ISMRM 23rd Annual Meeting & Exhibition • 30 May - 05 June 2015 • Toronto, Ontario, Canada

Scientific Session • Hepatobiliary 1

Monday 1 June 2015

Room 716 A/B

14:15 - 16:15


Mustafa Shadi R. Bashir, M.D., T.B.A.

14:15 0141.   
Correlating post-operative whole mount immunohistochemistry to functional MRI parameters in pancreatic cancer
Remy Klaassen1,2, Anne Steins1,2, Oliver J. Gurney-Champion3, Maarten F. Bijlsma2, Hessel Wijkstra4, Geertjan van Tienhoven5, Marc G.H. Besselink6, Johanna W. Wilmink1, Mark J. van de Vijver7, Jaap Stoker3, Aart J. Nederveen3, and Hanneke W.M. van Laarhoven1
1Department of Medical Oncology, Academic Medical Center, Amsterdam, Netherlands, 2Laboratory for Experimental Oncology and Radiobiology, Academic Medical Center, Amsterdam, Netherlands, 3Department of Radiology, Academic Medical Center, Amsterdam, Netherlands, 4Department of Urology, Academic Medical Center, Amsterdam, Netherlands, 5Department of Radiation Oncology, Academic Medical Center, Amsterdam, Netherlands,6Department of Surgery, Academic Medical Center, Amsterdam, Netherlands, 7Department of Pathology, Academic Medical Center, Amsterdam, Netherlands

Magnetic Resonance Imaging (MRI) enables the non-invasive characterization of the pancreas tumor microenvironment. Using diffusion weighted imaging, water diffusivity can be used as measure for stromal deposition and dynamic contrast enhanced MRI provides further insight on tumor vascularization. Although these sequences provide valuable information on macro scale, interpretation of the underlying biological processes is not unambiguous. In this pilot study we show the feasibility of matching post-operative axial tissue slices to in vivo MRI of the pancreas. Matching immunohistochemically stained whole mount tissue slices provides direct information on localization and local tumor heterogeneity for biological correlation of functional MRI parameters.

14:27 0142.   Feasibility study on reduced FOV Diffusion Imaging of the Pancreas using Navigator Triggering technique
Lorenzo Mannelli1, Maggie M Fung2, Gregory Nyman1, Sabrina Lopez1, and Richard Kinh Gian Do1
1Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, United States, 2Global MR Applications and Workflow, GE Healthcare, New York, NY, United States

Our preliminary results show that navigator echo respiratory triggering restricted FOV (rFOV) ss-DW imaging is feasible with similar SNR compared to large FOV DWI, and also demonstrates higher overall image quality with reduced artifacts. Furthermore, measurements from ADC maps derived from rFOV DWI show significantly lower ADC values in the body and trends towards lower ADCs in the head and tail, a finding that merits further investigation.

14:39 0143.   
Free-breathing fat-water-separated liver MRI using a multi-echo 3D stack-of-stars technique
Tess Armstrong1,2, Isabel Dregely1, Fei Han1, Ziwu Zhou1, Kyung Sung1,2, Peng Hu1,2, and Holden Wu1,2
1Radiological Sciences, University of California Los Angeles, Los Angeles, CA, United States, 2Biomedical Physics, University of California Los Angeles, Los Angeles, CA, United States

Non-alcoholic fatty liver disease affects about 30% of the general population and is the leading cause of chronic liver disease in the United States. The gold standard for diagnosis and monitoring is by an invasive biopsy, which has several limitations. MRI methods based on multi-echo fat-water separation can provide non-invasive quantification of fat in the entire liver. In this work, we have developed a free-breathing multi-echo 3D stack-of-stars MRI technique that can produce fat-water separated images of the liver with quality comparable to a breath-held multi-echo Cartesian technique. Our new technique has potential for free-breathing characterization of liver fat content.

14:51 0144.   Accuracy of liver fat quantification by CT, MRI and US: a prospective comparison with Magnetic Resonance Spectroscopy (MRS)
Harald Kramer1,2, Mark A Kliewer2, Perry J Pickardt2, Diego Hernando2, Guang-Hong Chen2, and Scott B Reeder2
1Department of Clinical Radiology, University of Munich, Munich, Bavaria, Germany, 2Department of Radiology, University of Wisconsin - Madison, Madison, Wisconsin, United States

Fatty infiltration of hepatocytes is the hallmark feature of non-alcoholic fatty liver disease (NAFLD) and potentially leads to inflammation, fibrosis and cirrhosis. Since the currently accepted diagnostic standard biopsy represents an invasive procedure and samples only very circumscribed regions within the liver, there is a need for a comprehensive, accurate and non-invasive quantitative biomarker.

15:03 0145.   MRS and MRI-determined Hepatic Proton Density Fat Fraction: Comparison of ROI Sampling Methods in Patients with Type 2 Diabetes
Kim Nhien Vu1, Guillaume Gilbert1,2, Marianne Chalut1, Miguel Chagnon3, Gabriel Chartrand4, Jacques de Guise4, and An Tang1
1Radiology, University of Montreal, Montreal, Qc, Canada, 2Philips Healthcare Canada, Montreal, Qc, Canada, 3Mathematics and Statistics, University of Montreal, Montreal, Qc, Canada, 4Imaging and Orthopaedics Research Laboratory (LIO), École de technologie supérieure, Montreal, Qc, Canada

Magnetic resonance spectroscopy (MRS) is widely accepted as the noninvasive reference standard for liver fat quantification. MRI-proton density fat fraction (PDFF) is an emerging biomarker of liver fat that offers the possibility to cover the entire liver volume. Conventionally, MRI-PDFF is calculated by sampling regions of interest (ROI). However, it is unclear how various ROI sampling methods reported in the literature would agree with the liver mean PDFF. In this study, we assessed the fat distribution heterogeneity across segments. We also examined the agreement between various ROI sampling methods reported in the literature.

15:15 0146.   
MR Tagging-based liver elasticity study with the use of full strain tensor analysis for better understanding of mechanical alterations in NAFLD
Anna Orzylowska1, Krzysztof Jasinski1, Pawel T. Jochym2, Edyta Maslak3, and Tomasz Skorka1
1Department of Magnetic Resonance Imaging, Institute of Nuclear Physics Polish Academy of Sciences, Krakow, Poland, 2Department of Materials Research by Computers, Institute of Nuclear Physics Polish Academy of Sciences, Krakow, Poland, 3Department of Endothelium Experimental Pharmacology, Jagiellonian Center for Experimental Therapeutics (JCET), Krakow, Poland

The purpose was to develop MR tagging (MRt) based cardiac-induced liver deformation analysis for the assessment of liver elasticity in mouse model of non-alcoholic fatty liver disease (NAFLD). The deformation was computed from MRt images as the maps of principal strains, fractional volume changes, and absolute strain magnitude, and quantified using two-dimensional central and invariant image moments. In NAFLD, the deformed area within all maps was more irregular in comparison to Controls. The central and invariant moments revealed decreased strain area and level. The proposed method provided a routine suitable for in-vivo measurements of the liver elasticity impairement in NAFLD.

15:27 0147.   Interplatform Variability of Liver and Spleen MR Elastography
Temel Kaya Yasar1, Octavia Bane1, Cecilia Besa1, Stephan Kannengiesser2, and Bachir Taouli1
1Icahn School of Medicine at Mount Sinai, New York, NY, United States, 2Siemens Healthcare, Germany

There is insufficient knowledge on variability of MR Elastography (MRE) between different platforms. In this study, 6 underwent MRE on 1.5T Siemens and 3.0T GE systems using a 2D-GRE sequence. Liver and spleen stiffness values obtained from the 2 scanners were compared. Excellent concordance was observed between scanners (CV of 9.8% and 12.0% for liver and spleen, respectively). It remains to be seen whether different sequences on different platforms will provide similar results.

15:39 0148.   
In vivo multifrequency MR elastography for the assessment of portal hypertension before and after transjugular intrahepatic portosystemic shunt (TIPS) implantation
Jing Guo1, Christian Althoff2, Carsten Büning3, Eckart Schott4, Thomas Kröncke5, Jürgen Braun6, and Ingolf Sack2
1Radiology, Charité - Universitätsmedizin Berlin, Berlin, Berlin, Germany, 2Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany,3Krankenhaus Waldfriede,Akademisches Lehrkrankenhaus der Charité, Berlin, Germany, 4Department of Hepatology and Gastroenterology, Charité - Universitätsmedizin Berlin, Berlin, Germany, 5Clinic for Diagnostic Radiology and Neuroradiology, Klinikum Augsburg, Bavaria, Germany, 6Department of Medical Informatics, Charité - Universitätsmedizin Berlin, Berlin, Germany

High-resolution multifrequency MRE based on MDEV inversion was applied to patients with portal hypertension before and after TIPS placement. The magnitude shear moduli |G*|of liver and spleen were both sensitive to the portal decompression following TIPS. The observed linear correlation between spleen viscoelasticity and HVPG raises the prospect of an image-based and noninvasive assessment of portal pressure by MR elastography in the follow-up of TIPS placements.

15:51 0149.   
The usefulness of magnetic resonance elastography in predicting progression of cirrhosis from Child-Pugh class A to B
Tomohiro Takamura1, Utaroh Motosugi1, Shintaro Ichikawa1, Katsuhiro Sano1, Hiroyuki Morisaka1, Tomoaki Ichikawa1, Nobuyuki Enomoto2, and Hiroshi Onishi1
1Department of Radiology, University of Yamanashi, Kofu, Yamanashi, Japan, 2First Department of Internal Medicine, University of Yamanashi, Yamanashi, Japan

It is important to identify the cirrhotic patients at a high risk of progression to the decompensated stage. Liver stiffness measurement with magnetic resonance elastography (MRE) is a recently developed method for non-invasively measuring liver stiffness. The purpose of this study was to evaluate the usefulness of MRE in predicting the progression of cirrhosis in patients with type C chronic viral hepatitis as assessed with the Child-Pugh classification system. In this study, we elucidate the stiffness measurement with MRE was the strongest indicator of cirrhosis progression from Child-Pugh class A to B among known risk factors.

16:03 0150.   4D-flow MRI for risk stratification of gastroesophageal varices in cirrhotic patients
Utaroh Motosugi1,2, Peter Bannas1,3, Alejandro Roldan-Alzate1, Sean G. Kelly4, Adnan Said4, Oliver Wieben5, and Scott B. Reeder1,5
1Radiology, University of Wisconsin, Madison, WI, United States, 2Radiology, University of Yamanashi, Chuo-shi, Yamanashi, Japan, 3Radiology, University Hospital Hamburg-Eppendorf, Humburg, Germany, 4Gastroenterology and Hepatology, University of Wisconsin, Madison, WI, United States,5Medical Physics, University of Wisconsin, Madison, WI, United States

Rupture of gastroesophageal varices is a dreaded complication of liver cirrhosis. Once ruptured, overall mortality is ~34%. Endoscopy is the only tool currently available to stratify the risk of rupture in patients with varices. Recently developed approach for 4D-flow-MRI allow for comprehensive mapping of hepatic vessels as well as quantitative flow measurements. We demonstrate here that 4D-flow-MRI enables detection of alteration of flow dynamics in the portal system caused by cirrhosis as well as the visualization of gastroesophageal varices. Flow measurements by 4D-flow-MRI are useful for stratification of variceal risk in patients with cirrhosis.