View Presentation Video

Sarah Helen Needleman¹, Mina Kim¹, Jamie R. McClelland¹, and Geoff J. M. Parker^1,2
1Centre for Medical Image Computing (CMIC), Department of Medical Physics & Biomedical Engineering, University College London, London, United Kingdom, ²Bioxydyn Limited, Manchester, United Kingdom

Keywords: Oxygenation, Lung

Analysis of dynamic lung oxygen-enhanced MRI (OE-MRI) is challenging due to the presence of substantial artefacts and poor SNR. Understanding and minimising sources of error is critical for reliable use of the method. We have created a pipeline using independent component analysis (ICA) for the automatic extraction of functional lung information from dynamic lung OE-MRI, for which confounding factors are reduced. The pipeline demonstrated good repeatability when utilised for the analysis of a scan-rescan dynamic lung OE-MRI study at 3.0 T; the algorithmic uncertainty of ICA on the analysis pipeline was found to be minimal.

View Presentation Video

Mina Kim¹, Sarah H. Needleman¹, Josephine H. Naish^2,3, Yohn Taylor¹, Marta Tibiletti², James P. B. O’Connor^4,5, and Geoff J. M. Parker^1,2
1Centre for Medical Image Computing (CMIC), Department of Medical Physics & Biomedical Engineering, University College London, London, United Kingdom, ²Bioxydyn Limited, Manchester, United Kingdom, ³BHF Manchester Centre for Heart and Lung Magnetic Resonance Research (MCMR), Manchester, United Kingdom, ⁴Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom, ⁵Division of Radiotherapy and Imaging, Institute of Cancer Research, Manchester, United Kingdom

Keywords: Lung, Contrast Mechanisms, oxygen-enhanced MRI

A recently developed protocol with a dual echo RF-spoiled gradient echo acquisition enabled simultaneous measurement of dynamic OE signal change and the substantial ∆R₂* effect at 3 tesla. To progress towards clinical translation, we evaluated repeatability and reproducibility across two sites, vendors and time points. Our results demonstrate good repeatability for the quantitative and semi-quantitative indices across time points, consistent signal behaviour and repeatable ∆R₂* across two sites and vendors, suggesting potential utility in multi-centre clinical studies. However, echo time dependence should be considered when interpreting percentage signal enhancement.

View Presentation Video

Fei Tan¹, Rachel L. Eddy^2,3, Vanessa M. Diamond², Jonathan H. Rayment^2,4, and Peder E. Z. Larson^1,5
1UC Berkeley-UCSF Graduate Program in Bioengineering, University of California, Berkeley and University of California, San Francisco, San Francisco, CA, United States, ²BC Children's Hospital Research Institute, Vancouver, BC, Canada, ³Centre for Heart Lung Innovation, University of British Columbia, Vancouver, BC, Canada, ⁴Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada, ⁵Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States

Keywords: Lung, Lung

This abstract compares the 3D UTE 1H ventilation calculated from Motion-Compensated Low-Rank constrained reconstruction (MoCoLoR) with the hyperpolarized 129Xe ventilation for validation. The dataset covers healthy volunteers and pediatric and adult patients with cystic fibrosis (CF). We validated that 3D UTE 1H has a positively correlated VDP with the gold standard 129Xe and a high spatial VDP accuracy.

View Presentation Video

Hyeonha Kim^1,2, Seokwon Lee¹, Jinil Park², Jooae Choe³, So Hyeon Bak³, Ho Cheol Kim⁴, and Jang-Yeon Park^1,2
1Department of Biomedical Engineering, Sungkyunkwan University, Suwon, Korea, Republic of, ²Department of Intelligent Precision Healthcare Convergence, Sungkyunkwan University, Suwon, Korea, Republic of, ³Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea, Republic of, ⁴Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea, Republic of

Keywords: Lung, Perfusion, Interstitial lung diseases

Since vascular abnormalities are common features of interstitial lung disease, not only structural images but also functional images such as perfusion maps are required to accurately evaluate vascular abnormalities including pulmonary hypertension. In this preliminary study, we proposed a method of evaluating an interstitial lung disease (ILD) patient particularly with idiopathic interstitial pneumonia (IIP) using 3D perfusion maps as well as high-resolution 3D structural images, both of which were obtained from 3D ultrashort echo-time imaging. Fibrotic areas were well identified in the structural UTE images as well as in the perfusion maps showing increased perfusion signals in the corresponding lesions.

View Presentation Video

Anne Slawig^1,2, Andreas Max Weng², and Herbert Köstler^2
1University Clinic and Outpatient Clinic for Radiology, University Hospital Halle (Saale), Halle (Saale), Germany, ²Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Würzburg, Germany

Keywords: Lung, Data Analysis, ventilation, functional lung imaging, senceful

SElf-gated Non-Contrast-Enhanced FUnctional Lung imaging (SENCEFUL) is a well-established method to determine functional lung parameters and was already successfully combined with 3D-UTE for robust ventilation quantification. Nevertheless, the evaluation of not only ventilation, but also perfusion, requires a 2D excitation, as it is based on the inflow effect. Additionally, coverage of more than one slice within short measurement times is valuable. Here, it is shown that functional information can be obtained from two slices acquired simultaneously, thus doubling the anatomical coverage of a conventional 2D acquisition.

View Presentation Video

Alexander Church¹, Shou Zhang¹, Junlan Lu¹, Cody Blanton¹, Jennifer Korzekwinski¹, David Mummy¹, and Bastiaan Driehuys^1
1Radiology, Duke University, Durham, NC, United States

Keywords: Lung, Hyperpolarized MR (Gas), New Devices

Hyperpolarized ¹²⁹Xe MRI requires repeatable lung inflation volumes to ensure consistent and accurate data. Current dose administration techniques require specialized study personnel to not only properly coach the subject through the inhalation maneuver, but also to directly administer the ¹²⁹Xe dose, often while leaning deep into the MRI bore. Since lung inflation directly affects imaging data, it is important to maximize the consistency of inflation volumes across imaging sessions. We propose a novel ¹²⁹Xe gas administration device intended to mitigate lung inflation differences as well as allow for remote administration of doses from outside the bore.

View Presentation Video

Agilo L. Kern^1,2, Marcel Gutberlet^1,2, Jens M. Hohlfeld^2,3,4, Frank Wacker^1,2, and Jens Vogel-Claussen^1,2
1Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany, ²Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany, ³Clinical Airway Research, Fraunhofer Institute for Toxicology and Experimental Medicine (ITEM), Hannover, Germany, ⁴Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany

Keywords: Lung, Hyperpolarized MR (Gas)

A filter exchange imaging (FEXI) sequence was developed for studying dynamic changes of apparent diffusion coefficient (ADC) in hyperpolarized ¹²⁹Xe MRI, thereby probing heterogeneity and connectivity of lung airspaces. The sequence was tested in healthy volunteers and patients of chronic obstructive pulmonary disease (COPD). An initial reduction of ADC after filter application was observed in all subjects. Relative reduction and recovery rate tended to be increased in COPD. Weak/moderate correlations of initial reduction and recovery rate with ADC before filter application were observed. ¹²⁹Xe FEXI lung MRI is feasible and derived quantities may be useful for disease phenotyping in COPD.

View Presentation Video

Rabea Klaar^1,2, Moritz Rabe³, Thomas Gaass^1,2, Moritz J. Schneider^1,2,4, Ilyes Benlala^1,2,5, Stefanie Corradini³, Chukwuka Eze³, Claus Belka^3,6, Guillaume Landry³, Christopher Kurz³, and Julien Dinkel^1,2
1Department of Radiology, University Hospital, LMU Munich, Munich, Germany, ²Comprehensive Pneumology Center (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany, ³Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany, ⁴Antaros Medical AB, BioVenture Hub, Mölndal, Sweden, ⁵Univ. Bordeaux, INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, U1045, F-33000 Bordeaux, France, ⁶German Cancer Consortium (DKTK), Munich, Germany

Keywords: Lung, Cancer, Ventilation, Perfusion

Hybrid MR-imaging and linear accelerators for radiotherapy allow highly accurate treatment of lung cancer patients. The potential of Non-uniform Fourier Decomposition (NuFD), a non-contrast enhanced free-breathing technique that allows the assessment of lung ventilation and perfusion, was investigated in 10 healthy subjects and 2 lung cancer patients at a 0.35 T MR-Linac. Due to challenging ventilation quantification and reproducibility, two normalization strategies were proposed. Evaluation on repeated scans demonstrated clear improvement compared to uncorrected cases. First longitudinal ventilation assessment over treatment course shows promising results for the use of NuFD as treatment response monitoring tool in the clinical workflow.

View Presentation Video

Paul John Clifford Hughes¹, Helen Marshall¹, Laurie Smith¹, Demi Jakymelen¹, Alberto Biancardi¹, Guilhem Collier¹, Ho-Fung Chan¹, Martin Brook¹, Joshua Astley¹, Ryan Munro¹, Smitha Rajaram¹, Andy Swift¹, David Capener¹, Jody Bray¹, James Ball¹, Oliver Rodgers¹, Bilal Tahir¹, Madhwesha Rao¹, Graham Norquay¹, Nicholas Weatherley¹, Leanne Armstrong¹, Latife Hardaker², Titti Fihn-Wikander³, Rod Hughes⁴, and Jim Wild^1
1POLARIS, University of Sheffield MRI Unit, IICD, The University of Sheffield, Sheffield, United Kingdom, ²Priory Medical Group, York, United Kingdom, ³3BioPharmaceuticals Medical, AstraZeneca, Gothenburg, Sweden, ⁴Early Development Respiratory, AstraZeneca, Cambridge, United Kingdom

Keywords: Lung, Lung

Directing treatment based on diagnosis is important in patients suffering with respiratory disease. This work investigated the ability of whole-lung mean T₁ and M₀, and measures of heterogeneity (median coefficient of variation and its interquartile range) to differentiate between patients with asthma and/or COPD and correlated these metrics with ¹²⁹Xe ventilation and diffusion MRI and pulmonary function test metrics. Measures of heterogeneity of T₁ and M₀ correlated with lung function test outcomes and sensitive measures of lung function derived from ¹²⁹Xe MRI and had the ability to separate patients with asthma+COPD and COPD from patients with asthma alone.

View Presentation Video

Andreas Voskrebenzev^1,2, Marcel Gutberlet^1,2, Filip Klimeš^1,2, Frank Wacker^1,2, and Jens Vogel-Claussen^1,2
1Institute of Diagnostic and Interventional Radiology, Medical School Hannover, Hannover, Germany, ²Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany

Keywords: Lung, Quantitative Imaging

Functional lung imaging with proton MRI based on acquisition of free-breathing image-time-series gained interest during the last years, as it offers potential for ventilation / perfusion measurements without requirement for high patient compliance or administration of contrast agents. Since these methods rely on indirect surrogate measurements, validation with more direct techniques (e.g. hyperpolarized MRI), is required, which is elaborate, costly and limited. In this study a framework for a digital lung model, including artificial pathologies, is introduced and tested for different ventilation and perfusion measurements. Using the proposed method important differences were found between the methods regarding ventilation defect detection.

 

Qiao Zou¹, Qi Wan¹, Xinchun Li¹, Weiyin Vivian Liu², and Yongzhou Xu^3
1Department of Radiology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China, ²MR Research China, GE Healthcare, Beijing, China, ³Philips Healthcare, Guangzhou, China

Keywords: Lung, Cancer

Intra-modality and inter-reader agreements of ground-glass opacity nodule (GGN) size were good between modalities (ZTE-MRI, T2WI-FS, CT). ZTE-MRI was susceptible to motion artifacts caused by breathing and vascular pulsation and had difficulty in displaying GGNs in specific lung locations, but was sensitive to GGNs with CT values of >-455 HU, highly possibly lung invasive adenocarcinomas , giving a hint to treatment strategies. In contrast, T2WI-FS can detect a smaller size of 6 mm for GGNs than ZTE-MRI. Overall, ZTE might play a unique role in differentiating invasive adenocarcinomas from precursor glandular lesions and minimally invasive adenocarcinoma (MIA) in eligible GGNs. 

View Presentation Video

wang xiaoyan¹ and zhang yan^1
1The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China

Keywords: Lung, MR Value

Pulmonary MRI zero-echo time (ZTE) and MRI conventional sequences were compared with thoracic computed tomography (CT) to evaluate the lesions.  All participants in the study underwent chest CT, ZTE, T2-TSE, T2-HASTE, and T1-VIBE scans. ZTE can be used as a supplementary examination of CT imaging. ZTE combined with T2WI can improve the detection rate and display performance of pulmonary nodules

Yu Zheng¹, Wenjing Huang¹, Jing Zhang¹, and Na Han^1
1Lanzhou University Second Hospital, Lanzhou, China

Keywords: Lung, Lung, intravoxel incoherent motion, diffusion kurtosis imaging, differentiation degree, lung cancer

  The purpose of this study was to assess differentiation degree of non-small cell lung cancer (NSCLC) by using intravoxel incoherent motion (IVIM) and diffusion kurtosis imaging (DKI) . There were statistically significant differences in D and Dapp values between the poorly differentiated group and the moderately and highly differentiated group (p＞0.05). D value had the best diagnostic efficacy in evaluating the differentiation degree of NSCLC [area under the curve (AUC) =0.773]. Our study demonstrated that D value derived from IVIM and Dapp derived from DKI can distinguish the differentiation degree of NSCLC.

View Presentation Video

Robert R Edelman^1,2, Nondas R Leloudas¹, Jianing Pang³, and Ioannis R Koktzoglou^1,4
1Radiology, NorthShore University HealthSystem, Evanston, IL, United States, ²Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States, ³Siemens Medical Solutions USA, Chicago, IL, United States, ⁴Pritzker School of Medicine, University of Chicago, Chicago, IL, United States

Keywords: Lung, Cancer, unbalanced steady state free precession

Cardiovascular MR is an invaluable diagnostic tool for the heart and great vessels.  As with cardiac CT, it is imperative to carefully evaluate areas outside of the heart to exclude the presence of clinically relevant lesions such as pulmonary infiltrates or lung cancer.  Unfortunately, existing CMR techniques are grossly inadequate for detecting and characterizing extra-cardiac lesions.  We hypothesized that prototype volumetric dark blood SSFP techniques could overcome these limitations and tested them in patients undergoing CMR.  In this pilot study, dark blood SSFP outperformed standard CMR techniques for the evaluation of incidental pulmonary lesions, including benign nodules and cancer. 

View Presentation Video

Nobuyuki Kawai¹, Yoshifumi Noda¹, Tetsuro Kaga¹, Kimihiro Kajita², Hiroshi Kawada¹, and Masayuki Matsuo^1
1Radiology, Gifu University, Gifu, Japan, ²Radiology Services, Gifu University Hospital, Gifu, Japan

Keywords: Vessels, Blood vessels

Contrast-enhanced MRA has been shown to be a safe and effective way to provide posttreatment visceral artery aneurysm (VAA) follow-up. However, this study cannot be performed for those who have contraindications to MR contrast agents. Balanced turbo field-echo (bTFE) sequence enables static and moving fluids to be shown as high intensity without the use of gadolinium. We assessed the feasibility of follow-up non-contrast-enhanced MRA using bTFE sequence for posttreatment VAA. Combined bTFE and unenhanced fat-suppressed T1-wighted (FS-T1W) images demonstrated excellent performance for the diagnosis of aneurysm reperfusion comparable to combined dynamic contrast-enhanced and unenhanced FS-T1W images.

Hongbin Wang¹, Wenyun Liu¹, Lei Zhang¹, Zhuo Wang¹, Ying Qiu¹, Yuejiao Sun¹, Dandan Guo¹, and Yi Zhu^2
1Department of Radiology, the First Hosipital of Jilin University, Changchun, China, ²Philips Healthcare, Beijing, China

Keywords: Vessels, Image Reconstruction, REACT

Patients with diabetic nephropathy and terminal renal insufficiency and those requiring combined kidney-pancreas transplantation should avoid using gadolinium-based contrast agents MR Angiography due to its potential nephrotoxicity. Compressed SENSE (CS) Artificial Intelligence (CS-AI) reconstructed Relaxation-Enhanced Angiography without Contrast and Triggering (REACT) sequence provides a simultaneous depiction of abdominal arterial and venous vessels. This study aims to improve the image quality of REACT sequence with CS-AI and further quantitatively evaluate the image quality in patients with diabetic nephropathy, and CS-AI reconstructed REACT sequence was first applied to image transplanted renal arteries in patients with combined kidney-pancreas transplantation.

View Presentation Video

Marianne Nabbout¹, Michael C Langham¹, and Felix W Wehrli^1
1Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States

Keywords: Vessels, Blood vessels, Neurovascular Compliance

Neurovascular compliance (NVC) is a vascular property involving the intracranial vascular arterial tree expressed as the arterial blood volume in response to a transient systolic blood pressure increase. NVC attracted attention due to its association with neurovascular diseases. We computed the NVC at the common carotid arteries with cine phase-contrast MR. This measure was shown to be significantly correlated with the quantification of the actual NVC in N=17 subjects (r= 0.84; p= 0.00002). Aortic pulse wave velocity, marker of aortic stiffness, was not found to be correlated with any of the two NVC computations.

View Presentation Video

Teresa Nolte¹, Jihun Kwon², Mark Terwolbeck¹, Masami Yoneyama², Christiane Kuhl¹, and Shuo Zhang^3
1Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Aachen, Germany, ²Philips Japan, Tokyo, Japan, ³Philips GmbH Market DACH, Hamburg, Germany

Keywords: Vessels, Vessels, non-contrast-enhanced angiography, REACT

Recently introduced Dixon-based MR angiographic techniques have shown promise for non-contrast enhanced vascular imaging, though off-resonance effects induced by B₀ inhomogeneities may result in water-fat separation errors (i.e., swaps) during Dixon water fat separation, typically seen in a large field of view at high field strength. In this work, we investigate possible swaps via numeric simulations and in vivo measurements with various shimming techniques as well as reconstruction options for B₀ demodulation. Initial results may suggest practical methods to mitigate water-fat swaps and improve technical robustness even in challenging applications.

View Presentation Video

Isao Shiina¹, Michinobu Nagao², Masami Yoneyama³, Yasutomo Katsumata³, Jihun Kwon³, Yasuhiro Goto¹, Yutaka Hamatani¹, Kazuo Kodaira¹, Takumi Ogawa¹, Mana Kato¹, and Shuji Sakai^2
1Department of Radiological Services, Tokyo Women's Medical University, Tokyo, Japan, ²Department of Diagnostic imaging & Nuclear Medicine, Tokyo Women's Medical University, Tokyo, Japan, ³Philips Japan, Tokyo, Japan

Keywords: Vessels, Blood vessels

Flow-sensitive CINE imaging is non-contrast-enhanced MRA technique based on the Turbo Field Echo Planar Imaging (TFEPI). Because TFEPI is sensitive to blood flow, the MRA acquired with flow-sensitive CINE imaging includes dynamic flow information. In this study, we applied flow-sensitive CINE imaging to a variety of body parts such as trunk and lower extremity. Volunteer data demonstrated its usefulness to a variety of body parts. The combination of anatomical vascular pattern and the dynamic flow information may enable comprehensive assessment of whole-body arteries.