Electronic Posters : Cancer Imaging
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Gastrointestinal & Hepatobiliary Cancers (Clinical Studies)

Monday May 9th
Exhibition Hall  14:00 - 16:00 Computer 8

14:00 3041.   Signal intensity of hepatic nodules detected by gadoxetic acid-enhanced MR imaging: Correlation with arterial and portal blood supply. 
Megumi TAKECHI1, Takaharu TSUDA1, Hiroaki TANAKA1, Shinji YOSHIOKA2, Michinobu NAGAO3, and Teruhito MOCHIZUKI1
1Department of Radiology, Ehime University School of Medicine, Shitsukawa,Toon, Ehime, Japan, 2Department of Radiology, Matsuyama Redcross Hospital, Japan,3Department of Molecular Imaging and Diagnosis, Kyushu University School of Medicine, Japan

Signal intensity of hepatic nodules detected by gadoxetic acid-enhanced MR imaging: Correlation with arterial and portal blood supply.

14:30 3042.   Hepatobiliary Phase of Gadoxetic Acid-enhanced MRI in the Diagnosis of Hepatocellular Carcinoma in Patients with Impaired Liver Function 
Eun-Suk Cho1, and Jeong-Sik Yu1
1Radiology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Korea, Republic of

Gadoxetic acid-enhanced MRI improves detection of hepatocellular carcinoma (HCC). However, since the degree of liver enhancement in hepatobiliary phase is known to be lower in patients with chronic liver dysfunction, diagnostic value of hepatobiliary phase imaging of Gadoxetic acid-enhanced MRI might be expected to be lower in the diagnosis of HCC in patients with impaired liver function. Therefore, we tried to evaluate the value of hepatobiliary phase of gadoxetic acid-enhanced MRI in the diagnosis of HCC in patients with impaired liver function.

15:00 3043.   Hypovascular nodules presented with hypointensity on the hepatobiliary phase of Gd-EOB-DTPA enhanced MRI in the cirrhotic liver: Implications for developing hypervascular hepatocellular carcinoma. 
Tomoko Hyodo1,2, Masahiro Okada1, Yuki Kagawa1, Sachiyo Kogita3, Seishi Kumano1, Izumi Imaoka1, Masatoshi Hori4, Kazunari Ishii1, Yasuharu Imai3, Teruhito Mochizuki2, Masatoshi Kudo5, and Takamichi Murakami1
1Radiology, Kinki University Faculty of Medicine, Osaka-Sayama, Osaka, Japan, 2Diagnostic and Therapeutic Radiology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan, 3Gastroenterology, Ikeda Municipal Hospital, Ikeda, Osaka, Japan, 4Radiology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan,5Gastroenterology and Hepatology, Kinki University Faculty of Medicine, Osaka-Sayama, Osaka, Japan

To clarify the significance of hypovascular nodules presented with hypointensity on hepatobiliary phase of Gd-EOB-DTPA enhanced MRI in screening for hepatocellular carcinoma (HCC) in the cirrhotic liver, 122 hypovascular hepatic nodules with hypointensity on hepatobiliary phase in 54 patients were reviewed. The incidence rate of developing hypervascular HCC from such nodules was 32%. Patients with higher growth rate (GR) may have potential arterial hypervascularization, and GR of >2.8x10-3(tumor volume doubling time of < 355 days) may justifiy follow-up at short intervals.

15:30 3044.   Diffusion-Weighted Imaging versus Superparamagnetic Iron Oxide (SPIO)-Enhanced MRI: Exclusive and Combined Values in the Assessment of Hepatic Metastases 
Hana Kim1, Jeong-Sik Yu1, Eun-Suk Cho1, Jae-Joon Chung1, Joo Hee Kim1, and Ki Whang Kim1
1Radiology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Korea, Republic of

SPIO-enhanced DWI showed higher sensitivity in the detection of liver metastases

Tuesday May 10th
  13:30 - 16:00 Computer 8

13:30 3045.   MRI of the cirrhotic liver with Gd-EOB-DTPA: Does the addition of the hepatocyte phase improve detection and confidence in characterization of hepatocellular carcinoma? 
Mustafa R Bashir1, Rajan T Gupta1, Matthew S Davenport1, Brian C Allen1, Lisa M Ho1, Daniel T Boll1, and Elmar M Merkle1
1Radiology, Duke University Medical Center, Durham, NC, United States

The purpose of this study is to evaluate whether the hepatocyte phase (delayed phase) image data set improves the detection and reader confidence in characterization of hepatocellular carcinoma in the MRI of the cirrhotic liver with Gd-EOB-DTPA.

14:00 3046.   Characterization of Hyperintense Nodules on Precontrast T1-weighted MR Imaging: The Utility of Gadoxetic Acid-Enhanced Hepatocyte-Phase Imaging 
Chen-Te Chou1, and Ran-Chou Chen2
1Radiology, Changhua Christian Hospital, Chang-Hua, Taiwan, Taiwan, 2Radiology, Taipei City Hospital, Taipei, Taiwan

Purpose: To evaluate the utility of gadoxetic acid-enhanced hepatocyte-phase imaging (HP) in characterization of T1W hyperintense nodules. Materials and Methods: 34 T1W hyperintense nodules in 19 patients with histopathological confirmation were included. ROC analysis was used to evaluate the diagnostic performance. Results: The mean size of dysplastic nodules were smaller than that of HCCs. (p<0.001) There were seven additional HCCs diagnosed using hepatocyte-phase imaging compared to conventional HCC diagnostic criteria (p=0.02). Conclusion: gadoxetic acid-enhanced MRI with HP is superior to conventional criteria alone in characterization of T1W hyperintense nodule.

14:30 3047.   Assessment of response to therapy by DCE-MRI and DWI MRI in primary liver cancers 
David H Gultekin1, Lawrence H Schwartz2, Nancy E Kemeny3, Mithat Gonen4, Michael I D'Angelica5, Peter J Allen5, Yuman Fong5, Leslie H Blumgart5, Ronald P Dematteo5, and William R Jarnagin5
1Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY, United States, 2Radiology, Columbia University Medical Center, New York, NY, United States,3Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, United States, 4Epidemiology-Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York, United States, 5Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, United States

The role of DCE-MRI and DWI-MRI have been evaluated in a Phase II study for the assessment of response to therapy in patients with unresectable primary liver cancers, hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC), undergoing regional combination chemotherapy and anti-angiogenic therapy through continuous hepatic arterial infusion (HAI) treatment procedure.

15:00 3048.   DCE-MRI Perfusion in Liver Disease with 3D Volumetric Coverage 
Yin Huang1, Ethan Brodsky1, Kevin Johnson1, Eric Bultman2, Debra Horng1,3, Sean Fain1,3, and Scott Reeder1,3
1Medical Physics, University of Wisconsin Madison, Madison, WI, United States, 2Biomedical Engineering, University of Wisconsin Madison, Madison, WI, United States,3Radiology, University of Wisconsin Madison, Madison, WI, United States

A novel method for acquiring dynamic contrast-enhanced (DCE) MRI of liver perfusion with full abdominal coverage is used to measure the blood supply to liver parenchyma and focal liver lesions non-invasively. This study aims to provide semi-quantitative metrics to evaluate 3D regional perfusion in a feasibility study to measure perfusion in focal liver lesions. The method is designed to predict long-term tumor response to chemotherapy by providing quantitative measures of early changes in perfusion specific to liver tumors.

Wednesday May 11th
  13:30 - 15:30 Computer 8

13:30 3049.   Normal pancreas and pancreatic cancer: comparison among different diffusion weighted MR imaging acquisitions at 3.0T 
Xiuzhong Yao1, Mengsu Zeng1, He Wang2, Fei Sun2, Shengxiang Rao1, and Yuan Ji3
1Radiology, Zhongshan Hospital of Fudan University, Shanghai, Shanghai, China, People's Republic of, 2The applied science lab,GE Healthcare, 3Pathology, Zhongshan Hospital of Fudan University, Shanghai, Shanghai, China, People's Republic of

To evaluate 3.0T DWI technique on Normal pancreas and pancreatic cancer, five DWI acquisitions were all performed in 15 normal volunteers and 30 patients with pancreatic cancer. Artifacts, SNR and ADC value of normal pancreas and C, CNR and ADC value of pancreatic cancer were investigated. Statistically higher C and CNR of pancreatic cancer was noticed in respiratory-triggered DWI with MPG pulses in X¡¢Y¡¢Z direction and inversion recovery for fat saturation compared to other four DWI acquisitions, and its ADC value can better disclose histopathological state in pancreatic cancer, adjacent pancreatic tissue and distal pancreatitis.

14:00 3050.   Pancreatic Cancer Screening and Surveillance with MRI – 7 Year Experience 
Masoom A Haider1, Wigdan Al-Sukhni2, Kartik S Jhaveri1, Heidi Rothenmund2, Spring Holter2, Steven Narod3, Malcolm Moore4, Stephanie Wilson5, and Steven Gallinger2
1Medical Imaging, Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada, 2Department of Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada, 3Women's College Research Institute, University of Toronto, Toronto, Ontario, Canada, 4Department of Medicine, Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada, 5Medical Imaging, University Health Network, University of Toronto, Toronto, Ontario, Canada

High risk patients were screened annually with non-contrast 20 minute MRI protocol from 2003-2010. Pancreatic cancer was found in 2 of the 259 patients (0.7%): 57 yo female with a 1.5cm adenocarcinoma and a concomitant IPMN, stage IIB ; 80 yo male with unresectable pancreatic adenocarcinoma. IPMNs were seen in 14 patients (5.4%).Seven significant incidental findings (2.7%) were detected by MRI. MRI has the potential to detect pancreatic cancer in a high risk screening populations but frequent scanning and IV contrast and may be required to impact survival. IPMN’s are a common finding.

14:30 3051.   Dynamic contrast-enhanced magnetic resonance imaging to assess desmoid tumours in familial adenomatous polyposis 
Santosh Bhandari1, N. Jane Taylor2, Ashish Sinha1, J. James Stirling2, Ian C Simcock2, Arun Gupta1, Robin K.S. Phillips1, Susan K Clark1, and Vicky J Goh2
1Polyposis Registry, St Mark’s Hospital, London, United Kingdom, 2Paul Strickland Scanner Centre, Mount Vernon Hospital, Northwood, Middlesex HA6 2RN, United Kingdom

Familial adenomatous polyposis (FAP) is an autosomal dominant hereditary condition characterised by multiple colonic polyps at an early age, which if left untreated become cancerous. Extracolonic manifestations are now the leading cause of death following prophylactic colectomy. Up to a quarter of patients will develop desmoid tumours, arising from the musculo-aponeurotic tissues of which about 10% will grow relentlessly, resulting in death. Outcome cannot be reliably predicted from histologic findings. DCE-MRI was performed on desmoid tumours to assess their vascularisation and to explore if it is possible to use it to predict aggressive phenotypes.

15:00 3052.   Comparison between pre and post chemoradiation therapy DCE-MR and pCT findings: initial observations in locally advanced rectal tumors 
Stefano Viotti1, Giuseppe Petralia1, Paul Eugene Summers1, Luke Bonello1, Moreno Pasin1, Roberto Di Filippi1, and Massimo Bellomi1,2
1European Institute of Oncology, Milano, Italy, 2School of Radiology, Università Statale degli Studi di Milano, Milano, Italy

The aim of our study was to compare DCE-MR and pCT parameters, pre and post neoadjuvant chemoradiation therapy (NACRT) in patients with advanced rectal cancer. 13 patients underwent DCE-MR and pCT, before and after NACRT. Pre-treatment, moderate correlation was seen between Kep and BV (R=0.64), and trends between Ktrans and BV (R=0.56) and between Ve and PS (R= 0.55). Post-treatment Ktrans, Kep and IAUC60 had moderate correlations with PS (R=0.63, 0.61, 0.61 respectively). The changing relationships following NACRT between DCE and pCT parameters may relate to different models applied or balances between flow and permeability limited conditions for different contrast agents used.

Electronic Posters : Cancer Imaging
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Prostate Cancer (Clinical Studies) I

Thursday May 12th
Exhibition Hall  13:30 - 15:30 Computer 9

13:30 3053.   Identifying prostate brachytherapy seeds at MRI: A study in phantom 
Ali Fatemi-Ardekani1, and Jette Borg1
1Radiation Medicine Program, Princess Margaret Hospital, Toronto, Ontario, Canada

This work illustrated the capability of magnetic resonance imaging (MRI) pulse sequence and a corresponding image processing algorithm to localize prostate brachy-therapy seeds in a phantom. SWI (3D fast gradient echo) filtered phase images is an MRI methodology that generates positive contrast in regions of magnetic field susceptibility, as created by prostate brachytherapy seeds. Phantoms comprising of several seeds were created to assess the usability of the SWI filtered phase for imaging seeds. Resulting images show that seeds are clearly visible with high contrast using SWI filtered phase image, agreeing with CT finding.

14:00 3054.   Value of combined 3T multiparametric MR Imaging and MR guided biopsy in patient selection for active surveillance within the PRIAS study: initial results of the MRPRIAS study, a prospective multicenter study. 
Caroline Maria Anna Hoeks1, Joyce G.R. Bomers1, Diederik M. Somford2, Roderick van den Bergh3, Inge M. Van Oort2, Henk Vergunst4, Geert Smits5, Jorg Oddens6, Christina A. Hulsbergen-van de Kaa7, Chris Bangma8, Fred Witjes2, and Jelle O Barentsz1
1Radiology, Radboud University Nijmegen Medical Centre, Nijmegen, Gelderland, Netherlands, 2Urology, Radboud University Nijmegen Medical Centre, Nijmegen, Gelderland, Netherlands, 3Urology, University Medical Centre Utrecht, Utrecht, Utrecht, Netherlands, 4Urology, Canisius Wilhelmina Hospital, Nijmegen, Gelderland, Netherlands,5Urology, Alysis Zorggroep, Arnhem, Gelderland, Netherlands, 6Urology, Jeroen Bosch Hospital, Den Bosch, Noord-Brabant, Netherlands, 7Pathology, Radboud University Nijmegen Medical Centre, Nijmegen, Gelderland, Netherlands, 8Urology, Erasmus University Medical Centre, Rotterdam

Problem: Current active surveillance (AS) patient selection is suboptimal. Aim: To prospectively evaluate the value of combined endorectal multiparametric MR imaging (MRI) and MR guided prostate biopsy (MRGB) for selection of prostate cancer patients for AS within the PRIAS study. Methods: 21 patients, included in 5 referral hospitals, underwent multiparametric MRI and MRGB. Patients who fulfilled predefined criteria for increased-risk prostate cancer were excluded. Results: Combined multiparametric MRI and MRGB excluded 5 of 21 patients (24%). Conclusion: Multiparametric MRI and MRGB may be of added value for identification of intermediate-to high-risk cancer patients in AS patient selection. MRGB is required to improve specificity.

14:30 3055.   Hierarchical Image Registration for Improved Sampling during 3T MRI-guided Transperineal Targeted Prostate Biopsy 
Andriy Fedorov1, Kemal Tuncali1, Fiona Fennessy1, Junichi Tokuda1, Nobuhiko Hata1, William M Wells1, Ron Kikinis1, and Clare M.C. Tempany1
1Department of Radiology, Brigham and Women's Hospital, Boston, MA, United States

Prostate imaging with multi-parametric MRI (mpMRI) (e.g., T2w in combination with DWI and DCE) leads to improved detection of prostate cancer (PCa). Application of mpMRI for targeting during transperineal MR-guided PCa biopsy requires image registration to compensate for the differences in prostate configuration between the pre- and intra-procedural acquisitions. We develop a novel application-specific registration technology to perform hierarchical registration with minimum operator intervention. Our evaluation shows that the computation can be accomplished within the time constraints of the clinical workflow and results in good overlap of the manually segmented gland and individual zones between the registered and intra-procedural MRI.

15:00 3056.   T1 relaxation changes of bone and lymph node lesions of metastatic prostate cancer during 4 cycles of antiangiogenic drug therapy 
Naira Muradyan1, Baris Turkbey2, William Dahut3, and Peter Choyke2
1iCAD, Inc., Nashua, NH, United States, 2Molecular Imaging Program, National Cancer Institute, Bethesda, MD, United States, 3Medical Oncology Branch, National Cancer Institute, Bethesda, MD, United States

The T1 relaxation rate changes of 22 patients with metastatic prostate cancer with antiangiogenic therapy are reported. The bone and lymph node lesions were monitored through 4 cycles of therapy. And the observed T1 changes suggest the need for accurate estimation of those if quantitative analyses incorporating T1 vales are to be used for therapy response monitoring.

Electronic Posters : Cancer Imaging
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Prostate Cancer (Clinical Studies) II

Monday May 9th
Exhibition Hall  14:00 - 16:00 Computer 10

14:00 3057.   High resolution 3D 31P spectroscopic imaging of the human prostate at 7T: technical feasibility and in vivo measurement 
Thiele Kobus1, Andreas K Bitz2, Mark J Van Uden1, Miriam W Lagemaat1, Stephan Orzada2, Arend Heerschap1, and Tom W.J. Scheenen1,2
1Radiology, Radboud University Nijmegen Medical Centre, Nijmegen, Gelderland, Netherlands, 2Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany

A thorough safety validation was performed to enable combined use of a 31P TxRx endorectal coil with a 8-channel 1H TxRx array coil. The maximum RF power with the 31P coil was determined. The coupling between the coils while transmitting with the 8-channel 1H coil was studied by B1+ and temperature mapping. Although an increased proton flip angle was observed near the endorectal coil wire, no local temperature increase was observed. The in vivo measurement using adiabatic excitation showed good quality of both prostate imaging and 31P spectra, demonstrating the potential of 31P MRSI of the prostate at high field.

14:30 3058.   Correlation between in vivo 1H MRSI and ex vivo 1H HR MAS in spatially matched regions in prostate cancer patients 
Kirsten Margrete Selnæs1, Ingrid Susanne Gribbestad1, Helena Bertilsson2,3, Alan Wright4, Anders Angelsen3, Arend Heerschap4, and May-Britt Tessem1
1Department of Circulation and Medical Imaging, NTNU, Trondheim, Norway, 2Department of Laboratory Medicine and Children's and Women's Health, NTNU, Trondheim, Norway, 3Department of Urology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway, 4Department of Radiology, Radboud University Nijmegen Medical Centre, Netherlands

Both in vivo and ex vivo spectroscopy are important in prostate cancer handling, with elevated (Choline+Creatine)/Citrate indicative of cancer. So far no studies have investigated the correlation of in vivo and ex vivo measurements in matched regions of the same prostate cancer patient. In this study ex vivo HR MAS spectra were compared to in vivo MRS spectra in spatially matched regions in the same prostate cancer patient. CC/C ratios from in vivo MRS and ex vivo HR MAS were significantly correlated with r=0.63. Both in vivo and ex vivo CC/C were significantly correlated to Gleason grade (r=0.62 and 0.65)

15:00 3059.   A peak phasing and alignment algorithm for automated post-processing of 3D MRSI data from the prostate of cancer patients. 
Alan James Wright1, and Arend Heerschap1
1Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands

Currently, prostate 3D MRSI acquisition methods have matured considerably, but automatic spectral processing remains a bottleneck to realise routine clinical application as processing is often hampered by variations in phase and chemical shift of metabolite peaks across the MRSI data set. Furthermore, the citrate resonance at 2.6ppm is sensitive to the salt concentration and pH of the local environment and can vary quite dramatically within one 3D MRSI slice. We have developed a phase and frequency alignment algorithm, specific to the unique problem of prostate cancer MRSI data sets, and tested it with simulated and patient data.

15:30 3060.   Automated lipid-removal for baseline correction of prostate-cancer MRSI data using prior knowledge. 
Alan James Wright1, and Arend Heerschap1
1Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands

MRSI is a promising technique for the detection and localization of tumours in patients with prostate cancer, the clinical relevance of this data may be realised by the application of Pattern recognition techniques. The performance of such algorithms is partly dependent on artifacts such as residual large lipid signals from the tissue surrounding the prostate; these signals are broad and can overlap with the citrate resonances at 2.6ppm that play a key role in cancer diagnosis by MRSI. We present an algorithm that uses prior knowledge to remove lipid signals from prostate MRSI data sets.

Tuesday May 10th
  13:30 - 15:30 Computer 10

13:30 3061.   Improving accuracy in measurement of choline as a predictor of early response to neoadjuvant chemotherapy: correction of internal reference using external reference 
Yuriko Suzuki1, Yoshifumi Kuroki2, and Marc Van Cauteren1
1MR Clinical Science, Philips Electronics Japan, Minato-ku, Tokyo, Japan, 2Tochigi Cancer Center, Utsunomiya, Tochigi, Japan

It is important to assess the response to neoadjuvant chemotherapy for optimizing the therapy regime. Recently, in vivo proton MR spectroscopy of breast is demonstrating promising results in early assessment of response to NAC. However those methods still have limitation in quantification. A new method is presented to measure tCho concentration using internal reference more accurately, by applying the correction of tissue water content using external reference. The changes in tCho following neoadjuvant chemotherapy significantly differed between responder group and non-responder group. Our data showed that tCho is a better predictor of early response to neoadjuvant chemotherapy.

14:00 3062.   Arterial Spin Labeling Perfusion Studies of the Prostate with an ERC 
Xiufeng Li1, Chaitanya Kalavagunta1, Michael T Nelson2, and Greg J Metzger1
1Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, United States, 2Diagnostic Radiology, University of Minnesota, Minneapolis, MN, United States

The use of an endorectal coil can improve prostate perfusion imaging with arterial spin labeling methods by providing high signal noise ratios, decreased prostate motion, and reduced B0 distortions and/or signal loss. To characterize the noise and evaluate achievable resolutions, prostate perfusion studies were performed at 3T with an endorectal coil. These preliminary results show that high quality perfusion imaging maps can be achieved at 3T with an ERC. Physiological noise was found to be the major source of temporal error, and increased with imaging resolution. With more averages, temporal error can be limited to a relatively low level.

14:30 3063.   Prostate Perfusion Using Arterial Spin Labeling: Initial Experience 
Xiufeng Li1, Chaitanya Kalavagunta1, and Greg Metzger1
1Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, United States

Non-contrast enhanced perfusion imaging method using arterial spin labeling can benefit prostate cancer patients with contraindications to the use of MR contrast-agent, and should be more suitable for repeated studies monitoring tumor progression or treatment response. To evaluate the feasibility of prostate perfusion using FAIR at 3T, multiple inversion perfusion studies were performed with healthy controls using surface array coils. Signal changes originating from labeled blood are measurable and correlate well with other measurement of prostate perfusion. However, SNR and physiological motion are limiting factors for obtaining perfusion maps, making the proposed method and hardware impractical for clinical applications. To our knowledge, these are the first attempts at obtaining ASL results in the human prostate.

15:00 3064.   A comparison between arterial input function approaches for high temporal resolution pharmacokinetic analysis of prostate cancer at 3.0T 
Fiona M Fennessy1, Sandeep N Gupta2, Andriy Fedorov1, Robert Mulkern1, Yi Tang1, Felipe Franco1, Kemal Tuncali1, Ehud Schmidt1, and Clare Tempany1
1Brigham and Women's Hospital, Boston, MA, United States, 2Functional Imaging Lab, GE Global Research Center, Niskayuna, NY, United States

Pharmacokinetic (PK) analysis allows for quantification of DCE MRI data in prostate cancer. The objective of this work is to determine the variability in PK analysis using model based Arterial Input Function (m-AIF) and accurate individualized AIF (i-AIF) from the femoral artery by comparing their performance in areas suspicious for prostate cancer on endorectal prostate MR at 3.0T. Mean prostate Ktrans values obtained were significantly different using m-AIF and i-AIF. mAIF results in less variable PK analysis results. Further studies are required to determine if mAIF will allow for more robust comparisons in longitudinal studies, or whether mAIF is in fact under-representing underlying areas of tumor

Wednesday May 11th
  13:30 - 15:30 Computer 10

13:30 3065.   The effect of tissue hydraulic conductivity on interstitial fluid pressure (IFP) as measured by DCE-MRI in human prostate 
Jarrett Grover1, and Yousef Mazaheri2
1Memorial Sloan Kettering Cancer Center, New York, NY, United States, 2Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York, United States

The present investigation aims to address how physiological properties of solid tumor impact the uptake and distribution of different macromolecular agents used in in vivo anti-tumor therapies in solid tumors using DCE-MRI analysis in human prostate.

14:00 3066.   Contrast-to-noise ratio in extrapolated and measured high b-value diffusion weighted prostate MR images 
Marnix Christiaan Maas1, Jurgen J. Fütterer1, and Tom W.J. Scheenen1
1Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands

High b-value (b>1000 s/mm2) DWI images potentially improve diagnostic accuracy, but are sensitive to artifacts and require long acquisition times for sufficient SNR. In this work we investigated high b-value images obtained by extrapolation from a set of lower b-value images, which aim to combine the diagnostic performance of high b-values with the improved SNR and reduced artifacts of lower b-values. The contrast-to-noise ratio (CNR) between suspicious lesions and normal-appearing tissue in extrapolated b=1400 s/mm2 images was comparable to that in measured images, and results suggested that a slight improvement in CNR may even be achievable with extrapolated images.

14:30 3067.   Non mono-exponential Analysis of DW-MRI data for the Detection of Prostate Cancer 
Yousef Mazaheri1, Alvarez Vargas2, Oguz Akin2, Debra Goldman2, and Hedvig Hricak2
1Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York, United States, 2Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, United States

In this study, we have compared the ability of mono- and non-monoexponential parameters measured with DW-MRI to identify malignant regions in the PZ and compared the findings with whole-mount pathology.

15:00 3068.   Role of Quantitative MRI Biomarkers for Evaluating Prostatic Transition Zone Tumors 
Jing Ren1, Yi Huan2, and Mengqi Wei2
1Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi¡¯an, Shaanxi, China, People's Republic of, 2Xijing Hospital, Fourth Military Medical University, China, People's Republic of

To evaluate the efficacy of apparent diffusion coefficient (ADC) maps combined with T2-weighted (T2w) methods in quantitatively assessing the detection of malignant nodules in the prostatic transition zone (TZ) Quantitative MRI biomarkers play very important roles in the differential diagnosis of cancer and BPH in prostatic TZ. In particular, T2w combined with ADC improves the clinical diagnosis of cancer in the prostatic TZ.

Thursday May 12th
  13:30 - 15:30 Computer 10

13:30 3069.   Diagnosis of Prostate Cancer: Comparison of MR Diffusion Tensor Imaging, Quantitative Dynamic Contrast-Enhanced MR Imaging and the Two Techniques Combined at 3.0T 
Chunmei Li1, Min Chen1, Saying Li1, Xuna Zhao2, Chen Zhang1, and Cheng Zhou1
1Beijing Hospital, Beijing, China, People's Republic of, 2Peking University

Purpose: To investigate the characteristics of combined DTI and quantitative DCE-MRI at 3.0 T in differentiating prostate cancer from noncancerous prostatic tissue in peripheral zone. Methods: DTI and DCE-MRI of patients with prostatic diseases were obtained. Parameters of DTI and DCE-MRI were calculated. Receiver operator characteristic curves were generated. Results: There were significant differences in all the parameters between prostate cancer and noncancerous prostatic tissue. The AUC for DTI and DCE-MRI combination was greater than either DTI or DCE-MRI alone. Conclusion: The combination of DTI and DCE-MRI has better accuracy in the diagnosis of prostate cancer than either technique alone.

14:00 3070.   Neuroanatomical evaluation of periprostatic nerve in patients submitted to nerve-sparing prostatectomy at 3T: feasibility study and preliminary experience 
Valeria Panebianco1, Sabina Prato 2, Daniele Lisi1, Valeria Buonocore1, Tommaso Biondi1, and Roberto Passariello1
1Department of Radiological Sciences, Sapienza University, Rome, Italy, 2MR Advanced Applications, GE Healthcare, Milan, Italy

In patients submitted to a nerve-sparing prostatectomy is important the depiction of the neuroanatomical distribution and relationship of periprostatic nerve with capsular profile using Diffusion Tensor Imaging (DTI) and tracing the spatial orientation of the neuro component depending of the diffusion process. Fibertracking with endorectal coil of the periprostatic nerve is a feasible application, obtaining a precise neuroanatomical evaluation of the periprostatic nerve in terms of: distance from nerve fiber to prostate capsular profile, distance from nerve fiber to the lesion and integrity and course of the nerve on each part of the prostate.

14:30 3071.   MRI Prostate Volumetry as a Surrogate for Transrectal Ultrasound Volumetry in Estimating Iodine – 125 Seeds in Brachytherapy: Inter-Observer Variability 
Liang Wang1, Hedvig Hricak2, and Oguz Akin2
1Tongji University Hositla of HUST, Wuhan, Hubei, China, People's Republic of, 2Memorial Sloan-Kettering Cancer Center

Synopsis: To evaluate inter-observer variability in assessment of with/without endorectal MRI prostate volumetry as a surrogate for transrectal ultrasound volumetry in estimating iodine – 125 seeds in brachytherapy.

15:00 3072.   MRI and Biopsy Performance in Delineating Recurrent Tumor Boundaries after Radiotherapy for Prostate Cancer 
Cynthia Menard1,2, Douglas Iupati1, Jenny Lee1, Anna Simeonov1, Jessy Abed1, Julia Publicover1, Peter Chung1, Andrew Bayley1, Charles Catton1, Michael Milosevic1, Robert Bristow1, Gerard Morton3, Padraig Warde1, Kristy Brock1, and Masoom Haider3
1Princess Margaret Hospital, Toronto, ON, Canada, 2Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada, 3Odette Cancer Center

We evaluated the performance of MRI (plus/minus guided biopsy) in delineating tumor boundaries for focal salvage therapy of prostate cancer recurrence after external beam radiotherapy. Twenty-three patients were enrolled and received an integrated multiparametric diagnostic and interventional biopsy procedure. MRI alone was not sufficiently accurate to define boundaries for tumor-targeted salvage even with addition of an uncertainty margin. MRI-guided biopsy improved both detection and delineation accuracy for recurrent tumor regions, and changed salvage therapy planning in the majority of patients.

Electronic Posters : Cancer Imaging
Click on to view the abstract pdf and click on to view the video presentation.
Breast I

Monday May 9th
Exhibition Hall  14:00 - 16:00 Computer 11

14:00 3073.   Initial clinical testing of RESOLVE: high-resolution diffusion weighted imaging at 3T 
Dorota Jakubowski Wisner1, Vibhas S. Deshpande2, Bonnie N. Joe1, David A. Porter3, C. Belinda Chang1, Gerhard A. Laub2, and Nola Hylton1
1Radiology and Biomedical Imaging, Univeristy of California, San Francisco, San Francisco, CA, United States, 2MR Research and Development, Siemens Medical Solutions USA, Inc., San Francisco, CA, United States, 3MR Research and Development, Siemens Medical Solutions, Erlangen, Bavaria, Germany

Diffusion weighted imaging (DWI) has shown promise for improving the specificity of breast MRI, but is hampered by poor resolution, field homogeneity, and overall image quality at 3T. We compare a novel DWI technique named RESOLVE against standard single short spin echo EPI for lesion conspicuity and level of detail in 15 patients, and for ADC values compared to pathology in a smaller sub-selection of these patients. Preliminary results suggest that RESOLVE provides robust, high-resolution DWI at 3T, which may eventually advance the potential clinical utility of DWI in breast imaging.

14:30 3074.   3.0 T Breast Diffusion Weighted MRI Using Readout Segmented EPI: Comparison With Single Shot EPI 
Shotaro Kanao1, Tomohisa Okada1, Mami Iima1, Kazuna Takeda1, Shigeaki Umeoka1, Takeshi Kubo1, and Kaori Togashi1
1Diagnostic Imaging and Nuclear Medicine, Kyoto Univerisity Graduate School of Medicine, Kyoto, Kyoto, Japan

Diffusion weighted imaging (DWI) is expected to increase diagnostic accuracy of detecting breast cancer. But compared to dynamic MRI, the imaging quality of DWI is poor because of distortion, poor fat suppression, low spatial resolution and so on. Recently DWI using readout segmented echo planner imaging (RS-EPI) is introduced to our institution as work-in-progress sequence and expected to improve imaging quality. We evaluated the imaging quality of 3.0 T diffusion weighted breast MRI using RS-EPI compared to single shot EPI (SS-EPI). Breast diffusion weighted MRI using RS-EPI can reduce imaging distortion and provide better visualization around the nipple.

Lisa Singer1, Lisa J Wilmes1, Emine U. Saritas2,3, Ajit Shankaranarayanan4, Evelyn Proctor1, Dorota Wisner1, Belinda Chang1, Bonnie N. Joe1, Dwight G. Nishimura3, and Nola M. Hylton1
1Radiology and Biomedical Imaging, UCSF, San Francisco, CA, United States, 2Department of Bioengineering, UC Berkeley, Berkeley, CA, United States, 3Department of Electrical Engineering, Stanford University, Stanford, CA, United States, 4Applied Science Laboratory, GE Healthcare, Menlo Park, CA, United States

Current diffusion-weighted MRI (DW-MRI) sequences used in the breast are often limited in spatial resolution. A reduced field-of-view (rFOV) DW-MRI sequence providing high in-plane resolution was optimized for imaging breast tumors and evaluated against a standard FOV DW-MRI sequence in patients with invasive breast cancer. Quantitative analysis found similar mean tumor apparent diffusion coefficient (ADC) values for both sequences; however, significant differences were found in parameters related to the tumor ADC distribution. Qualitative analysis suggested that tumor depiction on rFOV was improved. Larger studies comparing the ability of rFOV and standard FOV parameters to predict clinical outcomes are needed.

15:30 3076.   Technical advances for breast diffusion MR imaging on wide-bore 3T systems 
Vibhas S Deshpande1, Dorota J Wisner2, John W Grinstead1, Thorsten Feiweier3, Bonnie N Joe2, and Gerhard A Laub1
1Siemens Medical Solutions USA, Inc., San Francisco, CA, United States, 2Dept. of Radiology and Biomedical Engineering, UCSF, San Francisco, CA, United States, 3Siemens Medical Solutions, Erlangen, Germany

Breast MRI has high sensitivity in detecting malignancies, but suffers from moderate specificity for lesion characterization. Diffusion imaging has shown promise for better lesion characterization. Diffusion imaging at 3T offers higher SNR, which can translate to higher spatial resolution and improved diagnostic utility. However, single-shot EPI (ss-EPI) diffusion imaging is sensitive to B0 inhomogeneities, which can cause image artifacts. Moreover, in wide-bore (70 cm) 3T scanners, with the higher likelihood of larger patients, the problems of non-uniform B0 are exacerbated. In this work, we demonstrate the efficacy of technical improvements in ss-EPI breast diffusion imaging for improving image quality. These improvements are applicable to all field strengths and scanner types.

Tuesday May 10th
  13:30 - 15:30 Computer 11

13:30 3077.   Contrast enhanced MRI in neoadjuvant chemotherapy for locally advanced breast cancer: does accuracy vary across clinically relevant sub-sets? 
David John Manton1, Filip Van Kove1, Martin D Pickles1, and Lindsay W Turnbull1
1Yorkshire Cancer Research Centre for MR Investigations, Hull-York Medical School, Hull, East Yorkshire, United Kingdom

The accuracy, compared to pathology, of contrast-enhanced MRI-derived, pre-operative maximum tumour diameters was assessed across a range of clinically relevant sub-sets (e.g. tumour type and Her2 status) in a retrospective cohort of women who had undergone neoadjuvant chemotherapy for locally advanced breast cancer. Bland-Altman limits of agreement (LOAs) were not statistically significant within sub-sets so the data-set was analysed as a whole. MRI demonstrated a low false complete response rate (13%), a small bias (-4.85 mm on average) but quite large LOAs (95% of the differences lying between 38.1 and -47.8 mm) thus lending more credibility to its clinical utility.

14:00 3078.   The study of relationship between ADC value and maximal diameter of the breast cancer with Ki-67 expression during neoadjuvant chemotherapy 
Li Guo1, Xiao-ying Wang1, Nai-shan Qin1, and Xue-xiang Jiang1
1Radiology, Peking University First Hospital, Beijing, China, People's Republic of

48 patients underwent MR before and after 4 cycles neoadjuvant chemotherapy(NAC). The ADC value and the maximum diameter of the cancer foci were measured , and the rate of their changes ¨SADC% and ¨SD% were calculated. All the foci were divided into three groups with different Ki-67 index level.One-Way ANOVA was used to determine whether there were differences between the three groups. The result was that the ADC value and the maximal diameter of breast cancer differed with different expression levels of Ki-67 index before and after neoadjuvant chemotherapy, and their response to NAC varied as well.

14:30 3079.   Feasibility of 7 Tesla breast MRI. Determination of intrinsic sensitivity and high resolution MRI, DWI and 1H-MRS of breast cancer patients receiving neo-adjuvant therapy 
Mies A. Korteweg1, Wouter B. Veldhuis1, Fredy Visser1, Peter R. Luijten1, Willem P.Th.M. Mali1, Paul J. van Diest2, Maurice A.A.J. van den Bosch1, and Dennis W.J. Klomp1
1Radiology, University Medical Center Utrecht, Utrecht, Netherlands, 2Pathology, University Medical Center Utrecht, Utrecht, Netherlands

Feasibility of 7T breast MRI was evaluated. First the intrinsic sensitivity gain was compared to 3T in healthy volunteers resulting in a 5.7 times increased SNR. Next the clinical application of 7T MRI in breast cancer patients receiving neo-adjuvant chemotherapy was evaluated. High resolution images (450 µm isotropic) were acquired to describe tumor morphology. Apparent diffusion coefficients, tumor size and the total Choline pool were measured during chemotherapy. In one case the 7T results were more consistent with histopathology than 3T. Dedicated 7T breast MRI is technically feasible, can provide more SNR than 3T, and has diagnostic potential.

15:00 3080.   Feasibility of Using MR Spectroscopy Without Water-Fat Suppression to Monitor Tumor Response to Chemotherapy 
Hyeon-Man Baek1, Jeon-Hor Chen2, Orhan Nalcioglu2, and Min-Ying Su2
1Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, TX, United States, 2Tu & Yuen Center for Functional Onco-Imaging, UC Irvine, Irvine, CA, United States

The aim of our study was to determine the feasibility of using quantitative 1H-MRS without water-fat suppression to monitor tumor response to neoadjuvant chemotherapy. Our study showed the reduction in tCho at the first and second follow-up was significantly higher compared with the reduction in the tumor size (mean percentage change -72.6% vs. -9.7%, p < 0.0001; -96.6% vs. -56.7%, p < 0.003). In addition, the reduction in H2O and H2O/CH3 were also significantly higher than the reduction in tumor size at FU-1 (-36.2% vs. -9.7%, p = 0.028; -43.2% vs. -9.7%, p = 0.033). Therefore, the present study demonstrates that in vivo quantitative 1H-MRS without water–fat suppression can be useful for the detection and therapy response monitoring of breast cancer.

Wednesday May 11th
  13:30 - 15:30 Computer 11

13:30 3081.   Effect of Thin-Section Diffusion-Weighted Magnetic Resonance Imaging on Diagnosis of Malignant Breast Lesions 
April M. Chow1, Polly S.Y. Cheung2, Raymond Lee3, Ka Man Chan3, Sau Fan Liu1, Siu Ki Yu1, and Gladys G. Lo3
1Medical Physics & Research Department, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong SAR, China, People's Republic of, 2Breast Care Center, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong SAR, China, People's Republic of, 3Department of Diagnostic and Interventional Radiology, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong SAR, China, People's Republic of

Diffusion-weighted imaging (DWI) has been widely used to characterize malignant and benign lesions at 1.5 T. However, conventional DWI uses 5 - 8 mm slice thickness, partial volume averaging for small lesion and may lead to difficulty in distinguishing it from neighboring normal tissue. The use of thinner slices may allow small, low-contrast lesions to be detectable, improving the depiction of small tumors. In this study, we evaluated the effect of thin-section DWI in detecting malignant breast lesions at 3 T. Reduced ADC values were observed and characterized in malignant lesions, compared to normal breast tissues. Differential ADC values were demonstrated between conventional and thin-section DWI in malignant lesions. Sensitivity increased from 80% to 98% with thin-section DWI in diagnosis of malignant lesions, as compared to conventional DWI.

14:00 3082.   Correlation between apparent diffusion coefficient and molecular and histological prognostic factors in breast cancer: initial observations in 53 patients. 
Giuseppe Petralia1, Luke Bonello2, Paul Summers1, Lorenzo Preda1, Roberto Di Filippi1, Moreno Pasin1, Marzia Locatelli3, Giuseppe Curigliano3, and Massimo Bellomi1,2
1Radiology, European Institute of Oncology, Milan, Milan, Italy, 2School of Radiology, University of Milan, Milan, Italy, 3Medical Oncology, European Institute of Oncology, Milan, Milan, Italy

The clinical course of breast cancer (BCa) depends on several molecular and histological characteristics. The aim of this study was to correlate apparent diffusion coefficient (ADC) with molecular and histological prognostic factors of BCa. Fifty-three BCa patients underwent DW-MRI of the breast. ADC was lower for HER-2 than for triple receptor negative subtype, and for T3 than for T1 BCa (P=.055 and .03, respectively). There was a marginally significant correlation (Spearman r=-0.35, P<.05) between ADC and HER-2 expression. There was no correlation between ADC and variables examined, with possible exception for HER-2. T3 subgroup may bear a distinct ADC behaviour.

14:30 3083.   The relation of apparent diffusion coefficient (ADC) measurements in normal glandular breast tissue to menstrual cycle and menopausal state at 3.0T diffusion-weighted imaging. 
Elizabeth Anne Maxine O'Flynn1, Marco Borri1, Maria Schmidt1, Veronica Morgan1, Sharon Giles1, Catherine Parry-Jones1, and Nandita M deSouza1
1Clinical Magnetic Resonance, Cancer Research UK and EPSRC Cancer Imaging Centre, Sutton, Surrey, United Kingdom

ADC values during the secretory phase (days 15-28) of the menstrual cycle are known to be slightly higher and less restricted due to the increased water content within the breast. We have demonstrated significant differences in mean ADC values relating to menopausal state, with the ADC value being higher in premenopausal volunteers in the secretory phase (days 15-28) compared to postmenopausal volunteers (p=0.008) due to the effects of increased serum oestradiol and progesterone. This can have implications in the detection of tumours and increased false positives in dynamic contrast-enhanced breast MRI due to the high background parenchymal enhancement.

15:00 3084.   Difference of Apparent Diffusion Coeffcient in Breast Mass and Non-mass Like Enhancement Lesions 
Liuquan Cheng1, Yuhan Bai1,2, Jing Zhang1,3, Mei Liu4, and Xiru Li5
1Radiology, Chinese PLA General Hospital, Beijing, Beijing, China, People's Republic of, 2Radiology, The People's Hospital of Wuhan University, Hubei, 3Radiology, Chinese PLA Navy General Hospital, Beijing, 4Pathology, Chinese PLA General Hospital, Beijing, Beijing, China, People's Republic of, 5Surgery, Chinese PLA General Hospital, Beijing, Beijing, China, People's Republic of

We found that the cut-off point ADC value for differential diagnosis differed between mass and non-mass-like enhancement lesions and should be weighted in malignancy prediction. The optimized cutoff point ADC value for mass lesion is 1.05¡Á10-3mm2/s, which is lower than the NMLE where ADC=1.35¡Á10-3mm2/s and different than the benign and malignant without MRI types differentiation (ADC=1.25¡Á10-3mm2/s). This finding was different than the others studies whose ADC measurement was not affected by the lesion size.

Thursday May 12th
  13:30 - 15:30 Computer 11

13:30 3085.   Automatic Bolus Detection in Breast MRI: a method to improve accuracy and reliability? 
Christian Geppert1, Matthias Fenchel1, Rolf Janka2, Andre de Oliveira1, Berthold Kiefer1, Michael Uder2, and Evelyn Wenkel2
1Siemens Healthcare, Erlangen, Germany, 2Radiologisches Institut, Universitätsklinikum Erlangen, Erlangen, Germany

In diagnostic breast imaging, usually a dynamic scan is performed which consists of a native scan and a number (usually 3-10) of post contrast-administration (CA) scans of the identical volume. Despite the use of automatic injectors, the timing of the injection with the scan protocol is subject to operator dependent variations such as pause durations, patient weight- and injection location dependent changes etc. Moreover, due to the widespread use of CAD workstations that work with a fixed threshold for a defined time point such as 50 or 100% at the first post-CA time point, timing variations can significantly influence the appearance of enhancement maps. The goal of this work was to implement a bolus detection method for breast MRI in a routine clinical situation that eliminates many patient and operator dependent variations, helps to avoid re-scans due to CA problems and thus might improve the accuracy of dynamic breast protocols.

14:00 3086.   Transmit B1 Field Inhomogeneity and T1 Estimation Errors in Breast DCE MRI at 3T 
Kyunghyun Sung1, Bruce L Daniel1, and Brian A Hargreaves1
1Radiology, Stanford University, Stanford, California, United States

Variable flip angle spoiled gradient echo (SPGR) acquisitions, called DESPOT1, are a common choice to measure T1 since they can provide a fast 3D volumetric T1 mapping. DESPOT1, however, heavily depends on the set of flip angles used, and therefore is sensitive to any flip angle variation. Transmit B1 field (B1) inhomogeneity creates flip angle variation and the variation tends to be 30 - 50% across the breast at 3T. In this work, we include B1 mapping in our breast DCE imaging protocol, and compensate T1 maps by including B1 variation in the DESPOT1 calculation. We then compare T1 relaxation in fat (as a validation) with and without compensating B1 variation in a total of 25 patients at 3T.

14:30 3087.   Variable-Resolution Dynamic Contrast-Enhanced Breast MRI Acquisition 
Manojkumar Saranathan1, Brian A Hargreaves1, Catherine J Moran1, and Bruce Daniel1
1Radiology, Stanford University, Stanford, CA, United States

Dynamic-contrast enhanced (DCE) MRI is a standard element of clinical breast protocols, and is challenging due to the need for both high spatial and high temporal resolution. High temporal resolution is needed for accurate pharmacokinetic modeling and high spatial resolution for tumor characterization. Although some imaging protocols include a combination of rapid, low-resolution scans and slower high-resolution scans, these can cause practical complications such as delays and/or accidental changes to parameters (like gain) that could render the acquisition useless for quantifying contrast uptake. Here we present a simple, single scan technique that acquires images of variable temporal and spatial resolution, with the timing tailored to the contrast dynamics in breast imaging.

15:00 3088.   Improved lesion conspicuity on contrast enhanced breast MRI at 3 Tesla using linear vs. radial-centric k-space ordering 
Bonnie N. Joe1, Dorota Wisner1, Vignesh A Arasu1, Sachiko Suzuki1, Vibhas S. Deshpande2, Belinda Chang1, Gerhard Laub2, and Nola M Hylton1
1Dept of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, United States, 2Siemens Medical Solutions USA, Inc, San Francisco, CA, United States

We evaluated lesion conspicuity and level of detail on breast MR images of patients scanned with radial-centric and linear ordered k-space techniques on separate days. Breast imagers ranked linear ordering better than radial-centric for lesion conspicuity and level of image detail. Similarly, quantitative analyses showed increased peak signal enhancement ratio (SER) in 4/5 patients and increased SER total enhancing volume in 5/5 patients for linear versus radial-centric. More motion artifact was noted with linear ordering but overall image quality ranked similarly between linear and radial-centric. Radiologists should be aware of these tradeoffs when designing their breast MR cancer imaging protocol.

Electronic Posters : Cancer Imaging
Click on to view the abstract pdf and click on to view the video presentation.
Breast II

Monday May 9th
Exhibition Hall  14:00 - 16:00 Computer 12

14:00 3089.   Magnetization Transfer Imaging and Dynamic Contrast Enhanced Imaging of Breast Cancer at 3T 
Samantha Lynn Heller1, Linda Moy1, Sherlin Lavianlivi1, Melanie Moccaldi1, and Sungheon Kim2
1Radiology, NYU School of Medicine, New York, NY, United States, 2Center for Biomedical Imaging, Radiology, NYU School of Medicine, New York, NY

Dynamic contrast enhanced (DCE)-MRI has been used for breast tumor assessment with promising results. But recent studies show that the specificity of DCE-MRI is highly variable. Hence, the purpose of our study was to evaluate the feasibility of using magnetization transfer imaging (MTI) to improve the differentiation between malignant and benign lesions. MTI has been used to study various pathologies associated with changes in macromolecular contents, such as demyelination in white matter. It has also been used to characterize breast tissues. Recently, it was reported that the MT ratio (MTR) of malignant breast cancer lesion was significantly lower than that of benign lesions at 1.5T. In this study, we investigated the feasibility of using both MTI and DCE-MRI for differentiation of benign and malignant lesions in the same cohort at 3T.

14:30 3090.   Chemical Exchange Saturation Transfer (CEST) MRI of the Breast at 3T using Amide Proton Transfer (APT) 
Adrienne N. Dula1,2, Lori R. Arlinghaus1,2, Bennett A. Landman1,3, Richard D. Dortch1,2, John C. Gore1,2, Tom E. Yankeelov1,2, and Seth A. Smith1,2
1Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, United States, 2Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, United States, 3Electrical Engineering and Computer Science, Vanderbilt University Medical Center, Nashville, TN, United States

We used chemical exchange saturation transfer (CEST) MRI to examine fibroglandular (FG) and tumor tissue of the breast at 3T. Examination of z-spectra asymmetry at the amide proton resonance (3.5ppm) demonstrated heterogeneity of healthy FG tissue and an increase in tumor. As CEST measurements are reflective of the molecular composition of tissue, they may reflect tissue properties that change during the course of disease and treatment.

15:00 3091.   Enhancing Mass Detection and Classification in Breast Tissue Using Strain-Encoded (SENC) MRI 
Ahmed Amr Harouni1, Riham H El Khouli2, Jakir Hossain1, David A Bluemke2, Nael F Osman3, and Michael A Jacobs4
1Electrical and Computer Engineering, Johns Hopkins University, Baltimore, Maryland, United States, 2Radiology and Imaging Sciences, National Institute of Health, Bethesda, Maryland, United States, 3Department of Radiology, Johns Hopkins University, Baltimore, Maryland, United States, 4Department of Radiology and Oncology, Johns Hopkins University school of medicine, Baltimore, Maryland, United States

MRI has proven to have high sensitivity and moderate specificity in detecting breast cancer. Mechanical properties can increase specificity, by calculating the tissue’s stiffness. In this work, we demonstrate the use of strain-encoded MRI to measure strain that is inversely proportional to stiffness. We measure the compression and relaxation response of tissues. Phantom results show that using compression and relaxation complementary information with high CNR, we were able to detect and classify masses while ruling out image-artifacts. Moreover, Ex-vivo results show that SENC is able to detect masses that would be useful in clinical setting.

15:30 3092.   Sub-Millimeter Breast Imaging and Relaxivity Characterization at 7T 
Ryan Brown1, Kellyanne Mcgorty1, Linda Moy1, Scott DeGregorio1, Daniel K Sodickson1, and Graham C Wiggins1
1Center for Biomedical Imaging, NYU Langone Medical Center, New York, NY, United States

The breast may be a prime candidate for high field imaging given that typical high field hindrances such as poor B1 penetration, B1 inhomogeneity, and susceptibility artifacts are expected to be mild. Several facets of breast imaging at 7T are examined: in vivo SNR at 7T is shown to be 2-3 times greater than that at 3T; 0.6 mm isotropic images illustrate the potential of 7T breast imaging; in vivo tissue relaxation times are reported for the first time at 7T; finally, B0 mapping is performed to assess shimming robustness which is especially important for this application.

Tuesday May 10th
  13:30 - 15:30 Computer 12

13:30 3093.   Achieving Consistent, Homogeneous, Dark Fat Suppression on Bilateral Breast MRI at 3.0 Tesla in the Clinical Setting 
Bonnie N. Joe1, Vibhas S. Deshpande2, Dorota J Wisner1, Vignesh A Arasu1, Nola M Hylton1, and Gerhard A Laub2
1Dept of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, United States, 2Siemens Medical Solutions USA, Inc, San Francisco, CA, United States

Good fat suppression is a fundamental aspect of diagnostic quality breast MR for cancer screening. However, obtaining homogeneous, dark fat suppression for bilateral T1-weighted breast MR is particularly challenging at 3T due to higher B0 and B1 inhomogeneities compared with 1.5T. These fat suppression challenges present a significant limitation to widespread acceptance of clinical breast MR at 3T, often overshadowing the potential advantages afforded by the increased signal to noise at 3T. In this abstract we describe a technique to achieve consistent homogeneous, dark fat suppression for T1 breast MR imaging at 3T.

14:00 3094.   Breast Morphological and DCE MRI with SWIFT 
Curtis Andrew Corum1, Steen Moeller1, Djaudat Idiyatullin1, Diane Hutter1, Angela Snyder1, Michael T Nelson2, Tim Emory2, Jessica E Kuehn-Hajder2, Lynn E Eberly3, Gregor Adriany1, and Michael Garwood1
1CMRR, Radiology Department, Medical School, University of Minnesota, Minneapolis, MN, United States, 2Breast Center, Radiology Department, Medical School, University of Minnesota, Minneapolis, MN, United States, 3Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, United States

We show initial results from efforts to develop and optimize a breast imaging protocol with SWeep Imaging with Fourier Transformation (SWIFT). An advantage of SWIFT, due to 3d radial k-space sampling, is that the same MRI data can be reformatted into high temporal resolution DCE images at lower spatial resolution or high spatial low temporal resolution morphological images. In addition the short dead time makes SWIFT immune to high field R2* effects which can confound T1 based quantitative DCE MRI analysis. At this early stage of development, the quality of SWIFT images in terms of depicting breast morphology is already comparable to that as 3d gradient echo images

14:30 3095.   Normal Variability in the Quantitative Assessment of Breast Tissue by MRI 
Ania Szary1, Sheye Aliu1, Sachiko Suzuki1, Catherine Klifa1, Dorota Wisner1, Evelyn Proctor1, Bonnie Joe1, and Nola Hylton1
1Department of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, United States

Knowledge of normal breast tissue MRI variability is essential to increase MRI specificity in breast cancer detection. This study prospectively investigates variability of quantitative breast MRI parameters in healthy volunteers while controlling for hormonal fluctuation to improve knowledge of normal breast tissue range. All breast parameters show no significant difference between right and left breasts and between visits. Breast volume demonstrates the least variability per subject and amongst all subjects between visits, apparent diffusion coefficient values demonstrate the highest variability, and percent enhancement (PE) and fibroglandular volume show mild variability. No correlation between fibroglandular volume and PE was seen.

15:00 3096.   Clinical implementation of 3D high spectral and spatial resolution imaging 
Abbie M Wood1, Gillian M Newstead1, Hiroyuki Abe1, Milica Medved1, and Greg S Karczmar1
1Radiology, University of Chicago, Chicago, IL, United States

We demonstrate the first use of 3D high spectral and spatial resolution imaging to detect breast cancer. Images of the water peak height generated in this pilot study exhibited great morphological detail and near-complete fat suppression. This imaging technique could be used to target suspicious enhancing areas of the breast, or could be adapted to a fully bilateral technique by utilizing SENSE acceleration. High quality morphological images of the water peak height such as these could help improve the specificity of breast MRI.

Wednesday May 11th
  13:30 - 15:30 Computer 12

13:30 3097.   Meta-Population Breast Cancer Screening with the Capital Greek DeltaKtrans DCE-MRI Parameter 
Charles S. Springer1, Luminita A. Tudorica1, Xin Li1, Sunitha Thakur2, Elizabeth A. Morris2, Karen Y. Oh1, Mark D. Kettler1, Yiyi Chen1, Ian J. Tagge1, Stephanie L. Hemmingson1, Maayan Korenblit2, John W. Grinstead3, Gerhard Laub4, Jason A. Koutcher2, and Wei Huang1
1Oregon Health & Science University, Portland, Oregon, United States, 2Memorial Sloan Kettering Cancer Center, New York, New York, United States, 3Siemens Healthcare, Portland, Oregon, United States, 4Siemens Healthcare, San Francisco, California, United States

The ÄKtrans DCE-MRI parametric biomarker was tested on a meta-population of 137 positively screened breast lesions (129 patients), before these were biopsied. Two of the three cohorts had positive mammographic screening and the other (a high risk group) negative mammography but positive clinical MRI. A combination of ROI averaged and pixel-by-pixel mapping/histographic ÄKtrans analyses discriminated all of the 32 malignant tumors from all but one of the 105 benign lesions. The >105 biopsy/pathology procedures on the latter could have been avoided. This discrimination was independent of screening modality, scanner vendor (platform/software), data acquisition, CR, and magnetic field strength.

14:00 3098.   To compare MR Spectroscopy at 3T with tumor type and grading of breast cancers 
marianna telesca1, federica pediconi1, maria laura luciani1, valeria casali1, federica vasselli1, elena miglio1, carlo catalano1, and roberto passariello1
1"Sapienza" university of rome, rome, italy, Italy

we evaluated the diagnostic performance of magnetic resonance (MR) spectroscopy at 3T to detect different cancer types and prognostic factors in patients with biopsy-proven breast cancer.

14:30 3099.   Time-Frequency Analysis of In Vivo MRS of the Breast Improves Cancer Detection 
Frederick Shic1, Alexander P Lin2, Peter Stanwell2, Saadallah Ramadan2, Eva Gombos2, and Carolyn Mountford2
1Child Study Center, Yale University School of Medicine, New Haven, CT, United States, 2Center for Clinical Spectroscopy, Brigham and Women’s Hospital, Boston, MA, United States

Detection of small, malignant lesions in the breast by proton MRS is challenging in the USA due to MRS being conducted after patients have biopsies taken and clips positioned. This causes blood in the lesion degrading the local field homogeneity. In this study, our goal is to determine if choline, at 3.23ppm, a known marker for tumor malignancy, is present in spectra containing substantial levels of lipid and bruised tissues from the biopsy. We use the short-time Fourier transform (STFT), a method which allows simultaneous visualization of spectral time-frequency relationships, to improve the visualization of the choline resonance. We compare the diagnostic accuracy of this method with traditional analysis using the Fourier transform.

15:00 3100.   In Vivo Quantitative Proton MR Spectroscopy to Characterize Morphological Pattern of MR Enhancements in Breast Cancer 
Hyeon-Man Baek1, Jeon-Hor Chen2, Orhan Nalcioglu2, and Min-Ying Su2
1Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, TX, United States, 2Tu & Yuen Center for Functional Onco-Imaging, UC Irvine, Irvine, CA, United States

We reported a larger series study to further investigate if the tCho SNR, tCho concentration, and lipids ratio (e.g., CH2 at 1.3 ppm/CH3 at 0.9 ppm) levels show difference between mass and non-mass type breast cancers. Metabolite basis set signals (e.g., tCho, H2O, and Lipids) were simulated in SIMULATION in jMRUI software (e.g., S = S0 ~ exp(-ƒ¿t-(ƒÀt)2) ~ exp(i(2ƒÎft+ƒÓ0)) and quantified with QUEST. There was significant difference in tCho SNR level between mass-type and non-mass-type groups (p = 0.035). However, no significant group differences were observed in tCho concentration and lipids ratio of 1.3/0.9 ppm (p = 0.461 and 0.242), respectively. This result reflects that tCho SNR measured by 1H-MRS may be a good indicator to distinguish between different tumor morphologies (mass and non-mass).