Female Pelvis/Fetal/GI

Thursday 15 May 2014

Katherine Downey¹, John H Shepherd², Ayoma D Attygalle³, Steve Hazell³, Veronica A Morgan⁴, Sharon L Giles⁴, Thomas J Ind², and Nandita M DeSouza^1
1Clinical Magnetic Resonance Unit, Institute of Cancer Research, Sutton, Surrey, United Kingdom, ²Department of Gynecology, Royal Marsden Hospital, Sutton, Surrey, United Kingdom, ³Department of Histopathology, Royal Marsden Hospital, Sutton, Surrey, United Kingdom, ⁴Clinical Magnetic Resonance Unit, Royal Marsden Hospital, Sutton, Surrey, United Kingdom

Combined T2-W and ZOOM-DW endovaginal MRI in women with cervical cancer treated with fertility-sparing surgery shows good correlation between MRI and histological estimates of tumor size (0.8 and 0.86 Observers 1&2, p<0.0001) and volume (0.79 and 0.52 Observers 1&2, p<0.01). Sensitivity and specificity for detecting tumors (median volume 0.31cm3) was 86.7% and 80.0% respectively. The ratio between MRI and histology measurements for length of uninvolved endocervical canal above tumor was 1.7 + 1.1 (Observer 1) 1.7 + 1.3 (Observer 2); MRI underestimated the available length of normal endocervical canal in 5% (1/19) cases.

Katja Pinker^1,2, Pascal Baltzer¹, Heinrich Magometschnigg¹, Stephan Polanec¹, Piotr Andrezejewski³, Alina Sturdza³, Dietmar Georg³, Christoph Grimm⁴, Stephan Polterauer⁴, Veronika Seebacher⁴, Alexander Reinthaller⁴, Thomas Helbich¹, Richard Poetter³, and Petra Georg^3
1Dept. of Biomedical Imaging and Image-guided Therapy, Divison of Molecular and Gender Imaging, Medical University Vienna, Vienna, Vienna, Austria,²Christian Doppler Laboratory for Radiation Oncology, Medical University Vienna, Vienna, Vienna, Austria, ³Dept. of Radiation Oncology, Medical University Vienna, Vienna, Vienna, Austria, ⁴Dept. of Gynecology and Obstetrics, Medical University Vienna, Vienna, Vienna, Austria

Molecular imaging of cervical cancer with MP PET-MRI using T2-weighted, DCE-MRI, DWI, 18FDG and 18FMISO at 3T is feasible. MP 18FDG/18FMISO PET-MRI at 3T provides unique information on tumor morphology and biology, which may improve therapy planning and monitoring.

Patrick Asbach¹, Xiuyuan Jiang², Kaspar-Josche Streitberger³, Anke Thomas⁴, Sebastian Hirsch³, Juergen Braun⁵, Ingolf Sack³, and Jing Guo^3
1Radiology, Charite - Universitaetsmedizin Berlin, Berlin, Berlin, Germany, ²Radiology, The First Affiliated Hospital of China Medical University, Liaoning, China, ³Radiology, Charite - Universitaetsmedizin Berlin, Berlin, Germany, ⁴Gynecology and Obstetrics, Charite - Universitaetsmedizin Berlin, Berlin, Germany, ⁵Medical Informatics, Charite - Universitaetsmedizin Berlin, Berlin, Germany

We present for the first time viscoelastic properties of the in vivo healthy human uterus and cervix. Using high resolution MRE, we found that the uterine corpus is stiffer than the cervix. We also investigated the uterine tissue stiffness with respect to the menstrual physiology. The observed stiffness alteration correlated well with the anatomical and functional changes in the endometrium during different uterine phases. High resolution MRE provides images of the viscoelastic properties of uterine tissue in a short time which can be used for the diagnosis and characterization of uterine lesions such as uterine fibroids and adenomyosis.

Kun Cao¹, Ying-shi Sun¹, Xiao-ting Li¹, and Xiao-peng Zhang^1
1Radiology department, Peking University Cancer Hospital, Beijing, Beijing, China

It has been proved by many studies that diffusion-weighted imaging(DWI) can provide information about tumor biological behavior. But average ADC value does not always work well. Quartile ADC(ADCq), derived from statistical concepts, was created to reflect intra-tumor heterogeneity of water movement. We had proved that higher ADCq correlated with more aggressive endometrial cancer. In this study, it¡¯s ability in predicting five-year-survival was tested in a cohort of 87 endometrial cancer patients. The results showed that poorer survival were seen in tumors with high higher ADCq, high pathological grades and deep myometrial infiltration, but not mean ADC.

Anahita Fathi Kazerooni^1,2, Mohammad Hadi Arabi^1,2, Elahe Kia^1,2, and Hamidreza Saligheh Rad^1,2
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

Successful treatment outcome in complex ovarian masses depends on their accurate characterization, for which DCE- MRI has been shown to be promising. In this setting, accurate selection of quantitative parameters and classification approach could result in reliable tumor differentiation. In this work, we exploit a hierarchical clustering method for selection of the best descriptive parameters in predicting the tumor malignancy, and develop an optimal decision tree for accurate classification of benign and malignant complex ovarian cancers.

Liqun Sun^1,2, Joshua van Amerom^3,4, Mashael Al-Rujaib¹, Edgar Jaeggi², Lars Grosse Wortmann², Shi-Joon Yoo¹, Christopher K. Macgowan³, and Mike Seed^1
1Department of Diagnostic Imaging, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada, ²Department of Paediatrics, Division of Paediatric Cardiology, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada, ³Departments of Medical Biophysics and Medical Imaging, Hospital for Sick Children, University of Toronto, Ontario, Canada, ⁴Division of Imaging Sciences and Biomedical Engineering, Kings College, London, United Kingdom

We demonstrated evidence of reduced DO2 and VO2 due to placental insufficiency in a fetus with aortic coarctation and clinical evidence of fetal distress with associated hypoxic brain injury that was undetected by routine clinical monitoring. An unexpected finding was the lower placental oxygen delivery in fetuses with CHD, which could be due to abnormal placental development and function in the setting of CHD.

Yosuke Otake¹, Takuma Yamada¹, Katsumi Kose¹, Tomoyuki Haishi², and Shigehito Yamada^3
1University of Tsukuba, Tsukuba, Ibaraki, Japan, ²MRTechnology Inc., Ibaraki, Japan, ³Kyoto University, Kyoto, Japan

3D MR images of a Carnegie Stage 22 (54-58 days post conception) chemically fixed human embryo were acquired with a 512x512x1024 image matrix using a solenoid coil in a 4.74 T magnetic field for construction of an anatomical database of the human embryos. Because the T2 of the mobile water protons was around 10 ms, a 3D gradient echo imaging sequence with a short echo-time (~6ms) was used. Anatomical structures of the embryo were clearly visualized at 30 microns cube voxel resolution. The result demonstrated feasibility of a 3D image database of human embryos at the 512x512x1024 image matrix.

Shantanu Sinha¹ and M. Raj Rajasekaran^2
1Radiology, University of California San Diego, San Diego, CA, United States, ²Gastroenterology, San Diego VA Health Care System, San Diego, CA, United States

DTI and Fiber Tracking were used to characterize in a rabbit model, the architecture of external anal sphincter (EAS) muscle in (i) intact form, (ii) recovering untreated from surgical myotomy and, (iii) same as (ii) but treated with a pharmacological intervention of Wnt antagonist, SFRP-2. In (i) and (iii) tensors showed very homogenous well-ordered distribution while fiber tracking yielded long, continuous fibers, in contrast to the untreated (ii) which showed very heterogeneous tensor parameters and short fibers. Thus DTI and FT could demonstrate fibrosis in untreated muscle recovering from injury as well as its reversal by molecular signaling pathway intervention.

Alex Menys¹, Jesica Makanyanga², Doug Pendse², David Atkinson², and Stuart A Taylor^2
1UCL, London, London, United Kingdom, ²UCL, London, United Kingdom

In this study we examine the relationship between inflammatory activity in the small bowel, measured using faecal calprotectin, and the effect on global small bowel motility evaluated using Magnetic Resonance Enterography.

Susan E Pritchard¹, Luca Marciani², Klara C Garsed³, Caroline L Hoad¹, Wanvipa Thongborisute², Emily Roberts², Robin C Spiller^2,3, and Penny A Gowland^1
1Sir Peter Mansfield Magnetic Resonance Centre, University of Nottingham, Nottingham, United Kingdom, ²Nottingham Digestive Diseases Centre, School of Clinical Sciences, University of Nottingham, United Kingdom, ³Nottingham Digestive Diseases Biomedical Research Unit, University of Nottingham, Nottingham, United Kingdom

Previous assessments of colon morphology have had limitations. We carried out serial MRI regional volume measurements of the undisturbed fasted and fed colon of healthy volunteers and patients with diarrhoea predominant irritable bowel syndrome (IBS-D). While the ascending colon expanded 10% immediately after eating in healthy subjects this increase was not seen in IBS-D patients implying failure to accommodate ileal inflow which may account for the faster colonic transit in IBS-D. Assessing colon form and function has great potential to identify biomarkers and stratify patients and also for validating both pharmacological and dietary disease management.