Hikaru Fukutomi¹, Xavier Barreau², Lydia Hamitouche², Takayuki Yamamoto¹, Laurent Denat¹, Bei Zhang³, Lijun Zhang⁴, Bruno Triaire⁵, Valentin Prevost⁵, Vincent Dousset^1,2, and Thomas Tourdias^1,2
1Institut de Bio-imagerie IBIO, Université de Bordeaux, Bordeaux, France, ²CHU de Bordeaux, Neuroimagerie diagnostique et thérapeutique, Bordeaux, France, ³Canon Medical Systems Europe, Zoetermeer, Netherlands, ⁴Canon Medical Systems China, Beijing, China, ⁵Canon Medical Systems Corporation, Tochigi, Japan

Delayed post-gadolinium FLAIR can delineate peri- and endo-lymphatic spaces to capture endolymphatic hydrops, the pathological counterpart of Ménière’s disease. However, the four hours delay between injection and acquisition is a burden for patients and staff. No previous work has proposed a satisfying delineation of inner ear internal anatomy without injection yet. This study presents step-by-step 3D-FLAIR optimizations with specific T2 preparation and inversion time to maximize the contrast between peri- and endo-lymphatic spaces. We showed that optimized 3D-FLAIR sequence allowed delineating saccule and utricle in healthy volunteers without injection, paving the way toward future application to diagnose Meniere disease.

Timothy Bray^1,2, Alan Bainbridge^1,3, Susan Jawad², Sofia Otero², Timothy J Beale², Sumandeep Kaur², Mark McGurk⁴, Margaret A Hall-Craggs^1,2, and Simon Morley^2
1Centre for Medical Imaging, University College London, London, United Kingdom, ²Department of Imaging, University College London Hospital, London, United Kingdom, ³Medical Physics, University College London Hospital, London, United Kingdom, ⁴Head and Neck Academic Centre, University College London, London, United Kingdom

Injury to the facial nerve is a major risk during parotid surgery; pre-operative identification of its course is key to minimising complications. Unfortunately, conventional MRI sequences offer insufficient resolution whilst conventional ‘positive-contrast’ neurographic methods suffer from artifacts and inconsistent quality. We propose an approach to imaging the extracranial facial nerve at high resolution using variable flip angle turbo spin echo imaging. This method depicts the nerve as a low-signal structure (‘black nerve’) against the high-signal parotid parenchyma (‘white parotid’). We show that this ‘negative-contrast’ method outperforms a widely-used positive-contrast neurographic sequence and might be further improved using gadolinium-based contrast agent. 

Xiaohan Song¹, Lijun Wang¹, Ailian Liu¹, Jiazheng Wang¹, and Lihua Chen^1
1the First Affiliated Hospital of Dalian Medical University, Dalian, China

Neck malignant tumors is the seventh most common cancer in the world and the ninth most common cause of cancer death. Meanwhile, challenges remain in the differential diagnosis of benign and malignant tumors in the neck. In this study, we explored the value of APTw imaging in the differential diagnosis between malignant and benign neck tumors. Results showed significantly higher APTw values in the malignant tumors than in benign tumors (AUC=0.882, P=0.006), suggesting APT a promising non-invasive method in the differentiation of the neck malignant and benign tumors.

David Volders¹, James Rioux¹, Steven Beyea¹, Chris V Bowen², and Elena Adela Cora^1
1Diagnostic Radiology, Nova Scotia Health, Halifax, NS, Canada, ²Diagnostic Imaging, Nova Scotia Health, Halifax, NS, Canada

Evaluation of temporal bone MRI scans using a 0.5T high performance gradient head only system reveals high quality visualization of clinically relevant structures using 3D bSSFP imaging.

Dadi Zhao^1,2, James T. Grist^1,2, Heather E.L. Rose^1,2, Huijun Li², Lesley MacPherson², Yu Sun^1,2, and Andrew C. Peet^1,2
1Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom, ²Department of Oncology, Birmingham Children's Hospital, Birmingham, United Kingdom

Multi-modal functional imaging is expected to improve the classification of childhood brain tumours. Forty-three patients with a confirmed childhood brain tumour were enrolled in this 1.5T multi-modal functional imaging study. Short-echo proton magnetic resonance spectroscopy (¹H-MRS) and diffusion weighted imaging (DWI) were acquired and analysed through multi-class receiver operating characteristics for feature selection and a wavelet-based data-driven framework for ¹H-MRS noise suppression. The balanced classification accuracy across the three tumour types was improved to 95% through linear discriminant analysis by combining DWI and noise-suppressed ¹H-MRS, showing improved from 84% through only DWI and 88% through only noise-suppressed ¹H-MRS.

Yoshimi Anzai¹, John A Roberts², Seong-Eun Kim², Ying Hitchcock³, Richard Wiggins¹, Nousheen Alasti², and Eugene Kholmovski^2
1Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT, United States, ²UCAIR, Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT, United States, ³Radiation oncology, University of Utah, Salt Lake City, UT, United States

This prospective, single-arm, cohort patients study with a newly diagnosed head&neck cancer aims to demonstrate the feasibility of multiparametric MRI to reveal tumor hypoxia and treatment failure. Although tumor hypoxia is a critical physiologic feature related to treatment resistance and poor outcomes, effective imaging technology to detect the area of hypoxia in an individual patient is lacking. Incorporating multiparametric maps into cross-sectional imaging is critically essential for translating imaging information to radiation dose paining. We generated the composite color map incorporating oxygen-enhanced BOLD, ADC, and FDG-PET and correlated it with CRT response at 3 months, as a proof of concept.

Qing Fu^1,2, Xiang-chuang Kong^1,2, Ding-xi Liu^1,2, Yi-hao Guo³, Kun Zhou⁴, Zi-qiao Lei^1,2, and Chuan-sheng Zheng^1,2
1Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China, ²Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China, Wuhan, China, ³MR Collaboration, Siemens Healthcare Ltd., Guangzhou, China., Guangzhou, China, ⁴Siemens Shenzhen Magnetic Resonance Ltd., Shenzhen, China., Shenzhen, China

2D Turbo gradient and spin echo BLADE diffusion-weighted imaging (TGSE-BLADE-DWI) has been shown to improve image quality by reducing geometric distortions and susceptibility artifacts for middle ear cholesteatomas and optic neuritis; however, its use in depicting orbital tumors is still unknown. The results of this study demonstrated that TGSE-BLADE-DWI could provide significantly better image quality and comparable diagnostic performance for characterizing orbital tumors.

Qing Fu^1,2, Xiang-chuang Kong^1,2, Ding-xi Liu^1,2, Yi-hao Guo³, Kun Zhou⁴, Zi-qiao Lei^1,2, and Chuan-sheng Zheng^1,2
1Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China, ²Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China, Wuhan, China, ³MR Collaboration, Siemens Healthcare Ltd., Guangzhou, China., Guangzhou, China, ⁴Siemens Shenzhen Magnetic Resonance Ltd., Shenzhen, China., Shenzhen, China

   Geometric distortions and ghosting artifacts are found at bone-air interfaces using conventional diffusion-weighted imaging (DWI), which is a challenge for imaging cerebellopontine angle (CPA) tumors. Our study validated that geometric distortions and ghosting artifacts were not present on 2D turbo gradient- and spin-echo-BLADE-DWI scans, making this technique useful for visualizing CPA anatomic structures and diagnosing CPA tumors.

Yutaka Hamatani¹, Kayoko Abe², Masami Yoneyama³, Jaladhar Neelavalli⁴, Yasuhiro Goto¹, Isao Shiina¹, Kazuo Kodaira¹, Takumi Ogawa¹, Mamoru Takeyama¹, Isao Tanaka¹, and Shuji Sakai^2
1Department of Radioligical Services, Tokyo Women's Medical University Hospital, Tokyo, Japan, ²Department of Diagnostic imaging & Nuclear Medicine, Tokyo Women's Medical University Hospital, Tokyo, Japan, ³Philips Japan, Tokyo, Japan, ⁴Philips Healthcare, Bangalore, India

IRIS (Image Reconstruction using Image-space Sampling Function) is a DWI sequence for Multi shot (Mhs) echo planar imaging (EPI) with phase correction. The purpose of this study is to investigate the usefulness of IRIS for optic nerve, in which SSh EPI-DWI tends to show poor image quality due to magnetic susceptibility artifacts. As a result of comparing image quality among Single shot (SSh) EPI-DWI, SSh turbo spin echo (TSE)-DWI, MSh TSE-DWI, and IRIS, IRIS was the best sequence to visualize the optic nerve. IRIS suppressed magnetic susceptibility artifacts most clearly, and can provide excellent contrast with high robustness.

Hirotaka Ikeda¹, Yoshiharu Ohno¹, Kaori Yamamoto², Kazuhiro Murayama³, Masato Ikedo², Masao Yui², Satomu Hanamatsu¹, Akiyoshi Iwase⁴, Takashi Fukuba⁴, and Hiroshi Toyama^1
1Radiology, Fujita Health University School of Medicine, Toyoake, Japan, ²Canon Medical System Corporation, Otawara, Japan, ³Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Japan, ⁴Fujita Health University Hospital, Toyoake, Japan

There have been no major reports for assessing the utility of Compressed Sensing (CS) with Parallel Imaging (PI) as compared with routinely applied conventional PI for head and neck MR imaging.  We hypothesized that a newly developed CS with PI could shorten examination time and improve the image quality for head and neck MR imaging as compared with conventional PI.  The purpose of this study was to directly compare the capability for examination time shortening and image quality improvement of head and neck 3T MR imaging between CS with PI and conventional PI.

Heng Zhang¹, Shudong Hu¹, Weiqiang Dou², and Weiyin Vivian Liu^2
1Department of Radiology, Affiliated Hospital, Jiangnan University, Wuxi, China, ²GE Healthcare, MR Research, Bejing, China

76 patients with pathologically confirmed papillary thyroid carcinoma (PTC) underwent preoperative thyroid T2-weighted (T2WI) MRI examination in this retrospective study. Using texture analysis for acquired T2WI imaging, entropy was found significantly higher in PTC patients with extrathyroidal extension (ETE) than without ETE, and thus considered an independent index for predicting PTC patients with ETE. With this finding, we therefore consider that preoperative T2WI-based texture features may be valuable for identifying ETE status in PTC patients and may help customize treatment strategies.

Yanjun Wang¹, Shenghong Ju¹, Jilei Zhang², and Yuancheng Wang^1
1Radiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China, ²Philips Healthcare, Greater China, Shanghai, China

This study aimed to assess the clinical importance of 3D-FLAIR MR imaging in sudden sensorineural hearing loss (SSNHL) for head and neck radiologists and otolaryngologists. A novel MR protocol based on 3D-FLAIR and detailed clinical examinations were conducted among 60 patients. The results showed that the 3D-FLAIR MR protocol could identify the proper causes of SSNHL and reflect the severity of hearing loss, and the combination of clinical and MR features is beneficial for the prognostic evaluation of unilateral SSNHL, mainly for SSNHL with no recovery and complete recovery.

Zhiqiang Li¹, Sharmeen Maze¹, and John P Karis^1
1Neuroradiology, Barrow Neurological Institute, Phoenix, AZ, United States

DWI helps reveal many neurological disorders. However, its application in the optic nerve and pituitary gland is hindered by strong distortion artifacts associated with ssEPI, the method of choice for clinical DWI. Recently, IRIS (an msEPI sequence) and SPLICE-PROPELLER (a distortion-free technique) have become available in the clinic. In this work, we develop and optimize DWI protocols for imaging the optic nerve and pituitary gland. Volunteer studies and patient scans demonstrate immunity to geometric distortions, and good overall image quality with clinically friendly scan times.

Haonan Zhang¹, Qingwei Song¹, Jiazheng Zhang², Yishi Wang², Renwang Pu¹, Nan Zhang¹, and Ailian Liu^1
1Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian, China, ²PHILIPS——Philips Healthcare, beijing, China

Compared with echo planar imaging diffusion weighted iamging (EPI-DWI), turbo spin echo diffusion weighted imaging (TSE-DWI) can significantly reduce magnetic sensitivity artifacts in skull base imaging. However, the longer scan time limits its clinical promotion. The purpose of this study is to investigate the effect of the compression sensing acceleration factor on the image quality of TSE-DWI in the skull base area.

Zhen MA¹, Xin ZHAO¹, Kaiyu Wang², and Jinxia Guo^3
1The Third Affiliated Hospital of Zhengzhou University, Zhengzhou City, China, ²GE Healthcare, MR Research China,, Beijing, China, ³GE Healthcare, MR Research China, Beijing, China

Retrospective analysis of patients with brain MRI examination and confirmed by pathology, respectively in three groups of MR ADC axial images, using Mazda software to delineate the region of interest at each level of the tumor, and carry out gray-scale global histogram analysis, and statistical analysis of the three groups of histogram parameter characteristics.The nine parameters, mean, variance, kurtosis, skewness, perc. 01%, perc. 10%, perc. 50%, perc. 90% and perc. 99% were obtained by gray histogram analysis (P < 0.05). 

Timothy Bray^1,2, Ruaridh Gollifer^1,3, Simon Morley², Susan Jawad², Roganie Govender⁴, Stuart A Taylor^1,2, Nicholas Hamilton⁴, and David Atkinson^1
1Centre for Medical Imaging, University College London, London, United Kingdom, ²Department of Imaging, University College London Hospital, London, United Kingdom, ³Medical Physics, University College London Hospital, London, United Kingdom, ⁴Head and Neck Academic Centre, University College London, London, United Kingdom

Swallowing dysfunction (dysphagia) is a common problem and a major cause of morbidity in patients who have undergone radiotherapy for head and neck cancer. However, the pathophysiological basis of dysphagia in these patients is poorly understood and may differ between patients, creating a barrier to developing effective treatment strategies. Improved (and ideally quantitative) methods for characterising swallow function are therefore needed. We describe a method for imaging and analysis of pharyngeal and laryngeal motion during the swallow, based on joint image registration and modelling of intensity changes over a dynamic image series.

Yuhui Qin^1,2, Xiaoping Yu², Jing Hou², and Fabao Gao^1
1Department of Radiology, West China Hospital, Chengdu, China, ²Department of Radiology, Affiliated Cancer Hospital of Xiangya School of Medicine, Changsha, China

Although several studies have demonstrated that DCE-MRI is helpful in predicting the short-term therapeutic response for NPC, the relationship between the quantitative parameters and texture features (based on DCE-MRI and T2WI) and the prognosis of NPC is unclear. The present work is the first study to explore the performance of quantitative DCE-MRI and texture analysis in predicting the long-term outcome of NPC. Our data revealed that baseline quantitative DCE-MRI parameters and texture features might serve as predictors for the prognosis of NPC. These findings provide new insights to help optimize individual treatment regimen and improve the clinical outcome for patients.

Kilian Stumpf¹, Mariam Seyfang², Bernd Georg Lapatki², and Volker Rasche^1
1Department of Internal Medicine II, Ulm University Medical Center, Ulm, Germany, ²Department of Orthodontics, Ulm University Medical Center, Ulm, Germany

Magnetic resonance imaging (MRI) scans are the gold standard for confirming clinical diagnosis of temporomandibular disorders involving the condyle–articular disc complex, such as articular disc displacements (ADDs). Dynamic MRI has previously been applied for the visualization of motions of the temporomandibular joint. A combination of tiny golden angle (tyGA) profile ordering and a sliding window reconstruction allows retrospective reconstruction of images with nearly arbitrary temporal resolutions. In this contribution a real-time tyGA sequence with a frame rate of up to 125 ms was successfully applied for the diagnosis of ADD as well as occlusal splint therapy planning and evaluation.

Uzay E Emir^1,2, Jannie Wijnen³, Olaf E Ansorge⁴, Evita Wiegers³, Anja van der Kolk⁵, Alexander Lin⁶, and Clark Chen^7
1School of Health Sciences, Purdue University, West Lafayette, IN, United States, ²Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, United States, ³Radiology, University Medical Centre Utrecht, Utrecht, Netherlands, ⁴University of Oxford, Oxford, United Kingdom, ⁵Antoni van Leeuwenhoek Hospital, Netherlands Cancer Center, Amsterdam, Netherlands, ⁶Brigham and Women’s Hospital / Dana Farber Cancer Institute, Harvard Medical School, Boston, MA, United States, ⁷Department of Neurosurgery, University of Minnesota, Minneapolis, MN, United States

We have recently initiated a 7T MRS glioma consortium, intending to bring together experts in the field to discuss pitfalls, promises, and potential research avenues of MRS in gliomas. During the "GlioMaRS-NET Workshop" in 2020, we tested the efficacy of UHF MRS for predicting the molecular characteristics by visual inspection by conducting a survey with a set of previously acquired UHF spectra from glioma patients. There was a high concordance in diagnostic interpretation of spectra for the identification of IDH-mutant gliomas versus IDH-wildtype gliomas.

Agazi Samuel Tesfai¹, Andreas Vollmer², Ali Caglar Özen^1,3, Wiebke Semper-Hogg², Ute Ludwig¹, and Michael Bock^1
1Dept. of Radiology, Medical Physics, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany, ²Department of Oral and Maxillofacial Surgery, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany, ³German Consortium for Translational Cancer Research Partner Site Freiburg, German Cancer Research Center (DKFZ), Heidelberg, Germany

Accurate detection of dental root canals is vital to avoid complications in endodontic therapy; however, it is difficult to locate the root canals with their sub-millimeter diameter in dental CT. To display root canals with MRI, ex-vivo and in-vivo measurements were performed with a newly developed intra-oral flexible coil and were compared to conventional head and surface coil images. Ex-vivo, a minimum SNR gain of 6 could be achieved with the intra-oral coil setup, and in a volunteer a gain of 2.7 was seen with an improved delineation of the root canals.