1
1Helsinki Medical Imaging Centre, University of Helsinki, Helsinki, Finland; 2Department of Medicine, Division of Cardiology, University of Helsinki, Helsinki, Finland; 3Obesity Research Unit, Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland
We studied the effects of a normal high-fat meal and subsequent exercise on the 31P MR spectrum of healthy volunteers using a proton-decoupled 31P MR spectroscopy at 3 T. We found a trend of rising ATP resonance at postprandial state suggesting that the physiological state may have an impact and should be standardized in phosphorus studies.
Anshuman Panda1,2, Scott Ray Jones1,2, Ulrike Dydak1,2
1School of Health Sciences, Purdue University, West Lafayette, IN, United States; 2Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, United States
Regional changes in the 31P metabolite concentration of the whole liver can be acquired using a multi-channel phased-array 31P coil. However, changes in coil placement, separation between anterior and posterior coil, and spectroscopic imaging setup can significantly affect the reproducibility of the data. Methods to maximize data reproducibility including reproducible coil placement and spectroscopic planning, correction of coil sensitivities, and evaluation of the data variability from one scan to another for a whole liver 31P 2D MRSI experiment is presented for a dual tuned 8-channel 31P/1H coil.
Jerry S. Cheung1,2, Shu Juan Fan1,2, Darwin Shan Gao1,2, Kannie W.Y. Chan1,2, April M. Chow1,2, Kwan Man3, Ed X. Wu1,2
1Laboratory of Biomedical Imaging and Signal Processing, The University of Hong Kong, Pokfulam, Hong Kong SAR, China; 2Department of Electrical and Electronic Engineering, The University of Hong Kong, Pokfulam, Hong Kong SAR, China; 3Department of Surgery, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
Carbon tetrachloride (CCl4) intoxication is a well-characterized, reproducible and the most commonly used experimental model of liver fibrosis. Proton magnetic resonance spectroscopy (1H MRS) can provide insights into in vivo liver metabolism noninvasively, yet detailed in vivo MRS study of CCl4-induced liver fibrosis model has been limited. The aim of this study was to characterize early metabolic changes in CCl4-induced liver fibrosis in rodents by means of single-voxel 1H MRS. Our experimental results demonstrated that 1H MRS at high field may be valuable in characterizing metabolic changes in liver, in particular those related to lipid and glutamine metabolism, after CCl4 insult.
Dominick John McIntyre1, Franklyn Arron Howe2, Christophe Ladroue2, Fiona Lofts2, Marion Stubbs1, John Richard Griffiths1
1CRUK Cambridge Research Institute, Li Ka Shing Centre, Cambridge, United Kingdom; 2St George's, University of London, United Kingdom
We have applied 19F MRS to measure the pharmacokinetics of 5FU metabolism in the livers of 32 patients with colorectal cancer. 15 of the subjects had liver metastases. 5FU half-lives ranged from 4 to 15 minutes and were not significantly different between patients with and without liver metastases. In the group with metastases, high levels of toxic fluoronucleotides, primarily produced in tumour cells, were associated with poorer survival. This may be due to higher metastatic load giving higher concentrations of fluoronucleotides and poorer survival.
Aude Fregeville1, Stephane Silvera1, Lionel Groussin2, Olivier Vignaux1, Victoria Cavero Machado3, Nashiely Pineda Alonso3, Paul Legmann1
1Department of Radiology, University René Descartes Paris V, Hôpital Cochin, Paris, France; 2Service des Maladies Endocriniennes et Métaboliques, University René Descartes Paris V, Hôpital Cochin, Paris, France; 3Siemens Healthcare, Paris, France
A size up to 3 cm lesion in the adrenal glands leads the patient to surgery. MRS is a promising tool for the classification of adrenal masses. We evaluated the advantages of multiple channel phased array (32-channel) coil in the respiratory-triggered proton single-voxel MR spectroscopy technique at 1.5 T for the diagnosis of adrenal masses and the differentiation between them. The gain in signal of the 32 channel coil gave an excellent spectral quality even in a free breathing acquisition at 1.5 Tesla. It is possible in deed to differentiate the types of masses by their spectral characteristics and ratios.
Omkar B. Ijare1, Tedros Bezabeh1, Nils Albiin2, Annika Bergquist2, Urban Arnelo2, Mathias Lohr2, Espen Melum3, Ian C.P. Smith1
1National Research Council Institute for Biodiagnostics, Winnipeg, Manitoba, Canada; 2Karolinska University Hospital, Karolinska Institutet, Huddinge, Stockholm, Sweden; 3Deparment of Medicine, Oslo University Hospital, Oslo, Norway
Regurgitation of pancreatic juice into the biliary tract and the subsequent mixing with bile is frequently observed in patients with pancreaticobiliary maljunction (PBM), which is a potential risk factor for the carcinogenesis of bile duct and gallbladder. The mixing of bile with pancreatic juice is generally diagnosed by measuring the amylase activity in bile. We propose that pancreaticobiliary reflux can be detected by 1H MR spectroscopy as an alternative to the measurement of amylase activity. Moreover, it may be possible to detect non-invasively the regurgitation of pancreatic fluids into the gallbladder using in vivo spectroscopy.
Owen John Arthurs1, Ilse Joubert1, Martin John Graves1, Pat Set1, David John Lomas1
1Department of Radiology, University of Cambridge and Addenbrooke's Hospital, Cambridge, Cambridgeshire, United Kingdom
Vesico-ureteric reflux is a congenital disorder of the paediatric renal tract, for which the current gold standard is the Micturating Cystourethrogram (MCUG). This study evaluated the feasibility of MR voiding cystourethrography using dilute intravesical gadolinium in unsedated infants. Real time interactive switching between gradient echo (SPGR) and SSFSE based pulse sequences allowed 6 children with urinary tract abnormalities to undergo both MCUG and MRI. There was 83% concordance between MCUG and MRVC regarding vesicoureteric reflux, and complete agreement regarding the urethra and bladder. Fluoroscopic MR assessment of the complete paediatric renal tract is possible in unsedated infants.
Giulio Gambarota1, R L. Janiczek1, Robert V. Mulkern2, Rex D. Newbould1, Brandon Whitcher1
1GlaxoSmithKline Clinical Imaging Center, London, United Kingdom; 2Radiology, Children's Hospital Boston, Boston, United States
In clinical MR examinations of the prostate, a multiparametric approach (T1- and T2-weighted images, quantitative measurement of the apparent diffusion coefficient (ADC) of water, dynamic contrast-enhanced MRI) is becoming standard procedure. The Carr-Purcell-Meiboom-Gill (CPMG) approach has recently been proposed for T2 mapping of the prostate at 1.5 T. No such studies have been performed at 3 T. Translating the CPMG sequence to 3 T is not straightforward and involves compromises in clinical implementation. Here we have shown high quality measurements of T2 may be obtained over the entire prostate by careful design of the clinical acquisition.
14:30 4739. Ultra Short Gradient Echo Imaging of the Prostate at 7T - not available
Gregory John Metzger1, Steen Moeller1, Patrick J. Bolan1, Eddie J. Auerbach1, Jang-Yeon Park1, Michael Garwood1
1Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, United States
The purpose of this study was to investigate the potential of an ultra-short TE 3D radial sequence, for imaging the prostate at 7T. This technique is desirable for DCE-MRI because it would greatly reduce both the large T2* effect of paramagnetic contrast agents at high field, and the inflow artifacts that can bias the measurement of the arterial input function. Furthermore the sequence gives spatially isotropic resolution and, when combined with sparse temporal sampling methods, can provide very high temporal resolution. This work demonstrates the feasibility and imaging quality of this technique and discusses its strengths and weaknesses.
Susan M. Noworolski1,2, Kyle Kuchinsky3, Michelle Nystrom1, John Kurhanewicz1,2, Daniel B. Vigneron1,2, Peter R. Carroll4, Kirsten Greene4, Jeffry Simko3
1Radiology and Biomedical Imaging, University of California, San Francisco, CA, United States; 2The Graduate Group in Bioengineering, University of California, San Francisco and Berkeley, CA, United States; 3Pathology, University of California, San Francisco, CA, United States; 4Urology, University of California, San Francisco, CA, United States
Validation of MR measures of the prostate are challenging due to heterogeneity. Tissue compositions by histopathology and their impact on DCE MRI measures were evaluated and compared in high and moderate grade prostate cancers. Fourteen men had DCE MRI before prostatectomy. High Gleason Grade (≥4+4) lesions had higher %cancer than Gleason 3+3 lesions (87% vs. 58%, p<0.00001). Normalizing DCE MRI measures to %cancer led to higher measures versus healthy peripheral tissues and greater separations between 3+3 and 4+4 cancers. Heterogeneity of tissues and %cancer may impact DCE MRI measures, with potentially different effects in Gleason Grade 3+3 versus 4+4 cancers.