Yoshiharu Ohno^1,2,3, Masao Yui⁴, Takeshi Yoshikawa^3,5, Daisuke Takenaka⁵, Kaori Yamamoto⁴, Yoshimori Kassai⁴, Kazuhiro Murayama², and Hiroshi Toyama^1
1Radiology, Fujita Health University School of Medicine, Toyoake, Japan, ²Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Japan, ³Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan, ⁴Canon Medical Systems Corporation, Otawara, Japan, ⁵Diagnostic Radiology, Hyogo Cancer Center, Akashi, Japan

No major papers that directly compared the capability for N-stage evaluation among cDWIs with different b values, aDWI and FDG-PET/CT in NSCLC patients.  We hypothesize that cDWI has a potential for improving diagnostic performance of N-stage in NSCLC patients as compared with aDWI as well as FDG-PET/CT, when set appropriate b value.  The purpose of this study is to directly compare the capability for N-stage evaluation among cDWI with different b values, aDWI and FDG-PET/CT in NSCLC patients. 

Zhun Huang¹, Nan Meng², Zhixue Wang³, Fangfang Fu², Pengyang Feng¹, Ting Fang², Yan Bai², Wei Wei², Yaping Wu², Jianmin Yuan⁴, Yang Yang⁵, Hui Liu⁶, and Meiyun Wang*^1
1Department of Radiology, Henan University People’s Hospital & Henan Provincial People’s Hospital, School of Basic Medicine, zhengzhou, China, ²Department of Radiology, Zhengzhou University People’s Hospital & Henan Provincial People’s Hospital, Academy of Medical Sciences, zhengzhou, China, ³Department of Radiology, the First Affiliated Hospital of Henan Medical University, Kai Feng, China, ⁴Central Research Institute, UIH Group, Shanghai, China, zhengzhou, China, ⁵Central Research Institute, UIH Group, Beijing, China, Bei Jing, China, ⁶UIH America, Inc, Houston, TX, United States, Houston, TX, United States

PET/MRI is a very promising technology. PET can reflect metabolism, and stretch index diffusion imaging can reflect molecular diffusion rate and heterogeneity. The results show that the combination of the two has the best identification effect, and further analysis shows that SUVmax is negatively correlated with α.

Fangfang Fu¹, Nan Meng², Zhun Huang³, Yaping Wu¹, Pengyang Feng³, Xiaochen Li¹, Yan Bai¹, Wei Wei¹, Jianmin Yuan⁴, Tianyi Xu⁴, and Meiyun Wang^1
1Department of Medical Imaging, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China, ²Department of Radiology, Zhengzhou University People’s Hospital & Henan Provincial People’s Hospital, Academy of Medical Sciences, Zhengzhou, China, ³Department of Radiology, Henan University People’s Hospital & Henan Provincial People’s Hospital, School of Basic Medicine. Department of Radiology, Zhengzhou University People’s Hospital & Henan Provincial People’s Hospital, Academy of Medical Sciences., Zhengzhou, China, ⁴2258 Chengbei Road, Jiading District, Shanghai, China 201907, Shanghai, China

Distinguishing malignant from benign pulmonary lesions is critical. In the study, 18F-FDG PET/MRI were used to obtain metabolic parameters and IVIM diffusion parameters for differential diagnosis of benign and malignant lung lesions. Our results showed that multiparametric PET/MRI is helpful in the differentiation of pulmonary lesions. 18 FDG hybrid PET-MRI enables a robust differentiation of malignant and benign pulmonary lesions when several IVIM parameters and PET parameters are combined. Thus, PET-MRI may reduce some unnecessary lung biopsies.  

Gaofeng Shi¹, Liyun Zheng², Yongming Dai², Hui Liu¹, Hui Feng¹, and Hongshan Zhu^1
1Department of Radiology, Fourth Hospital of Hebei Medical University, Shijiazhuang, China, ²United Imaging Healthcare, Shanghai, China

Despite the introduction of new treatment options in recent years, the survival rates of patients with lung adenocarcinoma (LUAD) remain unsatisfactory. In order to care for patients effectively, clear insight into the processes of ventilation and perfusion of LUAD is required. In this work, Intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI) was used to monitor the blood flow while oxygen-enhanced MRI (OE-MRI) was used to measure the ventilation. Our results showed that the combined measurement of OE-MRI and IVIM-DWI may serve as a promising method for the noninvasive assessment of lung function and classification of LUAD subtype.

Yongqing Yang^1,2, Peng Zhao², Xiangtao Lin^1,2, Yu Wang^1,2, Mengxiao Liu³, Wenjing Ma², Shuai Duan², Nan Lin², Xiaoli Li^1,2, Dejuan Shan^1,2, and Zhongyu Hou^2
1Radiology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China, ²Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China, ³MR Scientific Marketing,Diagnostic Imaging, Siemens Healthcare Ltd., Shanghai, China

In order to diagnose of the pathological type of pulmonary occupied lesions by non-invasive imaging, 30 patients were scanned with chest MRI using Siemens 3T scanner. The T1 mapping sequences were used before and after the injection of contrast agent, and the extracellular volume (ECV) was calculated. The statistical differences of ECV between squamous, adenocarcinoma and small cell carcinoma were analyzed by single-factor variance, and there were significant statistical differences (P<0.05).

Dandan Peng¹, Cong Xia¹, Yuancheng Wang¹, Zhongshuai Zhang², and Shenghong Ju^1
1Zhongda Hospital, Medical School of Southeast University, Nanjing, China, ²SIEMENS Healcare, Shanghai, China

This study is expected to provide information about differentiating of benign from malignant pulmonary lesions with free-breathing Golden-angle RAdial Sparse Parallel (GRASP)-DCE MRI among 33 lung lesions. The results initially indicated that the quantitative DCE parameter maps calculated by GRASP-DCE MR could be a clinical useful technique for lung lesions detection.

Ting Fang¹, Nan Meng¹, Meiyun Wang^1,2, Zhun Huang², Pengyang Feng², Fangfang Fu³, Wei Wei³, Yaping Wu³, Yan Bai³, Jianmin Yuan⁴, Yang Yang⁵, and Hui Liu ^6
1Department of Radiology, Zhengzhou University People’s Hospital & Henan Provincial People’s Hospital, Zhengzhou, China, ²Department of Radiology, Henan University People’s Hospital & Henan Provincial People’s Hospital, Zhengzhou, China, ³Henan Provincial People’s Hospital, Zhengzhou, China, ⁴Central Research Institute, UIH Group, Shanghai, China, ⁵Central Research Institute, UIH Group, Beijing, China, ⁶UIH America, Inc. 9230 Kirby Dr. STE600, Houston, TX, United States

     Chemical exchange saturation transfer (CEST) is a new type of MRI technology, can selectively label the exchangeable hydrogen protons in endogenous or exogenous free macromolecules. Intravoxel incoherent motion (IVIM) MRI can be separated to obtain information related to true water molecule diffusion and microcirculation perfusion through double exponential model analysis. Our research shows that CEST and IVIM have similar diagnostic performance in the differential diagnosis of lung squamous cell carcinoma and lung adenocarcinoma.

Fu Yicheng¹, Zhang Zhongshuai², Yu Ye¹, and Wu Huawei^1
1Radiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China, ²SIEMENS Healthcare, China, Shanghai, China

We use quantitative parameters of T2 mapping and diffusion-weighted intro-voxel incoherent movement (DW-IVIM) with reduced field of view to distinguishing different type of solitary pulmonary nodules. Our result is the 90%, maximum of T2 value, ADC value, mean and maximum of D value had significant difference between benign and malignant SPNs which mean quantitative T2 mapping and IVIM parameters may provide valuable information and serve as a supplementary imaging marker for differentiating malignant from benign SPNs.

Dandan Peng¹, Zhongshuai Zhang², Cong Xia¹, Yuancheng Wang¹, and Shenghong Ju^1
1Zhongda Hospital, Medical School of Southeast University, Nanjing, China, ²SIEMENS Healcare, Shanghai, China

This study aimed to provide information about differentiation of benign from malignant pulmonary lesions with Intravoxel Incoherent Motion Diffusion-Weighted using individual shimming technique among 33 lung lesions. The results initially indicated that ADC and IVIM and could be great techniques for lung lesions detection.

Ho-Fung Chan¹, James A Eaden¹, Nicholas D Weatherley¹, Kevin Johnson², Guilhem J Collier¹, Madhwesha Rao¹, Graham Norquay¹, Jody Bray¹, Smitha Rajaram¹, Andrew J Swift¹, Ronald A Karwoski³, Brian J Bartholmai³, Stephen M Bianchi⁴, and Jim M Wild^1
1Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom, ²Radiology and Medical Physics, University of Wisconsin, Madison, WI, United States, ³Biomedical Imaging Resource, Mayo Clinic, Rochester, MN, United States, ⁴Academic Directorate of Respiratory Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom

A simple signal density-based analysis of UTE ¹H MRI was compared to hyperpolarized ¹²⁹Xe diffusion-weighted (DW)-MRI and CALIPER CT in twelve idiopathic pulmonary fibrosis (IPF) patients at baseline and after 1 year. A statistically significant correlation between the normalized UTE signal and CALIPER interstitial lung disease percentage was observed in the lower lung zone. Trends between UTE signal and ¹²⁹Xe DW-MRI metrics in the lower zone was observed, and no significant longitudinal change in UTE MRI signal was observed. UTE MRI signal is sensitive to IPF lung parenchyma changes and may demonstrate sensitivity to longitudinal changes in a larger cohort.

XinHui Chen¹, ZhiPeng Zhou², Cheng Ge², XinGuan Yang², Long Qian³, and Weiyin Vivian Liu^3
1Radiology, Doctor, Zhan Jiang, China, ²doctor, Gui Lin, China, ³MR Research, Beijing, China

Different treatments were not given to patients [1]HRCT on diagnosis of atypical interstitial pneumonia appears to be powerless, so further examination of pathological biopsy is usually required. However, pathological biopsy often causes a series of complications and reduces the survival rate of patients[2]. This study aims to distinguish between UIP and NSIP using MRI dynamic enhancement quantitative parameters. The results showed that the blood flow in the lungs of UIP patients is significantly reduced. The quantitative parameters of MRI dynamic enhancement had potential in distinguishing UIP from NSIP. 

James A Eaden^1,2, Guilhem J Collier¹, Ho-Fung Chan¹, Nicholas D Weatherley^1,2, Graham Norquay¹, Smitha Rajaram³, Andy Swift^1,3, Ronald A Karwoski⁴, Brian Bartholmai⁴, Stephen M Bianchi², and Jim M Wild^1,5
1POLARIS, MRI unit, Department of Infection Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom, ²Academic Directorate of Respiratory Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom, ³Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom, ⁴Mayo Clinic, Rochester, MN, United States, ⁵Insigneo institute, University of Sheffield, Sheffield, United Kingdom

Correlations between ¹²⁹Xe MRI measures of microstructure and gas exchange and CALIPER CT variables were evaluated both globally and regionally in IPF patients. To date, 27 subjects have undergone both baseline ¹²⁹Xe DW-MRI and CT with 13 of them having baseline dissolved ¹²⁹Xe imaging using a 3D radial spectroscopic method. Our findings demonstrate several significant correlations between dissolved ¹²⁹Xe MRI (RBC:TP, TP:Gas, RBC:Gas) and CALIPER variables. Vessel related structures % was the only CALIPER variable that showed a significant correlation between ¹²⁹Xe RBC:TP globally and in all lung zones. There were no significant correlations between ¹²⁹Xe DW-MRI and CALIPER variables. 

Laura Saunders¹, Dave Capener¹, David G Kiely^1,2, Andy J Swift¹, and Jim M Wild^1
1Infection Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom, ²Sheffield Pulmonary Vascular Disease Unit, Sheffield, United Kingdom

Assessment of lung changes in patients with pulmonary hypertension plays an important role in establishing patient aetiology and treatment. 82 patients with suspected pulmonary hypertension underwent 2D single slice Look-Locker inversion recovery T₁ mapping. Lung T₁ was significantly lower in patients with emphysema seen on 3D CT than in patients with fibrosis, centrilobular ground glass or no lung disease seen on 3D CT. Lung T₁ was more sensitive in differentiating lung pathology seen on CT when excluding lung vessels from average metrics, and when using median rather than mean lung T₁.

El-Sayed H Ibrahim¹, Abdul Parchur¹, Brian Fish¹, Meetha Medhora¹, and Amit Joshi^1
1Medical College of Wisconsin, Milwaukee, WI, United States

Lung injury after exposure to high-dose radiation during cancer treatment has been well described. Our goal in this study is to develop minimally invasive biomarkers for predicting radiation-induced lung injury and assess the role of DLL4 expression in response to radiation injury. We presented a non-invasive UTE-based DCE MRI method for in-vivo quantification of irradiation-induced vascular perfusion and permeability early changes in lungs using two rat models which only differ in 3rd chromosome and DLL4 expression on endothelium. Such knowledge is crucial for accurately evaluating the efficacy of radioprotectors and therapeutic agents, and for monitoring individuals with survivable radiation injury.

Laurence H. Jackson¹, Joanna Bell², Giulia Benedetti², Sze Mun Mak², Rachael Franklin³, Rebecca Preston², Andrea Bille⁴, John Spence², and Geoff Charles-Edwards^1
1Medical Physics, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom, ²Department of Radiology, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom, ³Medical Physics, King's College Hospital NHS Foundation Trust, London, United Kingdom, ⁴Department of Thoracic Surgery, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom

Despite recent advances in surgical techniques,  postoperative complications arise in 24-41% of patients undergoing thoracic surgery. Here we present an MRI protocol for the pre and postoperative assessment of chest wall and diaphragmatic motion which provides valuable dynamic information to aid radiological assessment in these highly variable patients. We also propose a novel method for fully automated extraction of the diaphragm motion which can provide an additional tool to aid radiologists in making the distinction between expected and adverse postoperative pathologies.  

Bilal A Tahir^1,2, Laurie J Smith¹, Joshua R Astley^1,2, Michael Walker¹, Alberto M Biancardi¹, Guilhem J Collier¹, Paul J Hughes¹, Helen Marshall¹, and Jim M Wild^1
1POLARIS, University of Sheffield, Sheffield, United Kingdom, ²Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom

Several methods of mapping regional ventilation from multi-inflation ¹H-MRI have been proposed, potentially transforming ¹H-MRI from a structural modality into one that can image and quantify pulmonary ventilation. However, their physiological accuracy and sensitivity to lung inflation level is an ongoing research question. Here, we compare surrogates of regional ventilation, derived from non-contrast inspiratory and expiratory breath-hold 3D gradient-echo ¹H-MRI with hyperpolarized ³He-MRI, pulmonary functions tests and multiple-breath washout in a cohort of cystic fibrosis patients with a range of disease severity and age. We observed moderate to strong correlations with all lung function measures and ³He-MRI.

William J Garrison¹, G Wilson Miller^1,2, Kun Qing², Y Michael Shim³, Jaime F Mata², Mu He³, Talissa A Altes⁴, Joanne M Cassani⁴, Sarah E Struchen², Roselove N Nunoo-Asare², Nicholas J Tustison², Alan M Ropp², and John P Mugler III^1,2
1Biomedical Engineering, University of Virginia, Charlottesville, VA, United States, ²Radiology and Medical Imaging, University of Virginia, Charlottesville, VA, United States, ³Medicine, University of Virginia, Charlottesville, VA, United States, ⁴Radiology, University of Missouri, Columbia, MO, United States

Same-session repeatability of quantitative measures of gas uptake derived from MRI of inhaled hyperpolarized ¹²⁹Xe was assessed in healthy and COPD subjects, as well as the impact of scan-to-scan lung volume differences on measured gas uptake. Strong tissue-to-gas and RBC-to-tissue repeatability was found in same-day dissolved-phase ¹²⁹Xe MRI scans performed at one-third of forced vital capacity, and regressing out scan-to-scan lung volume changes improved repeatability further. COPD subjects displayed similar or better repeatability when compared with healthy subjects.

Mary A. Neal^1,2, Benjamin J. Pippard^1,2, Kieren G. Hollingsworth^1,2, A. John Simpson², and Peter E. Thelwall^1,2
1Newcastle Magnetic Resonance Centre, Newcastle University, Newcastle upon Tyne, United Kingdom, ²Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom

¹⁹F-MRI of inhaled perfluoropropane (PFP) permits regional assessment of pulmonary ventilation. Dynamic multi-breath PFP wash-in and wash-out images were acquired in one healthy volunteer and two patients with chronic obstructive pulmonary disease (COPD) during short successive breath holds, using a repeated 3D ¹⁹F-SPGR sequence accelerated with compressed sensing. Resultant image quality achieved in each 7.5s compressed sensing acquisition dynamic was sufficient for segmentation and permitted visualisation of a case of gas trapping secondary to apical predominant emphysema. A strong negative correlation between regional wash-in and wash-out rates and spirometric indices was measured.

Seokwon Lee¹, Jinil Park², Hyonha Kim¹, Ho Yun Lee³, and Jang-Yeon Park^1,4
1Department of Biomedical Engineering, Sungkyunkwan University, Suwon, Korea, Republic of, ²Biomedical Institute for Convergence at SKKU, Sungkyunkwan University, Suwon, Korea, Republic of, ³Department of Radiology and Center for Imaging Science, Samsung Medical Center, Seoul, Korea, Republic of, ⁴Department of Intelligent Precision Healthcare Convergence, Sungkyunkwan University, Suwon, Korea, Republic of

Chronical Obstructive Pulmonary Disease (COPD) is an obstructive lung disease and mainly consists of emphysema and chronic bronchitis. Recent works proposed for the quantitative evaluation of emphysema severity based on the signal intensity of UTE lung images. Through this study, MRI, as well as CT, can represent the defect region for the ventilation defect region, and furthermore, the degree of the lesion and the ventilation function of the lungs can be evaluated such as ventilation map, ventilation flow map and histogram. The potential of methods was validated by ventilation map, ventilation flow map and ventilation histogram in emphysema patient.

Joshua R Astley^1,2, Alberto M Biancardi¹, Helen Marshall¹, Laurie J Smith¹, Guilhem J Collier¹, Paul J Hughes¹, Michael Walker¹, Matthew Q Hatton², Jim M Wild¹, and Bilal A Tahir^1,2
1POLARIS, University of Sheffield, Sheffield, United Kingdom, ²Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom

We evaluate a fully-automated generalizable deep learning (DL) approach for lung segmentation using a 3D convolutional neural network on a large and diverse proton (¹H) MRI dataset, containing images acquired at different resolutions and inflation levels. The dataset comprised of 336 ¹H-MR images from healthy subjects and patients with respiratory diseases. Our trained model was able to accurately segment scans of markedly different resolutions (3x3x3mm³, 4x4x5mm³ and 4x4x10mm³), achieving a mean±SD Dice similarity coefficient of 0.94±0.02. In addition, it was shown that DL generates more accurate segmentations compared to state-of-the-art solutions.