Bin Lin¹, WenHai Dai¹, JiaYan Chen¹, YangDong Zeng¹, ZhiPeng Zhou¹, Long Qian², and Weiyin Vivian Liu^2
1Department of Radiology,Affiliated Hospital of Guilin Medical University, Guilin, China, ²MR Research, GE Healthcare, Beijing, China

Hypointensity in the hepatobiliary phase is an important ancillary feature in the diagnosis of liver malignancies in the version 2018 of LI-RADS. In this study, Hypointensity in the hepatobiliary phase was used as the major features to explore the effect of hepatobiliary hypointensity on the diagnosis performance of LI-RADS in small hepatocellular carcinoma (sHCC). Our results indicated that the sensitivity of diagnosing sHCC can be significantly improved without affecting the specificity of diagnosing sHCC when Hypointensity in the hepatobiliary phase was used as the major features for classification of LR-3,LR-4.

RYUJI SHIMADA¹, Keitaro Sofue², Yuichiro Somiya¹, Tomohiro Noda¹, Shintaro Horii¹, Yoshiko Ueno², Naoki Yoshida¹, Wakiko Tani¹, Yu Ueda³, Akiko Kusaka¹, and Takamichi Murakami^2
1Center of Radiology and Radiation Oncology, Kobe University Hospital, Kobe, Japan, ²Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan, ³MR Clinical Science, Philips Japan, Tokyo, Japan

We prospectively evaluated the effect of injection rates on TIC analysis in free-breathing gadoxetic acid-enhanced MRI using radial sampling with KWIC reconstruction with different injection rate of 1, 2, and 3 mL/s in 48 patients. Time intensity curve analysis was performed and compared among the three injection rate groups. Time to peak in abdominal aorta was significantly shorter with higher injection rates, and the other parameters regarding portal vein, inferior vena cava, and liver parenchyma were not affected by the injection rates. Higher injection rate is recommended for the better discrimination on arterial input data.

Masaya Tanabe¹, Masahiro Tanabe¹, and Katsuyoshi Ito^1
1Yamaguchi University, Ube City, Japan

In the analysis of the hepatic contrast enhancement parameters based on continuous data of the signal changes over time obtained by free-breathing continuous multiphasic dynamic EOB-MR imaging using compressed sensing and self-gating technique, contrast enhancement ratio (CER) in the portal phase and 5min early hepatocyte phase had significant correlation with hepatic contrast enhancement effects in the 20min hepatobiliary phases and showed significant difference between sufficient and insufficient hepatobiliary phases enhancement groups, suggesting that sufficient 20min hepatobiliary phases enhancement may be estimated by the CER in the portal phase and 5min early hepatocyte phase.

Junjiao Hu¹, Weijun Situ¹, and Huiting Zhang^2
1Department of Radiology, the Second Xiangya Hospital of Central South University, Changsha, China, ²MR Scientific Marketing, Siemens Healthcare Ltd., Wuhan, China

This prospective study aimed to compare the image quality of T1w-VIBE sequence using generalized autocalibrating partially parallel acquisitions (GRPPA-VIBE) and controlled aliasing in parallel imaging results in higher acceleration (CAIPIRINHA-VIBE) and the  spatial position consistency of CAIPIRINHA with/without non-rigid 3D-registration motion correction (MOCO) in liver MRI. The results showed that the CAIPIRINHA had better image quality than the GRPPA with respect to respiratory motion artifact suppression, liver edge sharpness and intrahepatic vascular sharpness, and the spatial position consistency of the liver using CAIPIRINHA with MOCO was significantly better than that of images without MOCO.

Hirokazu Otsuka¹, Yoshihiko Fukukura², Takashi Iwanaga¹, Yuichi Kumagae², Yasumasa Saigo¹, Hiroshi Imai³, and Takashi Yoshiura^2
1Kagoshima University Hospital, Kagoshima, Japan, ²Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan, ³Siemens Healthcare K.K., Tokyo, Japan

This study focused on the feasibility of volumetric-interpolated breath-hold examination (VIBE) using compressed sensing (CS) acceleration (CS-VIBE) for the hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI in comparison with conventional VIBE. Our results showed a significantly higher signal-to-noise ratio and contrast-to-noise ratio (CNR) in CS-VIBE than in conventional VIBE. CS-VIBE showed a significantly higher CNR than conventional VIBE, even when decreasing a slice thickness from 1.5 mm to 1.1 mm of CS-VIBE. These results suggested CS-VIBE could replace conventional VIBE with superior CNR and spatial resolution.

Minxiong Zhou¹, Zhongshuai Zhang², Huiting Zhang², Guang Yang³, Jinrong Qu⁴, and Xu Yan^2
1Shanghai University of Medicine & Health Sciences, Shanghai, China, ²MR Scientific Marketing, Siemens Healthcare, Shanghai, China, ³3. Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, China, ⁴Department of Radiology, the Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China

Simultaneously multi-parameter quantification is recently a hot research topic for MRI. A series of techniques are available, such as MR fingerprinting, MAGIC and STAGE. This study proposed a rapid and high-quality T1/T2* quantification method, called TXI. The results showed that it can generate high SNR T1 and R2* maps with less motion artifacts, which is superior to the conventional T1 and R2* mapping method. The T1 map is significantly improved with higher measurement consistency among different liver regions than conventional method.

Yavuz Muslu^1,2, Ty A. Cashen³, Sagar Mandava⁴, and Scott B. Reeder^1,2,5,6,7
1Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, United States, ²Department of Radiology, University of Wisconsin-Madison, Madison, WI, United States, ³Global MR Applications and Workflow, GE Healthcare, Madison, WI, United States, ⁴Global MR Applications and Workflow, GE Healthcare, Atlanta, GA, United States, ⁵Department of Medical Physics, University of Wisconsin-Madison, Madison, WI, United States, ⁶Department of Medicine, University of Wisconsin-Madison, Madison, WI, United States, ⁷Department of Emergency Medicine, University of Wisconsin-Madison, Madison, WI, United States

Gadoxetic acid (GA)-enhanced MRI is an important tool for the detection of liver metastases. Through GA dose optimization and novel pulse sequence strategies, small lesions are often resolved using only high resolution GA-enhanced hepatobiliary phase T1w-MRI. However, such small lesions are often occult in T2w, diffusion weighted imaging (DWI) and dynamic contrast enhanced (DCE) T1w-MRI, which hinders the ability of MRI to characterize these lesions. In this work, we propose the development of a phase sensitive inversion recovery (PSIR) T1w-MRI in combination with 3D radial stack-of-stars imaging for detection and characterization of small focal liver lesions.

Yan Xiong¹, Weiyin Vivian Liu², Tongxiang He¹, Donglin Wen ¹, Fan He¹, and Xiaoming Li^3
1Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China, ²MR Research, GE Healthcare, Beijing, China, ³1Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

Amide proton transfer-weighted (APTw) imaging is a molecular MRI technique that generates image contrast based predominantly on the amide protons in mobile cellular proteins and peptides that are endogenous in tissue. Due to decreased vascular perfusion and increased glycolytic metabolism, tissue hypoxia is usually accompanied by acidosis; however, osteoclasts show significant functional enhancement in hypoxia and acidosis. The present study demonstrates that APT had higher diagnostic performance on identifying the differences of both bone and muscles between patients with different levels of CKD. It may have potential in distinction patients with CKD in accompanied with Mineral bone disease (MBD).

Meng Dou^1,2, Ailian Liu³, Yu Yao^1,2, ZheBin Chen^1,2, Han Wen^1,2, Xu Luo^1,2, and Ying Zhao^3
1Chengdu Institute of Computer Application, Chinese Academy of Sciences, Chengdu, China, ²University of Chinese Academy of Sciences, Beijing, China, ³Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian, China

In clinical practice, it is too expensive to collect large-scale labeled Magnetic Resonance Imaging liver scans which constrains the segmentation performance. However, we noted that plenty of labeled Computed Tomography datasets aimed at liver have been published. Inspired by this, we proposed a deep domain adaptation method which can exploit the published CT datasets to improve the segmentation performance on MRI images. Our experiments showed that the liver segmentation performance is boosted on limited labeled MRI images (20 cases). Lastly, our method achieved competitive performance on both modality images. This work will be benefit to computer-aided diagnosis and treatment planning.

Naoki Ohno¹, Satoshi Kobayashi¹, Tosiaki Miyati¹, Yu Ueda², Masami Yoneyama², and Toshifumi Gabata^1
1Kanazawa University, Kanazawa, Japan, ²Philips Japan, Tokyo, Japan

Although sensitivity encoding (SENSE) technique is commonly used to reduce distortion in diffusion-weighted imaging (DWI), highly accelerated SENSE results in significantly increased noise, leading to systematic errors to the quantification of apparent diffusion coefficient. In this study, we proposed a novel method using compressed sensing combined with a highly accelerated sensitivity encoding (CS-SENSE) to reduce both the distortion and noise in liver DWI. The CS-SENSE demonstrated the higher SNR and reduced geometric distortion compared with conventional SENSE reconstruction. Liver DWI with the proposed method can improve the image quality with better lesion conspicuity.

shuangshuang xie¹, yajie sun¹, caixin qiu¹, jinxia zhu², Elisabeth Weiland³, Bernd Kühn³, and wen shen^1
1Tianjin First Central Hospital, Tianjin, China, ²MR Collaboration, Siemens Healthcare Ltd., Beijing, China, ³MR Application Development, Siemens Healthcare GmbH, Erlangen, Germany

This study investigated the feasibility of optimized breath-hold compressed-sensing accelerated magnetic resonance cholangiography (BH-CS-MRCP) in visualizing the biliary system in living donor liver transplantation (LDLT) donors. Conventional navigator-triggered (NT) MRCP was performed preoperatively, and optimized BH-CS-MRCP was performed both preoperatively and one month after surgery. The optimized BH-CS-MRCP protocol showed similar motion or blurring artifacts, overall image quality, background suppression, and biliary duct depiction compared with conventional NT-MRCP protocols. This suggests that optimized BH-CS-MRCP with a short acquisition time (17 s) can be used for preoperative and postoperative evaluation of biliary ducts in LDLT donors.

Tom Bruijnen^1,2, Tim Schakel¹, Jan Lagendijk¹, Liesbeth Geerts³, Johannes Peeters³, Niels Blanken⁴, Wouter Veldhuis⁴, and Cornelis van den Berg^1,2
1Department of Radiotherapy, University Medical Center Utrecht, Utrecht, Netherlands, ²Computational Imaging Group for MRI diagnostics and therapy, Centre for Image Science, Utrecht, Netherlands, ³BIU MR, Philips Healthcare, Best, Netherlands, ⁴Department of Radiology, University Medical Center Utrecht, Utrecht, Netherlands

Magnetic resonance cholangiopancreatography (MRCP) is crucial for the diagnosis of biliary/pancreatic duct disease. However, conventional respiratory triggered (RT-MRCP) scans require long acquisition times and ultimately fail in patients with irregular breathing. In this work we propose a free-breathing motion corrected MRCP scan (MOCO-MRCP) based on a rewinded Cartesian Acquisition with Spiral Profile ordering (rCASPR). MOCO-MRCP eliminates idle time associated with respiratory triggering, thereby increasing the robustness to motion artefacts while reducing the overall scan time compared to RT-MRCP. We show preliminary results of MOCO-MRCP in three patients with suspected biliary/pancreatic duct disease.

Mehran Baboli¹, Pippa Storey², Terlika Pandit Sood², Justin Fogarty², Melanie Moccaldi², Alana Lewin², Linda Moy², and Sungheon Gene Kim^1
1Radiology, Weill Cornell Medicine, New York, NY, United States, ²Radiology, NYU Langone Health, New York, NY, United States

We assessed the influence of frequency variation on measurements of fatty acid composition in adipose tissue. A 3D bilateral gradient spectroscopic imaging sequence with a simultaneous dual-slab excitation followed by 128 monopolar echoes was used. The sequence included a short train of 12 navigator echoes without phase encoding at the beginning of each TR period to correct frequency variations due to hardware heating and patient respiration. The proposed method was tested in oil phantoms and ten postmenopausal women. Phase correction reduced measurement error in the phantom and spatial variation in estimates of fatty acid composition in vivo.

Aashley S.D. Sardjoe Mishre¹, Maaike E. Straat², Borja M. Martinez-Tellez², Oleh Dzyubachyk³, Mariette R. Boon², Patrick C.N. Rensen², Andrew G. Webb¹, and Hermien E. Kan^1
1Department of Radiology, C.J. Gorter Center for High Field MRI, Leiden University Medical Center (LUMC), Leiden, Netherlands, ²Department of Medicine, Division of Endocrinology and Einthoven Laboratory for Experimental Vascular Medicine, LUMC, Leiden, Netherlands, ³Department of Radiology, Division of Image Processing (LKEB) and Department of Cell and Chemical Biology, Electron Microscopy section, LUMC, Leiden, Netherlands

Brown adipose tissue (BAT) is considered as a potential therapeutic target against cardiometabolic diseases. Activated BAT combusts fatty acids leading to a reduction in fat fraction (FF). Both cold exposure and pharmacological stimuli can activate BAT, but the short-term dynamics of BAT activation are still unknown. To assess supraclavicular BAT (scBAT) FF dynamics during cold-exposure, we developed a 1-minute time resolution MRI protocol using breath-holds and co-registration to minimize motion-artefacts, and tested the protocol in five individuals. Co-registration resulted in low variation (<0.5%) and dynamic FF changes during cooling differed between subjects, possibly due to variable responses to thermoneutral conditions. 

Pandichelvam Veeraiah¹, Lucas Lindeboom^1,2, Kim Brouwers¹, Joachim E Wildberger¹, and Vera B Schrauwen-Hinderling^1,2
1Department of Radiology and Nuclear Medicine, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, Netherlands, ²Nutrition and Movement Sciences, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands

¹H-MRS has been widely used to measure total intrahepatic lipid content, but measuring lipid composition with specifically differentiating saturated, mono- and poly-unsaturated fatty acids in the liver, is challenging. At clinical field strength (3T), the allylic peak is overlapping with the alpha-carbonyl methylene resonance, which we recently addressed with a sophisticated fitting routine. However, this approach is difficult when shimming is suboptimal or in volunteers with low liver fat content (1-2%). Here, we evaluated the in vivo feasibility of J-difference editing, using MEGA-sLASER in the liver, to separate allylic from the alpha-carbonyl resonance for estimation of hepatic lipid composition. 

Kathan A Amin¹, Achille Mileto¹, and Orpheus Kolokythas^1
1Radiology, University of Washington, Seattle, WA, United States

Qualitative assessment of hepatic fat and iron from three radiologists were compared to the quantitative measurements from the mDIXON-quant sequences. There was a robust correlation providing support for the ability to use qualitative assessment to screen patients on routine abdominal MRI exams and recommend further evaluation with specialized quantitative sequences.

Zhaoting Meng¹, Gang Feng¹, Mingxiang Sun¹, Liling Peng¹, Min Zhu¹, Mu Lin², and Xin Gao^1
1Shanghai Universal Medical Imaging Diagnostic Center, Shanghai, China, ²MR Collaboration, Diagnostic Imaging, Siemens Healthineers Ltd., Shanghai, China

Globally, nonalcoholic associated fatty liver (NAFLD) is the predominant chronic liver disease, and it correlates to metabolic syndrome and type 2 diabetes, leading to cardiac and cerebral arteriosclerosis. In 2020, metabolic associated fatty liver disease (MAFLD) was newly defined to clarify the pathogenic mechanisms of this disease and to better guide clinical treatment. We hypothesized that with MAFLD, previously contradictory imaging results could be better explained. Liver MRS and FDG PET imaging were conducted simultaneously on an integrated PET/MR platform, which improved data accuracy. The study also analyzed whether the liver could be used as a reference tissue for PET imaging.

Gen Chen¹, Weiyin Vivian Liu², Hao Tang¹, Lifen Zhou¹, Daoyu Hu¹, and Zhen Li^1
1Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China, ²MR Research, GE Healthcare, Beijing, China, Beijing, China

This study aims to determine sampling strategy (SS) with the fewest regions of interest (ROIs) that could diagnose hepatic steatosis (HS) as reliably as the 9-ROI strategy before liver transplantation in ex vivo. All strategies with ≥5 ROIs had an intraclass correlation coefficients(ICC) ≥ 0.995 and limit of agreement (|LOA|)≤ 1.5%. The average proton density fat-fraction (PDFF) was moderately correlated with the histological diagnosis. The 5-ROI SS obtains similar PDFF results as the 9-ROI strategy before liver transplantation in ex vivo. After further verification, this method may become an available standard to assess HS before liver transplantation in ex vivo.

Snekha Thakran^1,2
1University of Pennsylvania, Philadelphia, PA, United States, ², Indian Institute of Technology Delhi, New Delhi, India, Delhi, India

Curvelet transform is used as a multi-scale level decomposition to represent images. It was hypothesized that curvelet based texture features extraction can improve accuracy of tumor classification. The objective of this study was to differentiate the breast tumor using curvelet based features extraction followed by principal component analysis(PCA) for feature reduction and support vector machine(SVM) classifier. The study included T₁ perfusion MRI data of 40 patients with breast cancer. The curvelet based texture feature using PCA with SVM classifier provided high average accuracy(0.93±0.04) in classification of malignant vs. benign and average accuracy (0.86±0.06) in characterization of high- vs. low-grade.

Zhongbiao Xu¹, Zhenguo Yuan², Yaohui Wang³, Junying Cheng⁴, Rongli Zhang⁵, Ling Xia⁶, Yanqiu Feng⁷, Feng Liu⁸, and Zhifeng Chen^7
1Guangdong Provincial People's Hospital, guangzhou, China, ²shandong medical imaging research institute ，shandong provincial hospital ，afflliated shangdong first medical uinversity, jinan, China, ³Institute of Electrical Engineering, Chinese Academy of Sciences, Beijing, China, ⁴First Affiliated Hospital of Zhengzhou University, zhengzhou, China, ⁵Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hongkong, China, ⁶Department of Biomedical Engineering, Zhejiang University, HangZhou, China, ⁷Southern Medical Southern, guangzhou, China, ⁸School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, Australia

High spatiotemporal resolution DCE-MRI has great clinical value in disease diagnosis and treatment. In this study, we propose to use a video block matching 3-D filtering approach to improve high spatiotemporal resolution DCE-MRI. Both phantom and in vivo experiments were performed in this work. The phantom experiment indicated that the proposed approach outperforms iGRASP and GRASP-Pro methods with lower reconstruction errors, especially in cases involving super high reduction factors. In vivo experiments draw similar conclusion. This new technique can provide a potential solution for real-time imaging and image guided radiation therapy.