Joint Annual Meeting ISMRM-ESMRMB 2014 10-16 May 2014 Milan, Italy

BODY (16:30-18:30)
3529-3552 Lung & Mediastinum MRI 
3553-3576 Renal & Male Pelvis
3577-3600 Hepatobiliary 1
3601-3624 Diabetes & Misc.
3625-3647 Body DWI/ MRS/ Female Pelvis Pregnancy
3648-3671 Hepatobiliary 2

Lung & Mediastinum MRI

Monday 12 May 2014
Exhibition Hall  16:30 - 17:30

  Computer #  
3529.   1 Quantification of lung microstructure in asthma using a 3He fractional diffusion approach
Juan Parra-Robles1, Helen Marshall1, Ruth A Hartley2, Christopher E Brightling2, and Jim M Wild1
1Unit of Academic Radiology, University of Sheffield, Sheffield, United Kingdom, 2Institute for Lung Health, University of Leicester, Leicester, United Kingdom

In this work, a new approach based on a fractional diffusion model is developed to allow for in-vivo estimation of the distributions of the microscopic length scales of acinar airways from 3He diffusion MRI data. This new technique is used to assess the acinar microstructure in asthma patients and the results are compared with CT densitometry and macroscopic 3He ventilation distributions.

3530.   2 Bronchodilatation Effect on Lung Function of Asthma Patients Measured by Static and Dynamic 3He MRI: First Results of Clinical Trial
Maxim Terekhov1, Ursula Wolf2, Klaus K Gast2, Christian Hoffmann2, Nina Bojadzic2, Sergei Karpuk3, Christian Mrozik3, Christoph Düber2, and Laura Maria Schreiber1
1Section of Medical Physics, Department of Radiology, Johannes Gutenberg University Medical Center Mainz, Mainz, Germany, 2Department of Radiology, Johannes Gutenberg University Medical Center Mainz, Mainz, Germany, 3Institute of Physics, Johannes Gutenberg University Mainz, Mainz, Germany

Static and Dynamic Ventilation of lungs measured with hyperpolarized 3He-MRI are efficient tools to visualize and quantify the lung ventilation and intrapulmonary gas inflow. Ventilation measurements give information on both spatial and temporal distribution of gas in airways and parenchyma being of great importance for the diagnostics of airways obstruction diseases e.g. asthma and COPD. Measurements of static and dynamic lung ventilation with HP-3He-MRI were performed on bronchial asthma patients before and after bronchodilatation in order find out if the BD-effect can be detected using 3He-MRI and to correlate the variation of measured parameters with the spirometry tests.

3531.   3 Airflow modulation due to the cardiac cycle in healthy subjects
Guilhem Jean Collier1, Helen Marshall1, and Jim Wild1
1Academic Radiology, University of Sheffield, Sheffield, United Kingdom

In this work, dynamic acquisition of hyperpolarized 3He ventilation images was combined with phase contrast velocimetry sequences to assess airflow modulation due to the cardiac cycle during inspiration in healthy subjects. The results show opposite flow oscillations at the heartbeat frequency between the left lower lobe and all other lobes, suggesting that the movement of the heart is influencing the airflow pattern in the lungs.

Madhwesha Rama Rao1, Neil J Stewart1, Graham Norquay1, and Jim M Wild1
1Academic Unit of Radiology, University of Sheffield, Sheffield, South Yorkshire, United Kingdom

Hyperpolarized 129Xe has large range of chemical shift and can be used to study the human brain when 129Xe dissolved in the blood is transferred to white matter, grey matter and cerebral lipids. In this work we demonstrate in vivo human brain spectroscopy with dissolved 129Xe at 1.5T. In addition to peaks from grey and white matter, we detected peaks from 129Xe in red blood cells and lipids in the brain. We have established optimal topology for RF coils for 129Xe brain spectroscopy and developed a model for dissolved xenon blood uptake from the lungs to the brain.

3533.   5 Assessing the Diagnostic Power of a Hybrid Combination of Hyperpolarized 3He MRI derived ADC, Specific Ventilation and Alveolar Oxygen Tension in COPDs
Hooman Hamedani1, Stephen Kadlecek1, Masaru Ishii2, Yi Xin1, Hoora Shaghaghi1, Biao Han1, Sarmad Siddiqui1, Milton Rossman1, and Rahim R. Rizi1
1University of Pennsylvania, Philadelphia, PA, United States, 2Johns Hopkins University, Merryland, United States

The hybrid multibreath 3He imaging technique has been previously used to measure regional lung parameters such as pAO2, specific ventilation (SV) and ADC measurements simultaneously. The combination of these three imaging measurements effectively probes the different aspects of lung disease in a manner analogous to current clinical measurements. The obtained measurements are highly correlated with conventional pulmonary tests (pulmonary function test, six-minute walk test, and the St. George’s Questionnaire). In this study, the pAO2, SV and ADC measurements acquired using the hybrid technique were assessed for their viability as markers for distinguishing between smokers and nonsmokers.

3534.   6 Optimal Oxygen Concentration for Hyperpolarized Xenon Brain MRI
Haidong Li1, Zhiying Zhang1, Jianping Zhong1, Weiwei Ruan1, Zhao Li1, Xianping Sun1, and Xin Zhou1
1Wuhan Institute of Physics and Mathematics,CAS, Wuhan, Hubei, China

We defined T1_total as a parameter to identify the total relaxation for the delivery of xenon gas to the brain, and the ventilation with 25-30% oxygen in the lung has shown the maximal HP xenon signal in the rat brain, which is valuable for in vivo brain applications

3535.   7 Comparison of Calculated Specific Ventilation using the 'Wash-in' and 'Wash-out' Hyperpolarized 3He MRI Techniques
Sarmad Siddiqui1, Mehrdad Pourfathi1, Hooman Hamedani1, Yi Xin1, Hoora Shaghaghi1, Stephen J. Kadlecek1, and Rahim R. Rizi1
1Radiology, University of Pennsylvania, Philadelphia, PA, United States

It has been previously demonstrated that hyperpolarized (HP) 3He MRI can be used to construct regional fractional ventilation maps by imaging HP signal build up, by delivering several HP breaths, each followed by a breath hold for image acquisition. More recently, it was shown [2] that a similar regional fractional ventilation map could be constructed by fitting the signal decay after only one inhalation of HP gas. In this study, we compare the regional fractional ventilation maps generated by both the ‘wash-in’ and ‘wash-out’ methods to determine the robustness of the ‘wash-out’ method compared to the ‘wash-in’ method.

3536.   8 Age-Dependent Changes in Alveolar Microstructure of Healthy Adults by in vivo Lung Morphometry with Hyperpolarized 3He Diffusion MRI
James D Quirk1, Jason C Woods2, Alexander L Sukstanskii1, Barbara A Lutey3, Mario Castro3, and Dmitriy A Yablonskiy1
1Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, United States, 2Pediatrics and Radiology, Cincinnati Children's Hospital, Cincinnati, OH, United States, 3Pulmonary and Critical Care Medicine, Washington University School of Medicine, St. Louis, MO, United States

Pulmonary function in adults is known to decline with age. Using non-invasive diffusion MRI-based in vivo helium-3 lung morphometry, we studied 38 healthy subjects (ages 18-70) to determine the changes in lung microstructure at the alveolar level associated with this decline. We found that with increased age, there is a significant decrease in alveolar density, associated with both an increase in acinar duct lumen and acinar duct radius and a decrease in the alveolar depth. This establishes a baseline of age-dependent lung parameters for use in future studies to detect changes associated with pulmonary diseases.

3537.   9 Enhanced 129Xe Hyper-CEST Efficiency Using PK11195 Functionalized Cryptophane-A
Krista M. Dowhos1,2, Matthew S. Fox3, Iain K. Ball3, Tao Li3,4, Gowtham Gajawada3,4, Jordan Wentzell4, Brenton DeBoef5, and Mitchell S. Albert3,4
1Lakehead University, Thunder Bay, Ontario, Canada, 2Thunder Bay Regional Research Institute, Thunder Bay, Ontario, Canada, 3Thunder Bay Regional Research Institute, Ontario, Canada, 4Lakehead University, Ontario, Canada, 5Rhode Island University, Rhode Island, United States

The combination of hyperpolarized 129Xe MRI and Chemical Exchange Saturation Transfer (CEST), Hyper-CEST, can potentially enhance MR sensitivity by 108, making it a promising molecular imaging technique via MRI. In this study, we employ a Hyper-CEST pulse sequence at 3T, which uses pulsed saturation to lower SAR and provides an unprecedented 87% depletion in 129Xe(dissolved) signal. In addition, we used the same pulse sequence to demonstrate Hyper-CEST imaging, which may eventually allow for molecular imaging of inflammation sites in the body caused by diseases such as COPD and arthritis, due to the ability of PK11195 to target these pathologies.

3538.   10 Whole-Body MRI vs. Co-registered Whole-Body FDG-PET with MRI (PET/MRI) vs. Integrated FDG-PET/CT: Capability of Clinical Stage and Operability Assessments in Non-Small Cell Carcinoma
Yoshiharu Ohno1, Shinichiro Seki2, Mizuho Nishio1, Hisanobu Koyama2, Takeshi Yoshikawa1, Sumiaki Matsumoto1, Nobukazu Aoyama3, Kota Aoyagi4, Hitoshi Yamagata5, Hideaki Kawamitsu3, and Kazuro Sugimura2
1Advanced Biomedical Imaging Research Center, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan, 2Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan, 3Center for Radiology and Radiation Oncology, Kobe University Hospital, Kobe, Hyogo, Japan, 4MClinical Application Research Center, Toshiba Medical Systems Corporation, Otawara, Tochigi, Japan, 5Toshiba Medical Systems Corporation, Otawara, Tochigi, Japan

Clinical stage assessment is important for treatment in NSCLC patients. We hypothesized that whole-body MRI at 3T MR system, which is utilized multiple array coil with parallel imaging capability and Quick 3D sequence with DFS technique, has equal to or better potential for T, N and M factors and operability assessments in NSCLC patients than co-registered FDG-PET/MRI and integrated FDG-PET/CT. The purpose of this study was to directly compare the capability for clinical stage and operability assessments among whole-body MRI, co-registered FDG-PET/MRI and integrated FDG-PET/CT in NSCLC patients.

3539.   11 CODE (COncurrent Dephasing and Excitation) MRI of human lung at 3T
Soon Ho Yoon1, Chanhee Lee2, Jinil Park2, JaeKyun Ryu2, Jin Mo Goo1, and Jang-Yeon Park2
1Department of Radiology, Seoul National University College of Medicine, Seoul, Korea, 2Department of Biomedical Engineering, Konkuk University, Chung-ju, Korea

The purpose of our study was to investigate the technical feasibility of CODE(Concurrent Dephasing and Excitation) MRI in human lung. 1.3mm3 isotropic voxel 3D radial CODE imaging was performed in three healthy adult volunteers on 3.0 T MR system. An overall image quality of CODE was graded good to excellent. Pulmonary vessels were consistently traceable from central to subpleural area in whole lung. Thin bronchial walls were traceable from main bronchus to segmental bronchi with mild motion and streak artifacts on CODE. Lobar fissures were also identifiable. CODE MRI was techinally feasible in human lung on a clinical scanner.

3540.   12 Comparison of Normalized T1 and Pulmonary Blood Flow Assessments in Cystic Fibrosis Lung Disease
Lan Lu1,2, Shannon Donnola1, Elliott C Dasenbrook3, David Weaver3, Michael W Konstan3, and Chris A Flask1,4
1Department of Radiology, Case Western Reserve University, Cleveland, OH, United States, 2Department of Urology, Case Western Reserve University, Cleveland, OH, United States, 3Department of Pediatrics, Case Western Reserve University, Cleveland, OH, United States, 4Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, United States

We have previously developed a normalized T1 (nT1) method to sensitively and rapidly detect early-stage lung disease in cystic fibrosis (CF) patients. In this study, we aimed to determine the mechanism underlying observed nT1 changes in CF patients by direct comparison with pulmonary perfusion assessed by Arterial Spin Labeling. ASL and nT1 assessments in nine CF patients demonstrated significantly reduced mean nT1 and pulmonary perfusion in the upper lungs in comparison to healthy controls. A significant correlation (p <0.05) was also observed between nT1 and pulmonary perfusion. These results suggest that the nT1 technique is related to pulmonary perfusion.

3541.   13 Quantitative Gadolinium-based Aerosol Deposition and Dynamics in Healthy Rat Lung by UTE-MRI
Hongchen Wang1, Catherine Sébrié1, Jean-Pierre Ruaud1, Geneviève Guillot1, Khaoula Bouazizi-Verdier1, Georges Willoquet1, Xavier Maître1, Luc Darrasse1, and Ludovic de Rochefort1
1Imagerie par Résonance Magnétique Médicale et Multi-Modalités (UMR8081) IR4M, CNRS, Univ. Paris-Sud, Orsay, France

Aerosol toxicology and drug delivery through the lungs require the development of methods to quantify particle deposition. The use of intrapulmonary-administered MRI contrast agent combined to lung-specific imaging sequences has been proposed and remains an active preclinical research topic. Various administration protocols and pulse sequences have been used, and more recently ultra-short echo (UTE) sequences that are more adapted for lung parenchyma imaging. Here, we present the use of 3D UTE implemented in a clinical scanner, performed pre- and post- administration of gadolinium-based aerosol delivery in spontaneously breathing healthy rats, thus mimicking chronic particle exposure or free-breathing drug delivery. The contrast-enhanced quantification method enabled us to follow up lung clearance and regional heterogeneity in the deposition.

3542.   14 High-resolution zero echo time lung imaging
Fabio Gibiino1,2, Laura Sacolick3, Anne Menini4, Luigi Landini1, and Florian Wiesinger4
1University of Pisa, Pisa, PI, Italy, 2GE Global Research, Munich, Bavaria, Germany, 3GE Heathcare, Munich, Germany, 4GE Global Research, Munich, Germany

A 3D radial zero-TE sequence similar to the Rotating-Ultra-Fast-Sequence was implemented and optimized for high-resolution structural imaging of the lungs. The pulse-and-acquire sequence scheme achieves a nominal echo time equal to zero with repetition time of about one millisecond. The minimal gradient ramping kept the sequence free from eddy current artifacts. A prospective triggering on the respiration signal was used to avoid motion artifacts. The receive bandwidth was chosen to obtain the best compromise between resolution and signal-to-noise ratio. 3D datasets of the lung structures at ~0.9mm isotropic resolution were acquired on volunteers in ~9min scan time.

3543.   15 Comparative Analysis of Predictive Capability of 3D Non-Contrast-Enhanced Perfusion MRI, 3D Contrast-Enhanced Perfusion MRI, Quantitatively Assessed Thin-Section CT, and Perfusion Scan for Postoperative Lung Function in Non-Small Cell Lung Cancer Patients
Yoshiharu Ohno1, Shinichiro Seki2, Mizuho Nishio1, Hisanobu Koyama2, Takeshi Yoshikawa1, Sumiaki Matsumoto1, Nobukazu Aoyama3, Yoshimori Kassai4, Masao Yui4, Hideaki Kawamitsu3, and Kazuro Sugimura2
1Advanced Biomedical Imaging Research Center, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan, 2Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan, 3Center for Radiology and Radiation Oncology, Kobe University Hospital, Kobe, Hyogo, Japan, 4MRI Systems Development Department, Toshiba Medical Systems Corporation, Otawara, Tochigi, Japan

We hypothesize that Non CE-perfusion MRI based on fresh blood imaging (FBI) technique at 3T system can accurately assess regional perfusion difference, and predict postoperative lung function in NSCLC patients, when compared with perfusion scan (Q scan), thin-section MDCT and dynamic CE-perfusion MRI. The purpose of this study was to prospectively and directly compare capabilities of regional perfusion assessment and prediction of postoperative lung function in NSCLC patients among Q scan, thin-section CT, dynamic CE-perfusion MRI and non-CE-perfusion MRI.

3544.   16 Multiparametric functional 1H-lung MRI using a free-breathing 3D Twisted Projection Imaging Sequence
Kathrin R Hemberger1, Daniel Haddad1, Peter M Jakob1,2, and Felix A Breuer1
1Magnetic Resonance Center Bavaria, Wuerzburg, Bavaria, Germany, 2Department of Experimental Physics 5, Wuerzburg, Germany

A T1-weighted oxygen-enhanced Twisted Projection Imaging sequence was used to assess several functional lung parameters in 3D during free breathing. Retrospective DC-gating to expiration and inspiration enables the assessment of changes in T2* and T1 due to increased concentration of oxygen in the breathing gas for each respiratory state as well as changes in spin density at different breathing states.

3545.   17 Comparison of AIF determination methods and gadolinium contrast agents for quantitative pulmonary perfusion
Laura Bell1, Kang Wang2, Alejandro Munoz Del Rio3, Thomas Grist1,3, Sean Fain1,3, and Scott Nagle1,3
1Medical Physics, University of Wisconsin - Madison, Madison, Wisconsin, United States, 2Global MR Applications and Workflow, GE Healthcare, Wisconsin, United States, 3Radiology, University of Wisconsin - Madison, Wisconsin, United States

Quantification of pulmonary perfusion using T1-weighted contrast-enhanced MRI is challenging due to both the nonlinear relationship between signal intensity (SI) and contrast agent (CA) concentration, and the inherently low signal within the lung itself. We assessed the performance of three different AIF reconstruction methods using both gadopentetate dimeglumine and gadobenate dimeglumine in 12 healthy human subjects for pulmonary blood flow (PBF) measurements. There were no observed differences in PBF between all three AIF reconsturction methods using Gd-DTPA, however there were differences using Gd-BOPTA that need to be considered within a clinical setting. Lung enhancement was improved with GD-BOPTA.

3546.   18 Diffusion-Weighted MR Imaging with Multiple b Values: Which Parameters and Assessment Methods Are Best for Quantitative Diagnosis of Solitary Pulmonary Nodules? - permission withheld
Hisanobu Koyama1, Yoshiharu Ohno1,2, Shinichiro Seki1, Mizuho Nishio2, Nobukazu Aoyama3, Takeshi Yoshikawa2, Sumiaki Matsumoto2, and Kazuro Sugimura1
1Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan, 2Advanced Biomedical Imaging Research Center, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan, 3Radiology, Kobe University Hospital, Kobe, Hyogo, Japan

Recently, image quality and diagnostic capability of chest MR imaging have been improving and chest DWI were reported the utility of diagnosis of solitary pulmonary nodules (SPNs) including lung cancer. Under these circumstances, it is important that comparisons of methods for evaluating SPNs differentiation and selecting b values result in useful contributions to clinical practice. The purpose of this study was to determine the appropriate parameters and evaluation method for quantitative differentiation of SPNs by means of DWI.

3547.   19 Population-based parameterization of the oxygen input function (OIF) for dynamic oxygen-enhanced MRI
Jose L Ulloa1,2, Weijuan Zhang2, Josephine Naish2, Alexandra R Morgan1,2, and Geoffrey JM Parker1,2
1Bioxydyn Ltd, Manchester, United Kingdom, 2Centre for Imaging Sciences, University of Manchester, Manchester, United Kingdom

An input function characterizing the amount of inspired oxygen is required to allow standardized parameterization of changes in T1 contrast due to oxygen inhalation when performing oxygen-enhanced MRI. In this work, we propose a functional form of an oxygen input function (OIF) derived from inspired oxygen measured in 110 dataset using two standard disposable non-rebreathing clinical masks. Results show that the OIF wash-in and wash-out can be adequately described by bi-exponential functions and a population-based OIF may provide an adequate description of the true OIF at the individual level.

3548.   20 Relevance of respiratory gating for proton Lung MRI
Marta Tibiletti1, Jan Paul2, Detlef Stiller3, and Volker Rasche1,2
1Core Facility Small Animal MRI, University of Ulm, Ulm, BW, Germany, 2Department of Internal Medicin II, University Hospital Ulm, Ulm, BW, Germany,3Target Discovery Research Germany, Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach, BW, Germany

We have tested the effect of prospective respiratory gating on image sharpness in two radial short T2 method (THRIVE and UTE) for lung imaging in human volunteers at 3T. Qualitative and quantitative results show a significant increase in image sharpness in gated acquisition with respect to not gated ones. We have demonstrated that respiratory gating is necessary when high definition images of lung vessels and airways are needed, even if radial acquisitions are robust to movement artifacts and prospective gating typically double acquisition time. UTE acquisitions show promising results for vessels visualization without contrast agent.

3549.   21 Non-contrast-enhanced free-breathing lung imaging using high-speed MRI data acquisition and phase dispersion analysis
Yu Li1, David Roach1,2, and Jason Woods1,2
1Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States, 2Center for Pulmonary Imaging Research, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States

We developed a new non-contrast-enhanced lung imaging technique using high-speed dynamic data acquisition and phase dispersion analysis. By evaluating regional MRI phase dispersion of dynamic lung images during free breathing, image contrast may be generated from susceptibility changes in pulmonary parenchyma. We found that temporal behaviors of MRI phase dispersion may be used to investigate lung function by examining regional susceptibility changes dynamically in every respiration cycle. This offers a new imaging technique that has the potential to improve functional imaging of the lung.

3550.   22 A quantitative technique for assessing the temporal dynamics of regional specific ventilation in response to methacholine challenge in asthma using oxygen enhanced proton MRI
Rui Carlos Sá1, Amran K Asadi1, Rebecca J Theilmann2, and G. Kim Prisk1,2
1Medicine, University of California, San Diego, La Jolla, CA, United States, 2Radiology, University of California, San Diego, La Jolla, CA, United States

Asthma is a dynamic disease that possesses strong, poorly understood temporal components. We describe an improved analysis of Specific Ventilation Imaging - a quantitative oxygen-enhanced MR-technique - that may be useful in elucidating time-varying ventilation heterogeneity after acute asthma events. Specific ventilation is quantified by comparing the modeled response of ideal lung units with individual voxel signal intensity time-series, following changes from breathing air to oxygen. Temporal changes are captured using an overlapping running window (120 breaths, 600s, shifted by 200s). Regional ventilation is seen to recover towards baseline over time following bronchoconstriction of a mild asthmatic subject with methacholine.

3551.   23 Pulmonary Ultra-short Echo-time (UTE) Two-dimensional Radial Acquisition with Compressed Sensing: Preliminary Quantitative Results with Comparison to Thoracic CT
Weijing Ma1, Khadija Sheikh1,2, Jonathon Leipsic3, Harvey O Coxson3, David G McCormack4, Roya Etemad-Rezai5, and Grace Parraga1,2
1Imaging Research Laboratories, Robarts Research Institute, London, Ontario, Canada, 2Department of Medical Biophysics, The University of Western Ontario, Ontario, Canada, 3Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada, 4Department of Medicine, The University of Western Ontario, London, Ontario, Canada, 5Department of Medical Imaging, The University of Western Ontario, London, Ontario, Canada

We developed thoracic 32-channel ultra-short echo time radial 1H MRI with compressed sensing to achieve quantitative 1H signal intensity maps on a clinical 3T scanner for quantitative measurements of the lung parenchyma. Such measurements were directly compared in healthy volunteers at different lung volumes and in patients with COPD and bronchiectasis with 3He MRI apparent diffusion coefficients, CT measurements of tissue density and pulmonary function test measurements. Compressed sensing UTE MRI was successfully implemented at 3T and showed significantly improved SI measurements acquired at expiration breath-hold that is safe and practical for patients with chronic respiratory disease.

3552.   24 Ultra-short Echo Time 3D Radial Retrospective self-gated navigator for lung motion correction
Konstantinos G. Zeimpekis1,2, Gaspar Delso3, Florian Wiesinger4, Patrick Veit-Haibach5, and Gustav von Schulthess5
1University Hospital, Zurich, Zurich, Switzerland, 2Information Technology and Electrical Engineering, ETHZ, Zurich, Zurich, Switzerland, 3Global MR Applications & Workflow, GE Healthcare, Waukesha, WI, United States, 4GE Global Research, Munich, Germany, 5University Hospital, Zurich, Switzerland

On this project, we propose a lung imaging gating with self-gating navigator extraction based on the DC signal of multiple acquisitions. The Dc navigator is based on the maximum values along DC the superimposed DC signals of all acquisitions of the coil nearest to the diaphragm. Gating is achieved without any applying any threshold and the images look significantly improved concerning resolution, motion correction near the diaphragm structures and contrast regaining.


Renal & Male Pelvis

Monday 12 May 2014
Exhibition Hall  16:30 - 17:30

  Computer #  
25 Role of Diffusion MRI in renal cell carcinoma: assessment of nuclear grade
Durgesh Kumar Dwivedi1, Girdhar Singh Bora2, Rajeev Kumar2, Sanjay Thulkar3, Sanjay Sharma3, Siddhartha Datta Gupta4, and Naranamangalam Raghunathan Jagannathan1
1Dept of NMR & MRI Facility, All India Institute of Medical Sciences, New Delhi, Delhi, India, 2Dept of Urology, All India Institute of Medical Sciences, New Delhi, Delhi, India, 3Dept of Radio-diagnosis, All India Institute of Medical Sciences, New Delhi, Delhi, India, 4Dept of Pathology, All India Institute of Medical Sciences, New Delhi, Delhi, India

Recently there has been an annual increase of 2% in the incidence of renal cell carcinoma (RCC) worldwide. It is detected on computed tomography or ultrasound. Diffusion imaging has been shown to have potential in diagnosing various malignancies. We studied RCC lesions using diffusion-weighted MRI (DW-MRI). We found ADC values for RCC to be significantly lower than normal kidney tissue. Our results suggested that DW-MRI has potential in the prognostication of the patient and possibly could guide in therapeutic management.

3554.   26 4D contrast enhanced MRI of the developing mouse kidney
Luke Xie1,2, Ergys Subashi2,3, Yi Qi2, and G. Allan Johnson1,2
1Biomedical Engineering, Duke University, Durham, North Carolina, United States, 2Center for In Vivo Microscopy, Radiology, Duke University Medical Center, Durham, North Carolina, United States, 3Medical Physics Graduate Program, Duke University Medical Center, Durham, North Carolina, United States

We acquired high spatiotemporal resolution datasets of the developing mouse kidney. The data were acquired with a cryogenic surface coil and a dynamic contrast enhanced (DCE) MRI sequence, allowing 3D images (1253 μm3) to be obtained every 7.7 sec over a 50-min scan (390 time points). The DCE curves were used to determine a 3D time-to-peak map (time of injection to peak enhancement). Time-to-peak values and volumes were determined in three renal regions—cortex, outer medulla, and inner medulla. These functional and structural changes were measured over 17 weeks at 6 points (3, 5, 7, 9, 13, 17 weeks).

3555.   27 Quantify renal ASL data with arterial input function (AIF) sampled from renal artery
Jeff L Zhang1, Christopher C Conlin1, Jason Mendes1, Niels Oesingmann2, and Vivian S Lee1
1Department of Radiology, University of Utah, Salt Lake City, Utah, United States, 2Siemens Medical Solutions USA, Inc., New York, United States

Current models for analyzing renal ASL data assume rectangular-shape function for tagged arterial input function (AIF). With imperfect magnetization inversion, this assumption can cause significant errors in the estimated perfusion. In this study using coronal FAIR labeling, we propose to sample AIF from renal segmental artery, and after some calibration with proton density, use the AIF to estimate renal tissue perfusion from ASL images. In a human subject data, we found that perfusion estimated with the ¡®ideal¡¯ rectangular AIF was lower than that from the sampled AIF, which agreed with our expectation.

3556.   28 The effect of renal denervation on renal oxygenation as measured on BOLD MRI
Anneloes de Boer1, Eva E Vink2, Tim Leiner3, Peter J Blankestijn2, and Hans M Hoogduin3
1Nephrology, University Medical Center, Utrecht, Utrecht, Netherlands, 2Nephrology, University Medical Center, Utrecht, Netherlands, 3Radiology, University Medical Center, Utrecht, Netherlands

Renal denervation (RD) is a promising new therapy for resistant hypertension. The mechanism of action is proposed to be a decrease in sympathetic activity, resulting in altered sodium handling by the kidneys and a decrease in peripheral vascular resistance. As a consequence, one can hypothesize that renal blood flow and oxygenation will increase. To assess changes in oxygenation in the kidney after RD, BOLD MRI was performed in 38 patients before and 12 months after RD. Data were analyzed using the compartmental method of Ebrahimi et al. No change in renal oxygenation was demonstrated.

3557.   29 BOLD MRI of the Kidneys under water loading at 7 Tesla using parallel Transmission and RF Shimming of individual slices - permission withheld
Inge Brinkmann1, Niravkumar Darji2, Oliver Speck2, and Michael Bock1
1Radiology - Medical Physics, University Medical Center Freiburg, Freiburg, Germany, 2Otto von Guericke University Magdeburg, Magdeburg, Germany

BOLD MRI of the kidneys has been proposed to determine renal oxygenation through the measurement of R2* changes during water loading. In this work we report first preliminary results of renal BOLD MRI at 7T using a dedicated parallel transmission coil setup. To increase the B1+ homogeneity at kidney region the B1+ profile was shimmed successfully by more than 30%. The measurements were done with a multi-echo 2D FLASH sequence. The experiments show strong changes of R2* in the renal medulla and cortex both at baseline and during water loading which facilitates the detection of the R2* changes at 7T.

3558.   30 Effect of Iodinated Contrast Medium in Diabetic Rat Kidney as Evaluated by BOLD MRI - permission withheld
Lu-Ping Li1,2, Tammy Franklin1, Richard Solomon3, and Pottumarthi V Prasad1,2
1Radiology, Northshore University HealthSystem, Evanston, IL, United States, 2University of Chicago Pritzker School of Medicine, Chicago, IL, United States, 3University of Vermont College of Medicine, VT, United States

Iodinated contrast induced acute kidney injury (CIAKI) is the third cause of hospital-acquired AKI. Diabetes is one direct risk factor. Streptozotocin (STZ) treated rat is the most common model of human diabetes. The effects of iodinated contrast were evaluated in STZ treated rats using BOLD MRI. Our preliminary data show R2* responses are much smaller than those previously observed in alternate model of CIAKI. This is probably due to the persistent hyperfiltration in this model resulting in enhanced washout of contrast medium. Future studies may be necessary to evaluate whether fluid restriction could make the responses comparable to previous models.

3559.   31 T2* Correction Using B0 Mapping for Renal BOLD Quantification
Joshua D Kaggie1, Vivian S Lee1, and Glen R Morrell1
1Utah Center for Advanced Imaging Research, Radiology, University of Utah, Salt Lake City, UT, United States

Renal BOLD-MRI has been proposed as a method of functional renal imaging. Baseline values of T2* (R2*) and change in T2* in the kidneys after administration of a diuretic such as furosemide have been reported to correlate with severity of kidney disease. However, other published data shows no correlation between renal R2* and severity of chronic kidney disease. Among the potential confounding factors for accurate T2* quantification are B0 inhomogeneities that can result in varying T2* values between measurements. In this work, B0 maps are used to correct the T2* images for more accurate quantification.

3560.   32 Improved estimation of renal perfusion with multiple inversion-time acquisitions in arterial spin labeling
Jeff L Zhang1, Christopher C Conlin1, Jason Mendes1, Niels Oesingmann2, and Vivian S Lee1
1Department of Radiology, University of Utah, Salt Lake City, Utah, United States, 2Siemens Medical Solutions USA, Inc., New York, United States

Conventional perfusion quantification model for renal ASL data ignores transit delay from tagging site to tissue voxels. In this study, we compared a convolution-based model incorporating transit delay to the conventional approach using both simulated and human kidney ASL data. We found that the conventional method to estimate renal perfusion from ASL data was sensitive to the selection of inversion time (TI), while by acquiring signals at multiple TIs and analyzing them with a convolution-based model, we can estimate renal perfusion with much lower variability.

3561.   33 Renal Perfusion by ASL is Associated with GFR in Long-term Survivors of Wilms’ Tumor
Ruitian Song1, Ralf B. Loeffler1, Aaryani Tipirneni-Sajja1, Adam M. Winchell1, Mary B McCarville1, Melissa M. Hudson2, Sheri L. Spunt2, and Claudia M Hillenbrand1
1Radiological Sciences, St Jude Children's Research Hospital, Memphis, Tennessee, United States, 2Oncology, St Jude Children's Research Hospital, Memphis, Tennessee, United States

ASL MRI was applied to investigate renal perfusion irradiated and non-irradiated long-term survivors of Wilms’ tumor and in healthy volunteers. Between survivors no significant differences were observed in cortical and medullary blood flow (CBF and MBF), and glomerular filtration rate (GFR). MBF values of survivors were significantly higher than those of healthy volunteers. Normalized CBF and MBF were well correlated with absolute GFR.

3562.   34 Sensitivity of Arterial Spin Labeling Perfusion Imaging to Pharmacologically Induced Changes in the Rat Kidneys
Huan Tan1, Jon Thacker2, Tammy Franklin3, and Pottumarthi V Prasad1,3
1University of Chicago, Chicago, IL, United States, 2Northwestern University, Evanston, IL, United States, 3NorthShore University HealthSystem, Evanston, IL, United States

The objective of this study was to investigate whether arterial spin labeling (ASL) MRI in rat kidneys can be sensitive to pharmacologically induced vasodilation and vasoconstriction. The preliminary results demonstrated the sensitivity of ASL to changes in renal cortical perfusion and showed the estimates to be reproducible (with adenosine) and cumulative (with L-NAME).

3563.   35 Intra-tumoral Heterogeneity in Tumor Vascularity Correlates with ADC Quantification in Renal Masses
Qing Yuan1, Koji Sagiyama2, Yue Zhang1, Naira Muradyan3, Annanth Madhuranthakam1,2, Yin Xi1, Ivan E Dimitrov2,4, Vitaly Margulis5, James Brugarolas6,7, Payal Kapur5,8, and Ivan Pedrosa1,2
1Radiology, UT Southwestern Medical Center, Dallas, TX, United States, 2Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, TX, United States, 3iCAD, Inc., Nashua, NH, United States, 4Philips Medical Systems, Cleveland, OH, United States, 5Urology, UT Southwestern Medical Center, Dallas, TX, United States, 6Internal Medicine, UT Southwestern Medical Center, Dallas, TX, United States, 7Developmental Biology, UT Southwestern Medical Center, Dallas, TX, United States, 8Pathology, UT Southwestern Medical Center, Dallas, TX, United States

The purpose of this study is to investigate the correlation between the in vivo heterogeneity in tumor perfusion and cellularity in renal masses using dynamic contrast-enhanced (DCE) and diffusion-weighted imaging (DWI) techniques. Quantitative DCE and DWI parameters were obtained from the whole tumor, and from areas with high- and low-enhancement in the tumor. High-enhancement tumor regions demonstrated significant higher perfusion measures as well as lower ADC values. Our results confirm the correlation between intra-tumoral heterogeneity in blood flow and ADC in patients with renal masses.

3564.   36 Evaluation of split renal function on obstructive hydronephrosis using Dynamic Contrast Enhanced - Magnetic Resonance Renography
Yuancheng Wang1 and Shenghong Ju1
1Zhongda Hospital, Medical School of Southeast University, Nanjing, Jiangsu, China

renal scintigraphy may fail to accurately access the renal function on patients with obstructive hydronephrosis, we seek to find a more robust as well as non-invasive method to serve as an alternative. Dynamic Contrast Enhanced - Magnetic Resonance Renography has been proved to be a promising method in calculating split renal functions. How would it perform in the context of hydronephrosis? We conducted this preliminary study on the above issue.

3565.   37 Changes in Intra-Renal Oxygenation by BOLD MRI as an Early Marker of Iodinated Contrast Induced Acute Kidney Injury - permission withheld
Lu-Ping Li1,2, Jon Thacker1,3, Tammy Franklin1, Jing Lu2,4, Ying Zhou5, Maria Papadopulou-Rosenzweig6, Richard Solomon7, and Pottumarthi V Prasad1,2
1Radiology, Northshore University HealthSystem, Evanston, IL, United States, 2University of Chicago Pritzker School of Medicine, Chicago, IL, United States, 3Biomedical Engineering, Northwestern University, Evanston, IL, United States, 4Obstetrics and Gynaecology, Northshore University HealthSystem, Evanston, IL, United States, 5Center for Clinical & Research Informatics, Northshore University HealthSystem, Evanston, IL, United States, 6Radiation Medicine, Northshore University HealthSystem, Evanston, IL, United States, 7Nephrology, University of Vermont College of Medicine, Burlington, VT, United States

Clinical definition of iodinated contrast induced (CI) acute kidney injury (AKI) is based on serum creatinine measurements made 48-72 hours post-contrast administration. Such a delay results in poor specificity in terms of causal relationship. Novel marker urinary neutrophil gelatinase-associated lipocalin (NGAL) has shown response 8 hours post-contrast. Previous reports have shown that changes in R2* by MRI can demonstrate responses in real time with contrast administration. Here, we evaluated the effects of interventions to prevent CIAKI using BOLD MRI and compare them to urinary NGAL measurements made at baseline and 4 hrs post-contrast in a CIAKI susceptible rat model.

El-Sayed H. Ibrahim1, Robert A. Pooley1, Mellena D. Bridges1, Joseph G. Cernigliaro1, Peter Kollasch2, and William E. Haley1
1Mayo Clinic, Jacksonville, Florida, United States, 2Siemens Healthcare, MN, United States

Computed tomography is the current gold-standard for imaging kidney stones, albeit at the cost of radiation exposure. Conventional MRI sequences are insensitive to detecting kidney stones because their appearance as signal void. With the development of 2D ultra-short echo-time (UTE) MRI sequences, it becomes possible to image kidney stones in-vitro, despite the limitations of long scan-time and low sensitivity for stone detection. In this work, we optimize and implement a modified 3D UTE sequence for high-resolution in-vitro imaging of kidney stones at 3.0T while avoiding the previously mentioned limitations, which makes this sequence a candidate for imaging kidney stone patients.

3567.   39 How does renal function change with nephrectomy? Initial experience using renal blood flow measured by arterial spin labelling MRI combined with 51Cr-EDTA filtration (GFR) to calculate renal filtration fraction
Marica Cutajar1, David L Thomas2, Tina Banks3, Christopher A Clark1, and Isky Gordon1
1Imaging and Biophysics, UCL, Institute of Child Health, London, London, United Kingdom, 2Department of Brain Repair and Rehabilitation, UCL, Institute of Neurology, London, London, United Kingdom, 3Department of Radiology, Great Ormond Street Hospital, London, London, United Kingdom

This study is the first to measure renal plasma flow (RPF) non-invasively in kidney donors before and after donation. RPF obtained using Arterial Spin Labelling MRI combined with 51Cr-EDTA filtration (GFR) was used to calculate renal filtration fraction and hence assess the effect of nephrectomy on renal function. 7 healthy kidney transplant donors underwent two MRI scans (without the use of exogenous contrast agents) as well as multiple blood samples 51Cr-EDTA, prior to nephrectomy and one year after donation. We found that GFR increased more than RPF hence causing the FF to increase.

3568.   40 3D dynamic contrast-enhanced (DCE) MR renography; Evaluation of image quality and estimation of GFR comparing Kwic and Flash sequences
Eli Eikefjord1,2, Erling Andersen3, Jan Anker Monssen4, Erlend Hodneland5, Frank Zoellner6, Erik Hanson7, Arvid Lundervold5,8, and Jarle Tor Rørvik4,9
1Haukeland University Hospital (HUH), Bergen, Hordaland, Norway, 2University of Bergen (UoB), Bergen, Hordaland, Norway, 3Dept. of Clinical Engineering, HUH, Bergen, Norway, 4Dept. of Radiology, HUH, Bergen, Norway, 5Dept. of Biomedicine, UoB, Bergen, Norway, 6Dept. of Computer Assisted Clinical Medicine, Heidelberg University, Mannheim, Germany, 7Dept. of Mathematics, UoB, Bergen, Norway, 8HUS, Bergen, Norway, 9Dept. of Clinical Medicine, UoB, Bergen, Norway

A reliable and reproducible MR Renography technique may provide valuable information about renal functional status. In this project we studied the relationship between image quality and the ability to estimate GFR reliably, using two different DCE-MRI sequences (Kwic and Flash) in 10 healthy subjects and the same post-processing scheme. The correlation between image quality and accuracy appeared to be strong. Considering the Iohexol-clearance as GFR gold-standard, we found the FLASH sequence to give better GFR-estimates than KWIC. In quantitative MRI image quality should be documented to assure good technical compromises in the design of fast imaging techniques.

3569.   41 ASL and BOLD MRI Measurements in Human Kidneys
Jon Thacker1, Huan Tan2, Lu-Ping Li3,4, Wei Li3, Stuart Sprague4,5, Orly Kohn6, Ivana Lazich6, and Pottumarthi V Prasad3,4
1Northwestern University, Evanston, IL, United States, 2Department of Surgery, University of Chicago, IL, United States, 3Department of Radiology, Northshore University HealthSystem, IL, United States, 4The University of Chicago Pritzker School of Medicine, IL, United States, 5Division of Nephrology, Northshore University HealthSystem, IL, United States, 6Section of Nephrology, The University of Chicago Pritzker School of Medicine, IL, United States

In this study we sought to assess if there was a correlation between arterial spin labeled perfusion and blood oxygen level dependent oxygenation measurements in healthy subjects and patients with chronic kidney disease (CKD). We found that there was no significant correlation between the two, suggesting that, unlike most organs, renal oxygenation is not determined by blood flow. Additionally we found a significant R2* change in healthy subject’s renal medulla between baseline and furosemide challenge. No significant change in R2* was observed in other regions or CKD patients.

3570.   42 Comparison of breathhold versus PACE triggering in renal BOLD MRI
Maryam Seif1, Chris Boesch1, and Peter Vermathen1
1Depts Clinical Research and Radiology, University of Bern, Bern, Bern, Switzerland

Blood oxygenation level dependent (BOLD) MRI is a non-invasive approach that can play an important role in investigating renal dysfunctions. To minimize respiratory motion, BOLD kidney MRI has been performed in breath hold, which may not be feasible for patients. Therefore the aim of this study is evaluating the feasibility of the PACE triggered renal BOLD MRI in comparison with breath-hold BOLD MRI. The small difference of means and the correlations between BH-BOLD and PACE-BOLD R2* values suggest that PACE-BOLD MRI can facilitate renal measurements on elderly and diseased subjects, who may have problems holding their breath.

3571.   43 Designing Tissue-specific Variable Flip Angle for Improved 3D Turbo-Spin-Echo Imaging of the Prostate at 3T MRI.
Yoshiko Ueno1, Satoru Takahashi1, Katsusuke Kyotani2, Yu Ueda2, Tomoyuki Okuaki3, Kazuhiro Kitajima1, Nobukazu Aoyama2, Hideaki Kawamitsu2, and Kazuro Sugimura1
1Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan, 2Division of Radiology, Kobe University Hospital, Kobe, Hyogo, Japan, 3MR Clinical Science Asia Pacific, Philips Healthcare, Minatoku, Tokyo, Japan

Recently, tissue-specific prescribed signal evolutions, achieved by variable refocusing RF-pulse flip angles (tissue-specific VRFA), have been used to decrease blurring and obtain better contrast for turbo spin-echo imaging. Our aim was to assess the impact of tissue-specific VRFA sequence on 3D T2W-TSE image quality of prostate at 3T by comparing to conventional 3D and 2D sequence.

3572.   44 Influence of Coil Channel Phasing on the Quality of Prostate Spectroscopy
Radhouene Neji1 and Vladimir Jellus1
1Siemens Healthcare, Erlangen, Bayern, Germany

The influence of coil channel phasing on the quality of 3D CSI prostate spectroscopy data is evaluated. Two methods are compared: phasing using the first point of the FID and phasing using prescan data. It is shown that the coil phasing technique has an influence on the quality of the obtained spectra.

3573.   45 More accurate estimation in prostate volume achieved by optimized single slab 3D SPACE compared with 2D-TSE: A quantitative study based on the radical prostatectomy specimens.
Souichirou Tateishi1, Masato Uchikochi2, Shohei Miyazaki1, Hitoshi Matsui1, Takashi Horinouchi1, Yasuhiko Tomita3, Kazuo Nishimura4, and Katsuyuki Nakanishi1
1Radiology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Osaka, Japan, 2SIEMENS JAPAN K.K., Tokyo, Japan, 3Pathology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan, 4Urology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan

More accurate estimation of prostate volume is important for therapeutic trials. A recently evolved 3D-TSE T2WI sequence termed SPACE provides a high spatial resolution and isotropic volume image compared with the conventional 2D-TSE sequences. These improvements expect to provide more accuracy in prostate volume estimation. We compared 3D-SPACE with 2D-TSE about prostate volumes. Reference standard of prostate volume was obtained from pathology report as a gold standard. 3D-SPACE showed a higher correlation (SPACE; r=0.98, 2D-TSE; r=0.96) and a less relative error (p<0.01): (SPACE; 0.12}0.13, 2D-TSE; 0.19}0.15) with reference standard of prostate volume.

3574.   46 High Spatio-temporal Resolution Dynamic Contrast Enhanced MRI of the Prostate Utilizing Differential Subsampling with Cartesian Ordering (DISCO)
Adam Froemming1, Dan Rettmann2, Kohei Sasaguri1, Judson Frye1, Manojkumar Saranathan3, Kang Wang4, and Akira Kawashima1
1Radiology, Mayo Clinic, Rochester, MN, United States, 2Global Applied Science Lab, GE Healthcare, Rochester, MN, United States, 3Radiology, Stanford University, Stanford, CA, United States, 4Global Applied Science Lab, GE Healthcare, Madison, WI, United States

Analysis of a new dynamic contrast enhanced MRI sequence (DISCO, GE Healthcare) with both very high temporal resolution as well as excellent spatial resolution for application to prostate perfusion imaging.

3575.   47 Computed Diffusion-Weighted MR Imaging for Prostate Cancer Detection: Optimization of b-Value Combinations for Generating High b-Value Images.
Yoshiko Ueno1, Satoru Takahashi1, Kazuhiro Kitajima1, Yu Ueda2, Masamori Kassai3, Masao Yui3, Yoshiharu Ohno1,4, and Kazuro Sugimura1
1Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan, 2Division of Radiology, Kobe University Hospital, Kobe, Hyogo, Japan, 3MRI Systems Development Department, Toshiba Medical Systems Corp., Otawara, Tochigi, Japan, 4Advanced Biomedical Imaging Research, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan

Computed DWI (cDWI) is proposed as a new technique that produces any b-value images from DWIs acquired with at least two different b-values. However, it remains unclear which combination of b-values is optimal for generating high-b-value images. We hypothesize that appropriate b value selection for cDWI can improve image quality and detection capability on cDWI as compared with actual DWI with ultra-high b value. The aim of this study was to determine the appropriate b-value combination for generating cDWI at b=2000 s/mm2 to improve prostate cancer detection, when compared with actual DWI at b=2000 s/mm2 on a 3T MR system.

3576.   48 Magnetic Resonance Imaging Evaluation of the Adaptive Response of the Contralateral Kidney Following Nephrectomy in Patients with Renal Cell Carcinoma
Mao-Yuan Marine Su1, Kuo-How Huang2, Chin-Chen Chang1, Vin-Cent Wu3, Wen-Chau Wu4, Kao-Lang Liu1, and Wen-Yih Isaac Tseng1,5
1Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan, 2Department of Urology, National Taiwan University Hospital, Taipei, Taiwan, 3Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan, 4Graduate Institute of Oncology, National Taiwan University, Taipei, Taiwan, 5Center for Optoelectronic Medicine, National Taiwan University College of Medicine, Taipei, Taiwan

This study aimed to evaluate the adaptive responses of the contralateral kidney in patients with renal cell carcinoma (RCC) following radical nephrectomy (RN). Eleven patients with RCC scheduled for RN and 15 control patients scheduled for adrenalectomy (Control) were prospectively studied. All the subjects underwent 4 MRI studies: 1 before surgery and 3 at 1 week, 1 month and 3 months after surgery, respectively. Our results indicated that RN in patients with RCC results in an early increase in renal blood flow (RBF) of the contralateral kidney. At 3 months, the patients showed normalization of the RBF, accompanied by compensatory renal hypertrophy. In patients with reduced renal mass, an early increase in RBF was associated with late renal hypertrophy. Therefore, given healthy conditions of the kidneys at baseline, we might be able to predict the late renal function of the contralateral kidney based on its early response to RBF.


Hepatobiliary 1

Monday 12 May 2014
Exhibition Hall  16:30 - 17:30

  Computer #  
3577.   49 Gadoxetic acid-enhanced MR imaging criteria for the diagnosis of hepatocellular carcinoma based on ¡°hypervascularity in the arterial phase and washout in the later phase¡±: Which later phase should be chosen? - permission withheld
Ijin Joo1, Jeong Min Lee1, Dong Ho Lee1, Ju Hyeon Jeon1, Joon Koo Han1, and Byung Ihn Choi1
1Seoul National University Hospital, Seoul, Seoul, Korea
3578.   50 Gadoxetic Acid-Enhanced MR Imaging for T-Staging of Gallbladder Carcinoma: Emphasis on Liver Invasion
Jiyoung Hwang1, Young Kon Kim2, Mi Hee Lee3, and Hyun-joo Kim1
1Department of Radiology, Soonchunhyang University Seoul Hospital, Seoul, Seoul, Korea, 2Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Seoul, Korea, 3Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Seoul, Korea

Purpose: To evaluate gadoxetic acid-enhanced MR imaging with an emphasis on the usefulness of hepatobiliary phase (HBP) in T-staging of gallbladder carcinoma. Methods: 66 patients with confirmed gallbladder carcinoma underwent gadoxetic acid-enhanced MR imaging. Two radiologists independently reviewed two sets of MR imaging without / with HBP for local tumor spread. Results: This study yielded acceptable diagnostic performance with gadoxetic acid-enhanced MR imaging with the overall accuracies of 86.4% and 87.9% for each observer. By adding HBP, the sensitivities to differentiate ¡Â T2 versus ¡Ã T3 lesions were increased for both observers although there was no significant difference (P > 0.05). Conclusions: Gadoxetic acid-enhanced MR imaging provided acceptable diagnostic performance for T-staging of gallbladder carcinoma. Addition of HBP aids in detection of liver invasion.

3579.   51 Comparison of Free-Breathing Radial 3D T1 VIBE to Standard Breath-hold 3D T1 VIBE During Hepatobiliary Phase Imaging after Gadoxetic Acid Injection for Image Quality and HCC Detection
Cecilia Besa1, Ally Rosen1, Karen Lee1, Elizabeth Chorney1, Guido Jajamovich1, Ashley Knight-greenfield1, and Bachir Taouli1
1Icahn School of Medicine at Mount Sinai, New York, NY, United States

The purpose of this study was to compare breath-hold cartesian 3D T1 VIBE (BH-VIBE) to free breathing (FB) Radial-VIBE during hepatobiliary phase (HBP) in terms of image quality (IQ) and HCC detection and lesion conspicuity (LC). Radial-VIBE at HBP phase was comparable in terms of HCC detection to BH-VIBE, with better LC for one reader. Lower degradation of image quality due to respiratory motion artifacts was found for Radial-VIBE in comparison with BH-VIBE for two readers.

3580.   52 Focal Nodular Hyperplasia: Classification and Mimics, MR Imaging Findings Correlating with Histopathology
Pardeep Mittal1, Juan C Camacho1, Kiran K Maddu1, Brian Quigley2, Nima Kokabi1, Kelly Cox1, Sadhna Nandwana1, and Courtney C Moreno1
1Radiology and Imaging Sciences, Emory Uni School of Medicine, Atlanta, Georgia, United States, 2Pathology, Emory Uni School of Medicine, Atlanta, Georgia, United States

Focal nodular hyperplasia (FNH) is a hyperplastic process in which all the normal constituents of liver are present but in an abnormally organized pattern. It is crucial to differentiate hypervascular lesions mimicking FNH such as HCC especially fibrolamellar, hepatic adenoma to ensure proper treatment. MRI is invaluable tool in diagnosing primary liver lesions such as FNH and identifying several entities that MIMIC focal nodular hyperplasia and thereby assist physicians in detection and management of such pathologies.

3581.   53 Feasibility of 10-minute delayed hepatocyte phase imaging with 30° flip angle in Gd-EOB-DTPA-enhanced MRI for detection of liver metastases, compared to 20-minute delayed hepatocyte phase imaging with standard 10° flip angle. - permission withheld
Eun-Suk Cho1, Jeong-Sik Yu1, Da Hye Lee1, Joo Hee Kim1, and Jae-Joon Chung1
1Radiology, Gangnam Severance Hospital, Seoul, Korea

On Gd-EOB-DTPA-enhanced MRI for detection of liver metastases, 10-min delayed hepatocyte phase imaging (HPI) using a 30¡Æ flip angle (FA) had higher lesion-to-liver CNR with no difference in lesion detection sensitivity compared to 20-min delayed HPI with a standard 10¡Æ FA. This result indicates that 10-min delayed HPI with a 30¡Æ FA could replace 20-min delayed HPI with better diagnostic performance for the detection of liver metastases and also allows 10 minutes of time-saving.

3582.   54 Inflammatory Hepatic Adenomas: Characterization with Gadolinium-enhanced MRI
James Glockner1
1Radiology, Mayo Clinic, Rochester, Minnesota, United States

MRI characteristics of 28 pathologically proven inflammatory hepatic adenomas were examined. 38% of lesions showed hyperenhancement relative to adjacent normal liver on hepatobiliary phase images, and 35% showed the presence of internal lipid. In our experience atypical presentations of inflammatory hepatic adenomas are not uncommon, in particular the presence of hyperenhancement on hepatobiliary phase post-gadolinium images.

3583.   55 The role of gadoxetic acid-enhanced MR imaging in characterizing atypical hepatocellular carcinoma in dynamic CT studies
Chen-Te Chou1,2 and Ran-Chou Chen3
1Radiology, Chang-Hua Christain Hospital, Chang-Hua, Taiwan, Taiwan, 2Biomedical Imaging and Radiological Science, National Yang-Ming Medical University, Taipei, Taiwan, Taiwan, 3Biomedical Imaging and Radiological Science, National Yang-Ming Medical University, Taiwan, Taiwan

Diagnosis of HCC can be made by tumor showing typical features of HCC (hypervascularity in the arterial phase and washout in the venous/delayed phase) on dynamic study in stead of pathology. However, some HCCs may present atypical features in dynamic studies. These atypical HCCs are diagnostically challenging in our daily practice. Our study was to evaluate the efficacy of gadoxetic acid-enhanced hepatocyte-phase imaging in characterizing HCCs with atypical enhancing pattern in CT dynamic studies. In our results, gadoxetic acid-enhanced hepatocyte-phase imaging provided higher diagnostic performance than other MR characteristics in characterization of the atypical nodules among high HCC risk patients.

3584.   56 Interobserver agreement in relative liver lesion signal intensity on hepatobiliary phase imaging with gadoxetic acid (Gd-EOB-DTPA)
Sharon Ngu1, Lizza Lebron-Zapata1, Christy Pomeranz1,2, Seth Katz1, Scott Gerst1, Michael Sohn1, Junting Zheng3, Chaya Moskowitz3, and Richard K. G. Do1
1Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York, United States, 2New York Presbyterian Hospital - Weill Cornell, New York, New York, United States, 3Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York, United States

A retrospective study was conducted to assess interobserver agreement in the qualitative and quantitative evaluation of liver lesions signal intensity (SI) on delayed hepatobiliary phase MRI with gadoxetic acid (Gd-EOB-DTPA). In 50 patients, four readers (2 fellows, 2 experts) assessed lesion SI compared to liver on a 4 point scale and measured SI of the lesion and adjacent liver parenchyma. Result showed almost perfect agreement in expert readers and substantial agreement among fellows. A cutoff point of lesion to liver SI ratio of 0.876 was found to differentiate hypointense from iso- to hyperintense liver lesions on delayed hepatobiliary phase.

3585.   57 Detection of Hepatocellular Carcinoma Using Combining Gadoxetic Acid-enhanced and Diffusion-weighted MR Imaging in Pretransplant Patients: Emphasis on the Severity of Liver Cirrhosis
Jiyoung Hwang1, Young Kon Kim2, Mi Hee Lee3, and Hyun-joo Kim4
1Radiology, Soonchunhyang University Seoul Hospital, Seoul, Seoul, Korea, 2Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Seoul, Korea, 3Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Seoul, Korea, 4Department of Radiology, Soonchunhyang University Seoul Hospital, Seoul, S, Korea

3586.   58 Stretched type adiabatic pulse with flexible TSL setting for estimation of liver function
Tomoyuki Okuaki1, Yukihisa Takayama2, Akihiko Nishie3, Makoto Obara4, Tetsuo Ogino4, Hiroshi Honda3, and Marc Van Cauteren1
1Philips Healthcare APAC, Tokyo, Japan, 2Department of Molecular Imaging and Diagnosis, Kyushu University, Graduate School of Medical Sciences, Fukuoka, Japan, 3Graduate School of Medical Sciences, Department of clinical Radiology, Kyushu University, Fukuoka, Japan, 4Philips Electronics Japan, Tokyo, Japan

Two stretched type adiabatic locking pulses were applied to obtain homogeneous spin locking with flexible TSL setting, and compared with block pulse locking. Visual evaluation was done to assess the homogeneity of the T1rho maps and T1rho values obtained by the three methods were measured. The visual evaluation of T1rho maps obtained by stretched type adiabatic pulses were scored higher and T1rho values obtained by stretched type adiabatic(HS8_5) was significantly different between normal and Child-Pugh BorC, normal and Child-Pugh A. The Stretched type adiabatic provided homogeneous and artifact free liver T1rho maps with flexible TSL setting at 3T.

3587.   59 Impact of inversion-recovery fat suppression on hepatic R2* quantitation in transfusional siderosis.
Antonella Meloni1,2, J. Michael Tyszka3, Alessia Pepe1, Massimo Lombardi1, and John C Wood2,4
1CMR Unit, Fondazione G.Monasterio CNR-Regione Toscana and Institute of Clinical Physiology, Pisa, Italy, 2Department of Pediatrics, Division of Cardiology, Children’s Hospital Los Angeles, Los Angeles, California, United States, 3Division of Biology, California Institute of Technology, Pasadena, California, United States, 4Department of Radiology, Children’s Hospital Los Angeles, Los Angeles, California, United States

This represents the first study to compare the impact of fat saturation prepulse on R2* quantitation in transfusional siderosis. We demonstrate that SPIR fat suppression systematically lowered R2* estimates by 3.9% – 7.0, and introduced comparable random uncertainty between the two measurements. Since calibration curves have been derived using non-fat saturated images, these biases should be corrected when reporting LIC values from fat saturated images.

3588.   60 Fat Quantification in Chronic Liver Disease Patients with 3D Multi-Echo GRE Dixon at 1.5 T: Comparison with T2 Corrected Spectroscopy
Liana Guerra Sanches-Rocha1, Ludmila Ribeiro1, Karine Minaif Martins2, Ralph Markus Strecker3, Xiadong Zhong4, Stephan Kannengiesser5, and Ronaldo Hueb Baroni2
1Imaging, Albert Einstein Hospital, São Paulo, São Paulo, Brazil, 2Imaging, Albert Einstein Hospital, São Paulo, Brazil, 3Siemens Ltda, São Paulo, Brazil, 4MR R&D Collaborations, Siemens Healthcare MR R&D Collaborations, Georgia, United States, 5MR R&D Collaborations, Siemens Medical Solutions, Germany

The fat fraction measure using magnetic resonance imaging has been highly accurate alternative method to the biopsy procedure. The spectroscopy has been used as accurated methodology to access and monitor liver steatosis. The method had some of it's problem solved with the T2 correction in a fast aquisition (HISTO). In this study, we aimed to validate against the HISTO spectroscopy, a new 6-echoes-gradient-echo sequence, that uses a hybrid magnitude/complex data algorithm, including correction for T1 bias and T2* decay, and multipeak fat spectrum, that already has been validated at 3T system, at a clinical wide -bore 1,5T system. We evaluated 69 sets from patients that are waiting for liver transplantation and had undergone abdominal MRI. The fat percentage result from inline HISTO report and the proton density fat fraction (PDFF) obtained from the map generate inline from the new sequence were correlated. The intraclass correlation coefficient (ICC) between both sequenceswas 0,830 (CI95%=0,737 to 0,891) for fat percentage . We conclued that the new sequence, with multipeak fat spectral modeling and six-echo chemical shift encoding, has a good correlation with HISTO spectroscopy in the PDFF for chronic liver disease patients at 1,5T.

3589.   61 Mapping Hepatic Blood Oxygenation based on quantitative BOLD
Xiang He1, Serter Gumus1, and Kyong Tae Bae1
1Department of Radiology, University of Pittsburgh, Pittsburgh, PA, United States

Hepatic tissue hypoxia is a significant indicator of cellular dysfunction in liver diseases and may predict the outcome of interventions. While BOLD or oxygen-enhanced BOLD can provide qualitative assessment of tissue oxygenation, the measurement is relative and lacks specific. In this study, we have demonstrated the feasibility of utilizing the liver qBOLD technique to non-invasively estimate the regional hepatic blood oxygen saturation and hepatic blood volume. Our results were in good agreement with the reported values in literature.

3590.   62 Usefulness of a 3D Dual-Flip-angle T1 mapping technique pre and post Gadoxetic acid administration for the Assessment of Diffuse Liver Disease
Cecilia Besa1, Octavia Bane1, Guido Jajamovich1, Joseph Marchione1, and Bachir Taouli1
1Icahn School of Medicine at Mount Sinai, New York, NY, United States

The purpose of this study was to assess the diagnostic value of a novel 3D FLASH dual-flip-angle (DFA) T1 mapping sequence with whole liver coverage, used before and after injection of gadoxetic acid for the evaluation of diffuse liver disease. We found significantly lower T1 at hepatobiliary phase and lower T1 changes (ΔT1) in cirrhotic patients compared with non-cirrhotic patients, and between Child Pugh B+C in comparison with Child Pugh A patients. 3D T1 mapping sequence with whole liver coverage used before and after gadoxetic acid injection can help detect cirrhosis and evaluate liver function.

3591.   63 Quantification of liver steatosis in morbidly obese patients: comparative performance of low-field open MRI and Steatotest
Philippe Garteiser1, Sabrina Doblas1, Gaspard D'Assignies2, Doryssema Tchatat3,4, Simon Msika5, Muriel Coupaye6, Pierre Bedossa1,7, Valérie Vilgrain1,8, Elisabeth Dion9, Pauline Jouet10, and Bernard E Van Beers1,8
1CRB3, INSERM, Paris, 75018, France, 2Radiology department, Hôpital Beaujon, AP-HP, Clichy, France, 3Groupement hospitalier Paris Nord, AP-HP, Colombes, France, 4Hepato-gastroenterology department, Hôpital Louis Mourier, AP-HP, Colombes, France, 5Visceral Surgery department, Hôpital Louis Mourier, AP-HP, Colombes, France, 6Endocrinology Department, Hôpital Louis Mourier, AP-HP, Colombes, France, 7Anatomo-pathology Department, Hôpital Beaujon, AP-HP, Clichy, France, 8Radiology Department, Hôpital Beaujon, AP-HP, Clichy, France, 9Radiology Department, Hôpital Louis Mourier, AP-HP, Colombes, France,10Hepato-gastroenterology Department, Hôpital Louis Mourier, AP-HP, Colombes, France

Quantification of intrahepatic fat represents an important challenge in disease management for morbidly obese patients. Liver biopsy is often problematic with associated risks and limited volume of coverage. Alternate techniques include serum tests such as Steatotest and MRI fat quantification. Moreover, obese patients are often difficult to examine in conventional MRI systems and may require examinations in open magnets at low field strengths. In this report, using histopathological analyses of liver biopsies as gold standard, the diagnostic performance of 1.0T open field MR fat quantification was found to significantly outperform the serum marker Steatotest in the determination of hepatic steatosis.

3592.   64 Feasibility and Reproducibility of R2* Measurement Under Oxygen and Carbogen Challenge in Healthy Subjects and Patients with Hepatocellular Carcinoma at 1.5 T and 3T
Octavia Bane1, Cecilia Besa1, Niels Oesingmann2, Hadrien Dyvorne3, Guido Jajamovich1, Marcelo Facciutto4, Sasan Roayaie4, and Bachir Taouli1
1Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, United States, 2US MR Division R&D, Siemens Healthcare, New York, NY, United States, 3ranslational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, United States, 4Transplant Institute, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, United States

Measurement of the transverse magnetization relaxation rate (R2*) is of great interest as a potential non-invasive marker of tumor oxygenation. The purpose of our study was to quantify R2* at baseline and after hyperoxic and hyperoxic-hypercapnic respiratory challenges, in hepatocellular carcinoma (HCC) lesions, liver and muscle. R2* measurements were reproducible within a 15% coefficient of variation at 1.5T for all tissues and gas challenges studied, but showed greater variability at 3T. The response of HCC lesions to oxygen and carbogen challenge, quantified by change in R2*, was highly variable, and will be correlated with pathologic findings in a future study.

3593.   65 Comparison of Water R2 Spectroscopy Measures in the Liver at 1.5T and 3T
Radhouene Neji1, Nashiely Sofia Pineda Alonso1, Pedro Miguel Itriago Leon1, Heinrich von Busch1, Stephan Kannengiesser1, and Berthold Kiefer1
1Siemens Healthcare, Erlangen, Bayern, Germany

Using the HISTO sequence, which is a five-echo STEAM single voxel spectroscopy technique, we validate the linear relationship between liver R2 values at 3T and 1.5T and the value of the regression slope. Fourteen volunteers underwent a HISTO measurement at 1.5T and at 3T, and the voxel positioning was made consistent across the measurements. Possible applications for this study are the extrapolation of iron overload level classification at 1.5T to 3T based on the R2 values.

3594.   66 Accuracy of HISTO-based Liver Fat Quantification at Different Field Strengths
Nashiely Sofia Pineda Alonso1, Radhouene Neji1, Pedro Miguel Itriago Leon1, Heinrich von Busch1, Stephan Kannengiesser1, and Berthold Kiefer1
1Siemens Helathcare, Erlangen, Bayern, Germany

We assessed the accuracy of HISTO-based liver fat quantification at 3T in subjects with a very low fat fraction in the liver (<15%). The results of liver fat quantification, relaxivity of water and relaxivity of fat were validated and compared to the results obtained at 1.5T for the same subjects.

3595.   67 The Importance of consistent RF Spoiling for MRI based Liver Iron Content Determination with Signal Intensity Ratios – preliminary data
Arthur Peter Wunderlich1, Volker Rasche2,3, Holger Cario4, Markus Juchems1, and Meinrad Beer1
1Dept. for Diagnostic and Interventional Radiology, Univ.-Clinic Ulm, Ulm, Germany, 2Experimental Cardiovascular Imaging, Univ.-Clinic Ulm, Ulm, Germany,3Internal Medicine II, Univ.-Clinic Ulm, Ulm, Germany, 4Pediatry, Univ.-Clinic Ulm, Ulm, Germany

Signal Intensity Ratio (SIR) between liver and reference tissue (paraspinal muscle) has proven to be a reliable method for determination of liver iron content (LIC). However, we found that SIR values depend on activation of RF spoiling. In a preliminary analysis, we determined LIC with the method published by Gandonin data with and without RF spoiling and compared these values to LIC determined from the commercial Ferriscan® method. Linear correlation between both methods was performed and R² was evaluated. While we achieve a good R² value without RF spoiling, it was significantly worse with RF spoiling.

3596.   68 MRI based Noninvasively Differentiation between Aggregated and Dispersed Liver Iron in vivo: a feasibility study
Arthur Peter Wunderlich1, Markus Juchems1, Holger Cario2, Matthias Weigel3, and Meinrad Beer1
1Dept. for Diagnostic and Interventional Radiology, Univ.-Clinic Ulm, Ulm, Germany, 2Pediatry, Univ.-Clinic Ulm, Ulm, Germany, 3Radiological Physics, University of Basel Hospital, Basel, Switzerland

A method previously described by Jensen et al. was implemented and tested in a clinical setting. 20 patients suspected for liver iron overload were scanned by MRI using spin-echo (SE) and multi-contrast spin-echo (MC-SE) sequences. Data of MC-SE were fitted to theory to get tissue parameters which are hypothesized to allow a differentiation between aggregated and dispersed liver iron. The two parameters in question were correlated to liver iron content (LIC) determined from SE sequences. Only the aggregation index A correlated positively to LIC. The other parameter reduced transverse relaxation rate RR2 showed no significant correlation to LIC.

3597.   69 Signal Intensity Ratio between Liver and Muscle Reference in Highly Iron Overloaded Patients: comparing 1.5 T to 3 T
Arthur Peter Wunderlich1, Steffen Klömpken1, Holger Cario2, Markus Juchems1, and Meinrad Beer1
1Dept. for Diagnostic and Interventional Radiology, Univ.-Clinic Ulm, Ulm, Germany, 2Pediatry, Univ.-Clinic Ulm, Ulm, Germany

The liver of highly iron overloaded patients was scanned with breathhold GRE sequences at 1.5 T and 3 T. To address high liver iron content (LIC), we measured the signal intensity ratio (SIR) between liver and paraspinal muscle serving as reference. In theory, logarithm of these SIR values are expected to depend linearly on R2* difference between liver and muscle tissue which itself varies with LIC due to R2* changes with iron deposition in the liver. Dependence of SIR on LIC was evaluated and results compared between field strengths.

3598.   70 Evaluation of Sensitivity of Fat Fraction Measurement to Fat Spectral Model Precalibration
Xiaoke Wang1, Diego Hernando2, and Scott B Reeder2,3
1Biomedical Engineering, University of Wisconsin, Madison, WI, United States, 2Radiology, University of Wisconsin, Madison, Wisconsin, United States,3Medical Physics, University of Wisconsin, Madison, Wisconsin, United States

In chemical shift encoded (CSE) fat water imaging, it has been shown that multi-peak spectral modeling of fat, compared with single peak models of fat, is necessary for accurate fat quantification. Different spectral models of fat (triglycerides) in the liver has been reported, and it is unknown how these differences will impact the technical accuracy and reproducibility of fat quantification. This work is evaluates the sensitivity of chemical shift encoded fat quantification to different spectral models of fat. Our results show that the use of spectral modeling of fat is needed for accurate CSE fat quantification. However, the specific choice of spectral model (among recently proposed choices) has a much smaller impact on fat quantification accuracy.

3599.   71 Effect of fat deposition in the liver on multi-parametric quantitative values at 3.0T MRI - permission withheld
Yong Eun Chung1, Hye-Jeong Lee2, Mi-Suk Park3, and Myeong-Jin Kim4
1Radiology, Yonsei University College of Medicine, Seoul, ., Korea, 2Radiology, Yonsei Univeristy College of Medicine, Seoul, ., Korea, 3Radiology, Yonsei Univeristy College of Medicine, Seoul, Korea, 4Radiology, Yonsei Univeristy College of Medicine, Korea

Recently, the number of patients who has fatty liver is increasing and fat deposition of the liver (Lfat) can be a confounding variable in quantitative MRI. In this study, we tried to assess the effect of Lfat on multi-parametric MRI values at 3.0T MRI. There was a significant correlation between T2 value and Lfat and between T2* value and Lfat. However, there was no significant correlation between Lfat and other MR parameters (T1, ADC, complex-,shear- and loss modulus). Hence, Lfat should be adjusted when T2/T2* values were used as quantitative parameter for the evaluation of focal or diffuse liver disease

Sarah Keller1, Björn Schönnagel1, Charlotte Pfeifer1, Zhiyue Jerry Wang2, Roland Fischer3, Christoph Berliner1, Moritz Brehmer1, Gerhard Adam1, and Jin Yamamura1
1Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, Hamburg, Hamburg, Germany, 2Department of Radiology, Children's Medical Center Dallas, Dallas, Tx, United States, 3Department for Biochemistry, University Medical Center Hamburg-Eppendorf, Hamburg, Hamburg, Germany

Due to the increased iron stores, patients with iron overloading diseases eventually develop hepato- and splenomegaly. The purpose of this study was 1.) to investigate the accuracy of liver volumen measurements using MR-volumetry and ultasonic planimetry and 2.) to correlate liver volume with liver iron concentration assessed with MR-R2* relaxometry in patients with iron overloading diseases.


Diabetes & Misc.

Monday 12 May 2014
Exhibition Hall  17:30 - 18:30

  Computer #  
1 Diffusion-weighted STEAM MRS to measure fat unsaturation in regions with low fat content
Stefan Ruschke1, Thomas Baum1, Hendrik Kooijman2, Marcus Settles1, Axel Haase3, Ernst J. Rummeny1, and Dimitrios C. Karampinos1
1Department of Diagnostic and Interventional Radiology, Technische Universität München, Munich, Germany, 2Philips Healthcare, Hamburg, Germany,3Zentralinstitut für Medizintechnik, Technische Universität München, Garching, Germany

MR spectroscopy has been previously employed as a technique for estimating fat unsaturation. However, if the fat fraction is low and the water peak overlaps with the olefinic fat peak, the quantification of fat unsaturation can become challenging. Long-TE PRESS sequences have been suggested as a way to reduce the water peak and measure fat unsaturation. However, a TE of the order of 200 ms should be employed to reduce J-coupling effects, resulting in a low SNR. We present an alternative approach to measure fat unsaturation using a diffusion-weighted STEAM sequence, which is shown to be able to reduce the water peak at moderate TEs.

3602.   2 In vivo assessment of skeletal muscle ATP synthesis in Ob/Ob mice
Patricia Maria Nunes1, Barbara Janssen1, Andor Veltien1, Henk Arnts2, Cees Tack3, and Arend Heeschap1
1Radiology, Radboud University Nijmegen Medical Centre, Nijmegen, Gelderland, Netherlands, 2Central Animal Laboratory, Radboud University Nijmegen Medical Centre, Nijmegen, Gelderland, Netherlands, 3Internal Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, Gelderland, Netherlands

Caloric overload stresses energy homeostasis maintenance in key metabolic tissues as the skeletal muscle. This phenomenon is, in the long run, characterized by intramyocellular lipid accumulation and impaired oxidative capacity. We tested in leptin deficient mice (Ob/Ob) mice whether ATP synthesis was impaired, by means of 31P MRS. The overall muscular Piright arrowATP flux assessed with ST showed no differences between WT and Ob/Ob mice, despite greater Pi concentration. When stimulated, muscles of Ob/Ob mice produced lower force and were prone to fatigue. Preliminary data suggests that Ob/Ob mice have higher mitochondrial ATP synthesis, as alluded by the PCr recovery curves.

3603.   3 Hepatic energy levels are not altered by fructose feeding in mice - permission withheld
Patricia Maria Nunes1, Andreas Boss2, Alan Wright1, Andor Veltien1, Cees Tack3, John Jones4, and Arend Heeschap1
1Radiology, Radboud University Nijmegen Medical Centre, Nijmegen, Gelderland, Netherlands, 2Radiology, Radboud University Nijmegen Medical Centre, Gelderland, Netherlands, 3Internal Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, Gelderland, Netherlands, 4Life sciences, Centre for Neurosciences and Cell Biology, Coimbra, Portugal

Excess fructose consumption has been associated with poor hepatic ATP synthesis. Yet it is unclear whether a chronic supply of fructose can per secompromise hepatic ATP homeostasis. Furthermore, the deleterious effects attributed to fructose do not seem disassociated from increased caloric intake. Thus, we assessed throughout 6 weeks, the hepatic high energy content of mice fed fructose or its isocaloric equivalent glucose, with 31P MRSI. Our results support that fructose feeding is not sufficient to alter hepatic ATP levels, differently from glucose. However it does increase more rapidly hepatic lipid content.

3604.   4 Resting acetylcarnitine concentration in skeletal muscle, as measured with long TE 1H-MRS, is associated with insulin sensitivity
Lucas Lindeboom1, Christine Nabuurs1, Joris Hoeks2, Maarten Vosselman2, Bram Brouwers2, Tineke van de Weijer1, Silvie Timmers2, Esther Phielix2, Eline Kooi1, Matthijs Hesselink3, Joachim Wildberger1, Patrick Schrauwen2, and Vera Schrauwen-Hinderling1
1Dept. of Radiology, MUMC+, Maastricht, Netherlands, 2Dept. of Human Biology, MUMC+, Maastricht, Netherlands, 3Dept. of Human Movement Sciences, MUMC+, Maastricht, Netherlands

The use of long TE in 1H-MRS enhances the visibility of the acetylcarnitine peak at 2.13 ppm. In this study we measured acetylcarnitine concentration in four groups, chosen to cover the whole range of metabolic health, from type 2 diabetic patients to endurance trained athletes. We found lower acetylcarnitine concentrations in subjects with lower insulin sensitivity. These results may indicate that T2DM subjects have a lower ability to form acetylcarnitine, possibly underlying a decreased insulin sensitivity and metabolic flexibility.

3605.   5 Water fat separated MRI during cooling-reheating for the estimation of brown fat amount and activity - permission withheld
Elin Lundström1, Lars Johansson1,2, Peter Bergsten3, Håkan Ahlström1, and Joel Kullberg1
1Department of Radiology, Uppsala University, Uppsala, Sweden, 2AstraZeneca, R&D Mölndal, Sweden, 3Department of Medical Cell Biology, Uppsala University, Uppsala, Sweden

The purpose of this work was two-fold: 1) To evaluate the effect of 3h cooling on human cervical-supraclavicular adipose tissue fat fraction (FF) and R2* 2) To evaluate the potential of a cooling-reheating water-fat MRI protocol for assessing brown adipose tissue (BAT) amount and activity. Imaging was performed in nine volunteers (22-37 years, 5 males). A general decrease in FF following 3h cold exposure was observed, which confirms results from previous PET/CT-studies. By adding a reheating timepoint to the cold exposure protocol, the BAT activity in terms of intracellular lipid consumption could potentially be separated from perfusion effects.

3606.   6 Effect of caloric and non-caloric sweeteners on liver lipid metabolism in rats
Sharon Janssens1, Klaas Nicolay1, and Jeanine J. Prompers1
1Eindhoven University of Technology, Eindhoven, Netherlands

Excessive use of caloric sweeteners such as glucose and fructose causes hepatic steatosis and obesity. To sweeten food and drinks without the excessive calories, non-caloric sweeteners can be used. In this study lipid metabolism in the liver of rats receiving different caloric and non-caloric sweeteners is examined using 1H-[13C] MRS combined with the administration of 13C-labeled lipids. The non-caloric sweetener aspartame did not have any effect on liver lipid content or metabolism. In contrast, carbohydrate consumption resulted in increased liver lipid content, which was not accompanied by an increased uptake of dietary lipids and is thus likely caused by increased lipogenesis.

3607.   7 Investigation of intrahepatic fat and liver glycogen in diet induced fatty liver disease model
Jadegoud Yaligar1, Venkatesh Gopalan1, Swee Shean Lee1, Bhanu Prakash KN1, and S Sendhil Velan1

Hepatic hyperlipidemia and hepatic glycogen content in insulin resistant non-alcoholic fatty liver model will help in understanding the early metabolic changes in liver metabolism. In this study we have evaluated the liver fat and glycogen content in non-alcoholic fatty liver using a diet induced insulin resistant rat model and compared with normal liver by in vivo and ex vivo MRS. Our preliminary studies show that the reduction in glycogen content in fatty liver compared to normal liver might be due to low glycogen synthase defects under hyperlipidemia and insulin resistant condition. Liver fat content in fatty liver is inversely correlated with glycogen indicating the impairment in glycogen synthesis due to lipotoxicity.

3608.   8 Pancreas fat via Dual-Echo mDIXON Imaging shows that Intracellular Fat does not Accumulate within the Pancreas of Healthy and T2DM Subjects
Paul Begovatz1, Chrysi Koliaki1, Julia Szendroedi1, Guido Giani2, Juergen Bunke3, and Michael Roden1,4
1Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Duesseldorf, Germany,2Institute for Biometry and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Germany, 3Philips Healthcare, Hamburg, Germany, 4Department of Endocrinology and Diabetology, University Clinics, Heinrich Heine University, Duesseldorf, Germany

Pancreatic steatosis has been linked to â-cell dysfunction in the development of type 2 diabetes (T2DM). However, 1H-MRS and MRI studies investigating pancreatic fat and â-cell function have shown conflicting results. In this work, mDIXON imaging with a noise reduction fat fraction algorithm was verified in comparison to 1H-MRS liver fat measurements. Pancreas fat was then measured in 48 participants: lean, overweight/obese, and T2DM. Results showed that avoiding regions of interlobular fat revealed clear regions of parenchymal tissue void of any lipid accumulation. These results show for that the pancreas does not consist of intracellular fat leading to pancreatic steatosis.

3609.   9 Magnetic Resonance in MiGTOFU Trial
Jun Lu1, Elaine Rush2, Lindsay Plank3, and Janet Rowan4
1Faculty of Health & Environmental Sciences and Institute of Biomedical Technology, Auckland University of Technology, Auckland, Auckland, New Zealand, 2Faculty of Health & Environmental Sciences, Auckland University of Technology, Auckland, New Zealand, 3Department of Medicine, University of Auckland, Auckland, New Zealand, 4Auckland District Health Board, Auckland, New Zealand

We used free breathing Dixon vibe protocol on a Siemens 3T Skyra scanner to study abdominal fat and MRS to study liver fat of 7-9 year old children born from mothers with gestational diabetes. We obtained clear and processable images and spectra. Intra-abdominal fat percentage showed good correlation with liver MRS. Total abdominal fat determined by MRI showed good correlation with DEXA scan. Free breathing protocols are suitable to study children.

3610.   10 Hypoxia accelerated metabolic alterations in the diabetic kidney assessed with hyperpolarized MRS
Christoffer Laustsen1,2, Sara Lycke3, Fredrik Palm3,4, Jakob Appel Østergaard5,6, Bo Martin Bibby7, Rikke Nørregaard8, Allan Flyvbjerg5, Michael Pedersen1, and Jan Henrik Ardenkjaer-larsen9,10
1MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Aarhus, Denmark, 2bDanish Research Centre for Magnetic Resonance, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark, 3Department of Medical Cell Biology, Uppsala University, Uppsala, Sweden,4Division of Drug Research, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden, 5Department of Endocrinology and Internal Medicine, Aarhus University, Aarhus, Denmark, 6The Danish Diabetes Academy, Aarhus, Denmark, 7Department of Biostatistics, Aarhus University, Aarhus, Denmark, 8Department of Clinical Medicine, Aarhus University, Aarhus, Denmark, 9GE Healthcare, Broendby, Denmark,10Department of Electrical Engineering, Technical University of Denmark, Kgs. Lyngby, Denmark

We demonstrated an increased oxygen sensitivity in kidneys of diabetic patients, using hyperpolarized [1-13C]pyruvate and BOLD MRI. This finding may explain the observed increased risk of developing nephropathy in diabetic patients inspiring reduced oxygen (<20%). The underlying explanation is likely explained by an acceleration of the hyperglycemia mediated polyol pathway cascade, leading to an overproduction of nicotinamide adenine dinucleotide (NADH), thereby increasing the lactate pool, while the oxidative phosphorylation is unaffected. In parallel, we observed a correlation between the [1-13C]pyruvate derivates: alanine and bicarbonate; which may potentially be used as a sensitive marker for intrarenal oxygen deficiency.

11 High-quality free-breathing abdominal MR imaging enabled by Repeated K-t-subsampling and Artifact-Minimization (ReKAM)
Mei-Lan Chu1,2, Hing-Chiu Chang2, Mustafa R Bashir3, and Nan-Kuei Chen2,3
1Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan, Taiwan, 2Brain Imaging and Analysis Center, Duke University, Durham, North Carolina, United States, 3Department of Radiology, Duke University, Durham, North Carolina, United States

We present a new technique to enable high-quality and artifact-free abdominal MRI data. The developed ReKAM module incorporates bootstrapping in k-t space and multiplexed sensitivity encoding to produce high-quality image. The ReKAM module can effectively remove motion-related artifacts resulting from global and local motion during free-breathing abdominal MRI scan, without navigator echo or any pulse sequence modification.

3612.   12 Fast and Perfectly Registered Multi-contrast Whole Body MRI in a Single Run for PET/MR Imaging - permission withheld
Benedicte MA Delattre1,2, Peter Koken3, Christian Stehning3, Holger Eggers3, Susanne Heinzer2, Giel Mens4, and Peter Börnert3
1Department of Radiology, Geneva University Hospitals, Geneva, Switzerland, 2Philips AG Healthcare, Zürich, Switzerland, 3Philips Research Laboratories, Hamburg, Germany, 4Philips, Best, Netherlands

With the recent introduction of hybrid modalities such as PET/MR, whole-body MRI reinforces its importance in the staging and follow-up of oncologic patients. A typical whole-body MRI exam contains T2w and T1w sequences as well as diffusion-weighted imaging with background suppression (DWIBS). We propose a flexible whole-body MR protocol using an interleaved multi-station approach where T1w and T2w sequences are acquired during the same breath-hold and DWIBS during free-breathing. This allows reduced number of breath-holds asked to the patient and guarantee perfect registration of images to facilitate for optimal clinical diagnosis and to support proper attenuation correction for the PET.

3613.   13 Diffusion-weighted imaging detects early progression of renal fibrosis in a murine model of unilateral ureteral obstruction
Guihua Zhai1, Guihua Zhai1, Bo Chen1, Hyunki Kim1, Kurt Zinn1, and Anupam Agarwal1
1University of Alabama at Birmingham, Birmingham, AL, United States

The purpose of this study was to confirm that apparent diffusion coefficient (ADC) is a reliable biomarker for the assessment of renal fibrosis in a murine model of unilateral ureteral obstruction (UUO). On day 0, group 1 had surgery for UUO, while group 2 was used as a sham group (only incision was applied). ADC and volume of kidneys were measured on days 1, 3 and 7. Relative ADC (ADC of ipsilateral side divided by ADC of contralateral side) of parenchyma differed significantly on days 3 and 7 between UUO group and control group. Our results suggest the relative ADC may serve as a reliable imaging biomarker.

3614.   14 Optimal MRI sampling and binning for online 4D retrospective respiratory motion analysis of the abdomen
Bjorn Stemkens1, Rob H. Tijssen1, Baudouin Denis de Senneville2,3, Jan J.W. Lagendijk1, and Cornelis A.T. van den Berg1
1Department of Radiotherapy, UMC Utrecht, Utrecht, Netherlands, 2Image Science Institute, UMC Utrecht, Utrecht, Netherlands, 3IMB, UMR 5251 CNRS/University Bordeaux, Bordeaux, France

Patient specific online characterization of abdominal organ motion will open the possibility for adaptive radiotherapy treatment that accounts for day to day variations in tumor motion and motion of surrounding organs. In this abstract we propose an online method, based on retrospective binning of the data with respect to the respiratory cycle, which allows 4D motion characterization in less than 15 minutes. The method utilizes a clinically available pulse sequence, and Matlab based reconstruction and post-processing software.

3615.   15 Whole-body Imaging of Adipose Tissues in Mouse at 9.4T
Patrick J Bolan1, Amrutesh Puranik2, John W Osborn Jr.3, Maria Razzoli3, Alessandro Bartolomucci3, Pu Tzu Liu4, Yi-Wei Lin4, and Li-Na Wei4
1Radiology - CMRR, University of Minnesota, Minneapolis, Minnesota, United States, 2Mayo Clinic, Rochester, MN, United States, 3Integrative Biology and Physiology, University of Minnesota, Minneapolis, MN, United States, 4Pharmacology, University of Minnesota, Minneapolis, MN, United States

This work demonstrates anatomic and parametric water-fat imaging of adipose tissues in post mortem mice at 9.4 T with spatial resolution (156 µm isotropic) substantially higher than previous studies. Anatomic and fat fraction images were used to segment different adipose tissue compartments (e.g., visceral vs. subcutaneous); fat fraction and R2* maps were used to distinctly identify brown adipose tissue depots. This approach is applicable for finely-segmented quantitative volumetry of brown and white adipose tissue depots.

3616.   16 Longitudinal patterns of diffusion measures in children treated for B-cell Lymphoma
John O Glass1, Emily M Paulus1, Zoltan Patay2, John T Sandlund3, and Wilburn E Reddick1
1Division of Translational Imaging Research, St. Jude Children's Research Hospital, Memphis, TN, United States, 2Division of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, TN, United States, 3Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, United States

This study examined the white matter (WM) integrity of 19 pediatric mature B-cell lymphoma patients without clinical signs or symptoms of neurotoxicity at five time points during treatment using fractional anisotropy (FA) and radial diffusion. FA from a defined region of interest was plotted for each patient, and two distinct patterns were found. Eleven patients showed a decrease in FA followed by a slow return toward baseline, consistent with demylination / remylination. Eight patients demonstrated an immediate spike in FA followed by a return to normal appearing development, possibly explained by restricted diffusion related to steroid therapy.

3617.   17 MR artifact reduction for dental alloys using MAVERIC sequences
Irene A. Burger1, Jeanne M. Gunzinger2, Porto Miguel2, Patrick Veit-Haibach2, and Delso Gaspar3
1Nuclear medicine, University Hospital Zurich, Zurich, Zurich, Switzerland, 2Nuclear medicine, University Hospital Zurich, Zurich, Switzerland, 3Global MR Applications & Workflow, GE Healthcare, Zurich, Switzerland

First results for metal artifact reduction for dental alloys in PET/MR imaging using a modified MAVRIC sequence, covering the jaw in only 3.5 minutes.

3618.   18 Monitoring of Rat Liver Regeneration following Portal Vein Ligation using MR Volumetry and Hepatic Arterial Spin Labelling
Rajiv Ramasawmy*1,2, Manil Chouhan*1,3, Dipok Kumar Dhar4, Adrienne E. Campbell-Washburn5, Jack Anthony Wells1, Rosamund Barbara Pedley2, Massimo Malago3, Raj Mookerjee4, Stuart A. Taylor3, Mark Francis Lythgoe†1, and Simon Walker-Samuel†1
1Centre for Advanced Biomedical Imaging, University College London, London, Greater London, United Kingdom, 2Cancer Institute, University College London, London, Greater London, United Kingdom, 3Centre for Medical Imaging, University College London, London, Greater London, United Kingdom,4Institute for Liver and Digestive Health, University College London, London, Greater London, United Kingdom, 5National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD, United States

Recently developed surgical procedures utilise the liver’s unique regenerational properties to promote lobe growth prior to curative partial hepatectomy in patients with liver malignancies. MRI offers accurate, non-invasive characterisation of anatomical changes, furthermore it can utilise perfusion imaging to functionally assess the proposed post-surgery liver remnant. This study monitored gross lobe changes in a novel rat model of liver regeneration using high-resolution anatomical MRI and applied hepatic arterial spin labelling to evaluate tissue viability. One week after selective PVL surgery, average lobe hypertrophy was 74% and average lobe atrophy was -43% from typical volume. A perfusion difference was observed between the atrophic and hypertrophic liver lobes.

3619.   19 Geometric Distortion in Diffusion-Weighted MR Imaging of the Prostate – Contributing Factors and Strategies for Improvement
Francisco Donato Jr1, Daniel N. Costa1, Qing Yuan1, Neil M. Rofsky1, Robert E. Lenkinski1, and Ivan Pedrosa1
1UT Southwestern Medical Center, Dallas, TX, United States

This study is the first investigation assessing parameters that may influence geometric distortion on DWI of the prostate. We explored the causes and degree of geometric distortion observed in DWI of the prostate and assessed different acquisition strategies to mitigate deformation. The magnitude of distortion was assessed in patients and the effects of phase-encoding direction, receiver bandwidth, and parallel imaging were assessed in a prostate phantom on two different 3T MRI scanners from different manufacturers. We found that distortion occurs in the phase-encoding direction, and is less pronounced when higher bandwidth or parallel imaging is used.

3620.   20 Quantitative Liver Function Analysis using T1 mapping with fast multi-slice B1 correction on Hepatocyte-specific contrast enhanced MR - permission withheld
Jeong Hee Yoon1, Jeong Min Lee1, Eun Ju Kim2, Tomoyuki Okuaki3, Joon Koo Han1, and Byung Ihn Choi1
1Radiology, Seoul National University Hospital, Seoul, Seoul, Korea, 2Philips Healthcare Korea, Seoul, Seoul, Korea, 3Philips Healthcare Japan, Tokyo, Japan

The purpose of this study is to determine whether T1 mapping sequence with fast multi-slice B1 correction shows better diagnostic performance than T1 mapping without B1 correction, for estimating liver function on Gd-EOB-DTPA enhanced MRI. Postcontrast T1 relaxation times (R1) with B1 correction of the liver on Gd-EOB-DTPA MRI were significantly different among different C-P score groups: 427.8¡¾145.8 msec in A5; 502.5¡¾134.9 msec in A6; and 640.9¡¾370.8 msec in B7 (P<0.001). As for R1s of the liver without B1 correction, values were 375.9¡¾156.8 msec in A5; 338.3¡¾82.8 msec in A6; and 565.2¡¾336.2 msec in B7. T1 mapping using VFA and B1 correction can be used for quantitatively estimate liver function using hepatocyte-specific contrast enhanced MRI.

3621.   21 Automated Fat and Muscle Quantification in the Thigh and Calf
Bryan T Addeman1, Robert A Hegele2, Houchun H Hu3, and Charles A McKenzie1,2
1Medical Biophysics, Western University, London, Ontario, Canada, 2The Robarts Research Institute, London, Ontario, Canada, 3Department of Radiology, Children’s Hospital Los Angeles, Los Angeles, California, United States

Measurement of muscle volume and fat distribution in the extremities is clinically important for the study of degenerative muscle diseases and aging. We aimed to extend, and validate a previously introduced abdominal adipose segmentation tool for use in the extremities. Using automatic segmentation of water and fat images, the volumes of subcutaneous adipose tissue, inter-muscular adipose tissue, and muscle were validated against manual segmentation. Excellent agreement between manual and automated methods was found, with automated segmentation being 80x faster. The automated tool is suitable for use in the extremities enabling rapid segmentation of complete tissue volumes rather than single-slices.

3622.   22 Time-effective MRI-based quantification of visceral adipose tissue (VAT) in morbidly adipose patients
Nicolas Linder1,2, Alexander Schaudinn1,2, Nikita Garnov1,2, Tatjana Schütz2, Veronika Peter2, Arne Dietrich2,3, Thomas Kahn1, and Harald Busse1
1Diagnostic and Interventional Radiology Department, Leipzig University Hospital, Leipzig, Saxony, Germany, 2IFB Adipositas Diseases, University Medicine Leipzig, Saxony, Germany, 3Department of Visceral-, Transplantation-, Thorax- and Vascular Surgery, Leipzig University Hospital, Leipzig, Saxony, Germany

MRI quantification of visceral adipose tissue (VAT) has promising applications in risk assessment and therapy monitoring of obesity-related diseases. The aim was to evaluate whether an accelerated, partial data analysis can be used to estimate total VAT in 70 morbidly obese patients. As observed in less obese patients, single-slice volume estimates at vertebral disc levels L3/4 (female) and L1/2 (male) were good predictors for total VAT volume. Analysis of 5 slices was found to be slightly beneficial in both groups. Small volume changes occurring under minor interventions like diets still seem to require a complete analysis of all (here 37) slices.

3623.   23 Body Composition Volumetry by Whole-Body Water-Fat Separated MRI - permission withheld
Patrik Tunón1, Thobias Romu1,2, Anette Karlsson1,2, Sepher Zanjanis3, Solveig Gjellan3, Fredrik H Nyström3, Peter Lundberg1,3, Örjan Smedby1,3, Magnus Borga1,2, and Olof Dahlqvist Leinhard1,3
1Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden, 2Department of Biomedical Engineering, Linköping University, Linköping, Sweden, 3Department of medical and health sciences, Linköping University, Linköping, Sweden

A method for calculation of total lean and adipose tissue volume based on intensity corrected whole body water-fat separated MRI is presented. The method was validated comparing data acquired from healthy volunteers scanned at different field strengths, resolutions and vendors. The whole body adipose tissue volume was also compared to air displacement plethysmography. Both adipose and lean tissue measurements showed excellent reproducibility between different MRI measurements as well as compared to air displacement plethysmography.

3624.   24 Non-contrast-enhanced MR Arteriography with Balanced Steady-State Free-Precession Sequence and Time-Spatial Labeling Inversion Pulses: Comparison of Imaging with Flow-in and Modified Flow-out Methods
Hiroyoshi Isoda1, Akihiro Furuta1, Rikiya Yamashita1, Tsuyoshi Ohno1, Seiya Kawahara1, Hironori Shimizu1, Aki Kido1, Koji Fujimoto1, Yasutaka Fushimi1, Kaori Togashi1, and Hiroshi Kusahara2
1Kyoto University Graduate School of Medicine, Kyoto, Kyoto, Japan, 2Toshiba Medical Systems Corporation, Otawara, Tochigi, Japan

Long TI of a selective tagging pulse in flow-out method is favorable for peripheral vessel visualization to maintain background signal suppression using a nonselective inversion recovery pulse. The aim of this study was to compare and evaluate images of non-contrast-enhanced MR arteriography acquired with two different methods, the flow-in and modified flow-out methods using the selective tagging pulse with long TI. The vessel-to-liver contrast and the quality of vessel visualization were better with the modified flow-out than flow-in method. Non-contrast-enhanced MR arteriography with the modified flow-out method improved the visualization of the intrahepatic artery in comparison with the flow-in method.


Body DWI/ MRS/ Female Pelvis Pregnancy

Monday 12 May 2014
Exhibition Hall  17:30 - 18:30

  Computer #  
3625.   25 The effect of cardiac phase on liver diffusion tensor imaging (DTI)
Oi Lei Wong1,2, Glady G Lo3, Raymond Lee3, Po Lung Polo Chan3, Wing Wa Li3, Siu Ki Yu4, and Michael D Noseworthy5,6
1Department of Medical Physics and Applied Radiation Science, McMaster University, Hamilton, Ontario, Canada, 2Medical Physics and Research Department, Hong Kong Sanatorium & Hospital, Hong Kong, Hong Kong, Hong Kong, 3Department of Diagnostic & Interventional Radiology, Hong Kong Sanatorium & Hospital, Hong Kong, Hong Kong, 4Medical Physics and Research Department, Hong Kong Sanatorium & Hospital, Hong Kong, Hong Kong,5Department of Electrical and Computer Engineering, McMaster University, Hamilton, Ontario, Canada, 6St.Joseph's Healthcare, Hamilton, Ontario, Canada

Performing diffusion weighted imaging at the left liver lobe is often problematic due to regional signal loss. From the literature, the regional signal loss is possibly related to respiratory and cardiac motion. In this study, we studied the effect of cardiac phase, and hence motion, on liver DTI metrics, performed at various cardiac trigger delay settings. Significant change in DT metrics between systole and diastole was observed in the left liver lobe, but not the right liver lobe. This suggests that these metrics are sensitive to cardiac phase, and thus likely deformation.

3626.   26 Are Respiratory Triggered Diffusion Weighted Acquisitions of the Liver Effective at Eliminating Respiratory Motion?
Naama Lev-Cohain1, Qing Yuan1, Daniella Pinho1, Yin Xi1, and Ivan M. Pedrosa1
1Radiology, UT Southwestern Medical Center, Dallas, TX, United States

Diffusion weighted imaging (DWI) acquisitions of the liver are performed for lesion detection and characterization. Respiratory triggered acquisitions (RT) are used to eliminate anatomic misregistration caused by respiratory motion. To our knowledge, the effectiveness of RT strategies has not been explored. We analyzed the effect of respiratory motion on slice misregistration in DWI acquisitions. 74% of the DWI acquisitions in our study had at least misregistration in one of the 4 anatomic locations analyzed. Our results indicate that the utility RT DWI for lesion characterization in the liver may lack the robustness needed for broad applicability in clinical practice.

3627.   27 Combined DWI and DCE-MRI of hepatocellular carcinoma: correlation of perfusion and diffusion parameters. Initial experience.
Guido Hugo Jajamovich1, Hadrien Dyvorne1, Cecilia Besa1, and Bachir Taouli1
1Icahn School of Medicine at Mount Sinai, New York, NY, United States

This study assesses diffusion and perfusion characteristics of hepatocellular carcinoma (HCC) and background liver parenchyma measured through the use of both DWI and DCE-MRI acquisition techniques. Semi-quantitative DCE-MRI parameters time to peak (TTP), slope and area under the curve at 60s (AUC60) and DWI parameters apparent diffusion coefficient (ADC) and true diffusion coefficient (D) demonstrated significant differences in HCC vs. liver parenchyma. There was no correlation between DWI and DCE-MRI metrics. These results suggest that the combination of DWI and DCE-MRI in a multiparametric MRI scan provides non-redundant information about HCC tumor biology.

3628.   28 IVIM DWI of the Liver: Inter-platform variability between 1.5T and 3T
Yong Cui1, Hadrien Dyvorne1, Cecilia Besa1, Guido Jajamovich1, Octavia Bane1, and Bachir Taouli1
1Icahn School of Medicine at Mount Sinai, New York, NY, United States

This study assessed Intravoxel Incoherent Motion (IVIM) diffusion-weighted imaging in the liver parenchyma at 1.5T and 3.0 T in terms of image quality, parameter quantification and inter-platform reproducibility. IVIM DWI at 3.0T provided better image quality than 1.5T. ADC and D were more reproducible than PF and D* between the two platforms.

3629.   29 Qualitative and Quantitative effects of Gadoxetate Disodium on DWI/ADC in a Healthy, Liver Donor Population
Anshuman Panda1, Judy R James1, and Alvin C Silva1
1Department of Radiology, Mayo Clinic, Scottsdale, Arizona, United States

Qualitative and quantitative impact on the liver DWI in the presence of a hepatobiliary contrast agent has been reported to be insignificant. However, our observation contradicts those findings. A year-long trial with over 25 healthy liver donor patients showed a significant change in the b-maps and ADC values in the pre- and post-gadoxetate disodium DWI. In particular, the signal drop was significantly higher post contrast when an inversion recovery (IR) pulse was added for fat suppression. Thus, we suggest that liver DWI should be performed pre-contrast when possible, or without an IR pulse post-contrast.

3630.   30 Optimizing b-value distribution for IVIM imaging using adjusted weighting factors
Sonia Isabel Goncalves1, Goncalo Cachola2, Filipe Caseiro-Alves3,4, and Miguel Castelo-Branco1
1IBILI-Faculty of Medicine, University of Coimbra, Coimbra, Coimbra, Portugal, 2Faculty of Sciences and Technology, Universidade Nova de Lisboa, Setubal, Portugal, 3Faculty of Medicine, University of Coimbra, Coimbra, Portugal, 4Radiology, University Hospital Coimbra, Coimbra, Portugal

Intra-voxel incoherent motion (IVIM) imaging differentiates between true molecular diffusion, diffusion due to perfusion, and quantifies perfusion fraction. Results from its clinical application have been ambiguous and this can be, at least in part, explained by the dependence of IVIM parameter estimation on the choice of b-value combination that is used to sample the data. In this paper we explore the influence of the perfusion rate regime in the total error propagated into IVIM diffusion/perfusion parameters, in order to optimize the b-value distribution that is used to sample the data.

3631.   31 Accelerated whole-body diffusion weighted imaging with blipped CAIPIRINHA based simultaneous multislice acquisition
Himanshu Bhat1, Thomas Doring2, Daniel Cornfeld3, Ralph Strecker4, Stephen F. Cauley5, Kawin Setsompop5, Leonardo Kayat Bittencourt2, Romeu Domingues2, and Keith Heberlein1
1Siemens Medical Solutions USA Inc, Charlestown, MA, United States, 2CDPI/DASA, Rio de Janeiro, Rio de Janeiro, Brazil, 3Department of Diagnostic Radiology, Yale-New Haven Hospital, New Haven, CT, United States, 4Siemens Ltda, São Paulo, São Paulo, Brazil, 5A. A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, United States

The goal of this work was to apply the blipped CAIPIRINHA slice acceleration technique to spin echo EPI based whole-body DWI and compare the results with a conventional non slice accelerated acquisition. 8 healthy volunteers and 6 patients were scanned with both sequences. Quantitative comparison between the two sequences showed similar ADC values in multiple organs. Qualitative comparison showed comparable image quality and diagnosis in all 6 patients with both sequences.

3632.   32 Multiparametric whole body MRI in castrate resistant prostate cancer bone metastases – total tumour volume, ADC and fat fraction parameters reproducibility
Nina Tunariu1,2, David J Collins1,2, Matthew D Blackledge1,2, Mihaela Rata1,2, Julie Hughes1, Zaki Ahmad1, Raquel PerezLopez1,2, Amelia Altavilla1,2, Roberta Ferraldeschi1,2, Gerhardt Attard1,2, Johann S de Bono1,2, Martin O Leach1,2, and Dow-Mu Koh1,2
1The Royal Marsden NHS Foundation Trust, Sutton, London, United Kingdom, 2The Institute of Cancer Research, Sutton, London, United Kingdom

More than 70% of castration-resistant prostate cancer patients have metastatic bone disease; the only available imaging response criteria are those of disease progression on bone scans, with no imaging criteria to positively assess therapy benefit. Diffusion weighted imaging (DWI) and fat fraction (FF) quantification are promising tools for detection and therapy monitoring of bone metastases. Currently, there are no published data documenting the reproducibility of total tumour volume (TTV) bone disease apparent diffusion coefficient (ADC) or FF values. The aim of this study was to document the reproducibility of TTV defined on DWI, ADC and FF using histograms methods.

3633.   33 Size, ADC and T2 signal- a reproducibility study of parametric measurements for classification of nodal disease in paediatric hodgkin's lymphoma
Arash Latifoltojar1, Paul Humphries2, Stephen Daw3, Ananth Shankar3, Stuart Taylor4, and Shonit Punwani4
1Centre for Medical Imaging, University College London, London, London, United Kingdom, 2Radiology, University College London Hospital, London, United Kingdom, 3University College London Hospital, London, United Kingdom, 4Centre for Medical Imaging, University College London, London, United Kingdom

Whole body MRI is being increasingly used as an alternative imaging modality to PET-CT in paediatric lymphoma. Moreover the addition of diffusion weighted images to whole body protocol makes the functional assessment of tumour possible. In this work the inter observer agreement on size measurement and quantitative derived parameters is investigated for anatomical and functional MRI,

3634.   34 Effect of secretin stimulation in healthy volunteers at 3T: comparison of mono- and biexponential (IVIM) models in pancreas diffusion-weighted imaging
Julie Absil1, Helena Torrao1, Thierry Metens1, Monia Bali1, and Celso Matos1
1MRI Unit - Radiology, CUB Hôpital Erasme, Brussels, Brussels, Belgium

In this IRB approved study, the quantification of Intravoxel Incoherent Motion (IVIM) parameters as well as monoexponential DWI parameters was performed in healthy pancreas in order to assess changes during secretin stimulation. Fifteen healthy volunteers underwent 3T diffusion-weighted SE-EPI MRI before and at 3 and 8 minutes following secretin injection (1CU/KgBW). Monoexponential apparent diffusion coefficients (calculated with different sets of b-values) as well as IVIM perfusion fraction significantly increased at 3 minutes after secretin administration, reflecting the expected increase in both perfusion and the exocrine free water release. All parameters decreased between 3 and 8 minutes after secretin administration.

3635.   35 Changes in Choline Level and Lipid Profile in Rat Liver During Lipid Infusion Measured by Dynamic Proton MRS
Peng Cao1,2, Shu-Juan J. FAN1,2, Anna M. Wang1,2, Victor B. Xie1,2, Iris Y. Zhou1,2, and Ed X. Wu1,2
1Laboratory of Biomedical Imaging and Signal Processing, The University of Hong Kong, Hong Kong, Hong Kong SAR, China, 2Department of Electrical and Electronic Engineering, The University of Hong Kong, Hong Kong, Hong Kong SAR, China

The liver proton MR spectroscopy (MRS) is typically used for quantifying lipid content. Previous proton MRS studies have reported the quantifications of liver lipid profile and liver choline in vivo. This study aimed to examine whether dynamic proton MRS can assess the time courses of liver choline level and lipid profile in response to the acute lipid intake. Our preliminary results suggested that dynamic proton MRS could measure the changes of choline level and lipid profile in normal rat liver with acute intravenous lipid infusion.

3636.   36 Boosting SNR with an internal antenna and external antennas in the human cervix uteri in TSE at 7T.
Irene Maria Louise van Kalleveen1, Jaap P. Hoogendam1, Alexander J.E. Raaijmakers1, Fredy Visser1, Hugo Kroeze1, Peter R. Luijten1, Wouter B. Veldhuis1, and Dennis W.J. Klomp1
1UMC Utrecht, Utrecht, Utrecht, Netherlands

In cervical cancer, high resolution T2 images are desired for determining loco-regional tumour spread. This requires an increased SNR, which may be provided at higher field strengths. Using external antennas combined with an internal antenna, we demonstrate that the SNR at 7T can be increased with an additional factor 3.2. Additionally, TSE visualization of the entire female pelvis is achieved. The boosted SNR is used to obtain high resolution T2-weighted MRI of the human cervix uteri and parametria, not only showing a high level of details, but also alterations in T2 contrasts that enables distinguishing the cervix from the parametria.

3637.   37 Clinical Feasibility of Distortion Corrected Diffusion-Weighted (DW) Images of Human Cervix
Maysam Jafar1, Katherine Downey1, Sharon L Giles2, Veronica A Morgan2, Geoffrey S Payne1, and Nandita M DeSouza1
1Clinical Magnetic Resonance Unit, Institute of Cancer Research, Sutton, Surrey, United Kingdom, 2Clinical Magnetic Resonance Unit, Royal Marsden Hospital, Sutton, Surrey, United Kingdom

DW sequences improve detection of cervical tumor but are prone to distortions, worse when using an endovaginal receiver coil. We corrected image distortions by acquiring forward and reverse gradient images and then used Chang&Fitzpatrick’s reverse gradient algorithm. Assessment of the correction by measuring the angle of the endocervical canal to the horizontal on corrected and uncorrected high b-value images showed significant differences in the former but not the latter when compared to measurements from T2-W images. Normalised cross-correlation using template matching to assess similarities between corrected/uncorrected DW and T2-W images varied marginally, indicating the need for feature tracking techniques.

3638.   38 The high negative predictive value to pre-operative MRI in Grade I endometrial cancer in the clinical setting.
Erin Bravo1, Krupa Patel-Lippmann2, Kristie Guite3, Jessica Robbins3, David Kushner2, Ahmed Al-Niaimi2, and Elizabeth Sadowski2
1Radiology, University of Wisconsin, Madison, Wisconsin, United States, 2University of Wisconsin, Wisconsin, United States, 3Radiology, University of Wisconsin, Wisconsin, United States

In grade 1 endometrial cancer there is debate whether or not lymphadenectomy is necessary. Strong evidence exists that women without myometrial or cervical invasion have decreased risk of lymph node metastasis, thus may potentially avoid lymphadenectomy. The goal of our study was to evaluate myometrial and cervical invasion in women with grade 1 endometrial cancer on preoperative MRI when being read by abdominal radiologists compared with surgical pathology. Our study determined the negative predictive value of MRI in detecting myometrial and/or cervical invasion is 96%, which may decrease the need for lymphadenectomy in women with very low risk for lymph node metastasis.

3639.   39 Carcinosarcoma of the Uterus: MR Findings including Diffusion-weighted imaging and in-vivo proton MR Spectroscopy
Mayumi Takeuchi1, Kenji Matsuzaki1, and Masafumi Harada1
1Department of Radiology, University of Tokushima, Tokushima, Tokushima, Japan

We evaluated the MR findings (morphologic appearances, ADC values on DWI and metabolite concentration on MRS) of pathologically proven 11 carcinosarcomas of the uterus. The mean and minimum ADCs were 0.92+/-0.21, and 0.73+/-0.16, respectively. The choline and lipid concentrations (mM) were 5.38+/-2.83 and 145.39+/-122.65, respectively. We conclude that large exophytic endometrial mass, often exhibiting gtumor prolapseh, containing strongly enhanced areas may suggest carcinosarcoma. Relatively higher mean ADC with low minimum ADC, relative low choline concentration and high lipid peak may reflect internal heterogeneity of carcinosarcoma due to the admixture of high-grade malignant tumor cells, necrosis, and epithelial glandular cystic components.

3640.   40 Entropy of T2-weighted Imaging and Apparent Diffusion Coefficient of Uterine Leiomyoma in Prediction of Leiomyoma Volume Reduction Following Uterine Artery Embolization
Mengqiu Cao1, Shiteng Suo1, Xuebin Zhang1, and Jianrong Xu1
1Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

The present study for the first time demonstrated that entropy of T2-weighted imaging as well as apparent diffusion coefficient (ADC) of leiomyomas before uterine artery embolization (UAE) has predictive value for leiomyoma volume reduction 6 months after embolization. A combination of entropy and ADC may help interventional radiologists with patient selection, preoperative planning and evaluation.

3641.   41 A Groupwise Non-Rigid Registration Approach for Accurate Quantification of DCE-MRI in Characterizing Ovarian Cancers
Elahe Kia1,2, Anahita Fathi Kazerooni1,2, Alireza Ahmadian1, and Hamidreza Saligheh Rad1,2
1Medical Physics and Biomedical Engineering Department, School of Medicine,Tehran University of Medical Sciences, Tehran, Tehran, Iran, 2Quantitative MR Imaging and Spectroscopy Group, Research Center for Cellular and Molecular Imaging,Tehran University of Medical Sciences, Tehran, Tehran, Iran

Dynamic contrast enhanced MRI (DCE-MRI) has shown to be promising for quantitative assessment of complex ovarian cancers. Quantification of DCE-MR images could be affected by motion artifacts and intensity inhomogeneity induced by bias fields. Proper selection of a registration algorithm could impact the outcome of this problem. In this work, we proposed an efficient non-rigid registration method in a group-wise setting to non-rigidly align DCE-MR images to reliable quantification of ovarian masses.

3642.   42 Can Reduced Phase Field of View Diffusion Weighted Imaging Increase Diagnostic Confidence when Imaging the Female Pelvis?
Martin D Pickles1 and Lindsay W Turnbull1
1Centre for Magnetic Resonance Investigations, HYMS at University of Hull, Hull, East Yorkshire, United Kingdom

The purpose of this study is to determine the technical feasibility of spatially selective small FOV DWI in the imaging of the female pelvis and to obtain preliminary comparative data against traditional T2W images. FOCUS DWI was successfully obtained from 14 patients utilising a 3.0T scanner. The images were then compared against T2W data. Discordance was noted in 6/14 cases. In each of these cases FOCUS images indicated less extensive disease than T2W images. Additionally, diagnostic confidence was increased in 12/14 cases. These preliminary results suggest that FOCUS is not only feasible but results in an increased diagnostic confidence.

3643.   43 Assessment of longitudinal changes in placental transverse relaxation time in normal murine pregnancy using compartmental analysis
UdayBhaskar Krishnamurthy1,2, Yimin Shen1, Gabor Szalai3, Jaladhar Neelavalli1,2, Bing Wang3, Tinnakorn Chaiworapongsa3,4, Edgar Hernandez-Andrad3,4, Nandor Gabor Than3,4, Ewart Mark Haacke1,2, and Roberto Romero3
1Radiology, Wayne State University, Detroit, MI, United States, 2Biomedical Engineering, Wayne State University, Detroit, MI, United States, 3Perinatology Research Branch, NICHD, NIH, DHHS, Detroit, MI, United States, 4Obstetrics and Gynecology, Wayne State University, Detroit, MI, United States

To quantify the T2 relaxation parameter in the different constituent regions of murine placenta at different gestational ages and to study their relative contributions to the overall change in placental T2 with gestational age

3644.   44 Comparison of Fetal Blood Flow Measured at 1.5T and 3.0T Using Phase Contrast MR and Metric Optimized Gating: Preliminary Results
Christopher K Macgowan1, Beverly Tsai Goodman2, Mashael Alrujaib3, and Mike Seed4
1Departments of Medical Biophysics and Medical Imaging, Hospital for Sick Children / University of Toronto, Toronto, Ontario, Canada, 2Department of Paediatric Cardiology, Bristol Children's Hospital / University of Bristol, United Kingdom, 3Department of Paediatrics and Division of Cardiology, Hospital for Sick Children / University of Toronto, Ontario, Canada, 4Department of Paediatrics and Division of Cardiology, Hospital for Sick Children / University of Toronto, Toronto, Ontario, Canada

Quantification of human fetal blood flow using phase contrast (PC) MR with metric optimized gating (MOG) has recently been demonstrated in normal pregnancies and fetal left-sided congenital heart disease. These studies were performed at a field strength of 1.5T; however, there is growing interest in fetal imaging at higher field strengths to improve SNR. The goal of this pilot study was to evaluate the agreement between fetal flows measured at 1.5T and 3.0T, using PC MR with MOG.

3645.   45 Volumetric assessment of fetal organ development using whole-body 3D-true-FISP - permission withheld
Tetsu Niwa1, Tomoaki Nagaoka2, Noriko Aida3, Koki Kusagiri3, Kumiko Nozawa3, Taro Takahara4, and Yutaka Imai1
1Radiology, Tokai University School of Medicine, Isehara, Kanagawa, Japan, 2EMC group, National Institute of Information and Communications Technology, Koganei, Tokyo, Japan, 3Radiology, Kanagawa Children's Medical Center, Kanagawa, Japan, 4Biomedical Engineering, Tokai University School of Engineering, Isehara, Japan

Seven fetuses images of whole body 3D-true fisp were assessed for fetal organ development. Whole-body 3D-true-FISP images were segmented with semiautomated method. The volume of the brain, lung, heart, liver and kidneys were calculated. As a result, positive correlations between the fetal organ volumes and the gestational week were found. Whole-body 3D-FISP imaging may reflect the volumetric development of the fetal organs along with the gestational age.

3646.   46 Comparison of US and MR measurement of amniotic fluid volume at 28-32 weeks
Nicholas Hilliard1, Rebecca Baker1, Andrew Patterson1, Martin Graves1, Christoph Lees2, Pat Set1, and David J Lomas1
1Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, Cambridgeshire, United Kingdom, 2Maternal And Fetal Assessment Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, Cambridgeshire, United Kingdom

This is a small pilot study comparing a rapid method of MRI measurement of amniotic fluid volume with standard manual planimetric (MP) approaches. The rapid method uses projection hydrography (PH) to compare amniotic signal with a reference fluid volume. Comparison is made with ultrasound as a ‘gold standard’ modality. Results show that PH shows strong correlation with MP, and they both show moderate correlation with ultrasound. Further development of this technique may prove useful in MRI assessment of the fetus.

3647.   47 Quantitative flow imaging in the human umbilical vessels in-utero using non-triggered phase contrast MRI
UdayBhaskar Krishnamurthy1,2, Wei Feng1, Jaladhar Neelavalli1,2, Pavan Kumar Jella1,2, Ehsan Hamtaei1, Edgar Hernandez-Andrade3,4, Swati Mody1, Lami Yeo3, S. Ehterami1, M. D. Cabrera1, Ewart Mark Haacke1,2, S. S. Hassan3, and Roberto Romero3
1Radiology, Wayne State University, Detroit, MI, United States, 2Biomedical Engineering, Wayne State University, Detroit, MI, United States, 3Perinatology Research Branch, NICHD, NIH, DHHS, Detroit, MI, United States, 4Obstetrics and Gynecology, Wayne State University, Detroit, MI, United States

Adaptation of time resolved PC-MRI technique which is used to measure the average velocity of the fetal umbilical vessels in utero


Hepatobiliary 2

Monday 12 May 2014
Exhibition Hall  17:30 - 18:30

  Computer #  
3648.   49 Normal range and Reproducibility of multi-frequency MR Rheology of healthy liver at 3.0T MRI - permission withheld
Yong Eun Chung1, Hye-Jeong Lee1, Mi-Suk Park2, and Myeong-Jin Kim2
1Radiology, Yonsei University College of Medicine, Seoul, ., Korea, 2Radiology, Yonsei Univeristy College of Medicine, Seoul, ., Korea

We tried to assess the normal value of shear modulus (Gd), loss modulus (Gl) and complex modulus (G*) of the healthy liver, and evaluate their reproducibility at 3.0T MRI. Multi-frequency MR rheology with transducer frequency of 28Hz, 56Hz and 84Hz was acquired in 60 healthy volunteers. Three modulus were calculated from central 4 slices, central 2 slices and the upper most 1 slice in each frequency. The reproducibility of MRR was higher at lower transducer frequency and MRR modulus should be calculated from the data which were obtained from at least central 2 slices of MRR.

3649.   50 Utility of MR Elastography in Staging of Liver Fibrosis among Asia Patients with Chronic Liver Disease
Chen-Te Chou1,2, Ran-Chou Chen3,4, and Chih-Wei Lee1
1Chang-Hua Christian Hospital, Chang-Hua, Taiwan, Taiwan, 2Biomedical Imaging and Radiological Science, National Yang-Ming Medical University, Taipei, Taiwan, Taiwan, 3Radiology, Taipei city Hospital, Taipei, Taiwan, Taiwan, 4Biomedical Imaging and Radiological Science, National Yang-Ming Medical University, Taiwan, Taiwan

According to the AASLD guidelines, aggressive treatment is advised for patients with hepatic fibrosis stages ¡Ý 2. Biopsy is the gold standard, but it is invasive. MR elastography (MRE) is a noninvasive method of measuring the hepatic viscoelastic properties. In our results, the stiffness values had a good correlation with the pathological fibrosis stage. In differentiation of fibrosis stage ¡Ý 2 from stage 0/1, the sensitivity and specificity were 93.4% and 91.0%, respectively, with a cutoff value of 2.83 kPa. MRE was a promising, noninvasive technique for prediction of fibrosis stage among Asia patients with chronic liver disease.

3650.   51 Accuracy of MR elastography (MRE)-determined liver shear stiffness for the diagnosis of non-alcoholic steatohepatitis (NASH) and advanced fibrosis in adults with known or suspected non-alcoholic fatty liver disease (NAFLD)
Nikolaus M Szeverenyi1, Claude Sirlin1, William M Haufe1, Michael S Middleton1, Yu Shi2, Kevin Glaser2, Richard Ehman2, and Rohit Loomba1
1Univ. of California, San Diego, San Diego, CA, United States, 2Mayo Clinic, MN, United States

This prospective study was performed to assess the accuracy of MR elastography (MRE)-derived shear stiffness values as predictors for non-alcoholic steatohepatitis (NASH) and advanced fibrosis in adults with known or suspected non-alcoholic fatty liver disease (NAFLD), using contemporaneous liver biopsy as reference. We found that MRE acquired using relatively low-frequency mechanical waves and a 3D inversion algorithm provides high accuracy in the diagnosis of NASH and advanced fibrosis in patients with NAFLD.

3651.   52 MR Elastography for the Assessment of Hepatic Fibrosis in Patients with Chronic Hepatitis B: Does Histological Necroinflammation Influence the Measurement of Liver Stiffness?
Yu Shi1,2, Qiyong Guo1, Fei Xia3, Bogdan Dzyubak2, Kevin J. Glaser2, and Richard L. Ehman2
1Department of radiology, Shengjing hospital, Shenyang, Liaoning, China, 2Mayo Clinic, Rochester, MN, United States, 3Department of infectious diseases, Shengjing hospital, Shenyang, Liaoning, China

MRE had a high diagnostic accuracy for hepatic fibrosis in chronic hepatitis B. Both fibrosis stage and necroinflammation grade were independent factors contributing to liver stiffness (Multivariate linear regression, ©¬=0.798, 0.275; P< .001). For liver tissue with F¡Â2 fibrosis, necroinflammation accounts for a portion of the elevated liver stiffness.

3652.   53 Wavelet Analysis of Liver Fibrosis
Zhitao Li1, Ali Bilgin1,2, Jean-Philippe Galons3, Puneet Sharma3, Diego Martin3, and Maria Altbach3
1Electrical and Computer Engineering, University of Arizona, Tucson, Arizona, United States, 2Biomedical Engineering, University of Arizona, Tucson, Arizona, United States, 3Department of Medical Imaging, University of Arizona, Tucson, Arizona, United States

Chronic liver disease due to Hepatitis B/C or non-alcoholic steatohepatitis is a major health problem. The first manifestation of CLD is inflammation, which can progress to fibrosis and cancer. Staging of liver fibrosis requires an invasive liver biopsy with associated morbidity, cost, and sampling errors. This study is to investigate if structural changes of fibrosis can be detected by localized frequency analysis of liver images using wavelets. The work is carried out in ex vivo tissue samples that resemble in vivo Gd-enhanced images.

3653.   54 Diagnostic accuracy of acute cholecystitis using MRCP and clinical relevance.
Stephanie Lyn Coleman1, Lindsey Storer2, Doro Gheorghe3, Stephan Anderson1, and Jaroslaw Tkacz1
1Radiology, Boston Medical Center, Boston, MA, United States, 2Boston University, Boston, MA, United States, 3Biostatistics, Boston University, MA, United States

Ultrasound imaging has known limitations and large variations in the sensitivity and specificity of diagnosis of acute cholecystitis. There is limited literature on the sensitivity and specificity of MR imaging, however, the reported are similar to ultrasound, but without the variation. We did a retrospective review of MR imaging in patients with suspected acute cholecystitis. Results showed that MRCP is very insensitive, but has excellent specificity in diagnosis of acute cholecystitis. In conclusion, additional imaging approaches are suggested such as those including functional imaging such as HIDA or MRI with the use of hepatobiliary contrast agents.

3654.   55 Correlation of T1-weighted Gradient Echo (GRE) Signal Intensity and Decreased Exocrine Function in Suspected Early Chronic Pancreatitis
Temel Tirkes1, Chen Lin1, Jordan K Swensson1, Zachary E Ballenger2, Chenkun Wang3, Evan Fogel4, Kumaresan Sandrasegaran5, Alex Aisen1, and Fatih Akisik1
1Diagnostic Radiology and Clinical Sciences, Indiana University School of Medicine, Indianapolis, Indiana, United States, 2Indiana University School of Medicine, Indianapolis, Indiana, United States, 3Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana, United States,4Department of Gastroenterology, Indiana University School of Medicine, Indianapolis, Indiana, United States, 5Diagnostic Radiology and Clinical Sciences, Indiana University School of Medicine, Indianapolis, IN, United States

Diagnosis of early chronic pancreatitis is challenging for both the gastroenterologist and the radiologist since the pancreatic ductal findings are usually normal. Diagnosis often times requires performing an endoscopic stimulation test collecting the pancreatic juice to check for decreased exocrine function in these patients. This study showed that decrease in the relative T1-weighted signal of the pancreas can be used as an indicator of decreased exocrine function in patients with suspected early chronic pancreatitis.

3655.   56 Diagnostic Challenge: Paraduodenal Pancreatitis: MR Imaging Characteristics, Differential Diagnosis and Histopathological Correlation
Pardeep Mittal1, William Small1, Juan C Camacho1, Kiran K Maddu1, Volkan Adsay2, Burcu Saka2, Courtney C Moreno1, and Bobby Kalb3
1Radiology and Imaging Sciences, Emory Uni School of Medicine, Atlanta, Georgia, United States, 2Pathology, Emory Uni School of Medicine, Atlanta, Georgia, United States, 3Diagnostic Radiology, University of Arizona, Tucson, Arizona, United States

Paraduodenal pancreatitis is rare form chronic pancreatitis and its appearance may resemble pancreatic adenocarcinoma as both entities can lead to dilatation of biliary and pancreatic ducts .Distinction between these two entities remain challenging .Contrast enhanced MRI may help accurately identify paraduodenal pancreatitis from entities having similar features such as adenocarcinoma and aid in therapeutic decisions.

3656.   57 Physiological Bile Flow in the Extrahepatic Bile Duct: Evaluation with Cine-Dynamic MR Cholangiopancreatography and a Spatially Selective Inversion-Recovery Pulse - permission withheld
Minoru Hayashida1, Akihiko Kanki1, Akira Yamamoto1, Tsutomu Tamada1, Kazuya Yasokawa1, Daigo Tanimoto1, Atsushi Higaki1, Yasufumi Noda1, and Katsuyoshi Ito1
1Diagnostic Radiology, Kawasaki Medical School, Kurashiki, Okayama, Japan

The purpose of this study was to determine the feasibility of directly and noninvasively visualizing physiological bile flow in the extrahepatic bile duct by means of non-pharmacologic cine-dynamic MRCP with a spatially selective inversion-recovery (IR) pulse and to assess the flow dynamic pattern of bile in the extrahepatic bile duct. Thirty-five patients without known pancreatobiliary diseases and 11 patients with dilatation of the extrahepatic bile duct were included. Non-pharmacological, cine-dynamic MRCP with a spatially selective IR pulse allowed direct and noninvasive visualization of antegrade/reversed bile flow in the extrahepatic bile duct, demonstrating that reversed bile flow is a physiological phenomenon.

3657.   58 Non-invasive investigation of exocrine pancreatic function using cine dynamic MRCP with a spatially selective inversion-recovery (IR) pulse - permission withheld
1Radiology, Kawasaki Medical School, Kurashiki, Okayama, Japan

This study investigated whether cine dynamic MRCP with a spatially selective inversion recovery pulse can be used for evaluation of exocrine pancreatic functions in 10 patients with suspected chronic pancreatitis in comparison with currently available pancreatic exocrine function test with N-benzoyl-L-tyrosyl-p-aminobenzoic acid (BT-PABA) reagent. The urinary PABA excretion rate (%) had significant positive correlations with both the mean secretion grade (the distance that the pancreatic juice moved in the pancreatic duct) and the frequency that the pancreatic juice flowed in the pancreatic duct. This technique has a potential to evaluate pancreatic exocrine function noninvasively in patients with suspected chronic pancreatitis.

3658.   59 Detecting CA-lys-TFA – a synthetized novel trifluorinated bile acid in murine gallbladder using in vivo 19F MRI
Su Xu1,2, Diana Vivian3, Kunrong Cheng4, Sandeep Khurana4, Wenjun Zhu1,2, Andrew Marshall1,2, Rao Gullapalli1,2, James Polli3, and Jean-Pierre Raufman4
1Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, United States, 2Core for Translational Research in Imaging @ Maryland, Baltimore, MD, United States, 3Department of Pharmaceutical Sciences, University of Maryland School of Pharmacy, Baltimore, MD, United States, 4Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, United States

Using in vivo 19F MRI, a novel synthesized trifluorinated bile acid – CA-lys-TFA was tested for its ability to concentrate in the gallbladders of C57BL/6 mice after oral gavage. Mice orally gavaged with 19F labled CA-lys-TFA revealed robust 19F signals from the gallbladder in vivo, and correlated with the concentrations determined independently using LC-MS on ex vivo tissue. The results from the study suggest that CA-lys-TFA, a fluorinated non-radioactive bile acid analogue, has potential for use in MRI to measure in vivo bile acid transport and diagnose bile acid malabsorption and other conditions associated with impaired bile acid transport.

3659.   60 Time-SLIP MR hepatic Arteriography using 3T-MRI - permission withheld
Keitaro Sofue1, Takeshi Yoshikawa2, Nobukazu Aoyama3, Yoshiharu Ohno2, Katsusuke Kyotani3, Saori Sato4, Naoki Kanata1, Mizuho Nishio2, Hisanobu Koyama1, and Kazuro Sugimura1
1Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan, 2Advanced Biomedical Imaging Research Center, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan, 3Division of Radiology and Radiation Oncology, Kobe University Hospital, Kobe, Hyogo, Japan, 4Toshiba Medical Systems Corporation, Otawara, Tochigi, Japan

The assessment and classification of anatomy of hepatic artery is an essential step for both diagnosis and management of various diseases in the upper abdomen. Development of non- invasive imaging techniques for this purpose is an urgent problem. Our results suggested that anatomy of hepatic artery can be assessed and classified using non-contrast MR arteriography using time-SLIP technique at 3T-MRI.

3660.   61 Portal Vein contribution to hepatic perfusion estimated using a Triple Inversion Recovery ASL Technique
Daniel Aguirre1, Camila Muñoz1, Cristian Tejos1, Pablo Irarrazaval1, Sergio Uribe2, and Marcelo E Andia2
1Biomedical Imaging Centre, Pontificia Universidad Catolica de Chile, Santiago, Chile, 2Radiology Department, Pontificia Universidad Catolica de Chile, Santiago, Santiago, Chile

The increase in the intrahepatic blood flow resistance in chronic liver disease has been identified as one of the most sensitive parameters to detect liver cirrhosis progression. Portal vein liver perfusion is affected very early during the liver diseases progression. In this work we investigated the feasibility of selectively visualizing the intrahepatic portal vein and estimating its intrahepatic volume in healthy subjects and patients with cirrhosis as a marker of liver perfusion, using a new Arterial Spin Labeling technique without the need of subtraction (TIR-ASL).

3661.   62 4D Flow Analysis of Patients with Advanced Liver Cirrhosis: Correlation between Clinical Parameters And Flow Parameters - permission withheld
Zoran Stankovic1, Michael Markl1, Edouard Semaan1, Robert Lewandowski1, Albert Nemcek1, Frank Miller1, Riad Salem1, james Carr1, and Jeremy Collins1
1Radiology, Northwestern University, Chicago, USA, United States

4D flow MRI provides visual and quantitative assessment of arterial and portal venous hemodynamics of the hepatic system. This study shows a high correlation between peak velocities as a flow parameter and the clinical disease scores in selected vessels of the arterial and portal venous system. 4D flow MRI may have the potential to provide biomarker in the early disease stage improving the detectability of the disease, but also the patient management.

3662.   63 Free Breathing Dynamic contrast MR imaging of the pancreas and liver with navigator technique
Takayuki Masui1, Motoyuki Katayama1, Yuji Iwadate2, Kimihiko Sato1, Naoyuki Takei2, Kei Tsukamoto1, Kenichi Mizuki1, and Masayoshi Sugimura1
1Radiology, Seirei Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan, 2GE Healthcare Japan, Hino, Tokyo, Japan

The purpose was to evaluate the feasibility of dynamic contrast study during free-breathing with navigator technique for evaluation of the lesions in the pancreas or liver. In all patients, dynamic contrast MR imaging of the pancreas and liver could be performed under free-breathing with acceptable image quality, temporal resolutions and lesion recognitions. Thus, this technique may be useful for evaluations of the patients who cannot hold their breaths.

Yasunari Fujinaga1, Ayumi Ohya1, Akira Yamada1, Masahiro Kurozumi1, Kazuhiko Ueda1, Yoshihiro Kitou2, Hitoshi Ueda2, Katsuya Maruyama3, and Masumi Kadoya1
1Department of Radiology, Shinshu University, School of Medicine, Matsumoto, Nagano, Japan, 2Radiology Division, Shinshu University Hospital, Matsumoto, Nagano, Japan, 3Imaging & Therapy Systems Division, Siemens Japan. K. K., Tokyo, Japan

The radial volumetric imaging breath-hold examination with k-space-weighted image contrast reconstruction (r-VIBE-KWIC) allows powerful view sharing and provides high temporal resolution sub-frame images as well as a full-frame image. Dynamic contrast-enhanced MRI (DCE-MRI) using r-VIBE-KWIC has the potential to provide high spatial and temporal resolution images like a dynamic CT during hepatic arteriography (dyn-CTHA) without an invasive procedure or radiation exposure. We compared hemodynamics of HCC in DCE-MRI using r-VIBE-KWIC with that in dyn-CTHA, and revealed that DCE-MRI using r-VIBE-KWIC had a diagnostic potential comparable to dyn-CTHA in the hemodynamic evaluation of HCC.

3664.   65 Feasibility of applying dual injection DCE-MRI technique in liver study
Amy Watkins1, Ka-Loh Li1, Xiaoping Zhu1, and Alan Jackson1
1Wolfson Molecular Imaging Centre, University of Manchester, Manchester, United Kingdom

Mapping kinetic parameters from DCE-MRI traditionally requires compromise in terms of spatial resolution, temporal resolution, and volume coverage. This study investigated feasibility of applying a dual injection DCE-MRI approach, which has been applied for brain tumor study, in liver. Combining information content from high temporal resolution (HTR) and high spatial resolution (HSR) data in liver produces a high quality HTR AIF, allowing kinetic mapping the HSR data with full liver coverage and a voxel size of 2 mm3. The low dose HTR data can also be advantageously used for kinetic analysis, e.g., providing more accurate bolus arrival time (BAT) maps.

3665.   66 Improved detection of hypervascularized liver lesions using dynamic contrast-enhanced T1w-3D-fs-GRE with multiple arterial subphases
Philipp Maximilian Kazmierczak1, Daniel Theisen1, Wieland Sommer1, Kolja Thierfelder1, Maximilian F Reiser1, and Konstantin Nikolaou1
1Department of Clinical Radiology, University Hospitals Munich, Grosshadern Campus, Muenchen, Germany

Dynamic contrast-enhanced T1w-3D-fs-GRE with multi-arterial volumetric interpolated breath-hold examination (multi-arterial VIBE) allows for the acquistion of five arterial subphases during a single breath-hold. The diagnostic performance of this technique was studied in twenty-five patients with known focal liver lesions. Two independent readers evaluated the diagnostic value of the five dynamic arterial subphases compared to the standard hepatic arterial, portal venous, delayed and hepatobiliary phases and the single shot turbo-spin echo sequence. Multi-arterial VIBE demonstrated greater diagnostic accuary at the detection of hypervascularized focal liver lesions as compared to the hepatic arterial standard phase.

3666.   67 Automated Detection of the Arterial Phase in TRACER Reconstructed Dynamic 3D Contrast Enhanced Liver Imaging
Mitchell Anthony Cooper1,2, Bo Xu1, Shan Hu2, Silvina Dutruel2, Martin R. Prince2, Yi Wang1, and Pascal Spincemaille2
1Biomedical Engineering, Cornell University, Ithaca, New York, United States, 2Radiology, Weill Cornell Medical College, New York, New York, United States

Capturing the arterial phase is crucial for the optimal detection and characterization of liver tumors using dynamic contrast enhanced imaging. Recently, TRACER, a method for high temporal liver imaging was proposed which uses a spiral readout in conjunction with a non-linear reconstruction to reconstruct 3D images with a sub-second temporal frame rate. It was demonstrated that this reconstruction increased the likelihood of capturing the arterial phase after bolus injection. However, the reader is now presented with a large number of images Here we adapt a previously proposed algorithm to automatically select the optimal arterial phase from a series of 3D dynamic contrast enhanced hepatic images reconstructed with TRACER

3667.   68 Motion correction of high temporal 3T Dynamic Contrast Enhanced MRI of pancreatic cancer - preliminary results
R. Klaassen1,2, O. J. Gurney-Champion3, E. G.W. ter Voert4, A. Heerschap4, M. F. Bijlsma2, M. G.H. Besselink5, G. van Tienhoven6, C. Y. Nio3, J. Stoker3, C. J.A. Punt1, J. W. Wilmink1, H. W.M. van Laarhoven1, and A. J. Nederveen3
1Department of Medical Oncology, Academic Medical Center - University of Amsterdam, Amsterdam, Netherlands, 2Department of Experimental Oncology and Radiation Biology, Academic Medical Center - University of Amsterdam, Amsterdam, Netherlands, 3Department of Radiology, Academic Medical Center - University of Amsterdam, Amsterdam, Netherlands, 4Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands,5Department of Surgery, Academic Medical Center - University of Amsterdam, Amsterdam, Netherlands, 6Department of Radiation Oncology, Academic Medical Center - University of Amsterdam, Amsterdam, Netherlands

Breathing and peristaltic motions make reliable quantification of DCE-MRI of the pancreas difficult. Here we present an approach to minimize the effects of movement on the quantification of DCE-MRI of the pancreas. Three patients with proven pancreatic cancer were scanned with our 3T DCE-MRI protocol. Images at expiration were selected and registered. Quantification was performed with a two compartment model. Ktrans maps after motion correction showed better correlation with anatomical structures. A larger patient group will show if motion correction favours the capability of DCE-MRI to discriminate between tumour and healthy tissue and if it increases reproducibility between scans.

3668.   69 Quantification of liver perfusion MRI with a time-signal curve fitting method
Lei Wang1, Sheng Xie2, YongLiang Sun2, ZhiYing Yang2, Jia Ning3, and HuiJun Chen3
1China-Japan Friendship Hospital, BeiJing, BeiJing, China, 2China-Japan Friendship Hospital, BeiJing, China, 3QingHua University, BeiJing, China

Purpose: To analyze the perfusion measurements of the liver with a simple method and to investigate the correlation of clinical results with parameters. Methods and materials: Patients with various levels of fibrosis underwent perfusion MRI of the liver. The time-intensity curves of MR signal from the perfusion MRI were analyzed by linear fitting in segments. Tin, Tout ,Kup and ratio were measured and compared between the S0-2 group and S3-4 group. Results: A significant difference of each parameter (Tin, Tout, Kup and Ratio) between two groups was detected. Conclusion: The new procedure quantifies the hepatocyte-specific uptake of the contrast agent.

3669.   70 Evaluation of 3D Deformable Registration to Improve Subtracted Dynamic Contrast Enhanced Liver Images for Characterization of Treated Hepatocellular Carcinoma
Dinesh K. Sundarakumar1, Gregory J. Wilson1, Sherif Osman1, and Jeffrey H. Maki1
1Radiology, University of Washington, Seattle, WA, United States

Subtraction of the pre-contrast phase in dynamic contrast enhanced (DCE) liver images is often necessary for accurate enhancement characterization of T1 hyperintense lesions such as treated hepatocellular carcinoma (HCC). However, variable displacement of the liver in successive breath-holds can lead to subtraction artifacts, making interpretation difficult. Furthermore, the liver is an elastic organ, and its displacement is not simply a rigid transformation. To address these issues, we evaluated an automatic 3D deformable registration algorithm for use in subtracted liver DCE. The method significantly reduced displacement (measured by anatomical landmarks) and improved the quality of subtracted images.

3670.   71 Respiratory phase-resolved 3D MRI with isotropic high spatial resolution: Determination of the average breathing motion pattern for abdominal radiotherapy planning
Zhaoyang Fan1, Jianing Pang1,2, Wensha Yang1, Yong Yue1, Richard Tuli1, Guoxi Xie1,3, Xiaoming Bi4, Benedick Fraass1, and Debiao Li1
1Cedars-Sinai Medical Center, Los Angeles, CA, United States, 2Northwestern University, Chicago, IL, United States, 3Shenzhen Institutes of Advanced Technology, Shenzhen, Guangdong, United States, 4MR R&D Siemens Healthcare, Los Angeles, CA, United States

Four-dimensional CT is currently a standard in radiotherapy planning to assess breathing motion and determine treatment margins for organ tumors. However, this modality has poor soft-tissue (or tumor) contrast and involves high radiation dose. These limitations can be overcome by using 4D MRI. The present work developed a retrospective 4D MRI technique (respiratory phase-resolved 3D MRI) that features: a) isotropic high spatial resolution (1.56 mm), b) a fixed scan time (8 minutes or less), c) an estimate of average respiratory phase resolved motion pattern with, and d) minimal intra-phase motion artifact.

3671.   72 Common and Uncommon Mimics of Primary Liver Cancers: MRI Characteristics, Differentiating Features and Histopathological Correlation
Pardeep Mittal1, Courtney C Moreno1, Juan C Camacho1, Brian Quigley2, Kiran K Maddu1, Nima Kokabi1, William Small1, and Bobby Kalb3
1Radiology and Imaging Sciences, Emory Uni School of Medicine, Atlanta, Georgia, United States, 2Pathology, Emory Uni School of Medicine, Atlanta, Georgia, United States, 3Diagnostic Radiology, Univesity of Arizona, Tucson, Arizona, United States

Liver is an important organ from oncologic perspective. Primary liver cancers are more common in presence of CLD than non CLD such as cirrhosis etc. and arise from different components of liver such as hepatocytes, bile duct epithelium, neuroendocrine cells and mesenchymal cells. Therefore imaging and histopathological features of primary liver cancers and their common and uncommon mimics will be discussed in this presentation. MRI has become the most important diagnostic tool over other imaging modalities due to its excellent soft tissue contrast and multi planar capabilities which assist in diagnostic accuracy of liver lesions as well as promoting successful management