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Archana Vadiraj Malagi^1,2, Devasenathipathy Kandasamy³, Deepam Pushpam⁴, Kedar Khare⁵, Raju Sharma³, Rakesh Kumar⁶, Sameer Bakhshi⁴, and Amit Mehndiratta^1,7
1Centre for Biomedical Engineering, Indian Institute of Technology Delhi (IIT Delhi), New Delhi, India, ²Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States, ³Department of Radiodiagnosis, All India Institute of Medical Sciences Delhi, New Delhi, India, ⁴Department of Medical Oncology, Dr. B.R. Ambedkar Institute-Rotary Cancer Hospital (IRCH), All India Institute of Medical Sciences Delhi, New Delhi, India, ⁵Department of Physics, Indian Institute of Technology Delhi (IIT Delhi), New Delhi, India, ⁶Department of Nuclear Medicine, All India Institute of Medical Sciences Delhi, New Delhi, India, ⁷Department of Biomedical Engineering, All India Institute of Medical Sciences Delhi, New Delhi, India

Keywords: Cancer, Diffusion/other diffusion imaging techniques

Intravoxel Incoherent motion-diffusion kurtosis imaging (IVIM-DKI) was used for evaluation and characterization of malignant lymph nodes in lymphoma. A total of twenty-one (n=21) patients diagnosed with biopsy proven Hodgkin lymphoma(HL: n=13) or non-Hodgkin lymphoma(NHL: n=8) were prospectively evaluated. IVIM-DKI parameters were estimated using standard IVIM-DKI model (standard model) and IVIM-DKI model with total variation(TV) penalty function method(IDTV model). Perfusion fraction (f) and kurtosis (k) estimated using IDTV model, and apparent diffusion coefficient(ADC) were significantly(p<0.05) lower in malignant lymph nodes than benign lymph nodes. f and k showed high AUC of 0.88 and 0.83, respectively for malignant vs. benign lymph nodes. 

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Katharina J Wenger^1,2,3,4, Seyma Alcicek^1,2,3, Ulrich Pilatus¹, Dennis C Thomas^1,2,3, Elke Hattingen^1,2,3,4, Florian Buettner⁴, Andreas Loth⁵, and Thomas Oellerich^2,3,4,6
1Institute of Neuroradiology, University Hospital Frankfurt, Frankfurt am Main, Germany, ²University Cancer Center Frankfurt (UCT), Frankfurt am Main, Germany, ³Frankfurt Cancer Institute (FCI), Frankfurt am Main, Germany, ⁴German Cancer Research Center (DKFZ) Heidelberg, Germany and German Cancer Consortium (DKTK), Partner Site Frankfurt/Mainz, Frankfurt am Main, Germany, ⁵Department of Oto-Rhino-Laryngology, University Hospital Frankfurt, Frankfurt am Main, Germany, ⁶Department of Hematology/Oncology, University Hospital Frankfurt, Frankfurt am Main, Germany

Keywords: Cancer, Tumor, lymphoma, multiomics, MR-Spectroscopy

With the presented protocol, key metabolites related to different metabolic profiles of aggressive lymphomas (such as lactate, alanine, as a surrogate for pyruvate, as well as choline components) can be detected in vivo in a clinical setting.
 

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Abdelazim Elsayed Elhelaly^1,2, Fuminori Hyodo¹, Yoshifumi Noda³, Hiroki Kato³, Koki Ichihashi⁴, Hiroyuki Tomita⁴, and Masayuki Matsuo^3
1Department of Radiology, Frontier Science for Imaging, Gifu University, Gifu, Japan, ²Department of Food Hygiene and Control, , Faculty of Veterinary Medicine, Suez Canal University, Ismailia, Egypt, ³Department of Radiology, School of Medicine, Gifu University, Gifu, Japan, ⁴Department of Tumor Pathology, Gifu University Graduate School of Medicine, Gifu University, Gifu, Japan

Keywords: Cancer, Deuterium, deuterium MR imaging

DMI emerged as a promising alternative in cancer metabolic imaging. We D2O-induced 2H-labeling followed by DMI to study deuterium kinetics and track tumor response to treatment at 1.5T. We succeeded to use dMRI to monitor 2H kinetics in tissues of a pancreatic carcinoma model. Higher 2H build-up was observed in tumor. Treated mice showed a significant decrease in 2H in tumor during 7 days of treatment and before anatomical changes were detectable. Tumor homogenates of treated mice also showed a significant reduction in 13C lactate production. DMI  of tumors is a potential imaging method for assessment of early treatment responses

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Khadija Sheikh¹, Akila N Viswanathan¹, Daniel Y Song¹, Junichi Tokuda², Junghoon Lee¹, Michael Jerosch-Herold², Mindy K Graham¹, Ravi Seethamraju³, Thomas Benkert⁴, Himanshu Bhat⁵, Bruce L Daniels⁶, and Ehud J Schmidt^1,7
1Radiation Oncology and Molecular Sciences, Johns Hopkins University School of Medicine, Washington, DC, United States, ²Radiology, Brigham and Women’s Hospital, Boston, MA, United States, ³Siemens Medical Solutions, Boston, MA, United States, ⁴MR Applications Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany, ⁵Siemens Healthineers, Boston, MA, United States, ⁶Radiology, Stanford University, Stanford, CA, United States, ⁷Medicine (Cardiology), Johns Hopkins University School of Medicine, Baltimore, MD, United States

Keywords: Pelvis, Radiotherapy, acute and chronic fibrosis

We developed means to quantify the volume and voxel-wise fraction of acute (F_A) and chronic fibrosis (F_C) present during and following radiation therapy (RT), using non-contrast and contrast enhanced stack-of-spirals IR-UTE scans. Imaging was performed in gynecologic and prostate cancer patients at multiple time points in relation to RT (pre-RT, on-RT, post-RT, and post-3 months RT). This study provides mm-resolution quantitative information on fibrosis changes during the course of RT based on MRI. Increases in F_A, followed by subsequent-time F_C increases were observed in both prostate and gynecologic cancer patients. 

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Fuminori Hyodo¹, Norikazu Koyasu¹, Ryota Iwasaki¹, Hinako Eto², Abdelazim Elsayed Elhelaly¹, Hiroyuki Tomita¹, Takashi Elsayed Mori¹, Masaharu Murata², Yoshifumi Noda¹, Hiroki Kato¹, and Masayuki Matsuo^1
1Gifu University, Gifu, Japan, ²Kyushu University, Fukuoka, Japan

Keywords: Cancer, Hyperpolarized MR (Non-Gas), redox, DNP MRI, radiation

In vivo dynamic nuclear polarization-MRI (DNP-MRI, also called OMRI, PEDRI) using carbamoyl-PROXYL(CmP) as a redox sensitive DNP probe enables the accurate monitoring of the tissue redox status.   We found that the redox status decreases 1 day after radiation treatment, and the decay of redox status occurs before any micro- or macroscopic changes in tumor morphology and pyruvate metabolism based on the Warburg effect. This decay of redox status can also be associated with the decreased production of intratumor reducing redox molecules such as GSH and AsA.

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Renee L Chin^1,2, Jorge de la Cerda¹, F William Schuler³, Sanhita Sinharay⁴, and Mark D Pagel^1
1Cancer Systems Imaging, UT MD Anderson Cancer Center, Houston, TX, United States, ²Immunology, MD Anderson Cancer Center, Houston, TX, United States, ³Cancer Systems Imaging, MD Anderson Cancer Center, Houston, TX, United States, ⁴Center for Biosystems Science and Engineering, Indian Institute of Science, Bangalore, India

Keywords: Cancer, CEST & MT, immunotherapy

Tumor acidosis causes resistance to immune checkpoint blockade (ICB) immunotherapy.  We have identified a “pH-sensitizer” that  increases the extracellular pH of the tumor microenvironment, improving immunogenicity and tumor control with ICB.  AcidoCEST MRI can measure the extracellular pH of the tumor microenvironment.  We used acidoCEST MRI to correlate the increase in tumor pHe immediately caused by the pH-senstizer with the tumor volume at study endpoint, in a pre-clinical model of breast cancer.  These results show that acidoCEST MRI can contribute to predicting the outcome of immunotherapy.

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Kota Yamashita¹, Kazumasa Horie¹, Kazutoshi Yamamoto¹, Jeffery R. Brender¹, Nallathamby Devasahayam¹, Murali C. Krishna¹, and Shun Kishimoto^1
1National Cancer Institute, Bethesda, MD, United States

Keywords: Cancer, DSC & DCE Perfusion

Radiation therapy (RT) on primary tumor rarely induces regression of non-irradiated metastatic lesions (abscopal effect), which is reported to be enhanced by immune-checkpoint blockade. In this study, we examined the physiological changes induced by abscopal effect using MRI-based imaging modalities such as EPR oximetry, DCE MRI, and ¹³C DNP MRI. Hypoxic fraction < 10 mmHg (HF10), permeability, perfusion, and CD8+ T cell infiltration in metastatic tumor increased after the combination of RT and PD-1 blockade. Interestingly, higher permeability/perfusion and lower HF10 in primary tumor before the treatment were associated with slower growth of the metastatic tumor after the treatment.

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Chenhui Li¹, Jinhuan Xie¹, Liling Long¹, Huiting Zhang², and Yang Song^2
1The First Affiliated Hospital of Guangxi Medical University, Nanning, China, ²MR Scientific Marketing, Siemens Healthineers, Shanghai, China

Keywords: Cancer, Liver

Vessels encapsulating tumor clusters (VETC) is a powerful predictor of a poor prognosis in patients with hepatocellular carcinoma (HCC) .Therefore, preoperative radiologic prediction of these histopathological results can allow optimized management of HCC and help improve long-term survival for patients.However,to our knowledge, no published studies have investigated preoperative VETC patten of HCC using IVIM parameters and comparing with DWI. Our study indicated that IVIM-derived D* provides a non-invasive analytical approach for preoperative predicting VETC of HCC.ADC value were not predictive for VETC.

Yue Wang¹, Ying Zhao¹, and Ailian Liu^1
1the First Affiliated Hospital of Dalian Medical University, Dalian, China

Keywords: Cancer, fMRI

The global incidence and mortality of hepatocellular carcinoma (HCC) are high [1]. Although radical resection of HCC is the most effective treatment, the postoperative recurrence rate is high. Diffusion kurtosis imaging (DKI) is based on the non-Gaussian diffusion motion of water molecules, which can quantitatively reflect the characteristics of lesions from the perspective of diffusion and heterogeneity[2]. Texture analysis provides information about tissue complexity and heterogeneity based on mathematical methods. This study showed that DKI-based entire-tumor texture analysis could assist in prediction of the early recurrence of HCC patients after hepatectomy, which was beneficial to improve the prognosis.

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Annemarie Knill^1,2, Matthew Blackledge¹, Jessica Winfield^1,2, Hannah Barnsley², Benjamin Malawo², Georgina Hopkinson², Dow-Mu Koh^1,2, Samuel Withey², and Christina Messiou^1,2
1The Institute of Cancer Research, London, United Kingdom, ²The Royal Marsden NHS Foundation Trust, London, United Kingdom

Keywords: Cancer, Diffusion/other diffusion imaging techniques

Systematic clinical validation of noise-corrected, exponentially-weighted, diffusion-weighted MRI (niceDWI) is performed in metastatic melanoma including soft tissue disease. Previous assessments of niceDWI demonstrated improvement in the in-plane bias field. No clinical advantage is found over clinical DWI: the signal-to-noise ratio was assessed as significantly worse in niceDWI both quantitatively and by an experienced reader; there was no difference demonstrated in the contrast-to-noise ratio (CNR) of bone or nodal lesions; when soft tissue disease is included CNR is significantly worse on niceDWI. It is recommended that future evaluations of niceDWI assess the maximum intensity projection for use as a survey tool.

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Raj Kumar Sharma¹, Michael T. McMahon², Meiyappan Solaiyappan¹, Yasser Ged³, and Zaver M Bhujwalla^1
1Division of Cancer Imaging Research, The Russell H. Morgan Department of Radiology and Radiological Science, JOHNS HOPKINS UNIVERSITY, SCHOOL OF MEDICINE, BALTIMORE, MD, United States, ²F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, JOHNS HOPKINS UNIVERSITY, SCHOOL OF MEDICINE, Baltimore, MD, United States, ³Genitourinary Oncology, Sidney Kimmel Comprehensive Cancer Center, JOHNS HOPKINS UNIVERSITY, SCHOOL OF MEDICINE, Baltimore, MD, United States

Keywords: Cancer, Metabolism, Clear Cell Renal Cell Carcinoma , Cancer , 1H MR metabolomics

A minimally invasive, blood-based assay to predict and detect response to immune-checkpoint inhibitors (ICIs) would be of significant importance.  1H MRS of plasma samples provides a robust reproducible assay that require minimal sample preparation, and convenience of sample storage.  Here we evaluated changes in plasma metabolites of clear cell renal cell carcinoma (ccRCC) patients receiving ICIs using 1H MRS.  We identified a significant increase of acetate, formate, glutamine, glycine, myoinositol, and lactate following ICI that may reflect response.

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Nima Gilani¹, Artem Mikheev¹, Inge Manuela Brinkmann², Dibash Basukala¹, Thomas Benkert³, Malika Kumbella¹, James S. Babb¹, Hersh Chandarana¹, and Eric E. Sigmund^1
1Department of Radiology, NYU Langone Health, New York, NY, United States, ²Siemens Medical Solutions USA Inc., New York, NY, United States, ³Siemens Healthcare GmbH, Erlangen, Germany

Keywords: Kidney, Diffusion/other diffusion imaging techniques

The effect of cardiac gating on quantitative diffusion weighted magnetic resonance imaging of the kidney was investigated using an advanced cardiac triggered diffusion-weighted imaging sequence which allows the acquisition and estimation of diffusion tensor imaging and intra-voxel incoherent motion parameters. Cardiac gating significantly influences the repeatability of IVIM parameters that reflect flow of blood and fluids in the kidney and allow interpretations of renal function.

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Fang Wang¹, Yong-Sheng Xiang¹, Peng Wu², Ai-Jun Shen¹, and Pei-Jun Wang^1
1Tongji Hospital, School of Medicine, Tongji University, Shanghai, China, ²Philips Healthcare, Shanghai, China

Keywords: Urogenital, Bladder

Amide proton transfer (APT) imaging is an emerging chemical exchange saturation transfer (CEST)-based MRI technique that is sensitive to mobile proteins and peptides in tissue and has drawn considerable attention in the field of cellular and molecular imaging.In the present work, our result demonstrates that APT imaging can predict tumor grade and muscular invasion in bladder cancer, the diagnostic performance for evaluating muscular invasion is better than that of diffusion-weighted imaging (DWI) and adding APT imaging to DWI significantly improved the diagnostic accuracy for evaluating muscular invasion versus DWI alone, thus opening new research avenues in this field. 

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Wei Wang¹, Ke Xue², Yongming Dai², and Jianxing Qiu^1
1Department of Radiology, Peking University First Hospital, Beijing, China, ²MR Collaboration, Central Research Institute, Shanghai United Imaging Healthcare, Shanghai, China

Keywords: Urogenital, Diffusion/other diffusion imaging techniques

Accurately determining the histologic grade and variant status is essential. In this study, the diagnostic value of the CTRW model in characterizing histological grade or histological variants was evaluated and compared with ADC. The optimal diagnostic performance of CTRW diffusion model suggested it could provide more diagnostic value than conventional ADC not only for pathological grading but also for histological variant of bladder urothelial carcinoma.

Cong You¹, Yujiao Zhao², Cheng Zhang¹, Mengyao Chen¹, Jinxia Zhu³, Feifei Qu³, Thomas Benkert⁴, Robert Grimm⁴, and Wen Shen^2
1The First Central Clinical School, Tianjin Medical University, Tianjin, China, ²Department of Radiology, Tianjin First Central Hospital, School of Medicine, Nankai University, Tianjin, China, ³MR Collaboration, Siemens Healthineers Ltd., Beijing, China, ⁴MR Application Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany

Keywords: Urogenital, Diffusion/other diffusion imaging techniques, bladder cancer; diffusion-weighted imaging; monoexponential model;intravoxel incoherence motion;diffusion kurtosis imaging

This comparative study aimed to investigate the ability of Gaussian distribution models, including monoexponential model (MEM) and intravoxel incoherence motion (IVIM), and non-Gaussian diffusion kurtosis models to differentiate the pathologic stages and histologic grades of bladder cancer. The results indicated that the diffusion kurtosis imaging (DKI) parameters had the highest diagnostic performance. The mean kurtosis (MK) value among individual parameters and the combination of MK and mean diffusivity (MD) among combined values had the largest area under the curves. Also, the MK values were most strongly correlated with the Ki-67 labeling index.

Yue Wang¹, Anliang Chen¹, Lizhi Xie², and Ailian Liu^1
1the First Affiliated Hospital of Dalian Medical University, Dalian, China, ²GE Healthcare (China), Beijing, China

Keywords: Cancer, Quantitative Imaging, tumor budding

This study used diffusion kurtosis imaging (DKI) to predict the tumor budding (TB) grade in rectal cancer. The results showed that the parameters MK, MD and their combination parameter both perform great diagnostic efficiency. DKI could noninvasively predict TB grade of rectal cancer, which is an important prognostic information, and has important guiding significance for clinical treatment.

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Ziyou Wang¹, Chong Wang², Haini Zhang¹, Jianwei Zeng², Zhongxiao Liu², Wenbei Xu¹, Shenman Qiu², Yanchun Zhang³, Hao Wang³, Peng Wu⁴, Yankai Meng², and Kai Xu^2
1Xuzhou medical university, Xuzhou,Jiangsu Province, China, ²The affilliated hospital of Xuzhou Medical University, Xuzhou,Jiangsu Province, China, ³Suining Country People's hospital affiliated to Xuzhou Medical University, Xuzhou,Jiangsu Province, China, ⁴Philips Healthcare, Shanghai Province, China

Keywords: Cancer, Diffusion/other diffusion imaging techniques, diagnosis confidence

We aimed to evaluate the added value of reduced field-of-view (rFOV) IRIS-DWI sequence for T2WI sequence in evaluating T staging of rectal cancer. ROC analysis showed the diagnosis performance based on T2WI + rFOV IRIS-DWI imaging was superior to single T2WI sequence. The AUC, sensitivity and specificity were 0.928, 93.3%, 91.7% and 0.658, 73.3%, 58.3% for two diagnosis methods respectively. The result showed significant difference between two methods with P = 0.002. rFOV IRIS-DWI combined T2WI imaging could provide higher diagnosis confidence and higher diagnosis accuracy for rectal cancer T staging.

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Zhongyan Xiong¹, Yu Luo², Yang Yang³, Meiyun Wang², Xin Liu^4,5, Hairong Zheng¹, and Chao Zou^4,5
1Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China, ²Department of Medical Imaging, Henan Provincial People’s Hospital & Zhengzhou University People’s Hospital, Zhengzhou, China, ³Central Research Institute, United Imaging Healthcare, Shanghai, China, ⁴Paul C. Lauterbur Centre for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China, ⁵Key Laboratory for Magnetic Resonance and Multimodality Imaging of Guangdong Province, Shenzhen, China

Keywords: Lung, Diffusion/other diffusion imaging techniques

A novel diffusion weighted imaging model called restriction spectrum imaging (RSI) captures the distinct diffusion behavior of tumors. The restricted diffusion correlates to tumor cellularity, a potential indicator of cancer aggressiveness. To assess its capability of characterizing lung cancer metastasis, we applied a three-compartment RSI model and intravoxel incoherent motion model to DWI images of locally advanced and metastatic lung cancer patients with the diagnosis of biopsy. The RSI model demonstrated its ability to discriminate the lung cancer of locally advanced (III) and metastatic (IV) stage, and the results outperforms the traditional IVIM model.

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Nan Wang¹, Ailian Liu¹, Guobin Li², Shuheng Zhang², Shaoxin Xiang³, Yongming Dai³, and Qingwei Song^1
1the First Affiliated Hospital of Dalian Medical University, Dalian, China, ²Shanghai United Imaging Healthcare Co., Ltd, Shanghai, China, ³MR Collaboration, Central Research Institute, United Imaging Healthcare, Shanghai, China

Keywords: Cancer, Whole Body

Whole-body MRI (WB-MRI) is proposed as a potential modality to evaluate the entire body with excellent spatial resolution and high sensitivity. However, the long scanning time of WB-MRI has still limited the clinical application. This study compared the time cost and lesion display effect of WB-MRI in different scan directions. This study demonstrated that using coronal scanning in WB-MRI is an effective method to reduce the scan time and achieve good performance in detecting lesions in clinical applications.