Electronic poster

Thursday 13:30-15:30 Computer 97

13:30 4658. Is Shear Viscosity a Sign for Malignancy in Liver Tumours?

Jean Luc Daire¹, Ralph Sinkus², Mathilde Wagner¹, Nathalie Haddad¹, Valerie Vilgrain¹, Bernard van Beers<sup>1

1</sup>INSERM U773, CRB3 Centre de Recherches Biomédicales Bichat-Beaujon, Paris, France; ²Institut Langevin, ESPCI, Paris, France

Liver tumours are very frequent. They include benign lesions and malignant primary or secondary tumours (metastases). Currently, there is no established non-invasive imaging Goldstandard available in order to characterize malignancy for liver tumours. Very often, the enhancement characteristics of a bolus are used in order to differentiate benign from malignant tumours. Here, we intend to prospectively evaluate the complex shear modulus as measured via MR-elastography in the assessment of malignancy or benignity of liver lesions and compare its performance to those of three enhancement characteristics of the bolus passage.

14:00 4659. Evaluation of Nonalcoholic Liver Disease Using ²³Na MRI and Shift Reagent-Aided ²³Na and ³¹P MRS

Paige Nicole Hopewell^1,2, Navin Bansal<sup>1,2

1</sup>Radiology, Indiana University School of Medicine, Indianapolis, IN, United States; ²Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, United States

Changes in signal intensity with disease progression in single quantum (SQ) and triple quantum-filtered (TQF) ²³Na MRI are validated with shift reagent-aided SQ and TQF ²³Na and ³¹P MRS studies in a nonalcoholic fatty liver disease model. Changes in intracellular Na⁺ concentration and fibrosis-associated macromolecule deposition in the extracellular space both contribute to an increased TQF ²³Na MRI signal with advanced disease progression.

14:30 4660. Liver Fibrosis Grading Based on MR Elastography and 31P Spectroscopy

Edmund Mark Godfrey¹, Anant S. Krishnan¹, Susan E. Davies², Nyree M. Griffin³, Graeme J. Alexander⁴, Mike E. Allison⁴, Alexander E. Gimson⁴, William H. Griffiths⁴, David J. Lomas<sup>1

1</sup>Department of Radiology, Addenbrooke's Hospital, Cambridge, Cambridgeshire, United Kingdom; ²Department of Histopathology, Addenbrooke's Hospital, Cambridge, Cambridgeshire, United Kingdom; ³Department of Radiology, St Thomas' Hospital, London; ⁴Department of Hepatology, Addenbrooke's Hospital, Cambridge, Cambridgeshire, United Kingdom

Standard imaging techniques are insensitive to liver fibrosis. Current clinical assessment of liver fibrosis requires a biopsy, which risks complications and sampling error. This work describes our experience with 2 new MR techniques: MR elastography and 31P spectroscopy. MR elastography was found to correlate with histological grade of fibrosis in contrast to 31P PME/PDE ratio. Our findings do not correlate with previous work. This may be because histological grade in our study was based on the original report, rather than review of the biopsy material. We plan to repeat the analysis of our results with this data.

15:00 4661. Use of a Two-Point Dixon VIBE Sequence for Post-Contrast Liver MRI: Comparison with Standard Chemically-Selective Fat-Suppressed VIBE for Image Quality and Lesion Detection

Andrew B. Rosenkrantz¹, Lorenzo Mannelli¹, Sungheon Kim¹, James Babb<sup>1

1</sup>Radiology, NYU Langone Medical Center, New York, NY, United States

In 30 consecutive patients at 1.5T, a breath-hold two-point Dixon VIBE acquisition was obtained of the liver immediately following a standard chemically-selective fat-suppressed VIBE acquisition, both performed during the equilibrium phase after intravenous contrast administration. Compared with the standard VIBE sequence, the Dixon VIBE sequence demonstrated significantly improved strength of fat suppression, homogeneity of fat suppression, vessel sharpness, and subjective overall image quality. There were no significant differences between the two sequences for sensitivity or PPV for focal liver lesion detection. We conclude that Dixon-VIBE achieved higher image quality with preserved diagnostic ability for post-contrast liver MRI.

Bowel

Hall B Monday 14:00-16:00 Computer 98

14:00 4662. Fast 3D Tracking of 19F Labeled Small Capsules for Combined Morphology and Real-Time Flow Studies in the Gastrointestinal Tract

Tobias Hahn¹, Sebastian Kozerke¹, Mark Fox^2,3, Werner Schwizer², Andreas Steingoetter, ^1,4, Michael Fried², Peter Boesiger<sup>1

1</sup>Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland; ²Division of Gastroenterology and Hepatology, University Hospital Zurich; ³Nottingham Digestive Diseases Centre and Biomedical Research Unit Queen's Medical Centre, University Hospital Nottingham; ⁴Institute of Radiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.

3D tracking of small-sized 19F labeled capsules is studied using fast modified balanced FFE sequences for concurrent measurements of gastrointestinal function and morphology. Perfluoro-15-crown-5-ether and Hexafluorobenzene are proposed and studied for use as tracking mediums. The proposed imaging protocol is shown to be reliable in tracking small capsules through realistic abdominal phantoms and might therefore bear potential of being a valuable tool in detecting abnormal gastric function and at the same time posing the basis for creating a 3D anatomical model of the complex bowel geometry.

14:30 4663. MR Fluoroscopy for Gastrointestinal Malrotation in Unsedated Infants

Owen John Arthurs¹, Ilse Joubert¹, Martin John Graves¹, Pat Set¹, David John Lomas<sup>1

1</sup>Department of Radiology, University of Cambridge and Addenbrooke's Hospital, Cambridge, Cambridgeshire, United Kingdom

Gut malrotation is a congenital disorder of abnormal intestinal rotation, for which the current diagnostic technique is an upper GI X-ray contrast study. This study evaluated the feasibility of interactive MR fluoroscopy for defining the gastro-intestinal tract anatomy in un-sedated children with suspected malrotation. We imaged 9 children using both X-ray fluoroscopy, FIESTA and interactive SSFSE MR imaging. We confidently identified the DJ flexure (7/9; 77%), orientation of the SMA / SMV (8/9; 88%) and the caecum (9/9; 100% using MRI. Interactive MR Fluoroscopy is feasible for gut imaging in un-sedated children.

15:00 4664. Customised Rotational Imaging Support for Paediatric MRI (CRISP-MRI)

Owen John Arthurs¹, Erich Zammer², David John Lomas<sup>1

1</sup>Department of Radiology, University of Cambridge and Addenbrooke's Hospital, Cambridge, Cambridgeshire, United Kingdom; ²Department of Orthopaedics, University of Cambridge and Addenbrooke's Hospital, Cambridge, Cambridgeshire, United Kingdom

Traditional X-ray fluoroscopy methods for upper gastro-intestinal (GI) tract imaging in children require postural alteration to help move contrast media to the required locations. In order to establish an equivalent MRI technique for imaging the paediatric gut, we have developed a custom-built coil insert which allows for gentle rotation of a child within a rigid surface coil. It has a Vitrothene polymer backing, with a Plastazote foam insert, which is currently for orthopaedic supports in our hospital. These materials are strong, non-ferromagnetic, easily cleanable, lightweight and breathable. This type of device should help facilitate MR fluoroscopy in small children.

15:30 4665. Colonic Response to an Experimental Model of Human Diarrhoeal Disease

Elisa Placidi¹, C. L. Hoad¹, L. Marciani², R. C. Spiller², P. A. Gowland<sup>1

1</sup>SPMMRC, School of Physics and Astronomy, University of Nottingham, Nottingham, United Kingdom; ²Nottingham Digestive Diseases Centre Biomedical Research Unit, University of Nottingham, Nottingham, United Kingdom

MRI was used to investigate the colonic response to two contrasting test meals: a readily absorbable glucose drink (control) and a non absorbable mannitol drink, which acts as a model of acute diarrhoeal disease. Eight healthy volunteers were imaged on a 1.5 T Philips Achieva scanner with several sequences up to 8 hours after the drink, to assess changes in the ascending colon in terms of water content, volume, and image signal intensity. Differences between the two conditions have been quantified. A scoring system based on subjective assessment of colonic contents has also been developed.

Tuesday 13:30-15:30 Computer 98

13:30 4666. Comparison Study on Differentiating Active from Remissive Crohn’s Disease by 3.0T and 1.0T MRI

Ambreen Sattar¹, J Zhu², Y Yu², L Hamm², Y Ye², Y Xuan², J Hu<sup>2

1</sup>Radiology, Wayne State University, Detroit, MI, United States; ²WSU MR RESEARCH, Wayne State University, detroit, MI, United States

This study analyzes the abiltiy of 3.0 T MRI to better evaluate the activity of active vs remissive Crohn's disease over 1.0 T MRI.3.0 T magnet is better capable of detecting various signs of active Crohn's diseases such as Stenosis, bowel wall thickening and bowel wall enhancement. MRI is safer option because it does not uses ionizing radiation and provides better diagnostic outcome in staging disease which can significantly alter treatment options offered by the physician.

14:00 4667. Performance of Non-Contrast MR Enterography to Localize and Predict Disease Activity in Crohn's Disease.

Srigouri Yalamanchili¹, Michael Macari¹, Rafael Rivera¹, Danny Kim¹, Alec Megibow¹, James Babb¹, Joseph Levy¹, Kerry Zabriskie¹, Sooah Kim<sup>2

1</sup>New York University; ²New York University, New York, NY, United States

Secific findings at MR imaging- mural T2 high signal intensity and contrast enhancement patterns- have been proposed as accurate markers of disease activity. The purpose of our study is to assess the performance using conventional non-contrast MR imaging sequences as a tool to localize and predict disease activity in Crohn’s disease in comparison to post-contrast images. Thirty patients referred for MR enterography were evaluated at 1.5 T using steady state free precession, single shot fast spin echo, fat suppressed T2, and pre- and post contrast enhanced T1-weighted sequences. Images were reviewed by two radiologists in two separate sessions; the readers interpreted non-contrast images of MRI during the first session and whole images including post-contrast sequences during the second session. The readers evaluated the presence or absence of disease in regard to the presence of active inflammation using a six-point grading system (0, No evidence of disease; 1, definite absence of active inflammation; 2, probable absence of active inflammation; 3, equivocal; 4, probable presence of active inflammation; and 5, definite presence of active inflammation). Reference standard was constructed by combining surgical, endoscopy, physical, and all available imaging findings. There were 34 bowel segments with active inflammation on reference standard in 18 subjects (proximal ileum, n=1, distal ileum, n=4; terminal ileum, n=16; cecum, n=6; ascending colon, n=1; rectosigmoid, n=2). Inter-reader agreement was significantly higher for whole imaging including post-contrast images relative to non-contrast images (Kappa 0.31 for non-contrast and 0.41 for whole images). Although there is no significant difference localizing abnormal bowel segment involved with Crohn’s disease using non-contrast images, inter-reader agreement, sensitivity, and accuracy are significantly higher in the assessment of active disease adding post-contrast images to non-contrast images for MRI interpretation.

14:30 4668. The Effect of High Fat or High Carbohydrate Meals on the Gastrointestinal Tract: A MRI Study

Eleanor F. Cox¹, Michael Mellows², Susan E. Pritchard¹, Mahamoud Hussein¹, Caroline L. Hoad¹, Carolyn Costigan³, Luca Marciani², Robin C. Spiller², Penny A. Gowland<sup>1

1</sup>SPMMRC, Physics & Astronomy, University of Nottingham, Nottingham, Nottinghamshire, United Kingdom; ²Nottingham Digestive Diseases Centre, NIHR BRU, Nottingham University Hospitals, Nottingham, United Kingdom; ³Brain & Body Centre, University of Nottingham, Nottingham, United Kingdom

The effect of a high fat (HF) meal and an equicaloric high carbohydrate (HC) meal on satiety, gastric volumes, small bowel water content (SBWC) and gallbladder contraction (as a marker of CCK release) was investigated using MRI. The HF meal resulted in increased fullness and decreased hunger and appetite compared with the HC meal. Gastric emptying was initially faster for the HF meal. After 90 minutes, SBWC was greater after the HF meal than after the HC meal. This delayed increase may reflect delayed emptying of fat which stimulates pancreatic secretions.

15:00 4669. The Use of MR Thermometry in Legal Medicine: A Feasibility Study Utilizing Rat Rectal Temperature.

Hideto Kuribayashi¹, Fanlai Cui², Keiko Hirakawa², Yoshimasa Kanawaku³, Youkichi Ohno<sup>2

1</sup>Varian Technologies Japan Limited, Minato-ku, Tokyo, Japan; ²Nippon Medical School; ³National Defence Medical College

Proton resonance frequency-shift based MR temperature imaging was introduced into the rectal temperature measurement in cooling dead bodies in order to estimate the time of death in legal medicine. A series of MR temperature difference maps in cooling dead rats could be obtained. Moreover, distribution of cooling rates among pelvic tissues was observed and shown to be related to body position.

Female Pelvis MRI

Wednesday 13:30-15:30 Computer 98

13:30 4670. Clinical Significance of the 2 Ppm Resonance in In-Vivo 1H-MR Spectroscopy of Ovarian Tumors

Mayumi Takeuchi¹, Kenji Matsuzaki¹, Masafumi Harada¹, Hiromu Nishitani<sup>1

1</sup>Department of Radiology, University of Tokushima, Tokushima, Japan

We evaluated 31 ovarian tumors including 8 mucinous tumors by 1H-MR spectroscopy at 3T. High to moderate 2 ppm peaks were observed in all 8 mucinous tumors, whereas low to slight 2 ppm peaks were observed in 14 of 23 non-mucinous tumors. The 2 ppm concentration in mucinous tumors (7.39+/-2.85 mM) was significantly higher than that in non-mucinous lesions (3.12+/-1.42 mM) (p<0.005). Using a cut off value of 4.45 mM for mucinous tumors had a sensitivity of 88%, specificity of 86%, PPV of 78%, and NPV of 92%.

14:00 4671. Differentiation of Benign and Malignant Uterine Corpus Tumors: Value of 1H-MR Spectroscopy at 3T

Mayumi Takeuchi¹, Kenji Matsuzaki¹, Masafumi Harada¹, Hiromu Nishitani<sup>1

1</sup>Department of Radiology, University of Tokushima, Tokushima, Japan

We evaluated 32 uterine corpus tumors (14 malignant including 11 endometrial carcinomas and 3 myometrial tumors; 18 benign including 5 endometrial and 13 myometrial masses) by 1H-MR spectroscopy at 3T. Choline peaks were observed in all 32 lesions, and tended to show higher peaks in malignant tumors. The choline concentration in malignancy (8.77+/-1.91 mM) was significantly higher than that in benign lesions (4.82+/-2.23 mM) (p<0.0001). Using a cut off value of 7.00 mM for malignant lesions had a sensitivity of 93%, specificity of 83%, PPV of 94%, and NPV of 81%.

14:30 4672. 23Na/1H MR Imaging of Female Pelvis at 7T Using a Dual-Tuned Multi-Channel Body Coil

Kyongtae Ty Bae¹, Jung-Hwan Kim¹, Chan Hong Moon¹, Alessandro Furlan¹, Bumwoo Park¹, JinHong Wang<sup>1

1</sup>University of Pittsburgh, Pittsburgh, PA, United States

For the first time, we were able to demonstrate MR imaging of the female pelvis and distribution of sodium signal intensities in the female pelvic organs in normal subjects at 7T with a multi-channel dual-tuned body RF coil. Future development of 23Na MR imaging will concentrate on the clinical application of sodium MR imaging of the female pelvis to assess various physiological and pathological conditions accompanied with changes in sodium concentration.

15:00 4673. In Vivo ³¹P MR Spectroscopy of Human Placenta

Jan Weis¹, Kathrine Bjersand², Anna Karin Wikström², Mats Olovsson², Johan Wikström<sup>3

1</sup>Department of Oncology, Radiology and Clinical Immunology, Uppsala University, Uppsala, Sweden; ²Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; ³Department of Oncology, Radiology and Clinical Immunology, Uppsala University , Uppsala, Sweden

31P image-selected in vivo spectroscopy (ISIS) with proton decoupling and nuclear Overhauser effect enhancement was used for measurement the spectra of placental tissue in vivo. Major metabolites of normal human placenta and placentas from women with preeclampsia were quantified. Our results demonstrate that the 31P MRS is able to measure spectra of the placenta with acceptable quality and measurement time. 31P MRS is a promising tool to detect in vivo changes of human placental metabolites.

Thursday 13:30-15:30 Computer 98

13:30 4674. Pre- And Postoperative Dynamic MRI: Evaluation of Pelvic Organ Prolapse in Symptomatic Women

Céline D. Alt¹, Kerstin Brocker², Florian Lenz², Christof Sohn², Hans-Ulrich Kauczor¹, Peter Hallscheidt<sup>1

1</sup>Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany; ²Obstetrics and Gynecology, University Hospital Heidelberg, Heidelberg, Germany

Description: Evaluation of dynamic changes of pelvic organ prolapse by MRI. Method: Dynamic 1.5T MRI was performed preoperative and after surgery in women with pelvic organ prolapse. For measurement two referential lines and four anatomical landmarks were taken. Results: 77 women were yet included. Surgical treatment was anterior (43/62), posterior (15/62) and combined anterior/posterior mesh-repair (4/62). Median values of organ prolapse often showed significant changes (p<0,05) in short term follow-up compared to preoperative results. With posterior mesh-repair the changes weren´t significant. Conclusion: Dynamic MRI offers an accurate extent of prolapse and allows to evaluate the success after reconstructive surgery.

14:00 4675. Development of MR Visible Mesh for Soft Tissue Reinforcement in Surgical Treatment of Genital Prolapse.

Sébastien Blanquer^1,2, Olivier Guillaume^1,2, Laurent Lemaire^3,4, Florence Franconi⁵, Xavier Garric^1,2, Jean Coudane<sup>1,2

1</sup>CNRS UMR 5247, Montpellier, France; ²UFR Pharmacie - Université Montpellier I, Montpellier, France; ³Université Angers, Angers, France; ⁴INSERM U646, Angers, France; ⁵PIAM, Université Angers, Angers, France

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14:30 4676. Differentiation of Benign and Malignant Solid Components of Ovarian Masses by Diffusion-Weighted MR Imaging with ADC Measurement

Mayumi Takeuchi¹, Kenji Matsuzaki¹, Hiromu Nishitani<sup>1

1</sup>Department of Radiology, University of Tokushima, Tokushima, Japan

We evaluated surgically proven 52 ovarian tumors (36 malignant; 6 borderline malignant; 10 benign). All 42 malignant/borderline malignant tumors showed homogeneous or heterogeneous high intensity on DWI, whereas 3 of 10 benign tumors (3 thecomas) showed high intensity. The ADCs in 42 malignant/borderline malignant tumors and in 10 benign tumors were 1.02 +/- 0.19 and 1.38 +/- 0.30, respectively (p<0.001). Using a cut off ADC of 1.15 had a sensitivity of 76%, specificity of 80%. The ADCs in high intense 3 thecomas on DWI were relatively low (1.08 to 1.20), possibly due to their abundant cellular nature as functioning tumors.

15:00 4677. Functional MRI of the Uterus with Quantitative T2, Diffusion-Weighted, and Magnetization-Transfer Contrast Imaging

Srigouri Yalamanchili¹, Genevieve L. Bennett¹, Pippa Storey¹, Andrew B. Rosenkrantz<sup>1

1</sup>Radiology, NYU Langone Medical Center, New York, NY, United States

5 female volunteers underwent pelvic MRI at 1.5T that included T2-mapping, diffusion-weighted imaging, and magnetization-transfer contrast imaging, each performed through the uterus in the sagittal plane with matching slice positions. There were trends toward a longer T2 time within the endometrium, a lower ADC within the junctional zone, and a lower magnetization-transfer ratio within the myometrium. There was a moderate positive correlation between T2 and ADC, but poor correlation between T2 and MTR as well as between ADC and MTR, suggesting that MTR may reflect a characteristic of tissue not measured by either ADC or T2.

Renal MR Imaging

Hall B Monday 14:00-16:00 Computer 99

14:00 4678. Renal Perfusion and Oxygen Bioavailability in Swine: Comparing Isoflurane to Propofol

Logan Dance¹, Andrew Wentland², Nathan Artz², Sean Fain^1,2, Arjang Djamali³, Elizabeth Sadowski<sup>1

1</sup>Radiology, University of Wisconsin, Madison, WI, United States; ²Medical Physics, University of Wisconsin, Madison, WI, United States; ³Nephrology, University of Wisconsin, Madison, WI, United States

Blood oxygen level dependent (BOLD) and arterial spin labeling (ASL) MR imaging can analyze the drug-specific effects of anesthetics on regional perfusion. Conflicting data currently exists regarding isoflurane's effect on renal perfusion. Using a swine model, we found that isoflurane decreased renal perfusion (ASL; microspheres) and renal oxygen bioavailability (BOLD MR) when compared to propofol. Isoflurane also caused a significant increase in heart rate and decrease in mean arterial pressure, compared to propofol. These effects should be considered when designing kidney perfusion studies.

14:30 4679. Blood Oxygen-Level Dependent (BOLD) MR Imaging of Diabetic Nephropathy-Preliminary Study

Zhen Jane Wang¹, Rahi Kumar¹, Benjamin M. Yeh¹, Suchandrima Banerjee², Chi-yuan Hsu<sup>3

1</sup>Department of Radiology and Biomedical Engineering, University of California, San Francisco, San Francisco, CA, United States; ²Global Applied Science Laboratory, GE Healthcare, Menlo Park, CA, United States; ³Department of Medicine, Division of Nephrology, University of California, San Francisco, San Francisco, CA, United States

The preliminary data showed decreased medullary R2* values (corresponding to increased oxygen bioavailability) in patients with diabetic kidney disease compared to healthy volunteers; and the decrease in medullary R2* values appeared to be related to the degree of kidney disease.

15:00 4680. Free Breathing Renal BOLD Signal Frequency Assessment Following Diuresis

Brendan Boyd¹, Michael D. Noseworthy<sup>2

1</sup>School of Biomedical Biomedical Engineering, McMaster University, Hamilton, Ontario, Canada; ²Electrical and Computer Engineering, School of Biomedical Engineering, McMaster University, Hamilton, Ontario, Canada

Real time, free breathing, T2*-weighted (BOLD) images of the kidneys were retrospectively motion corrected and analyzed for physiologic spectral energies. Following induced diuresis a corresponding decrease in cardiac BOLD signal frequency energy was observed in the renal cortex. We hypothesize this corresponds to a decrease in O₂ utilization due to decreased renal H₂O reabsorption.

15:30 4681. Functional Renal Imaging with BOLD: Validation of a Model for R2* in Kidney Cortex and Medulla

Jeff Lei Zhang¹, Henry Rusinek¹, Hersh Chandarana¹, Pippa Storey¹, Eric E. Sigmund¹, Pierre Hugues Vivier^1,2, Qun Chen¹, Hua Guo¹, Vivian S. Lee<sup>1

1</sup>Department of Radiology, New York University, New York, NY, United States; ²Rouen University Hospital, Rouen, France

In this study we used a Monte Carlo simulation approach to explore the mechanism of BOLD R2* contrast in kidney. Kidney pO2 levels predicted based on R2* values by the simulation were in agreement with literature values for a healthy volunteer, and correlated well with pO2 values measured by microprobe for diabetic rats of a previous study. The results indicate that the approach is a promising tool for quantifying kidney oxygenation level based on BOLD data.