Contract grant sponsorNational Natural Science Foundation of China; Contract grant number: 81260214.BackgroundRecent studies have highlighted the diagnostic value of Gadolinium‐ethoxybenzyl‐diethylenetriamine pentaacetic acid (Gd‐EOB‐DTPA)‐enhanced MRI in small hepatocellular carcinoma (HCC). Ki67 and CD34 are histologic markers that reflect the proliferation of tumor cells and the microvascular density (MVD).PurposeTo explore the diagnostic value of Gd‐EOB‐DTPA‐enhanced MRI for Ki67 expression and MVD in HCC.Study TypeRetrospective.SubjectsIn all, 180 patients with HCC.Field Strength/Sequence3.0T, Gd‐EOB‐DTPA‐enhanced T1WI volumetric interpolated breath‐hold examination (VIBE) axial fat suppression plain, and enhanced scanning.AssessmentThe T1 relaxation time (T1rt) and signal intensity (SI) of the lesion were measured. The Ki67 expressions and MVD were evaluated by immunohistochemistry.Statistical TestReceiver operating characteristic (ROC) curves were used to analyze the diagnostic efficacy of T1rt for high Ki67 expression (≥50%) and high MVD (≥100).ResultsThe T1rt‐20min, rrT1rt‐20min, and SI‐hepatobiliary phase (SI‐HBP) were strongly correlated with Ki67, the r values were 0.846, –0.765, and –0.760 (P < 0.05), respectively. There were moderate correlations with CD34, with r values –0.444, 0.336, and –0.463 (P < 0.05), respectively. The T1rt‐Pre, T1rt‐20min, SI‐Pre, and SI‐HBP were significantly different both between the high and low ki67 expression groups (P < 0.05) and between the high MVD and low MVD groups (P < 0.05). In the two groups the T1rt‐20min and SI‐HBP was 800.06 ± 128.91 vs. 530.06 ± 139.29 (P < 0.05) and 122.29 ± 39.39 vs. 173.49 ± 46.15 (P < 0.05); T1rt‐20min was found to have high diagnostic efficiency for high ki67 expression (area under the curve [AUC], 0.937; P < 0.05) T1rt‐20min had moderate diagnostic value for high MVD (AUC, 0.716; P < 0.05).Data ConclusionThe T1rt and SI of Gd‐EOB‐DTPA‐enhanced MRI were correlated with Ki67 expression and MVD. T1rt‐20min has a high diagnostic value for high ki67 expression and high MVD in HCC tissues.Level of Evidence: 3Technical Efficacy Stage: 2J. Magn. Reson. Imaging 2020;51:1755–1763.

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Background Recent studies have highlighted the correlation between diabetes and pancreatic fat infiltration. Notably, pancreatic fat content (PFC) is a potential biomarker in diabetic patients, and magnetic resonance imaging (MRI) provides an effective method for noninvasive assessment of pancreatic fat infiltration. However, most reports of quantitative measurement of pancreatic fat have lacked comparisons of pathology results. The primary objective of this study was to determine the feasibility and accuracy of pancreatic MRI by using pancreatic fat fraction (PFF) measurements with the IDEAL-IQ sequence; the secondary objective was to explore changes in PFC between pigs with and without diabetes. Methods In this prospective study, 13 Bama Mini-pigs (7 females, 6 males; median age, 2 weeks) were randomly assigned to diabetes ( n = 7) or control ( n = 6) groups. Pigs in the diabetes group received high fat/high sugar feed, combined with streptozotocin injections. At the end of 15 months, biochemical changes were evaluated. All pigs underwent axial MRI with the IDEAL-IQ sequence to measure PFF; PFC of fresh pancreatic parenchyma was measured by the Soxhlet extraction method; and pancreatic fat distribution was observed by histopathology. Results of all analyses were compared between the diabetes and control groups by using the Mann-Whitney U-test. Correlations of PFF and PFC, fasting blood glucose (GLU), and serum insulin (INS) were calculated by using the Spearman correlation coefficient. Single-measure intraclass correlation coefficient (ICC) was used to assess interreader agreement. Results There were significant differences between diabetes and control groups: GLU (mmol/L) was 18.06 ± 6.03 and 5.06 ± 1.41 ( P < 0.001); INS (mU/L) was 21.59 ± 2.93 and 29.32 ± 3.27 ( P = 0.003); PFC (%) was 34.60 ± 3.52 and 28.63 ± 3.25 ( P = 0.027); and PFF (%) was 36.51 ± 4.07 and 27.75 ± 3.73 ( P = 0.003). There was a strongly positive correlation between PFF and PFC (r = 0.934, P < 0.001); there were moderate correlations between PFF and GLU (r = 0.736, P = 0.004; positive correlation), and between PFF and INS (r = − 0.747, P = 0.003; negative correlation). Excellent interreader agreement was observed for PFF measurements (ICC, 0.954). Conclusions Pancreatic fat infiltration shows a clear association with diabetes. MRI with the IDEAL-IQ sequence can be used to accurately and reproducibly quantify PFC.