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Xiaokai Wang¹, Jiayue Cao¹, Kuan Han¹, Minkyu Choi¹, Ana Cecilia Saavedra Bazan¹, Jon-Fredrik Nielsen¹, Douglas C. Noll¹, and Zhongming Liu^1
1University of Michigan, Ann Arbor, MI, United States

Keywords: Digestive, Digestive

MRI with oral contrast agents has been increasingly used to image the gastrointestinal tract in animals and humans. However, it has not been established for broad clinical applications. This study describes a set of natural ingredients abundant in manganese ions to enable rapid and contrast-enhanced MRI of the human gastrointestinal tract. A pipeline of advanced analyses reveals the structure of the stomach, dynamic transit of the food inside the stomach, and muscle activity of the stomach wall. Results offer quantitative biomarkers and mechanistic insights for gastric emptying, accommodation, and motility in humans, and merit future studies of gastrointestinal functional disorders.

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Qing Liu¹, Qi Liu², Jing Li¹, Eric Z Chen³, Zhongqi Zhang², Xiao Chen³, Shanhui Sun³, Jian Xu², and Haoran Sun^4
1Radiology, Beichen Hospital, Tianjin, China, ²UIH America, Inc., Houston, TX, United States, ³United Imaging Intelligence, Cambridge, MA, United States, ⁴Radiology, Tianjin Medical University General Hospital, Tianjin, China

Keywords: Digestive, Digestive

A real-time MRI technique is developed using deep-learning reconstruction. Its feasibility is evaluated in both healthy subjects and patients with gastroesophageal reflux diseases.

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Emre Altinmakas¹, Himanshu Sharma², Octavia Bane^1,3, Ghadi Abboud¹, Alex Menys⁴, Yansheng Hao⁵, Jean-Frederic Colombel⁶, Noam Harpaz⁵, and Bachir Taouli^1,3
1Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States, ²Icahn School of Medicine at Mount Sinai, NY, NY, United States, ³BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States, ⁴Motilent Ltd, London, United Kingdom, ⁵Department of Pathology, Icahn School of Medicine at Mount Sinai, NY, NY, United States, ⁶Department of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, United States

Keywords: Digestive, Quantitative Imaging, Crohn's disease; stricture; mpMRI;

Small bowel stricture (SBS) is the one of the most common complications of Crohn’s Disease (CD) and it usually requires surgical management. Imaging diagnosis and characterization of SBS is essential for proper patient management, however this may be challenging with conventional MRI techniques. In current study, we investigate the utility of advance MRI techniques namely multiparametric MRI (mpMRI) including diffusion, perfusion, and motility in the characterization and tissue composition in CD-related SBS. Our preliminary results suggest that mpMRI parameters are promising tools to characterize SBS and may be helpful in the stratification of patients for medical treatment vs surgery.

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SERGE DIDENKO VASYLECHKO¹, LINA LU¹, CEMRE ARIYUREK¹, JEANNETTE PEREZ-ROSSELLO¹, MICHAEL CALLAHAN¹, ONUR AFACAN¹, and SILA KURUGOL^1
1RADIOLOGY, BOSTON CHILDREN'S HOSPITAL, HARVARD MEDICAL SCHOOL, BOSTON, MA, United States

Keywords: Digestive, Motion Correction

Diffusion-weighted MRI is increasingly used for detection and characterization of Crohn’s disease. However, unavoidable respiratory motion and bowel motility reduces accuracy and precision of quantitative parameter fitting, which hinders clinical applicability DW-MRI.  We use a 3D slice-to-volume registration approach that sequentially tracks rigid motion parameters for each slice and regularises the parameters with a Kalman filter in the order of acquisition of each slice. We assess the quality of images and estimated parameter maps and the precision of IVIM parameters in the areas of disease using the proposed motion correction technique, and compare them with results from the uncorrected data.  

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Keywords: Cancer, Diffusion/other diffusion imaging techniques

The prognosis prediction of locally advanced rectal cancer (LARC) was important to individualized treatment, we investigated the performance of ultra-high b-value DWI (UHBV-DWI) in progression risk prediction of LARC and compare with routine DWI. It was found that ADCuh derived from UHBV-DWI performed better than ADC based on routine DWI in predicting prognosis of LARC. The model based on combination of ADCuh, TNM-stage and extramural venous invasion (EMVI) could help to indicate progression risk before treatment.

Ge yuxi¹, Dai Jiankun², Hu Shudong¹, and Jia Yanlong^3
1Affiliated Hospital of Jiangnan University, Wuxi, China, ²GE Healthcare, Shanghai, China, ³Department of Radiology，Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China

Keywords: Pelvis, Quantitative Imaging, synthetic MR, rectal cancer, vessels

This study aimed to investigate the feasibility of synthetic phase-sensitive inversion recovery (SyPSIR) vessel for extramural venous invasion (EMVI) detection in patients with rectal cancer. One hundred and six histologically confirmed rectal cancer patients (35 EMVI+ and 71 EMVI−) were evaluated. Compared with using T2WI alone, the area under the receiver operating characteristic curve using the combination of T2WI and SyPSIR was increased from 0.86 to 0.96 and from 0.65 to 0.88 for the senior and junior radiologist, respectively. Therefore, SyPSIR can provide additional information to improve EMVI diagnostic efficiency of in rectal cancer.

Zhijun Geng¹, Shaolei Li², Yunfei Zhang², Yongming Dai², and Chuanmiao Xie^1
1Sun Yat-sen University Cancer Center, Guangzhou, China, ²MR Collaboration, Central Research Institute, United Imaging Healthcare, Shanghai, China

Keywords: Pelvis, Diffusion/other diffusion imaging techniques

This study evaluates a new pre-operatively method to grade rectal cancer based on Continue Time Random Walk (CTRW) model. The method is to calculate three parameters of the CTRW model by fitting the model with DWI signal and a series of b-values and to differentiate low- and high-grade tumors by fitting a logistic regression with different combinations of parameters. An additional k-mean clustering analysis is performed to evaluate how differentiable the low and high-grade groups are in the CTRW parameters’ phase space. Our study shows that CTRW model has the potential to accurately grade rectal cancer.

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Takumi Ogawa¹, Michinobu Nagao², Yasuhiro Goto¹, Masami Yoneyama³, Johannes M Peeters⁴, Isao Shiina¹, Yutaka Hamatani¹, Kazuo Kodaira¹, Mana Kato¹, and Shuji Sakai^2
1Department of Radiological Services, Tokyo Women's Medical University, Tokyo, Japan, ²Department of Diagnostic image & Nuclear Medicine, Tokyo Women's Medical University, Tokyo, Japan, ³Philips Japan, Tokyo, Japan, ⁴Philips Healthcare, Best, Netherlands

Keywords: Digestive, Biliary

Breath-hold MRCP has gained more attention in routine clinical MRI, but its limited scan time during the breath-hold period often results in poor signal-to-noise ratio (SNR) and spatial-resolution. Despite being a single breath-hold method, 3D gradient and spin-echo (GraSE) sequence has been reported to provide high image quality. In this study, accelerated GraSE sequence combined with Compressed SENSE has been developed to obtain high-resolution MRCP images with a single breath-hold.

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Yu Zhang¹, Chunchao Xia¹, Zhenlin Li¹, and Xiaoyong Zhang^2
1West China Hospital of Sichuan University, Chengdu, China, ²Clinical Science, Philips Healthcare, Chengdu, China

Keywords: Liver, Biliary

In this work, we aimed to compare image quality and lesion detectability in patients suspected with gallstones among single breath-hold three-dimensional magnetic resonance cholangiopancreatography (MRCP) with gradient and spin-echo (GRASE) technique, with compressed sensing (CS) and with deep learning (DL) technique. DL MRCP showed the best image quality and better lesion conspicuity and lesion edge sharpness. 

Leonard W.F. Seelen^1,2, Lieke van den Wildenberg¹, Ayhan Gursan¹, W.J. Mark Gosselink¹, Wybe J.M. van der Kemp¹, Firdaus A.A. Mohamed Hoesein³, Nadia Haj Mohammad⁴, I. Quintus Molenaar², Hjalmar C. van Santvoort², Dennis W.J. Klomp¹, and Jeanine J. Prompers^1
1Center for Image Sciences, University Medical Center Utrecht, Utrecht, Netherlands, ²Dept. of Surgery, UMC Utrecht Cancer Center and St Antonius Hospital Nieuwegein: Regional Academic Cancer Center Utrecht, Utrecht University, Utrecht, Netherlands, ³Dept. of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands, ⁴Dept. of Medical Oncology, UMC Utrecht Cancer Center, Regional Academic Cancer Center Utrecht, Utrecht University, Utrecht, Netherlands

Keywords: Pancreas, Non-Proton

³¹P MRS could be valuable for the assessment of treatment response in pancreatic cancer. Using a ³¹P whole-body transmit coil in combination with a 16-channel receive array at 7T, we could obtain ³¹P MRSI data covering both the whole liver and the deeply lying pancreas. The aim of this study was to compare ³¹P metabolite levels in the pancreas and liver in healthy volunteers. The PME/PDE ratio, which has been used as a tumor marker, was 2.1-fold higher in the pancreas compared to the liver. This will be important to take into account when applying ³¹P MRS in pancreatic tumors.

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Yoshifumi Noda¹, Nobuyuki Kawai¹, Tetsuro Kaga¹, Kimihiro Kajita², Yu Ueda³, Masatoshi Honda³, Fuminori Hyodo^1,4, Hiroki Kato¹, and Masayuki Matsuo^1
1Department of Radiology, Gifu University, Gifu, Japan, ²Department of Radiology Services, Gifu University Hospital, Gifu, Japan, ³Philips Japan, Tokyo, Japan, ⁴Institute for Advanced Study, Gifu University, Gifu, Japan

Keywords: Pancreas, Pancreas

Dynamic contrast-enhanced imaging is an essential examination in pancreatic MRI. However, non-diagnosable image quality due to motion artifacts and inappropriate scan timing for pancreatic phase are common problems. Recently, free-breathing sequence (4D FreeBreathing) has been introduced and it can provide diagnosable image quality even in free-breathing. In this study, we evaluated the feasibility of 4D FreeBreathing in pancreatic MRI. Our results showed that 4D FreeBreathing could provide diagnosable image quality and appropriate pancreatic phase scanning could be achieved in all examinations.

Dingxia Liu¹, Jiejun Chen¹, Yunfei Zhang², Yongming Dai², and Xiuzhong Yao^1
1Shanghai Institute of Medical Imaging, Shanghai, China, ²MR Collaboration, Central Research Institute, United Imaging Healthcare, Shanghai, China

Keywords: Pancreas, Cancer

Magnetic resonance elastography (MRE) is a noninvasive technique capable of quantifying tissue mechanical properties (stiffness) in vivo. Given its specialty, it is supposed to be potential for identifying malignant tumors that are characterized by a marked desmoplastic reaction and build-up of fibrotic tissues in cancer cells and tumor microenvironment. However, the field has been largely restricted to studies in pancreatic MRE. This study sought to determine the diagnostic performance of MRE for pancreatic solid masses, compared with diffusion-weighted imaging (DWI) and serum CA19-9, to establish a threshold for differentiating between pancreatic ductal adenocarcinoma (PDAC) and benign tumors in pancreas.

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Jingyue Dai¹, Yufei Zhao¹, and Xingui Peng^1
1Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Southeast University, Zhongda Hospital, NANJING, China

Keywords: Endocrine, Metabolism, Brown Adipose Tissue

Irisin is an exercise-induced myokine which can induce white adipose tissue browning; however, its impact on BAT remains unclear. Here, we employed MR chemical shift-selective imaging to quantify fat fraction, and to verify these MR-derived data by that from laboratory analysis to investigate the effects of irisin on BAT and systemic metabolism in obese mice. Irisin reduced the fat fraction and increased the UCP1 protein expression of BAT. Besides, irisin helped obese mice to loss weigh and improve systemic metabolic disorders. These results suggests that irisin can reactivate brown adipose tissue and improve systemic metabolic disorders in obese mice.

qi an¹, qinhe zhang¹, ailian liu¹, liangjie lin², and lizhi xie^3
1Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian, China, ²Philips health care, Dalian, China, ³GE health care, Dalian, China

Keywords: Endocrine, Diabetes

This study was carried out to evaluate the correlations between abdominal fat, vertebral density and ectopic fat deposition patients with T2DM using IDEAL-IQ.We found that SAT area,VAT area,Pancreatic FF and Abdominal wall muscle FF was positively correlated with BMD in patients with T2DM.

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Daniela Junker¹, Mingming Wu¹, Selina Rupp¹, Jessie Han¹, Stella Näbauer¹, Anna Reik², Meike Wiechert², Arun Somasundaram¹, Marcus R. Makowski¹, Hans Hauner², Christina Holzapfel², and Dimitrios C. Karampinos^1
1Department of Diagnostic and Interventional Radiology, School of Medicine, Technical University of Munich, Munich, Germany, ²Institute for Nutritional Medicine, School of Medicine, Technical University of Munich, Munich, Germany

Keywords: Endocrine, Fat

Results of weight loss interventions differ individually. MRI-based quantification and characterization of adipose tissue (AT) offers methods to identify possible AT-phenotypes that facilitate AT loss. The purpose of this analysis was to evaluate how, in people with obesity undergoing an 8-week formula-based weight loss intervention, the relative AT and lipid volume loss of the subcutaneous and visceral AT depot correlate to the proton density fat fraction (PDFF) and the total volume of AT as well as the volume of lipids in each depot at the beginning of the diet.