ISMRM 25th Annual Meeting & Exhibition • 22-27 April 2017 • Honolulu, HI, USA

Electronic Poster Session: Body
3427 -3450 Metabolism, Diabetes, Fat Imaging
3543 -3566 Hepatopancreaticobiliary
Metabolism, Diabetes, Fat Imaging
Electronic Poster
Body: Breast, Chest, Abdomen, Pelvis

Monday, 24 April 2017
Exhibition Hall  13:45 - 14:45


    Computer #

97 Sex and ethnic differences in abdominal fat partitioning and adipose tissue hydration in 4.5-year-old Asian children
Suresh Anand Sadananthan, Mya Thway Tint, Navin Michael, Kuan Jin Lee, Lynette Shek, Yap Fabian, Keith Godfrey, Melvin Leow, Yung Seng Lee, Michael Kramer, Peter Gluckman, Yap Seng Chong, Christiani Jeyakumar Henry, Marielle Fortier, S. Sendhil Velan
In this study, we used MR-based estimation of abdominal fat distribution and the degree of adipocyte hypertrophy to study sex and ethnic differences in 4.5-year-old Asian children. Our results show sexual dimorphism in abdominal fat distribution in preschool children. Girls had higher subcutaneous fat depot volumes and lower adipose tissue hydration than boys. We also found that at 4.5 years, both deep and superficial subcutaneous fat volumes in Indian children were higher, while the ethnic difference in internal fat was non-significant. These differences may help explain why Indians are more susceptible to metabolic and cardiovascular diseases.


98 Inter-ethnic variation and SCD1 polymorphism predict risk for intramyocellular lipid accumulation in early childhood
Navin Michael, Varsha Gupta, Suresh Anand Sadananthan, Aparna Sampathkumar, Li Chen, Hong Pan, Mya Thway Tint, Kuan Jin Lee, Lynette Shek, Yap Fabian, Keith Godfrey, Melvin Leow, Yung Seng Lee, Michael Kramer, Yap Seng Chong, Christiani Jeyakumar Henry, Marielle Fortier, Peter Gluckman, Neerja Karnani, S. Sendhil Velan
A large intramyocellular lipid (IMCL) pool is associated with early pathogenesis of insulin resistance and type 2 diabetes. Studies from mother-offspring cohorts indicate that, like obesity and metabolic traits, IMCL is also highly heritable. However, here have been not many studies on the effect of genetic variation on IMCL. Although a number of genome-wide association studies (GWAS) have established associations between several genetic loci and metabolic disorders, it is not yet known if these loci also contribute to IMCL levels, and help explain ethnic difference in IMCL levels. In this study, we examined the ethnic differences (Indian, Malay and Chinese) in IMCL in Singaporean children and the genetic risk variant(s) associated with these differences.


99 Determination of Droplet Size Distribution in Brown Adipose Tissues by Diffusion NMR Spectroscopy - permission withheld
Sanjay Kumar Verma, Jadegoud Yaligar, Navin Michael, Tian Xianfeng, Venkatesh Gopalan, Suresh Anand Sadananthan, Rengaraj Ananthraj, S. Sendhil Velan
Non-Invasive Imaging of Brown Adipose Tissue is of significant interest due to its potential to combat obesity and diabetes. In this study, we have utilized diffusion spectroscopy to estimate the droplet size distribution in chow and high-fat diet fed brown adipose tissues obtained from rodents. The high-fat diet BAT exhibited reduction in the restriction due to the increase in droplet size. The histology results confirm the droplet size distribution in both control and high-fat diet tissues.


100 Detection of Brown Adipose Tissue: Hyperpolarized 129Xe MRI vs Xenon Enhanced CT
Rosa Tamara Branca, Andrew McCallister, Hong Yuan, Le Zhang, Alex Burant, Michael Antonacci
Despite histological evidence that all humans have brown adipose tissue, the detection of this tissue in overweight and obese subjects has proven to be a challenge. Here we demonstrate the combined used of hyperpolarized xenon gas (HP129Xe) MRI and xenon enhanced CT for the detection of BAT thermogenic activity and mass in lean and obese mouse phenotypes as well as our preliminary results in healthy young volunteers.


101 Anti-FGFR1/KLB treatment reduces hepatic fat fraction in a murine model of NAFLD
Maj Hedehus, Mark Chen, Jose Zavala-Solorio, Lance Kates, Oded Foreman, Junichiro Sonoda, Richard Carano
Anti-FGFR1/KLB is a novel experimental therapy to treat metabolic disorders and reverse lipid accumulation in the liver.  MRI estimates of proton density fat fraction demonstrated a dose-dependent anti-FGFR1/KLB treatment effect in a murine model of NAFLD.


102 Supraclavicular and gluteal adipose tissue PDFF is associated to volumes of VAT and SAT and to anthropometric obesity markers in healthy adults
Daniela Franz, Dominik Weidlich, Friedemann Freitag, Christina Holzapfel, Thomas Baum, Holger Eggers, Ernst Rummeny, Hans Hauner, Dimitrios Karampinos
Proton density fat fraction (PDFF) mapping has been emerging as important metabolic phenotyping parameter in obesity enabling spatially-resolved fat quantification in multiple organs. PDFF of adipose tissue has also recently gained significant attention due to the interest in developing biomarkers of brown fat which is assumed to be present in the adult supraclavicular fossa. However, it remains unknown how adipose tissue PDFF relates to other fat depots and anthropometric parameters. The present study aims to investigate the relationship of the supraclavicular and gluteal fat PDFF with SAT and VAT volumes and anthropometric obesity markers.


103 Clinical evaluation of the early renal hypoxia in Type 2 Diabetes based on BOLD-MRI - permission withheld
Junjie Ren, Shengzhang Ji, Chunxia Li, Zhizheng Zhuo, Hao Wang
Till now the type 2 diabetes (T2DM) is more and more prevalent, and diabetic nephropathy (DN) has become the main leading cause of end-stage renal disease (ESRD). However the onset of DN is always ambiguous. In recent years, many studies focused on the change of renal oxygenation in diabetes and showed renal hypoxia especially in medulla. Blood oxygen level dependent magnetic resonance imaging (BOLD-MRI) is a non-invasive method that can assess hypoxia in prostate gland by utilizing the endogenous contrast generated by paramagnetic deoxyhemoglobin.


104 Characterization of brown and white adipose tissue in 7-year old children
Jonathan Andersson, Emma Kjellberg, Elin Lundström, Mathias Engström, Josefine Roswall, Stefan Bergman, Pär-Arne Svensson, Håkan Ahlström, Jovanna Dahlgren, Joel Kullberg
The purpose of this study was to characterize and compare brown and white adipose tissue in 7 year-old overweight/obese and normal weight children using whole-body water-fat MRI. Correlations were also performed between the brown adipose tissue measurements and other measurements, such as VAT and SAT volumes. Results overall showed expected differences and associations to several measures relevant for obesity. We conclude that whole-body water-fat MRI of 7 year-old children is feasible and allows characterization of brown and white adipose tissue. 


105 Urine Metabolic profiling of patients with colorectal cancer based on NMR and Pattern Recognition - permission withheld
Wang Zhening, Liang Jiahao, Huang Yao, Ma Changchun, Wu Renhua, Yang Jurong, Liu Xingmu, Lin Yan
After our fecal metabonomic study of colorectal cancer (CRC) patients recently published in Oncotarget , we profiled urine metabolites from the same group of CRC patients, 40 age-matched healthy controls (HC), 18 esophageal cancers (EC), using proton nuclear magnetic resonance spectroscopy in conjunction with a multivariate statistics technique. OPLS-DA revealed that each stage of CRC could be clearly distinguished from HC and EC based on their different metabolomic profiles. These altered urine metabolites of CRC patients from HC potentially involved in the disrupted common pathways, and the different metabolites in CRC compare to EC indicated the special of the CRC.


106 Spin Densities and Relaxation Parameters of the Spectral Components of Brown Fat and Subcutaneous Fat with Localized 1H-MRS at 3T.
Ronald Ouwerkerk, Aaron Cypess, Kong Chen, Peter Herscovitch, Robert Brychta, Brooks Leitner, Ahmed Gharib
1H-MRS was used to measure relaxation properties, lipid peak ratios and water content of white adipose tissue (WAT) and brown adipose tissue (BAT) in humans with the aim of providing information that can be used to improve MRI based methods for identifying BAT.


107 Receiver operating characteristic analysis of fat fraction reveals no universal cut-off to reliably identify in vivo brown adipose tissue in adult humans
Terence Jones, Sarah Wayte, Narendra Reddy, Oludolapo Adesanya, Thomas Barber, Charles Hutchinson
Lower fat content within brown adipose tissue (BAT) compared to white adipose tissue (WAT) has been exploited using Dixon-based MRI imaging methods to visualize BAT but is subject to inter-rater variability. To determine the optimal fat fraction threshold for identifying BAT, receiver operating characteristic (ROC) analyses of fat fraction maps derived from 3 point IDEAL MRI scans were performed for sixteen subjects.

This method had good-to-excellent accuracy in four cases, and fair accuracy in two, but failed in ten. A single universal cut-off point to differentiate BAT and WAT could not be identified, instead the optimal thresholds varied between individuals.


108 Adipose tissue and ectopic fat responses to an extended fast in healthy male adults - permission withheld
Alison Sleigh, Ajay Thankamony, Albert Koulman, Vlada Bokii, Graham Kemp, Leanne Hodson, David Dunger
We have investigated the response of different fat deposits to a 28 h fast in healthy nonobese males and shown significant increases in CH2 IMCL in both the soleus and tibialis anterior muscles, and significant decreases in subcutaneous fat. Increases in TA and SOL IMCL correlated with oleic and palmitic acid FFA concentrations respectively. The compositional change of IMCL during the fast related inversely to the baseline composition, suggesting a selective efflux of unsaturated shorter chain IMCLs for preferential oxidation, which is in agreement with rat biopsy data, and supportive of the idea of IMCL as a flexible lipid store.


109 Identification and in vivo quantification of fatty acid metabolism in liver of a lipogenic methionine-choline-deficient diet-fed animal model by using magnetic resonance spectroscopy at 9.4 T
Kyu-Ho Song, Song-I Lim, Min Young Lee, Chi-Hyeon Yoo, Bo-Young Choe
Non-alcoholic steatohepatitis (NASH) is associated with metabolic syndrome as a result of insulin resistance and the accumulation of lipid droplets within hepatocytes. There is a need to diagnose and to accurately assess the progressive severity of hepatic steatosis with non-invasive biomarkers that are distinguishable from those in non-alcoholic fatty liver disease (NAFLD). Our findings demonstrate that fatty acid metabolism (saturated- and unsaturated-fatty acids) of hepatic steatosis induced by a methionine-choline diet can be distinguished from progressive NAFLD by using high-resolution magnetic resonance spectroscopy (MRS).


110 Metabolic Imaging of Brown Adipose Tissue Activation by Exercise in Control and High Fat Diet Fed Rats
Venkatesh Gopalan, Jadegoud Yaligar, Sanjay Kumar Verma, Suresh Anand Sadananthan, Anna Ulyanova, Navin Michael, Anantharaj Rengaraj, Tian Xianfeng, S. Sendhil Velan
Exercise is an important intervention for correction of irregular fat-partitioning and treatment of metabolic dysfunction. There is a large interest in development of non-invasive methods for activation of brown adipose tissue (BAT) due to its potential to combat obesity. In this study we have investigated exercise induced BAT activation and IMCL from skeletal muscle of rodents fed with control and high fat diet. Our results show that exercise modulates the brown fat with reduction in fat fraction, increased UCP1 expression and reduction in “white” like adipocytes in control and high fat diet fed rats.


111 Metabolic Imaging of Aging Adipose Tissues
Venkatesh Gopalan, Sanjay Kumar Verma, Jadegoud Yaligar, Anantharaj Rengaraj, Tian Xianfeng, Bhanu Prakash K N, Suresh Anand Sadananthan, Navin Michael, S. Sendhil Velan
There is a global interest in healthy aging and also to avoid metabolic dysfunction.   BAT and WAT play an important role in modulating the energy expenditure.   In this study we have investigated the interscapular BAT and abdominal adipose tissues in young and old rats.  During aging the iBAT activity is reduced due to the increase in “white” like adipocytes.  The abdominal adipose tissues including VAT and SAT show increase in adipocyte size resulting in hypertrophy. Modulating these fat depots with nutritional interventions is of significant clinical interest.


112 Automated MRI fat quantification in obese patients – impact of reader experience and degree of obesity on time exposure - permission withheld
Nicolas Linder, Alexander Schaudinn, Nikita Garnov, Roland Stange, Kilian Solty, Thomas Rakete, Nora Dipper, Sophia Michel, Thomas Karlas, Matthias Blüher, Stefanie Lehmann, Andreas Oberbach, Rima Chakaroun, Thomas Kahn, Harald Busse
The last decades have seen an increasing socioeconomic impact of obesity and obesity-related diseases. Noninvasive measures like subcutaneous and visceral adipose tissue (SAT, VAT) amounts and are also increasingly correlated with other, often clinical or metabolic findings as well as independent patient characteristics, even interventional complication rates. MRI fat quantification is common but manual processing is often laborious and time consuming while fully automatic segmentation is prone to errors. This work takes a custom-made semiautomatic MRI tool and prospectively analyzes the processing and interaction times for readers with different experience as well as patients from different BMI groups. 


113 Preliminary study for the quantification of fatty composition and relation to metabolic syndrome using modified Dixon method.
Satoshi Goshima, Kimihiro Kajita, Tomoyuki Okuaki, Keita Fujimoto, Shoma Nagata, Yoshifumi Noda, Hiroshi Kawada, Nobuyuki Kawai, Hiromi Koyasu, Masayuki Matsuo
We successfully quantified fatty acid composition in the liver, subcutaneous, and visceral fat tissue using modified Dixon technique with flexible six echo times and seven-peak spectral model with lipid components. Our results suggested that fatty acid composition of depot fat was varied among the patients with different metabolic status. We also demonstrated the possible relationship of unsaturated fatty acid in depot fat to cholesterol level and insulin tolerance.


114 Liver and muscle energy metabolism in patients with organic acidemias using 31P and 1H MR spectroscopy
Alessandra Bierwagen, Daria Caspari, Maik Rothe, Klaus Straßburger, Jong-Hee Hwang, Michael Roden, Regina Ensenauer
This study assessed energy and fat metabolism in a well phenotyped cohort of patients with organic acidemias using non-invasive MR spectroscopy. 31P and 1H spectra of the liver as well as 1H spectra of the muscle were acquired in 27 patients and 30 healthy controls (age-, sex-, BMI-matched). We found higher liver fat content in patients with propionic acidemia. The level of creatine in the soleus muscle was higher in patients with methylmalonic acidemia and propionic acidemia. In conclusion, the results provide evidence for previously unknown abnormalities of liver fat and muscle energy metabolism in patients with organic acidemias.


115 Validity of estimating subcutaneous and visceral fat volume from single MRI slice in older adults with sarcopenia and sarcopenic obesity
Yu Xin Yang, Wee Shiong Lim, Mei Sian Chong, Laura Tay, Suzanne Yew, Audrey Yeo, Cher Heng Tan
The demand for measurements of fat quantities is driven by the rising prevalence of sarcopenia and sarcopenic obesity (SO). In order to reduce the time and the cost of image processing, several studies have estimated the subcutaneous fat (SF) and visceral fat (VF) volume from a single slice. However, the population of studies may not have necessarily included patients with either sarcopenia or SO. This study aims to determine the correlation between the cross-sectional areas in a single slice at different vertebra levels and the volumes of SF and VF in the abdomen for sarcopenic and SO populations using MRI.


116 Water-fat MRI demonstrates seasonal proliferation of brown adipose tissue near the eyes of juvenile hibernators: An additive effect of cold exposure
Amanda MacCannell, Kevin Sinclair , Lannete Friesen-Waldner, Charles McKenzie, James Staples
Hibernating mammals use brown adipose tissue (BAT) as a primary source of heat production. Volumes of both white adipose tissue (WAT) and BAT increase in the autumn even when temperatures are warm. Between Aug 19th and Oct 13th we used water-fat MRI to measure the dynamics of BAT and white adipose tissue as ground squirrels prepared for hibernation under either cold or thermoneutral temperatures. We found that the volume of a tissue that resembles BAT around the eye, increased significantly in cold exposed animals to warm exposed in October, as the animals are preparing for winter.


117 Evaluation of renal hemodynamics and oxygenation with BOLD, oxygen extraction fraction (OEF) and ASL techniques in animal model of diabetic nephropathy
Rui Wang, Zhiyong Lin, Xueqing Sui, Kai Zhao, Feng Wei
Our study was to investigate the feasibility of using blood oxygen level dependent (BOLD), oxygen extraction fraction (OEF) and arterial spin labeling (ASL) techniques for the detection of renal hemodynamics and oxygenation changes in rabbits with diabetic nephropathy (DN).


118 The effects of sprint interval training on visceral, subcutaneous and hepatic fat stores: An MRI and 1H-MRS study of lipid content and composition
Stephen Bawden, Jack Sargeant, Liz Simpson, Mehri Kaviani, Myra Nimmo, Penny Gowland, Ian MacDonald, James King, Guruprasad Aithal
In this study, 9 obese male participants underwent 6 weeks of sprint interval training (SIT) and changes in visceral, subcutaneous and intra-hepatocellular fat were measured using MRI and MRS at baseline, control (>4 weeks later) and post exercise. Change in liver lipid composition was also assessed.


119 Multiparametric MR characterisation of a high-fat, high-cholesterol diet rodent model of liver disease
Manil Chouhan, Tim Bray, John Connell, Jane MacNaughtan, Alan Bainbridge, Helen Jones, Abeba Habtieson, Nathan Davies, Rajiv Jalan, Shonit Punwani, Tammy Kalber, Mark Lythgoe, Margaret Hall-Craggs, Rajeshwar Mookerjee, Stuart Taylor
There is a growing interest in the development of new animal models of non-alcoholic fatty liver disease.  In this study, we use T1, proton density fat fraction (PDFF) and R2* mapping to characterise hepatic parenchymal tissue and the evolution of MR properties over time in a high-fat, high-cholesterol diet model of fatty liver disease.


120 Longitudinal Assessment of Visceral and Subcutaneous Adipose Tissue in Obese Patients undergoing Weight Loss Surgery
Curtis Wiens, Cristobal Arrieta, Ignacio Osorio, Ben Ratliff, Timothy Colgan, Alan McMillan, Nathan Artz, Luke Funk, Guilherme Campos, Jacob Greenberg, Daniela Esparza, Sergio Uribe, Claude Sirlin, Scott Reeder
This work monitored longitudinal changes in visceral (VAT) and subcutaneous (SCAT) adipose tissue in response to weight loss.  Twenty-one patients undergoing clinical weight loss surgery (WLS) were recruited for 5 MRI studies: 2-3 weeks prior, 1 day prior to WLS and 1, 3, and 6 months post-WLS. Single breath-hold, chemical shift encoded acquisitions were analyzed using an Osirix semi-automated segmentation software to monitor changes in VAT and SCAT volumes.  Continual reductions in VAT and SCAT were measured over the five visits.  At every visit, each patient’s relative body fat distribution remained relatively constant despite overall reductions in both VAT and SCAT.
Electronic Poster
Body: Breast, Chest, Abdomen, Pelvis

Monday, 24 April 2017
Exhibition Hall  14:45 - 15:45


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97 Comparing liver fat quantification obtained with Complex Chemical Shift-Encoded MRI and Conventional method in an oncologic population sample.
Alessandra Borgheresi, Davinia Ryan, Simone Krebs, Sarah Eskreis-Winkler, Lorenzo Mannelli
Chemotherapy is hepatotoxic. Since steatosis is an early sign of hepatotoxicity, an accurate estimation of the changing of fat liver concentration would be useful in the management of oncologic patients. The purpose of this study was to compare fat liver concentration estimated by T1-weightened-in-and-out-of-phase (IOP) imaging with the one obtained by IDEAL-IQ method in an oncologic patients population with unknown liver iron concentration. A statistical difference was demonstrated between fat fraction estimated with conventional IOP imaging and IDEAL-IQ method.


98 Feasibility of computed diffusion-weighted MR imaging for visualization of pancreatic adenocarcinoma: comparison with acquired diffusion-weighted imaging
Yoshihiko Fukukura, Yuichi Kumagae, Hiroto Hakamada, Koji Takumi, Kiyohisa Kamimura, Masanoari Nakajo, Tomoyuki Okuaki, Takashi Yoshiura
We compared directly acquired diffusion-weighted imaging (DWI) at b-values of 1500 s/mm2 and 2000 s/mm2 with computed DWI (cDWI) at the same b-values, which was calculated from directly acquired DWI data at b-values of 0 s/mm2 and 1000 s/mm2. Our main result is that the incidence of clear hyperintense pancreatic adenocarcinomas was significantly higher on cDWI at a b-value of 1500 s/mm2 than on directly acquired DWI at a b-value of 1000 s/mm2 (P < 0.001) and was comparable to the incidence on directly acquired DWI at a b-value of 1500 s/mm2, suggesting that cDWI to a b-value of 1500 s/mm2 has diagnostic merit.


99 Hyperpolarized [1-13C]pyruvate reveals increase of hepatic LDH activity following a glucose challenge in pigs
Uffe Kjærgaard, Christoffer Laustsen, Thomas Nørlinger, Emmeli Mikkelsen, Rasmus Tougaard, Qi Haiyun, Lotte Bertelsen, Niels Jessen, Hans Stødkilde-Jørgensen
Hepatic regulation of glucose homeostasis is of pivotal importance and thus in vivo interrogation of hepatic energetic alterations in disease and treatment non-invasively using [1-13C] pyruvate has been proposed as a novel modality for assessing metabolic status. Here we investigated the metabolic effect of a glucose challenge on the porcine liver. A hepatic metabolic shift towards a reduced gluconeogenesis (increased lactate pool size) was observed following the glucose challenge, confirming hyperpolarized 13C MR’s ability to detect such changes. These findings support the use of hyperpolarized MR in metabolic challenge test in patients. 


100 4D-MRI with 3D radial sampling and self-gating-based K-space sorting: image quality improvement by slab-selective excitation
Zixin Deng, Wensha Yang, Jianing Pang, Richard Tuli, Behrooz Hakimian, Robert Reznik, Xiaoming Bi, Benedick Fraass, Debiao Li, Zhaoyang Fan
Stereotactic body radiation therapy with a simultaneous integrated boost (SBRT-SIB) has been used to improve tumor resection rate by sterilizing cancerous tissue that are surrounding the vessels. Accurate tumor imaging and tumor motion assessment will enhance the potential for SBRT-SIB. 4D-MRI (respiratory resolved, 3D volumetric images) has emerged as a promising imaging technique for characterizing tumor motion due to the absence of ionizing radiation and its superior soft tissue contrast. This study explored a slab-selective excitation approach to increase the blood vessel to tissue contrast with the goal of improving the accuracy of boost volume definition in radiation therapy.


101 PET/MR in pancreatic cancer: correlation between overall survival and functional imaging biomarkers from DCE-MRI, DWI, MR spectroscopy and PET - permission withheld
Bang-Bin Chen, Yu-Wen Tien, Ming-Chu Chang, Mei-Fang Cheng, Shih-Hung Yang, Tiffany Ting-Fang Shih
The purpose of this study is to evaluate the association of imaging biomarkers from PET/MR with overall survival in pancreatic cancer patients. Sixty-four patients with pathologically-proven pancreatic adenocarcinoma underwent PET/MRI before treatment. The imaging biomarkers included Ktrans and Peak from DCE-MRI, minimal apparent diffusion coefficient from DWI, choline from MR spectroscopy, standard uptake values, metabolic tumor volume, and total lesion glycolysis of the tumors. Among all imaging parameters, Peak was found to be an independent predictor for overall survival in these patients. Thus, the imaging biomarkers from PET/MRI reflect different tumor characteristics and may predict survival outcome in these patients.


102 T1- MRI Assessment of Hepatobiliary Fibrosis in Cystic Fibrosis Patients: Significance for Chronic Liver Diseases
Shannon Donnola, Kimberly McBennett, David Weaver, Lan Lu, Xin Yu, James Chmiel, Michael Konstan, Mitchell Drumm, Chris Flask
Liver disease is the third leading cause of death in Cystic Fibrosis (CF). Unfortunately, conventional liver function tests cannot sensitively detect it.1-3 Liver stiffness measurements via MRI and ultrasound have shown promise but are unfortunately impacted by other factors (e.g., hepatic fat) potentially resulting in over-estimation of fibrosis.4,5 We recently validated a T1-MRI assessment of biliary dilatation and fibrosis in a rat model of congenital hepatic fibrosis (Figs. 1-3).6 In this clinical study, we show that T1-MRI can be used to sensitively detect increased percent bile duct volumes in CF patients in comparison to control subjects with normal liver function. 


103 Reliable determination of bile acids from human gallbladder by 1H MRS - protocol optimization and estimation of reproducibility
Gaelle Diserens, Roland Kreis, Dino Kroell, Philipp Nett, Guido Stirnimann, Peter Vermathen, Reiner Wiest
Bile exerts multiple functions in the liver and gut with a crucial role for triglyceride-, sterol- and carbohydrate-metabolism and is a key player in disease processes. The study purpose was to develop a reliable MRS protocol and to assess variability of bile acid determination in human gallbladder. Our study demonstrated higher stability and reliability of gallbladder spectra with subjects measured  in prone position compared to back position. Relatively small coefficients of variation were obtained in a reproducibility study particularly within subjects, suggesting clinical applicability of the method, especially for longitudinal studies.


104 MR Imaging Characteristics of Benign and Malignant Biliary Strictures
Nikhar Kinger, Peter Harri, Lauren Alexander, Courtney Moreno, Pardeep Mittal
Wide spectrum of hepatobiliary and pancreatic diseases can lead to development of benign and malignant biliary strictures such as cholangiocarcinoma, pancreatic adenocarcinoma, ampullary carcinoma, PSC, autoimmune pancreatitis, ischemic strictures, post cholecystectomy, trauma etc. MRI characteristic of malignant strictures such as length, location, wall thickness, asymmetry, luminal regularity and enhancement will be discussed. CE_MRI helps to reach specific diagnosis and narrow differential diagnosis which is important for management and treatment planning


105 Early Detection of Acute Pancreatitis (AP) Using MR Elastography (MRE) with Multislice Spin-echo Echo-planar Imaging
Yu Shi, qiyong guo, yin liu, yanqing liu
An accurate early diagnosis(<24h of admission) of acute pancreatitis is clinically important. Our work shows that MR elastography has significantly better diagnostic performance for detecting AP than that achieved using the conventional CT/MR imaging, with improved sensitivity and accuracy. Early MRE is a promising technique to diagnose AP in a noninvasive fashion on admission.


106 Gadoxetate-disodium-enhanced T1-weighted R2* Mapping Improves Visualization of Biliary Anatomy in Liver Donor Candidates
Soudabeh Fazeli Dehkordy, Saya Igarashi, Carolina Lamas Constantino, Jonathan Hooker, Cheng Hong, Adrija Mamidipalli, Alan Hemming, Claude Sirlin
Gadoxetate-disodium (Gd-EOB-DTPA)-enhanced 3D T1- weighted (T1W) MR cholangiography (MRC) is recognized as an efficient method for evaluation of biliary anatomy, which is critical in the preoperative evaluation of living liver donors. We hypothesize that bile duct visualization could be improved by acquiring Gd-EOB-DTPA-enhanced T1W multi-echo (ME) gradient-echo (GRE) images and generating parametric R2* map cholangiograms. In 10 liver donor candidates, we retrospectively compared biliary duct visualization on T1W-R2* maps vs. 3D T1W cholangiograms obtained 20 minutes after IV administration of gadoxetate disodium. T1W-R2* maps provided comparable visualization of the first-order bile duct branches and better visualization of the second-order branches (p<0.05).


107 Evaluation of T1 Parametric Mapping using Inversion Recovery Fast Spoiled Gradient Echo: Application for Pre- and Post-Contrast Liver MRI
Puneet Sharma, Xiaodong Zhong, Marcel Nickel, Hiroumi Kitajima, Pardeep Mittal
This investigation evaluates the performance and accuracy of a fast inversion recovery Look-Locker method for in vivo liver T1 mapping. Several parameters were assessed using T1 phantoms to describe accuracy trends and prevalence for artifacts. The method was also applied in vivo to demonstrate feasibility of fast T1 mapping of liver parenchyma and blood pool. The results offer insight into optimal imaging parameters, and showed good agreement with known T1 values at 1.5T.


108 Black Blood T2-weighted Turbo Spin-Echo Imaging of the Liver with DANTE Preparation Module
Huimin Lin, Weibo Chen, Li Jiang, Lyu Li, Ruokun Li, Fuhua Yan
The purpose is to implement high resolution black blood T2-weighted TSE liver imaging in order to facilitate focal liver lesion detection and characterization. DANTE black blood preparation module, T2 weighted Multivane XD multi-slice acquisition and respiratory trigger were combined together. 8 healthy volunteers underwent MRI scanning on 3T Ingenia MR Syste. The black blood T2-weighted sequence showed high image quality and no artifacts. Hepatic veins, portal vein and their main branches were all suppressed successfully. No significant difference was shown in the SNR between black blood and routine T2-weighted images. In conclusion, the black blood T2-weighted imaging could provide robust and good imaging quality.


109 Splenic MR Elastography in Prediction of Hepatic Fibrosis Stage
Chen-Te Chou, Ran-Chou Chen
The purpose of our study was to investigate the relationship between splenic MR elastography (MRE) and liver fibrosis stages. 109 patients underwent histological examination and abdominal MR examination within 3-months interval were enrolled in our study. MRE was performed with passive driver on right and left chest wall separately. The mean stiffness value of liver and spleen was determined and showed good correlation between hepatic/splenic stiffness and liver fibrosis stage. Our results demonstrated that spleen stiffness measured by MRE was significant correlated with liver fibrosis stage. Combination of the spleen/liver stiffness provide higher diagnostic value than liver stiffness alone.


110 Hepatocyte Fraction: Correlation with non-invasive liver functional biomarkers
Yoshifumi Noda, Satoshi Goshima, Tomoyuki Okuaki, Kimihiro Kajta, Hiroshi Kawada, Nobuyuki Kawai, Hiromi Koyasu, Masayuki Matsuo
The hepatocyte fraction (HeF) is based on simple pharmacokinetics and can quantitatively estimate the fraction of hepatocyte. In our study, the HeF, quantitative liver-to-spleen contrast ratio (Q-LSC), and delta T1 value were compared and correlated with Child-Pugh and MELD score. The HeF demonstrated the highest correlations with Child-Pugh score (r = -0.58, P < 0.0001) and MELD score (r = -0.57, P < 0.0001). The HeF could be a useful biomarker for the evaluation of liver function, compared to conventional imaging based quantitative methods.


111 Cardiac-induced liver deformation as a measure of liver stiffness: normal volunteer reproducibility and post-prandial stress studies
Manil Chouhan, Alex Menys, Alan Bainbridge, David Atkinson, Shonit Punwani, Rajeshwar Mookerjee, Stuart Taylor
Liver stiffness measured with elastography has useful clinical applications but requires the use of expensive, specialist equipment.  In this study, we acquire dynamic ‘cine’ data of the liver to capture cardiac-induced liver motion during cardiac cine MRI.  We quantify these data by applying a registration algorithm and use the deformation fields as a surrogate for liver stiffness. We demonstrate feasibility and good seven-day reproducibility and evaluate the effects of physiological haemodynamic changes using a liquid meal challenge. This technique would be widely applicable to hospital MRI scanners without elastography equipment. 


112 Investigation of liver cirrhosis using 31P-MRS at 7T
Lucian Purvis, William Clarke, Ladislav Valkovic, Christina Levick, Michael Pavlides, Eleanor Barnes, Jeremy Cobbold, Stefan Neubauer, Matthew Robson, Christopher Rodgers
Phosphorus (31P) metabolites have potential value as markers in liver disease. The increase in field strength from 3 to 7T allows more accurate quantitation of the liver 31P-MRS spectrum. Ten volunteers and eleven patients with liver cirrhosis were scanned using a 16-channel array and a 3D UTE-CSI sequence. Metabolite concentrations were calculated using an endogenous 2.5mM ATP reference. Significant reductions in inorganic phosphate and phosphoenolpyruvate/phosphatidylcholine concentrations were seen, as well as an increase in glycerophosphoethanolamine (P<0.05). The splitting of PDE into its constituent peaks allows more insight into changes in metabolism.


113 Assessment of Liver Function of HBV-induced Cirrhosis using T1 Mapping on Gd-EOB-DTPA-Enhanced MRI
Xueqin Zhang, Jian Lu, Tao Zhang, Jifeng Jiang, Ding Ding, Sheng Du, Weibo Chen
The purpose of this study was to investigate the ability of T1 mapping on Gd-EOB-DTPA-enhanced MRI for the assessment of liver function of HBV-induced cirrhosis. We used Look-Locker sequences to acquire T1 mapping images pre and post-contrast at 5, 10, 15 and 20 minutes after Gd-EOB-DTPA administration, T1 relaxation times of the liver parenchyma were measured, reduction rates of T1 relaxation times between pre- and post-contrast enhancement were calculated, our study showed that Gd-EOB-DTPA-enhanced T1mapping MRI is useful for the evaluation of Liver function of HBV-induced cirrhosis.


114 Assessment of Hepatic Iron Content by an Automatic Vessel Exclusion Technique in Patients with Iron Overload
Aaryani Tipirneni-Sajja, Ruitian Song, M. Beth McCarville, Ralf Loeffler, Jane Hankins, Claudia Hillenbrand
Extraction of liver parenchyma is an important step in the evaluation of R2*-based hepatic iron content. Traditionally this is performed by radiologists via thresholding, an iterative, time consuming process susceptible to interrater variability. Here, a new method based on Frangi vesselness filtering is presented that automatically removes hepatic vessels from liver tissue, thereby reducing potential bias and improving workflow. The method was evaluated in digital liver phantoms and 42 iron overloaded patients. Excellent agreement between manual and automated liver parenchyma segmentation was found which demonstrates accuracy and robustness of the proposed method. 


115 Steatohepatitic Hepatocellular Carcinoma:  Distinctive MR Imaging Features with Pathologic and OPTN Correlation
Kelly Tung, Alvin Silva, Marcela Salomao, Christine Menias, Christine Zwart, Sukhdeep Singh, Amy Hara
Hepatocellular carcinoma (HCC) has specific imaging criteria such as arterial hyperenhancement, contrast washout, and pseudocapsule that allow it to be diagnosed with confidence and relative accuracy.  However, a novel HCC variant, steatohepatitic hepatocellular carcinoma (SH-HCC), has been described which tends to not exhibit the classic HCC imaging features. In this study, we explored alternative secondary MR features of HCC such as T1 and T2 signal intensity, intralesional fat, and restricted diffusion which may be more applicable in diagnosing steatohepatitic hepatocellular carcinoma.


116 Retrospective reconstruction of hepatic arterial phases in gadoxetic acid-enhanced liver MR using continuous golden-angle radial sequence
Yoon-Chul Kim, Eunju Kim, Gabrielle Beck, Hans Peeters, Young Kon Kim
We apply a 3D continuous golden-angle radial sparse parallel (GRASP) sequence to gadoxetic acid-enhanced imaging of the liver at 3 T.  Arterial phase imaging may need high spatial and temporal resolution as well as correct timing of capturing arterial enhancement to obtain hemodynamic information of the tumor. Continuous golden-angle radial sampling provides a flexible retrospective selection of temporal window. We develop a technique that identifies the arterial peak from high temporal resolution data and reconstructs arterial phases with different temporal windows. The characteristics of hepatic arterial images after retrospective temporal resolution selection are demonstrated.


117 Qualitative and Quantitative Comparison of 2D Gradient Recalled Echo and Rapid 2D Gradient Recalled Echo Magnetic Resonance Elastography
Ely Felker, Steven Raman, Bradley Bolster, Holden Wu, Kyung Sung, Ning Jin, Brenda Brown, David Lu
Conventional GRE-based MR elastography requires a breath hold of approximately 18 seconds per slice, which is difficult for some patients.  We compared a rapid GRE-based sequence (9 second breath hold) to conventional GRE in terms of quantitative liver stiffness (LS) measurement and image quality score (IQS), based on wave propagation and confidence mask coverage, determined by two independent radiologists.  The two sequences were equivalent in terms of LS measurement, but the rapid GRE sequence had significantly higher IQS for both readers.  Rapid GRE-based MR elastography may be an improved alternative to GRE in patients with limited breath hold capacity.


118 Evaluation of Portal Vein System Hemodynamics with Magnetic Resonance Angiographic Inflow-Sensitive Inversion Recovery
Di Zhu, Xianlun Zou, Hao Tang, Xiao Chen, Xiaoyan Meng, Zhen Li, Daoyu Hu
To evaluate the ability of magnetic resonance angiographic inflow-sensitive inversion recovery (IFIR-MRA) to assess hemodynamics of portal vein system in patients with portal hypertension, we compared visualized portal vein branching grade scores at different blood suppression inversion time (BSP TI) settings and signal intensity contrast ratio of the vessles and the liver parenchyma with color Doppler ultrasonograghy (CDUS) measured hemodynamics. Statistically significantly correlation demonstrated that IFIR-MRA of portal vein system has the potential to suggest hemodynamic changes, especially for RPV.


119 Validation of Feasibility of Magnetic Resonance Imaging for the Measurement of Depth of Tumor Invasion in Distal Bile Duct Cancer
Na Yeon Han, Min Ju Kim, Beom Jin Park, Deuk Jae Sung, Ki Choon Sim, Ki Choon Sim, Sung Bum Cho
We performed the study to develop and validate a method for measuring the depth of tumor invasion (DoI) on magnetic resonance imaging (MRI) and to investigate the diagnostic performance of the measured DoI for stratifying T classification in patients with distal bile duct cancer. Our result showed that this newly developed method reliably measured DoI on T2-weighted MR images, and can be used for the preoperative T classification of distal bile duct cancer patients.


120 Pancreatic exocrine function estimated by cine dynamic MRCP with a spatially selective IR pulse: Correlation with T1 mapping of the pancreatic parenchyma - permission withheld
Katsuyoshi Ito, Akira Yamamoto, Kazuya Yasokawa, Minoru Hayashida, Daigo Tanimoto, Akihiko Kanki, Tomohiro Sato, Hidemitsu Sotozono, Takeshi Fukunaga, Koji Yoshida, Kazunori Moriya, Tomoyuki Okuaki
This study assessed the correlation between pancreatic exocrine function estimated by cine dynamic MRCP with a spatially selective IR pulse and T1 mapping of the pancreatic parenchyma on 3T MR imaging. There was a statistically significant correlation between the secretion grade of the pancreatic juice in cine-dynamic MRCP and T1 relaxation time of the pancreatic parenchyma. Therefore, T1 mapping of the pancreatic parenchyma will be used as collaborative, noninvasive technique of cine-dynamic MRCP with a spatially selective IR pulse for the estimation of pancreatic exocrine function.

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