Xue Wang¹, Shujian Li², Zhijun Ye³, Tang-San Koh⁴, Zujun Hou⁵, Zhihan Yan¹, and Lu Han^6
1The Second Affiliated Hospital and Yuying Children′s Hospital of Wenzhou Medical University, Wenzhou, China, ²The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China, ³The Second Affiliated Hospital of Sichuan University, Chengdu, China, ⁴National Cancer Center, Singapore, Singapore, Singapore, ⁵Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, China, ⁶Philips Healthcare, Shanghai, Shanghai, China

Keywords: Uterus, Reproductive, Dynamic Contrast-Enhanced Imaging

By comparing the distributions of measured DCE kinetic parameters in cervical cancer tissue by three MRI scanners in different clinical centers. It was demonstrated that (i) Each of the three scanners consistently showed similar findings on the characterization of cervical cancer microenvironment. (ii) The difference in MRI3 stemmed from keyhole imaging in the DCE protocol which could lead to underestimation of concentration of contrast media in viable tumor region. (iii) The close distribution between MRI1 and MRI2 indicated that consistent DCE quantitative metrics could be attained in scanners from different vendors if imaging protocol and data postprocessing could be standardized.

liu hui¹, liu wei yin², and ou xiao rong^1
1xiangya hospital, changsha, China, ²GE, taiwan, China

Keywords: Pelvis, Cancer, DWI

Differentiation of patients with IB-IIA from those with IIB-IIC assist track treatment selection for cervical cancer. A diffusion-weighted imaging (DWI) sequence based on field-of-view optimized and constrained undistorted single shot (FOCUS) combined with multiplexed sensitivity-encoding (MUSE) technique (named FOCUS-MUSE DWI) was used in our study to explore the differentiation performance on stages of cervical cancer. We found the reliability of apparent diffusion coefficient (ADC) for FOCUS MUSE-DWI is the highest among single-shot DWI (ss-DWI), FOCUS-DWI and MUSE-DWI, and better image quality, SNR, and CNR than the former two. There was no significant difference of ADC values for four DWI sequence between IB-IIA group and IIB-IIIC, but ADC values were consistent with previous studies.

View Presentation Video

Akiyo Takada¹, Hajime Yokota², Ryuna Kurosawa¹, Takayuki Sada¹, Koji Matsumoto¹, Namiki Takashi³, Masami Yoneyama³, Adam Wu⁴, and Takashi Uno^2
1Department of Radiology, Chiba University, Chiba-shi, Japan, ²Department of Diagnostic Radiology and Radiation Oncology, Graduate School of Medicine, Chiba University, Chiba-shi, Japan, ³Philips Japan, Tokyo, Japan, ⁴Philips Healthcare (Shanghai) Ltd., Shanghai, China

Keywords: Uterus, Diffusion/other diffusion imaging techniques, uterine cervical cancer

Reduced field-of-view (rFOV) DWI is the essential sequence for the diagnosis and staging of uterine cervical cancer (CC). We compared the image quality of rFOV DWI taken with iZoom, which applies tilted 2D Echo-Planar RF excitation, and that of conventional Zoom combined with Reconstruction with Image-space Sampling (Zoom-IRIS) for CC patients. Reduced FOV DWI with iZoom showed higher image quality than Zoom-IRIS both in quantitative and qualitative evaluation. Anatomical details display and lesion conspicuity were mainly improved in quantitative evaluation. iZoom can be helpful for the diagnosis and staging of CC.

Zanxia Zhang¹ and Shujian Li^1
1The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China

Keywords: Uterus, Uterus

The objectives of this study were to investigate the feasibility of accelerated T2 mapping in the clinical diagnosis of the pathologic subtypes and histologic grades of endometrial carcinoma (EMC), and to compare synthetic T2-weighted and diffusion-weighted (sT2W/DW) images to conventional T2W and diffusion-weighted (cT2W/DW) images for the myometrial invasion depth. 56 EMC patients underwent T2mapping and DW.  Distinct T2 values were obtained for the various pathologic and histologic grades of EMC. Furthermore, pathologic EA grading was more accurate with the T2 values than ADC values. Additionally, in terms of detecting deep myometrial invasion, sT2W/DW showed similar accuracy to cT2W/DW. 

View Presentation Video

Yin YunJuan¹, Chen Sujing¹, Chang Jun¹, Guan Rongping¹, Ge Yuxi¹, Pylypenko Dmytro², and hu Shudong^1
1Medical Imaging, Affiliated Hospital of Jiangnan University, Wuxi, China, ²GE Healthcare, Beijing, China

Keywords: Pelvis, Cancer

The purpose of this study was to investigate the feasibility of using synthetic MRI to identify and differentiate stage I endometrial cancer. A total of 51 patients with endometrial carcinoma were recruited. Quantitative MRI, including T1, T2 and PD mapping were used. The endometrial carcinoma had significantly different T1, T2 and PD values compared to normal uterus tissue, therefore quantitative MRI is an effective method for detection of endometrial cancer. There was no statistical difference of synthetic MRI in differentiation grades or risk stratification, which needs to be further verified.

Qingling Song¹, Ye Li¹, and Ailian Liu^1
1Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China

Keywords: Pelvis, Cancer

Ovarian cancer is the leading cause of death of gynecological malignant tumors, however, most of BEOTs can be completely cured. The treatment and prognosis of ovarian cancer and BEOTs are very different, so it is very important to accurately distinguish ovarian cancer from BEOTs

View Presentation Video

Lingjie Zhang¹, Meiying Cheng¹, Teng Pan², Kaiyu Wang³, Shifang Tan¹, Lin Lu¹, Junjie Liao¹, and Xin Zhao^1
1Department of Radiology, the third affiliated Hospital of Zhengzhou University, Zhengzhou, China, ²Office of Scientific Research, the third affiliated Hospital of Zhengzhou University, Zhengzhou, China, ³MR Research China, GE Healthcare, Beijing, China

Keywords: Pelvis, Quantitative Imaging

This study aimed to evaluate the diagnostic value of synthetic MRI in ovarian epithelial cell neoplasms and to explore the correlation between the quantitative parameters like T1, T2, and proton density derived from synthetic MRI and Ki-67 expression. Our preliminary study shows that the values of these quantitative parameters were significantly lower in the malignant group than in the benign group, and the parameters were negatively correlated with Ki-67 expression, which can indirectly reflect the degree of tumor invasion.

Lincheng He¹, Ping Yan¹, Wenhong Liu¹, Weijia Song¹, Huiting Zhang², Robert Grimm³, Hong Zhou¹, and Guanghua Luo^1
1The First Affiliated Hospital, Hengyang Medical School, University of South China, HengYang, China, ²MR Scientific Marketing, Siemens Healthineers Ltd, Wuhan, China, ³MR Application Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany

Keywords: Breast, Cancer

This study investigated the feasibility of ultra-fast DCE-MRI in accurately assessing axillary lymph node (ALN) metastasis in breast cancer. Our results showed that maximum slope (MS) accurately estimated the axillary lymph node status using the early-stage data of ultra-fast DCE-MRI. Furthermore, larger size (≥10mm diameter) of ALN and absence of hilum in the ultrafast DCE-MRI was associated with ALN metastasis in breast cancer patients. Our study demonstrated that MS from ultrafast breast MRI is a potential imaging biomarker of ALN metastasis in breast cancer. 

View Presentation Video

Sai Man Cheung¹, Kwok-Shing Chan², Nicholas Senn¹, Ravi Sharma³, Trevor McGoldrick³, Tanja Gagliardi^1,4, Ehab Husain⁵, Yazan Masannat⁶, and Jiabao He^1,7
1Institute of Medical Sciences, University of Aberdeen, Aberdeen, United Kingdom, ²Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands, ³Department of Oncology, Aberdeen Royal Infirmary, Aberdeen, United Kingdom, ⁴Department of Radiology, Royal Marsden Hospital, London, United Kingdom, ⁵Department of Pathology, Aberdeen Royal Infirmary, Aberdeen, United Kingdom, ⁶Breast Unit, Aberdeen Royal Infirmary, Aberdeen, United Kingdom, ⁷Translational and Clinical Research Institute, Newcastle University, Aberdeen, United Kingdom

Keywords: Breast, Fat

Peri-tumoural lipid composition plays a major role in the disease progression of breast cancer, and novel chemical shift-encoded imaging (CSEI) allows rapid lipid mapping of the whole breast. We have previously observed an imbalance of peri-tumoural lipid composition in postmenopausal women with breast cancer using CSEI. Monitoring of lipid composition for early sign of tumour regression might be crucial for an accurate differentiation of patients responding to neoadjuvant chemotherapy (NACT). We hence set out to elucidate the longitudinal change in lipid composition in the peri-tumoural region and the whole breast in patients with breast cancer using CSEI.

View Presentation Video

Judith Zimmermann¹, Julia Carmona-Bozo¹, Nu N Le¹, Natsuko Onishi¹, Lisa J Wilmes¹, Jessica Gibbs¹, Jiachao Liang¹, David C Newitt¹, Savannah C Partridge², Patrick J Bolan³, John Kornak⁴, Elissa Price¹, Bonnie N Joe¹, Barbara LeStage⁵, I-SPY 2 Investigator Network⁶, I-SPY 2 Imaging Working Group¹, Wen Li¹, and Nola Hylton^1
1Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States, ²Radiology, University of Washington, Seattle, WA, United States, ³Radiology, University of Minnesota, Minneapolis, MN, United States, ⁴Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, United States, ⁵I-SPY 2 Advocacy Group, San Francisco, CA, United States, ⁶Quantum Leap Healthcare, San Francisco, CA, United States

Keywords: Breast, Diffusion/other diffusion imaging techniques, treatment response prediction, biomarkers, neoadjuvant chemotherapy

In breast imaging, diffusion-based (DW) MRI delivers complementary quantitative value to conventional dynamic contrast enhanced MRI. ADC maps of tumor tissue calculated from DW-MRI, specifically mean ADC of the tumor region of interest, have shown promise for measuring early response to neoadjuvant chemotherapy (NAC). However, depending on intra-tumoral heterogeneity, other histogram-based ADC metrics may provide even better predictive performance than mean ADC, but are yet to be studied thoroughly. Here, we investigated nine ADC-based metrics regarding their predictive performance for NAC treatment response.

View Presentation Video

Natsuko Onishi¹, Jessica E Gibbs¹, Ella F Jones¹, Teffany Joy Bareng¹, Jiachao Liang¹, Julia Carmona-Bozo¹, Wen Li¹, David C Newitt¹, Kimberly M Ray¹, Courtney Lawhn Heath¹, Rita Mukhtar², Bonnie N Joe¹, the I-SPY 2 Investigator Network³, the I-SPY 2 Imaging Working Group¹, Laura J Esserman ², A. Jo Chien⁴, and Nola M Hylton^1
1Department of Radiology & Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States, ²Department of Surgery, University of California, San Francisco, San Francisco, CA, United States, ³Quantum Leap Healthcare Collaborative, San Francisco, CA, United States, ⁴Department of Medicine, University of California, San Francisco, San Francisco, CA, United States

Keywords: Breast, Cancer

This study aimed to investigate the longitudinal changes in functional tumor volume (FTV) and background parenchymal enhancement (BPE) derived from dynamic contrast-enhanced breast MRI during neoadjuvant endocrine therapy (NET). For comparison, we also evaluated a similar cohort of patients who received standard neoadjuvant chemotherapy (NAC).  Similar to the NAC cohort, the NET cohort showed early changes in FTV and BPE as early as three weeks of treatment. In the NET cohort, early BPE decrease was prominent especially for patients with higher baseline BPE and premenopausal patients. These finding illustrate the potential of MRI metrics as early imaging biomarkers for NET.

View Presentation Video

Mengfan Wang¹, Siyao Du¹, Lizhi Xie², Min Zhao², and Lina Zhang^1
1The First Hospital of China Medical University, Shenyang, China, ²GE Healthcare, Beijing, China

Keywords: Breast, Cancer, breast cancer, neoadjuvant chemotherapy

We analyzed the correlation between MRI-based tumor shrinkage patterns after the early stage (first and second cycles) of NAC and pathological response in different subtypes. Fragmentation and diffuse decrease are collectively referred to as non-CS. We found that non-CS could be observed in some patients after the early stage of NAC, and non-CS and pCR were significantly correlated in HR+/HER2 subtypes after the first cycle of NAC.

View Presentation Video

Julia Carlota Carmona¹, Natsuko Onishi², Jiachao Liang², Jessica Gibbs², Ella Jones³, Teffany Joy Bareng², Wen Li², David Newitt², Kim Ray², Courtney Lawhn¹, Bonnie Joe², Rita Mukhtar², I-SPY 2 Network², ISPY 2 Imaging Working group², Laura Esserman², Jo Chien², and Nola Hylton^2
1Radiology, UCSF, San Francisco, CA, United States, ²UCSF, San Francisco, CA, United States, ³NIH, San Francisco, CA, United States

Keywords: Breast, Cancer, MRI, fluoroestradiol, PET, endocrine, therapy

The aim of our study was to assess early parenchymal changes during neoadjuvant endocrine therapy (NET) using both DCE-MRI and dedicated breast PET with [18F]-fluoroestradiol (FES-dbPET). We investigated background parenchymal enhancement (BPE) on MRI and background parenchymal uptake on FES-dbPET for seventeen patients with ER+/HER2- breast cancers. Statistically significant decrease in BPE was shown after 3 weeks of NET. Estimated SUVs (mean, max and peak) were lower after 3 weeks of NET, although the difference did not reach statistical significance. Our results illustrate the potential of DCE-MRI and FES-dbPET to detect early change in breast parenchyma during NET.

View Presentation Video

Berat Bersu Ozcan¹, Justin Yan^1,2, Yin Xi¹, Serine Baydoun³, Marion E. Scoggins⁴, and Basak E. Dogan^1
1Radiology, University of Texas Southwestern, Dallas, TX, United States, ²Radiology, HCA Houston Healthcare Kingwood, Houston, TX, United States, ³Radiology, Cleveland Clinic Foundation, Cleveland, OH, United States, ⁴Radiology, University of Texas MD Anderson Cancer Center, Houston, TX, United States

Keywords: Breast, Breast, MRI-guided breast biopsy

MRI-guided breast biopsy (MRBB) methods and clinicopathological outcomes may vary between institutions. To identify benchmark metrics to help define a successful MRBB program, we identified and systematically reviewed articles on MRBB outcomes through 04.01.2021. Random intercept logistic regression model was used to pool the data. We found that MRBB is an efficient, highly accurate technique with high technical success (99.05%, 95%CI:97.75%-99.60%), low false-negative (0.65%, 95%CI:0.29%-1.44%), and complication (2.45%, 95%CI:2.13%-2.81%) rates. Our findings can assist the development of evidence-based clinical guidelines on follow-up recommendations in benign-concordant lesions and a transparent discussion with patients on the consequences of having an MRBB.

View Presentation Video

Maki Amano^1,2, Shohei Fujita^1,3, Naoyuki Takei⁴, Katsuhiro Sano¹, Akihiko Wada¹, Kanako Sato¹, Junko Kikuta¹, Yoshiki Kuwatsuru¹, Rina Tachibana^1,5, Towa Sekine^1,5, Yoshiya Horimoto⁶, and Shigeki Aoki^1
1Radiology, Juntendo University, Tokyo, Japan, ²Radiology, Nihon University Hospital, Tokyo, Japan, ³Radiology, The University of Tokyo Graduate School of Medicine, Tokyo, Japan, ⁴MR Applications and Workflow, GE Healthcare Japan, Tokyo, Japan, ⁵Radiological Sciences, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan, ⁶Breast Oncology, Juntendo University, Tokyo, Japan

Keywords: Breast, Cancer

The present study aimed to evaluate the feasibility of 3D quantitative synthetic MRI for discriminating the immunohistochemical (IHC) status of invasive ductal carcinoma (IDC) of the breast. We found that volumetric T1 and T2 values of IDC varied according to IHC status, including those for hormone receptors and Ki-67, indicating the feasibility of this method for discriminating the IHC status of IDC of the breast.

Mengyi Wang¹, Xiaoling Zhang¹, Shaofu ling He¹, Yangling Hu¹, and LiJuan Mao^1
1Department of Radiology, Sun Yat-sen University First Affiliated Hospital, Guangzhou, China

Keywords: Breast, Cancer, Neoadjuvant chemotherapy

Our study suggests that the percentage change for second visits relative to baseline of enhanced tumor volume-based imaging metrics of DCE-MRI can quantify heterogeneous changes within the tumor as an indicator of therapy response and improve prediction of PCR as early as the first treatment time point in NAC. 

View Presentation Video

Qing FU¹, Jie Liu¹, Ding-xi Liu¹, Ting Yin², Peng Sun³, Zi-qiao Lei¹, and Fan Yang^1
1Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China, ²MR Collaborations, Siemens Healthineers Ltd., Chengdu, China, ³Philips Healthcare, Beijing, China

Keywords: Breast, Breast, MRI; Dixon; fat suppression; 3T

For patients with breast lesion resection, conventional contrast enhanced T1WI images with SPAIR provides poor fat suppression in the post-mastectomy breasts side due to the uneven skin surface, inhomogeneous tissues environment, and the frequency-selective feature of SPAIR scheme. Our study aimed to investigate the performance of fat suppression with the Dixon method in single side post-mastectomy patients. Subjective and objective evaluation suggested the Dixon method is superior to conventional SPAIR fat suppression in depicting the bilateral breast. Dixon method provided better image uniformity and higher fat suppression efficiency, and showed significant advantages in delineating the anatomical structures, with better axillary and lesion visibilities, especially in the completely removed breast side.

View Presentation Video

Junhui Huang^1,2, Lihua Qiu³, Yongsheng Ao³, Lan Mu⁴, Zhanli Hu⁵, Dong Liang⁵, Xin Liu⁵, Hairong Zheng⁵, and Na Zhang^5
1Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, ShenZhen, China, ²Faculty of Information Engineering and Automation, Kunming University of Science and Technology, Kunming, China, ³Yibin Second People's Hospital, Yibin, China, ⁴Chengdu Pidu District People's Hospital, Chengdu, China, ⁵Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China

Keywords: Breast, Data Analysis, Conventional DCE-MRI, ultrafast DCE-MRI, quantitative parameters, semiquantitative parameters

The conventional dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) technique has been shown to be very sensitive in detecting benign and malignant breast cancer lesions. However, it requires a relatively long acquisition time and hence a semiquantitative imaging technique. To reduce the acquisition time, ultrafast DCE-MRI techniques have been proposed for breast tumor imaging. Our study aims to investigate the feasibility of the ultrafast DCE-MRI technique in differentiating benign and malignant breast tumors. The results show that the semiquantitative and quantitative parameters obtained with ultrafast DCE-MRI are superior to those obtained with conventional DCE-MRI in differentiating benign and malignant breast tumors.

View Presentation Video

Lulu Zhuang¹, Chun Lian¹, Zehao Wang¹, Ximin Zhang¹, Zhigang Wu², Qingping Gu³, and Rong Huang^1
1Department of Radiology, Peking University Shenzhen Hospital, ShenZhen, China, ²Clinical & Technical Support, Philips Healthcare Ltd, ShenZhen, China, ³Clinical Application, Philips Healthcare Ltd, ShenZhen, China

Keywords: Breast, Breast

MRI is a non-invasive method for breast lesions diagnosis.However, some imaging features of benign and malignant lesions in breast are still overlap. APT-weighted imaging (APTw) is a endogenous biomarker that allows non-invasive visualization of tissue composition and microscopic information for mobile proteins and peptides. The present study explores the feasibility of the combination of APT and dynamic contrast-enhanced MR imaging to assess of breast lesions. Results of this study indicate the APT value has significant difference between benign and malignant breast lesions. 

View Presentation Video

Lingsong Meng¹, Xin Zhao¹, Jinxia Guo², Lin Lu¹, Meiying Cheng¹, Qingna Xing¹, Honglei Shang¹, Yafei Guo¹, Shifang Tan¹, Lingjie Zhang¹, and Xiao-an Zhang^1
1The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China, ²General Electric (GE) Healthcare, MR Research China, Beijing, Beijing, China

Keywords: Breast, Breast

Breast cancer is the most frequently diagnosed malignant tumor in women and badly threatens the female's health. Kaiser score (KS) shows excellent and robust performance in evaluating breast lesions. This scoring system doesn’t include quantitative image features and clinical information, however, which may result in false-negative diagnoses, especially for cancers showing atypical morphological characteristics. In this study, we evaluated the importance of five features in KS, apparent diffusion coefficient (ADC), and patient age respectively and combined them to build new models to explore if there will be an improvement in the differential diagnosis of breast lesions compared with KS.