Ji yong Gu¹, Fei Xing², Yi shi Wang³, and Xian ce Zhao^4
1Nantong Haimen People’s Hospital, Nantong, China, ²the Third Affiliated Nantong Hospital of Nantong University, Nantong, China, ³Philips Healthcare, Beijing, China, ⁴Philips Healthcare, Shanghai, China

Keywords: Liver, Cancer, HCC

 This study evaluates imaging features that can help to differentiate hyperintense HCC from  non-HCC benign and malignant lesions. On HBP images, hyperintense nodules can be differentiated with several imaging characteristics, especially HBP hypointense rim, and a focal defect in contrast uptake, that indicate the diagnosis of hyperintense HCCs. 

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Jiahui Jiang¹, Lixue Xu¹, Xiaolan Zhang², Niange Yu², Dawei Yang¹, Hui Xu¹, and Zhenghan Yang^1
1Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China, ²Shukun (Beijing) Technology Co., Ltd, Beijing, China

Keywords: Liver, Liver

Accurate detection of focal liver lesions in Gd-DTPA-enhanced magnetic resonance imaging (MRI) necessitates a high level of skill and experience. This task is typically performed by radiologists through visual inspection, which is time-consuming, labor-intensive, and subject to intra- and inter-observer variation. Convolutional neural networks (CNNs) have demonstrated significant potential in detecting lesions on medical imaging. Our study presents a unified multi-sequence lesion detector model for automatically detecting focal liver lesions on Gd-DTPA-enhanced MR images to aid in treatment decision-making.

Feifei Gao¹, Yi Wei², Qian Li², Xiaocheng Wei³, Lisha Nie³, Miaoqi Zhang³, and Bin Song^2
1Radiology, West China Hospital, Chengdu, China, ²West China Hospital, Chengdu, China, ³MR Research China，GE Healthcare, Beijing, China, Beijing, China

Keywords: Liver, Cancer

Accurate preoperative risk stratification is of critical importance for determine patients who will benefit from liver resection. Our study developed three subgroups of patients with HCC associated with different prognosis (RFS and OS) after resection based on preoperative MR imaging features using the Survival Classification and Regression Tree (CART) method. The generated subgroups using CART method demonstrated good discriminatory for preoperatively stratification of the prognosis. Therefore, the CART model of this present study may help clinicians to consider non-surgical treatment more often in worse prognostic patients and as well as inform more intense surveillance following resection.

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Yue Li¹, Huan Zhang¹, Lei Yue¹, Caixia Fu², Robert Grimm³, Wenhua Li⁴, Weijian Guo⁴, and Tong Tong^1
1Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, China, ²MR Application Development, Siemens Shenzhen Magnetic Resonance Ltd, Shenzhen, China, Shenzhen, China, ³MR Applications Predevelopment, Siemens Healthineers Ltd., Erlangen, Germany, Erlangen, Germany, ⁴Fudan University Shanghai Cancer Center, Shanghai, China

Keywords: Liver, Diffusion/other diffusion imaging techniques

This study investigated and compared the feasibility of whole tumor based texture analysis of various magnetic resonance diffusion imaging as early predictors of the clinical response to chemotherapy in patients with colorectal liver metastases (CRLM). The results showed that baseline DWI parameters and the follow-up changes of IVIM and DKI parameters can be conductive to predict the chemotherapeutic response of patients with CRLM. And Changes in D-parameters (Δ% D_Mean, Δ% D_{5th percentile}, and Δ% D_Diff-entropy) are superior to other diffusion related parameters. This suggests that DKI-related parameters could effectively predict the response in short period after treatment (2-3 weeks).

Yu Luo¹, Nan Meng¹, Lei Shen¹, Pengyang Feng², Ziqiang Li³, Han Jiang³, Han Jiang³, Han Jiang³, Yunfei Zhang⁴, Yongming Dai⁴, and Meiyun Wang^1
1Zhengzhou University People’s Hospital & Henan Provincial People’s Hospital, Henan, China, ²Henan University People’s Hospital & Henan Provincial People’s Hospital, Henan, China, ³Xinxiang Medical University & Henan Provincial People's Hospital, Henan, China, ⁴MR Collaboration, Central Research Institute, United Imaging Healthcare, Shanghai, China

Keywords: Liver, Cancer

Restricted spectrum imaging (RSI) is an advanced technique, which can detect the signal fractions of restricted, hindered and free diffusion of water molecules in the water compartments inside and outside the cell. However, the application of RSI in the assessment of liver disease is rare. Therefore, this study was to evaluate the diagnostic performance of RSI and DWI models in distinguishing benign and malignant liver lesions. Our results showed that the RSI model has better discriminative performance, and the combination of RSI parameters can further improve diagnostic performance. RSI provides a new perspective for exploring the information of tissue microenvironment, and its clinical application has broad prospects.

Tong Zhang¹, Qian Li¹, Yi Wei¹, Hehan Tang¹, Lisha Nie², Xiaocheng Wei², and Bin Song^1,3
1West China Hospital, Sichuan University, Cheng Du, China, ²MR Research China，GE Healthcare, Bei Jing, China, ³Sanya People’s Hospital, San Ya, China

Keywords: Liver, Elastography, liver regeneration, elasticity imaging techniques, hepatocellular carcinoma, hepatectomy

The liver stiffness (LS) value based on MRE may be a useful preoperative predictor of liver regeneration in patients with HCC. The LS derived from MRE shows a significant negative correlation with fibrosis, an important predictor of liver regeneration. In the low and high parenchymal hepatic resection rate (PHRR) groups, there was no significant relationship between regeneration index (RI) and LS values of MRE. However, a negative relationship was shown between LS values and RI in the intermediate PHRR group.

Dexin Yu¹, Liping Zuo¹, Mingyuan Hou¹, Jinlei Fan¹, Yueming An¹, and Bowen Wang^1
1Qilu Hospital of Shandong University, Jinan, China

Keywords: Liver, Cancer

Problem: To illustrate the MRI manifestations of spontaneous intratumoral coagulative necrosis (iCN) in hepatocellular carcinoma (HCC) and its value in predicting postoperative early recurrence. Methods: 263 patients with HCC confirmed by surgical pathology were enrolled. The qualitative assessments of MRI features were performed. Results: The iCN in HCC was characterized by a similar appearance to the tumor on pre-contrast MRI but with non-enhancement on post-contrast MRI. Presence of iCN on MRI was associated with early tumor recurrence. Conclusions: Presence of iCN on MRI is associated with early tumor recurrence and might assist to guide clinical treatment.

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Christian Simonsson^1,2,3, Wolf Claus Bartholomä^1,2, Anna Lindhoff Larsson⁴, Markus Karlsson¹, Jens Tellman¹, Gunnar Cedersund^2,3, Bengt Norén¹, Nils Dahlström^1,2, Per Sandström⁴, and Peter Lundberg^1,2
1Department of Radiation Physics, Radiology, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden, ²Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden, Linköping University, Linköping, Sweden, ³Department of Biomedical Engineering, Linköping University, Linköping, Sweden, ⁴Department of Surgery, Department of biomedical and clinical sciences, Linköping University, Linköping, Sweden

Keywords: Liver, Liver, Hepatectomy, Gd-DPTA-EOB, Pharmacokinetic Modeling , Risk assessment

For a range of late-stage liver disease the only curative treatment option may be hepatectomy surgery, which can have fatal complications. Therefore, a pre-operative risk assessment is vital. However, usually the assessment only investigates global liver function. For a more precise assessment, we investigate the possibility of using DCE-MRI in combination with pharmacokinetic modeling to quantify both global- and regional liver function. Also, we show a novel eight-compartment hepatic model, capable of performing an in-silico resection. We show the tentative predictive capabilities of this approach. This approach could lead to a more precise pre-operative assessment.

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Nan Meng¹, Yu Luo¹, Lei Shen¹, Pengyang Feng², Ziqiang Li³, Han Jiang³, Yunfei Zhang⁴, Yongming Dai⁴, Yan Bai^1,5, and Meiyun Wang^1
1Zhengzhou University People’s Hospital & Henan Provincial People’s Hospital, Henan, China, ²Henan University People’s Hospital & Henan Provincial People’s Hospital, Henan, China, ³Xinxiang Medical University & Henan Provincial People's Hospital, Henan, China, ⁴MR Collaboration, Central Research Institute, United Imaging Healthcare, Shanghai, China, ⁵Department of Medical Imaging, Zhengzhou University People’s Hospital & Henan Provincial People’s Hospital, Zhengzhou, China

Keywords: Liver, Cancer

Diffusion-weighted imaging (DWI) can be used to evaluate the degree of tumor cell proliferation and tumor necrosis. The diffusion motion of water molecules is assumed to be Gaussian distribution, which has some limitations. In recent years, some advanced models have emerged that can provide more parameters to explore complex biological behaviors. Restricted spectral imaging (RSI) is one of them. However, the application of this model in liver disease is rare. The purpose of this study was to explore the potential value of the RSI model in the preoperative non-invasive differential diagnosis of hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC).

Kun Zhang¹, Zhi Wei Shen², and Wen Shen^1
1Department of Radiology, Tianjin First Central Hospital, Tianjin Institute of imaging medicine, Tianjin, China, ²Philips healthcare，Beijing，China, Beijing, China

Keywords: Liver, Cancer, Hepatocellular carcinoma · Neoplasm invasion

• The novel radiomics nomogram developed based on Gd-EOB-DTPA MRI achieved preoperative non-invasive MVI risk prediction.• An m-score based on the radiomics nomogram could stratify HCC patients and further identify individuals who may benefit from the PA-TACE.• The radiomics nomogram could help clinicians to implement more appropriate interventions and perform individualized precision therapies.

Fei Xing¹, Yi shi Wang², and Xian ce Zhao^3
1the Third Affiliated Nantong Hospital of Nantong University, Nantong, China, ²Philips Healthcare, Beijing, China, ³Philips Healthcare, Shanghai, China

Keywords: Liver, Cancer, HCC

The Liver Imaging Reporting and Data System (LI-RADS) is widely adopted for noninvasive diagnosis of hepatocellular carcinoma (HCC). It’s updated to version 2018 recently, with some major changes compared with v2017.Therefore, the aim of this study was to compare the diagnostic performances of LI-RADS for diagnosing HCC between v2017 and v2018 based on Gd-EOB-DTPA enhanced MRI.

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Qihao Xu¹, Ailian Liu^1,2, Ying Zhao¹, Yue Wang¹, Tao Lin¹, Xue Ren¹, Qingwei Song¹, Yan Guo³, Xin Li³, and Tingfan Wu^3
1Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China, ²Engineering Research Center for Artificial Intelligence in Medical Imaging, Dalian, China, ³GE Healthcare, Shanghai, China

Keywords: Liver, Cancer

Hepatectomy is an important therapeutic method for hepatocellular carcinoma (HCC). The overall survival rate of patients with early recurrence is often lower than that of patients without early recurrence. Therefore, this worked aimed at investigating the value of texture analysis based on R2* map for predicting early recurrence of HCC after hepatectomy. Eleven optimal texture features were obtained to predict early recurrence of HCC. This research suggested that R2* map texture analysis had certain predictive value for early recurrence of HCC after hepatectomy, which was valuable for noninvasively, preoperatively and accurately predicting the prognostic factors during clinical practice.

Qian Li¹, Tong Zhang¹, Lisha Nie², Xiaocheng Wei², Yi Wei¹, and Bin Song^1,3
1Department of radiology, West China hospital, Sichuan Univeristy, Chengdu, China, ²MR Research China, GE Healthcare, Beijing,China, Beijing, China, ³Department of radiology, Sanya People’s Hospital, Sanya, China

Keywords: Liver, Diffusion/other diffusion imaging techniques, Liver regeneration; Intravoxel incoherent motion; Carcinoma, Hepatocellular; Hepatectomy

The D value derived from IVIM diffusion-weighted imaging may be a useful marker for the preoperative prediction of liver regeneration in patients with HCC. and the D value derived from IVIM diffusion-weighted imaging shows a significant negative correlation with fibrosis, an important predictor of liver regeneration.  No IVIM parameters were associated with liver regeneration in patients who underwent major hepatectomy, but the D value was a significant predictor of liver regeneration in patients who underwent minor hepatectomy.

Fei Xing¹, Yi shi Wang², and Xian ce Zhao^3
1the Third Affiliated Nantong Hospital of Nantong University, Nantong, China, ²Philips Healthcare, Beijing, China, ³Philips Healthcare, Shanghai, China

Keywords: Liver, Cancer, HCC

central scar is not a rare feature of conventional non-fifibrolamellar HCC. The dynamic enhancement mode of Gd-EOB-DTPA was helpful to distinguish inflammatory, collagenous, and vascular scars. The EOB “target sign” had a certain characteristic but non-specific, which still needed to be combined with MRI features of the mass.

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Yanxi Xiong¹, Zhao Ying¹, Ailian Liu¹, Ren Xue¹, Qihao Xu¹, and Qingwei Song^1
1The First Affiliated Hospital, Dalian Medical University, Dalian, China

Keywords: Liver, Blood vessels

Microvascular invasion (MVI) is an independent factor leading to poorer prognosis after liver resection and transplantation. In this retrospective study, we evaluated the discrimination power of Diffusion Kurtosis Imaging for predicting microvascular invasion Microvascular Invasion in hepatocellular carcinoma Hepatocellular Carcinoma （HCC）. Our resuts showed that DKI-based quantitative parameters might have a certain value in identifying MVI status in HCC. 

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Hiroyuki Nagata¹, Yoshiharu Ohno^1,2, Takeshi Yoshikawa^2,3, Kaori Yamamoto⁴, Masato Ikedo⁴, Masao Yui⁴, Maiko Shinohara⁴, Akiyoshi Iwase⁵, Takahiro Matsuyama², Takahiro Ueda², Hirotaka Ikeda², Yoshiyuki Ozawa², and Hiroshi Toyama^2
1Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Japan, ²Radiology, Fujita Health University School of Medicine, Toyoake, Japan, ³Diagnostic Radiology, Hyogo Cancer Center, Akashi, Japan, ⁴Canon Medical Systems Corporation, Otawara, Japan, ⁵Fujita Health University Hospital, Toyoake, Japan

Keywords: Liver, Cancer

We hypothesize that CS with DLR can improve spatial resolution, image quality and tumor detection on Gd-EOB-enhanced 3D T1WI in suspected liver tumor patients.  The purpose of this study was to determine the utility of CS and DLR for image quality and liver tumor detection improvements on high-resolution 3D CE-T1WI (HR-CE-T1WI) as compared with conventional 3D CE-T1WI with PI (conventional CE-T1WI) in patients with suspected liver tumors. 

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Elisabeth Pickles^1,2, Eleanor Cox^3,4, Alison Telford², Ferenc Mozes⁵, Gabriela Belsley⁵, Elizabeth Tunnicliffe⁵, Michael Brady², Michael Pavlides^5,6,7, Daniel Bulte¹, and Susan Francis^3,4
1Institute of Biomedical Engineering, University of Oxford, Oxford, United Kingdom, ²Perspectum Ltd, Oxford, United Kingdom, ³Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, United Kingdom, ⁴NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, United Kingdom, ⁵Oxford Centre for Magnetic Resonance, University of Oxford, Oxford, United Kingdom, ⁶NIHR Nottingham Biomedical Research Centre, University of Oxford, Oxford, United Kingdom, ⁷Translational Gastroenterology Unit, University of Oxford, Oxford, United Kingdom

Keywords: Liver, Cancer

Survival rates for hepatocellular carcinoma (HCC) are poor, and improved methods for early detection are required. One such method may be the detection of iron sparing in HCC compared to the liver tissue using R₂* mapping. We optimised sequences for the assessment of whole liver 3D R₂* mapping, and developed a HCC phantom comprising small spheres with a range of R₂* values to assess them. Agreement of the phantom R2* with reference values and between vendors, as well as the ability to detect small differences in R₂* indicated the sequences have strong potential to detect iron sparing.

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Qian Chen¹, Huimin Lin¹, Shu Fang¹, Jiankun Dai², Guifeng Fu², Ruokun Li¹, and Fuhua Yan^1
1Department of Radiology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, China, ²MR Research, GE Healthcare, Beijing, China

Keywords: Liver, Tumor, Magnetic resonance imaging, T2-weighted imaging, DIffusion weighted imaging

In this study, deep learning reconstruction (DLR) of liver fast spin echo T2-weighted (FSE-T2WI) and diffusion-weighted (DWI) was performed. The results showed the liver SNR, and lesion CNR were dramatically increased for both the FSE-T2WI and DWI with DLR compared with conventional reconstruction. The image quality of DLR FSE-T2WI even surpassed that of the routinely used PROPELLER T2WI. DLR didn’t impact the quantitative apparent coefficient derived from DWI. T2WI and DWI with DLR also improved the delineation of lesion structure due to improvement of image quality. Our study indicated DLR FSE-T2WI and DWI would be beneficial for liver disease diagnosing.

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Qianhui Dou¹, Pinzhu Huang², Jesse Kirkpatrick^3,4, Disha Skelton-Badlani², Gopal Varma¹, Aaron K. Grant¹, Yury Popov², and Leo Lee Tsai^1
1Radiology, Beth Israel Deaconess Medical Center, Boston, MA, United States, ²Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, MA, United States, ³Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, United States, ⁴Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA, United States

Keywords: Liver, Tumor, preclinical models, cholangiocarcinoma

Cholangiocarcinoma (CCA) is a primary biliary malignancy with very poor prognosis. Early diagnostic detection and effective targeted therapies remain challenging. A novel hepatic fibrosis/CCA mouse model provides an investigative platform, but in vivo tumor detection/tracking is needed. Here we trial the use of in vivo MRI with gadoxetate disodium to detect CCA tumors and to differentiate infiltrative CCA from fibrosis in these models.

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Qihao Xu¹, Ailian Liu^1,2, Tao Lin¹, Dandan Zheng³, Xiaoxiao Zhang³, Lihua Chen¹, Qingwei Song¹, Renwang Pu¹, Ying Zhao¹, and Xue Ren^1
1Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China, ²Engineering Research Center for Artificial Intelligence in Medical Imaging, Dalian, China, ³Clinical & Technical Support, Philips Healthcare, Beijing, China

Keywords: Liver, CEST & MT

Hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC) are the two most common primary intrahepatic malignant tumors, and the prognosis and treatment methods are significantly different between them. The purpose of this study was to explore the diagnostic ability of APTw and DKI in distinguishing ICC from HCC. When the APTw values were combined with DKI parameters, the AUC was improved from 0.760 to 0.784 and the sensitivity reached 100%. Our preliminary study showed that APTw combined with the mean diffusivity and kurtosis anisotropy values drived from DKI demonstrated a better performance in the differential diagnosis of HCC and ICC.