Yajie Wang¹, Ming Xiao², Canhong Xiang², Yuewei Zhang², Haikun Qi³, Yishi Wang⁴, Jiahong Dong², and Huijun Chen^1
1Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China, ²Hepato-pancreato-biliary Center, Beijing Tsinghua Changgung Hospital, School of Medicine, Tsinghua University, Beijing, China, ³School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom, ⁴Philips Healthcare, Beijing, China

T1 mapping combined with MR contrast agent administration has been applied to evaluate the liver function. However, conventional liver T1 mapping techniques have some limitations, such as the need of breath-holding, limited slice coverage or the need of multiple acquisitions. In this study, a free-breathing whole liver T1 mapping technique was proposed using a single scan. Preliminary results in patients with HCCA demonstrated its great potential for T1 quantification of the liver and liver function estimation.

Lihua Chen¹, Ailian Liu¹, Qingwei Song¹, and Lizhi Xie^2
1The First Affiliated Hospital of DaLian Medical University, DaLian , China., Dalian, China, ²GE Healthcare China, Beijing, China, Beijing, China

Treatment options differ significantly between ICC and HCC; the only curative treatment option for ICC is surgical resection, whereas for HCC, liver transplantation, percutaneous ethanol injection, and radiofrequency ablation are available. So, it is very important to accurately distinguish between these two tumors before therapy is planned. The purpose of this study is to evaluate and compare the FA value of DTI and the ADC value of DWI in ICC and HCC.

Zhijun Geng¹, Yunfei Zhang², Chuanmiao Xie¹, and Yongming Dai^2
1Sun Yat-sen University Cancer Center, Guangzhou, China, ²Central Research Institute, United Imaging Healthcare, Shanghai, China

Susceptibility weighted imaging (SWI) has shown tremendous clinical potential in visualizing the micro-haemorrhage, calcification, neovascularization and so forth, which serve as important micro-structural manifestations during the carcinogenesis. Radiomics is of great significance for providing valuable quantitative image markers via high throughput feature extraction. However, hardly have the radiomics been applied for extracting the quantitative markers from SWI images. This research, hence, aims to extract the diagnostic markers from the SWI images for evaluating several important prognostic markers of hepatocellular carcinoma including histopathologic grade, microvascular invasion (MVI) as well as the expression status of cytokeratin 7, cytokeratin 19 and Glypican-3.

Dahua Cui¹, Ailian Liu¹, Hongkai Wang², Mingrui Zhuang², Ying Zhao¹, and Qingwei Song^1
1The First Affiliated Hospital of Dalian Medical University, Dalian, China, ²Dalian University of Technology, Dalian, China

The aim of this study was to explore the value of intratumoral susceptibility signal intensities (ITSS) in quantitatively and automatically evaluating histological grading of hepatocellular carcinoma (HCC) by using enhanced T2 star-weighted angiography (ESWAN). The results showed that quantitative ITSS providied a promising differential performance (AUC = 0.812, P< 0.0001, sensitivity of 83.33%, specificity of 66.67%) in automatically evaluating histological grading of HCC.

Ying Zhao¹, Ailian Liu¹, Wenjing Qi², Xue Ren¹, Tao Lin¹, and Qingwei Song^1
1The First Affiliated Hospital of Dalian Medical University, Dalian, China, ²Department of Pathology, The First Affiliated Hospital, Dalian Medical University, Dalian, China

Cytokeratin 19 (CK19) is well acknowledged as a biliary/progenitor cell marker and a marker of tumor stem cell. CK19-positive HCCs demonstrate more aggressive behaviors and poorer outcomes. This worked aimed at exploring the value of intravoxel incoherent motion (IVIM) diffusion-weighted (DW) magnetic resonance (MR) imaging in the diagnosis of CK19-positive HCC. The results showed that Slow ADC Mono and Slow ADC Bi were significantly different between the CK19-positive and CK19-negative HCC groups. The area under the curves (AUCs) of Slow ADC Mono, Slow ADC Bi, and combine (Slow ADC Mono & Slow ADC Bi) were 0.817, 0.988, and 0.992, respectively.

Changjun Ma¹, Ailian Liu¹, Dahua Cui¹, Ying Zhao¹, Hongkai Wang², and Mingrui Zhuang^2
1Radiology Department, The First Affiliated Hospital of Dalian Medical University, Dalian, China, Dalian,China, China, ²the School of Biomedical Engineering, Dalian University of Technology, Dalian,China, China

The aim of this study was to explore the value of intratumoral susceptibility signal intensities (ITSS) in quantitatively and automatically differentiating intrahepatic cholangiocarcinoma (ICC) from hepatocellular carcinoma (HCC) using enhanced T2 star-weighted angiography (ESWAN). The results showed that quantitative ITSS could provide a promising differential performance (AUC = 0.927,  sensitivity = 85%, specificity = 92.3%) in quantitatively differentiating ICC from HCC. 

Junying wang¹, Weiqiang Dou², Xiaoyi He³, and Hao Shi^4
1Medical Imaging, Shandong Provincial Qianfoshan Hospital, the First Hospital Affiliated with Shandong First Medical University, Jinan, China, ²GE Healthcare, MR Research China, Bejing,, Beijing, China, ³Medical Imaging, Shandong Provincial Qianfoshan Hospital, the First Hospital Affiliated with Shandong First Medical University, Jinan, Shandong, China, ⁴Shandong Provincial Qianfoshan Hospital, the First Hospital Affiliated with Shandong First Medical University, Jinan, Shandong, China

Diffusion kurtosis imaging (DKI) is able to describe the deviations of water molecules diffusion from Gaussian form and depict the microstructural environment precisely. Previous study applied DKI in assessing the therapeutic response of Transcatheter Arterial Chemoembolization (TACE) in Hepatocellular Carcinoma (HCC), and showed promising results. On this basis, this study further explored the clinical value of DKI in assessing liver cancer and tumoral cell invasion of peritumoral zone between HCC progressive group and pseudo-progressive group after TACE treatment, in order to provide new ideas for clinical follow-up. 

Shan Yao¹, Yi Wei¹, Zheng Ye¹, and Bin Song^1
1Department of Radiology, West China Hospital, Sichuan University, Chengdu, China

Hepatocellular carcinoma (HCC) is the most common malignancy cancer and the second major contributor to cancer-related mortality worldwide. Diffusion-weighted imaging (DWI) has been widely used in HCC evaluation  and showed great potential, while with some limitations like low SNRs and artifacts causing by high b values, and prolonged acquisition time. Synthetic DWI is mathematically derived from directly acquired DWI with at least two different b-values, which may tackle the limitations of conventional acquired DWI. This study aims to investigate the clinical feasibility and diagnosis performance of synthetic DWI in patients with HCC compared with conventional acquired DWI qualitatively and quantitatively.

Huanhuan Chen¹, Ailian Liu¹, Ying Zhao¹, Qingwei Song¹, Xin Li², Yan Guo², and Tingfan Wu^2
1The First Affiliated Hospital of Dalian Medical University, Dalian, China, ²GE Healthcare, Shanghai, China

Hepatocellular carcinoma (HCC) is the most common primary liver cancer, and surgical resection has been regarded as the most effective treatment of HCC; however, the high postoperative recurrence rate leads to poor prognosis. Microvascular invasion (MVI) is a risk factor for postoperative recurrence of HCC [1]. This study aimed to investigate the value of intravoxel incoherent motion (IVIM) and enhanced T2 star weighted angiography (ESWAN) for prediction of MVI in HCC.

Ying Zhao¹, Ailian Liu¹, Wenjing Qi², Xue Ren¹, Tao Lin¹, and Qingwei Song^1
1The First Affiliated Hospital of Dalian Medical University, Dalian, China, ²Department of Pathology, The First Affiliated Hospital, Dalian Medical University, Dalian, China

Dual-phenotype hepatocellular carcinoma (DPHCC) is associated with high rate of post-operative recurrence and low rate of survival. This worked aimed at exploring the value of susceptibility weighted imaging (SWI) quantitative parameters for diagnosis of DPHCC. The results showed that R2* provided a promising performance (AUC = 0.830, sensitivity = 85.0%, specificity = 77.3%) in quantitatively evaluating DPHCC.

LI SHAO PENG¹, DENG KE XUE¹, and WANG PENG^2
1Department of Radiology, The First Affiliated Hospital of USTC, Southern District of Anhui Provincial Hospital, Hefei, China, ²The First Affiliated Hospital of USTC, Southern District of Anhui Provincial Hospital, hefei, China

To investigate the MRI technique based on the sequence of IDEAL-IQ (iterative decomposition of water and fat with echo asymmetry and least squares quantification sequence) in differential diagnoses between Hepatocellular Carcinoma with Negative Alpha Fetal Protein and Hepatic Focal Nodular Hyperplasia (FNH).The fat fraction and R2* value measured by IDEAL-IQ sequence are useful to distinguish HCC with Negative Alpha Fetal Protein from FNH.

Andor Veltien¹, Sjaak van Asten¹, Nia Ravichandran¹, Robin de Graaf², Henk de Feyter², Jeannette Oosterwijk³, Egbert Oosterwijk³, and Arend Heerschap^1
1Medical Imaging, Radboud UMC, Nijmegen, Netherlands, ²Radiology and biomedical imaging, Yale University, New Haven, CT, United States, ³Urology, Radboud UMC, Nijmegen, Netherlands

Increased glucose and choline uptake are hallmarks of cancer. In this study we demonstrated that it is possible to follow the uptake and to image the presence of [2H9]choline in tumors after a bolus administration of this compound. In addition we demonstrated the successful performance of DMI simultaneously of [2H9]choline and of [6,6 2H2]glucose. As DMI of glucose uptake and its metabolic conversions has been shown to be feasible in patients, the simultaneous performance of choline DMI next to glucose DMI is an important complementary extension with clinical potential.
 

Ting Jiang¹, Diego Hernando², Scott B. Reeder², and Jin Wang^1
1Radiology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China, ²University of Wisconsin, Madison, WI, United States

Hepatocellular carcinoma (HCC) is the third most common cause of cancer-related mortality. Microvascular invasion (MVI) of HCC is a major prognostic factor that influences treatment strategy and long-term survival, but it is difficult to identify MVI until the tumor is surgically removed and analyzed histologically. Both DCE-MRI and Chemical shift encoded (CSE) MRI can be used to evaluate of HCC in clinical practice. Using CSE-MRI, we found a high percentage of elevated peritumoral R2* on quantitative R2* maps with MVI-positive patients compared to MVI-negative patients. CSE-MRI has the potential to assess MVI of HCC preoperatively.

Guangzi Shi¹, Hong Chen¹, Weike Zeng¹, Mengzhu Wang², and Jun Shen^1
1Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China, ²Department of MR Scientific Marketing, Siemens Healthineers, Guangzhou, China

R2* derived from multi-echo Dixon imaging is a potential biomarker to differentiate malignant from benign FFLs. R2* value of malignant FLLs was significantly higher than that of the benign FLLs.  The multi-echo Dixon sequence is easy to perform and required only a single breath-hold of 16 s to image the entire liver, which holds a good potential for clinical application.

Fu Shen¹, Xiaolu Ma¹, and Fangying Chen^1
1Changhai Hospital, Shanghai, China

In the current study, we evaluated Imaging and genomic data for patients with Microsatellite instability high (MSI-H) metastatic colorectal carcinoma (mCRC) to determine whether Radiomics Based on MRI could be used to select the patients with MSI-H status. Using the pretreatment MRI data, we developed a radiomics model with excellent performance for individualized, noninvasive prediction of MSI-H in patients with mCRC and potentially guide treatment.

Lei Zhang¹, Bei Zhang¹, and Xiuzheng Yue^2
1First Hospital of Jilin University, Changchun, China, ²Philips Healthcare, Beijing, China

Whole-body diffusion-weighted imaging (WB-DWI) in the evaluation of bone marrow infiltration in multiple myeloma, and it will be a helpful supplement to the evaluation of multiple myeloma. 

Huazheng Dong¹, Wenyang Huang², Xiaodong Ji³, Shuang Xia³, Zhiwei Shen⁴, Dehui Zou², Wen Shen³, and Zhiyi Song^1
1Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, China, Tianjin, China, ²State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Diseases Hospital, CAMS and PUMC, Tianjin 300020, China, Tianjin, China, ³Tianjin First Central Hospital Affiliated To Nankai University, Tianjin, China, Tianjin, China, ⁴Philips healthcare，Beijing， China, Beijing, China

For patients with newly diagnosed multiple myeloma, red marrow reconversion caused by anemia is  common,its hyperintense signal on DWI image could affect the evaluation , because it is very similar with the diffusion signal in focal lesions.  We aim to evaluate the efficacy prediction of early treatment response in MM patients with and without anemia based on the tumor burden score (TBS), ADC value and signal fat fraction (sFF). We found that early treatment response of MM could be predicted in patients without anemia using TBS, ADC and sFF,  anemia is a factor which must be taken into consideration in  evaluation.

Ghoncheh Amouzandeh¹, Kevin A Heist¹, Dariya I Malyarenko¹, Youngsoon Jang¹, Tanner Robison¹, Christopher Bonham¹, Cyrus Amirfazli¹, Scott D Swanson¹, Gary D Luker¹, Brian D Ross¹, and Thomas L Chenevert^1
1Radiology, University of Michigan, Ann arbor, MI, United States

This study assesses the use of non-invasive MRI to monitor evolution and treatment of Myelofibrosis (MF) in both clinical and pre-clinical settings to quantify disease progression and treatment efficacy. Based on a limited number of studies, MRI can detect changes in the bone marrow fat distribution and fibrosis caused by the progression and treatment of MF. This work seeks quantitative measures such as proton density fat fraction, magnetization transfer and diffusion weighted imaging to investigate proportions of fat, cellularity and fibrosis in bone marrow caused by MF.

Pengyang Feng¹, Nan Meng², Zhun Huang¹, Ting Fang², Fangfang Fu³, Yaping Wu³, Wei Wei³, Yan Bai³, Jianmin Yuan⁴, Yang Yang ⁵, Hui Liu ⁶, and Meiyun Wang*^1,2
1Department of Radiology, Henan University People’s Hospital & Henan Provincial People’s Hospital, Zhengzhou, China, ²Department of Radiology, Zhengzhou University People’s Hospital & Henan Provincial People’s Hospital, Zhengzhou, China, ³Department of Radiology, Henan Provincial People’s Hospital, Zhengzhou, China, ⁴Central Research Institute, UIH Group, Shanghai, China, ⁵Central Research Institute, UIH Group, Beijing, China, ⁶UIH America, Inc, Houston, TX, United States

PET-MR is a new multi-modal imaging system that organically integrates PET and MRI. SUVmax is the most commonly used semi-quantitative index to measure how much 18F-FDG is taken up by the lesion. Intravoxel incoherent motion (IVIM), including D, D*, f values, provide parameters for the movement of tissue water molecules and parameters for the degree of tissue perfusion. Our results show that SUVmax and IVIM have similar diagnostic performance in the diagnosis of lung squamous and adenocarcinoma.

Puneet Bagga¹, Jeffrey Steinberg², Walter Akers², Matthew Scoggins¹, Zoltan Patay¹, Beth McCarville¹, Burkhard Hoeckendorf³, Khaled Khairy³, Michael Dyer³, and Beth Stewart^3
1Department of Diagnostic Imaging, St Jude Children's Research Hospital, Memphis, TN, United States, ²Center for In Vivo Imaging and Therapeutics (CIVIT), St Jude Children's Research Hospital, Memphis, TN, United States, ³Department of Developmental Neurobiology, St Jude Children's Research Hospital, Memphis, TN, United States

A recent development in multi-modality treatment with poly ADP-ribose polymerase inhibitors (PARPi’s) combined with DNA damaging agents (temozolomide), is increasingly recognized as an important approach for curing or prolonging survival in patients with recurrent Ewing sarcoma (EWS). In this study, we employed multimodal quantitative imaging methods to predict treatment response in EWS. We used T2-weighted MRI, diffusion-weighted MRI, and ¹H MRS in a patient derived xenograft model of EWS. We envisage that multi-parametric MR indices will be able to evaluate the treatment response and predict treatment response in the tumors.