ISMRM 24th Annual Meeting & Exhibition 07-13 May 2016 Singapore

Scientific Session: Clinical Cancer Investigations & Methods

Friday, May 13, 2016
Summit 2
08:00 - 10:00
Moderator: Yu-Ting Kuo

Reconstruction and validation of T2-weighted 4D Magnetic Resonance Imaging for radiotherapy treatment planning
Zdenko van Kesteren1, Danil Tekelenburg1,2, Oliver Gurney-Champion1,3, Aart Nederveen3, Eelco Lens1, Astrid van der Horst1, Aleksandra Biegun2, and Arjan Bel1
1radiotherapy, Academic Medical Centre, Amsterdam, Netherlands, 2KVI-Center for Advanced Radiation Technology, University of Groningen, Groningen, Netherlands, 3radiology, Academic Medical Centre, Amsterdam, Netherlands
We developed a respiratory-correlated 4DMRI for abdominal imaging by retrospective sorting 2D T2-weighted TSE images. Each image is assigned to a respiratory state, which is either binned in phase or the amplitude domain. The diaphragm motion per image was determined by registering the diaphragm to the begin-inhale image of a series. Per slice and per bin multiple images were acquired and we defined the intra-bin variation as the standard deviation of diaphragm positions. Amplitude binning results in lower intra-bin variation with respect to phase binning, 0.8 versus 2.4 mm respectively.

Clinical evaluation of ultra high field MRI for three-dimensional visualization of tumour size in uveal melanoma patients, with direct relevance to treatment planning.
Jan-Willem Beenakker1, Teresa Ferreira1, Karina Soemarwoto1, Lorna Grech Fonk1, Stijn Genders1, Wouter Teeuwisse1, Andrew Webb1, and Gregorius Luyten1
1Leiden University Medical Centre, Leiden, Netherlands
Recent advances in ocular MRI make it possible to acquire high resolution three dimensional images of uveal melanoma in eye tumour patients, allowing a much better assessment of the maximal tumour prominence compared to conventional clinical ultrasound measurements.  Nine uveal melanoma patients were examined on a 7 Tesla  using a custom-built eye-coil. Eye-motion artefacts were minimized by the use of a cued-blinking protocol. For all patients the MR-images showed a slightly lower tumour prominence. For two of these patients this resulted in a substantial change in treatment planning, saving an eye that would otherwise have been removed.

Non-muscle-invasive and Muscle-invasive Bladder Cancer: Image Quality and Clinical Value Compared between Reduced Field-of-view DWI and Single-shot Echo-planar-imaging DWI
Yanchun Wang1, Zhen Li1, Daoyu Hu1, and Xiaoyan Meng1
1radiology, Tongji hospital, Wuhan, China, People's Republic of
Bladder cancer is the most common malignant tumor of the urinary tract, and the incidence rate of bladder cancer is 6% for men and 2% for women. Clinical treatment of bladder cancer depends on the level of muscle invasion (stage T2 or higher) or non-invasion of the muscle of the bladder wall (stage T1 or lower). Non-invasive tumors are mainly treated with transurethral resection (TUR), whereas invasive tumors are mainly treated with radical cystectomy . Therefore, its important to precisely differentiate between non-muscle-invasive and muscle-invasive bladder cancer before treatment. 

Precise staging  of preoperative 3.0-T MR imaging for esophageal carcinoma by using ex vivo MR imaging-matched pathologic findings as the reference standard
Yi Wei1,2, Shao-Cheng Zhu1,2, Sen Wu1,2, Da-Peng Shi1,2, and Dan-Dan Zheng3
1Radiology, Zhengzhou University People's Hospital, Zhengzhou, China, People's Republic of, 2Henan Provincial People's Hospital, Zhengzhou, China, People's Republic of, 3GE Healthcare,MR Research China, Beijing, China, People's Republic of
Magnetic resonance imaging (MRI) was reported to evaluate the esophageal layers invasion in vitro and demonstrated that high-resolution T2-weighted imaging can clearly depict 8 layers of esophagus. However, former studies were mostly carried on ultra-high-field scanner ex vivo, which can not satisfy the need of preoperative staging and provide essential information for clinic. In this study, an in vivo experiment was conducted on 3.0T clinical scanner to prospectively establish the MRI signal characteristics of the normal esophageal wall and to assess the diagnostic accuracy of high-resolution MR imaging for depicting the depth of esophageal wall invasion by corresponding to  ex vivo MR imaging-matched certain histopathological slice.

Comparison of Whole-body MRI and PET-CT for staging adult lymphoma: Preliminary result at 3.0T
Arash Latifoltojar1, Natacha Rosa1, Maria Klusmann2, Mark Duncan2, Kirit Ardeshna2, Jonathan Lambert2, Alan Bainbridge2, Magdalena Sokolska2, Sajir Mohamedbhai2, and Shonit Punwani1
1University College London, London, United Kingdom, 2University College London Hospital, London, United Kingdom
Whole body MRI (WB-MRI) offers a radiation-free imaging technique for staging lymphoma. However, there are conflicting reports concerning appropriate sequence(s) being used in various WB-MRI protocols. In this work we investigated diagnostic performance of different morphological and functional MRI sequences as part of a WB-MRI protocol.  

The benefits of in vivo 2-hydroxyglutarate detection using semi-LASER at 7T and 3T: a comparative study
Adam Berrington1, Natalie Voets1, Sarah J Larkin2, Nick de Pennington2, James Mccullagh3, Khalid Al-Qahtani3, Richard Stacey4, Peter Jezzard1, Stuart Clare1, Christopher J Schofield3, Olaf Ansorge2, Tom Cadoux-Hudson4, Puneet Plaha4, and Uzay E Emir1
1FMRIB Centre, University of Oxford, Oxford, United Kingdom, 2Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom, 3Department of Chemistry, University of Oxford, Oxford, United Kingdom, 4Department of Neurosurgery, University of Oxford, Oxford, United Kingdom
We assess the ability of semi-LASER to detect 2-hydroxyglutarate (2-HG), a metabolic product of mutation in the enzyme IDH, in gliomas at 3T and 7T. Robust detection could lead to increased patient stratification yet is hindered by signal overlap and compartmental artifacts. We find semi-LASER (TE=110ms), with broadband adiabatic refocussing, is able to correctly identify IDH-mutants at 3T and 7T in a sample of six patients. Fitting errors are greatly reduced at 7T and additional metabolites (GABA, Gly) are detected in some IDH-mutated tumours. We conclude semi-LASER provides a unique clinical opportunity for 2-HG detection at both 3T and 7T. 

ACRIN 6684: Multicenter, phase II assessment of tumor hypoxia in newly diagnosed glioblastoma using magnetic resonance spectroscopy - Permission Withheld
Eva-Maria Ratai1,2, Zheng Zhang3, James Fink4, Mark Muzi4, Lucy Hanna3, Erin Greco3, Todd Richards4, Akiva Mintz5, Lale Kostakoglu6, Edward Eikman7, Melissa Prah8, Benjamin Ellingson9, Kathleen Schmainda8, Gregory Sorensen1,2, Daniel Barboriak10, David Mankoff11, and Elizabeth Gerstner12
1Radiology, Massachusetts General Hospital, Boston, MA, United States, 2A. A. Martinos Center for Biomedical Imaging, Charlestown, MA, United States, 3Brown University, Providence, RI, United States,4University of Washington, Seattle, WA, United States, 5Wake Forest University, Winston-Salem, NC, United States, 6Mt. Sinai Medical Center, New York, NY, United States, 7Moffitt Cancer Center, Tampa, FL, United States, 8Medical College of Wisconsin, Milwaukee, WI, United States, 9UCLA Medical Center, Los Angeles, CA, United States, 10Duke University, Durham, NC, United States, 11University of Pennsylvania, Philadelphia, PA, United States, 12MGH Cancer Center, Massachusetts General Hospital, Boston, MA, United States
The Phase II multi-center trial ACRIN 6684 conducted by the American College of Radiology Imaging Network was designed to assess tumor hypoxia in newly diagnosed glioblastoma (GBM) using [18F] Fluoromisonidazole (FMISO)-PET and MRI. Data from magnetic resonance spectroscopic imaging (MRSI) were available on 17 participants from four sites. The MRS marker of tumor burden (NAA/Cho) was a significant predictor of one-year survival (OS-1). Furthermore, the MRS marker of tumor hypoxia (Lac/Cr) was a significant predictor of six-month progression-free-survival (PFS-6) using receiver operating characteristic (ROC) analysis.

Texture analysis of hepatocellular carcinomas in Contrast-enhanced MR images for malignant differentiation
Wu Zhou1, Kaixin Wang1, Lijuan Zhang1, Zaiyi Liu2, Guangyi Wang2, and Changhong Liang2
1Key Laboratory for Health Informatics, Shenzhen Institutes of Advanced Technology, Shenzhen, China, People's Republic of, 2Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Shenzhen, China, People's Republic of
Lesion characterization based on imaging features is essential to the successful treatment of hepatocellular carcinomas (HCC). In this work, we investigate the malignant of HCC from Contrast-enhanced MR images based on the analysis of texture features. Our study demonstrated that the texture feature (average intensity value and grey level nonuniformity) of HCC in contrast-enhanced MR images was a good predictor to characterize the malignant of HCC. By quantitatively comparing the texture parameters in well differentiated and moderately differentiated HCCs, the values of average intensity remarkably decreased and GLN significantly increased according to the increasing degree of malignant for HCCs. 

A feasibility study to perform combined MR Elastography, IVIM and DCE-MRI in pancreatic cancer patients. - Permission Withheld
Jurgen H Runge1, Remy Klaassen2, Oliver J Gurney-Champion1,3, Hanneke WM van Laarhoven2, Ralph Sinkus4, Aart J Nederveen1, and Jaap Stoker1
1Radiology, Academic Medical Center, Amsterdam, Netherlands, 2Medical Oncology, Academic Medical Center, Amsterdam, Netherlands, 3Radiation Oncology, Academic Medical Center, Amsterdam, Netherlands, 4Biomedical Engineering, King's College London, London, United Kingdom
Pancreatic cancer remains one the most deadly cancers. New therapeutic agents cause confusion as prior morphological criteria to determine the presence of a response appear to be unreliable. MR Elastography (MRE) is uniquely able to determine tissue stiffness, a property potentially useful for therapy response monitoring. Here we present our first preliminary results of combining MRE with IVIM and DCE MRI.

Estimate of liver functional reserve using T1 mapping on Gd-EOB-DTPA-enhanced MRI in HCC patients
Chenyang Chen1, Jie Chen1, Chunchao Xia1, Panli Zuo2, and Bin Song1
1Department of Radiology, West China Hospital, Sichuan University, Chengdu, China, People's Republic of, 2Siemens Healthcare, MR Collaboration NE Asia, Beijing, China, People's Republic of
We found that liver tumors showed clearer borderline on T1 map during hepatobiliary phase of Gd-EOB-DTPA enhanced MRI. A significant correlation between the reduction rate of liver parenchyma with ICG-15 indicated that the T1 mapping is useful to estimate the liver functional reserve in HCCs patients.

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