<scp>MR</scp>Elastography of the Pancreas: Bowel Preparation and Repeatability Assessment in Pancreatic Cancer Patients and Healthy Controls

Wassenaar, Nienke P.M.; van Schelt, Anne‐Sophie; Schrauben, Eric M.; Kop, Marnix P.M.; Nio, C. Yung; Wilmink, Johanna W.; Besselink, Marc G.H.; van Laarhoven, Hanneke W.M.; Stoker, Jaap; Nederveen, Aart J.; Runge, Jurgen H.

doi:10.1002/jmri.28918

Cited by 3 publications

(1 citation statement)

References 31 publications

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“…Magnetic resonance (MR) elastography (MRE) is a non-invasive imaging technique that uses an external vibration transducer, a motion-sensitive MR sequence, and an inversion algorithm to quantify soft tissue viscoelastic properties ( 1 ). These properties can reflect tissue microenvironment, such as tumor stroma in pancreatic ductal adenocarcinoma (PDAC) ( 2 ). MRE has been shown to be valuable in a number of abdominal organs, including the assessment of liver fibrosis ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

Free-breathing motion corrected magnetic resonance elastography of the abdomen

van Schelt,

Wassenaar,

Runge

et al. 2024

Quant Imaging Med Surg

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Background Magnetic resonance elastography (MRE) is a non-invasive method to measure the viscoelastic properties of tissue and has been applied in multiple abdominal organs. However, abdominal MRE suffers from detrimental breathing motion causing misalignment of structures between repeated acquisitions for different MRE dimensions (e.g., motion encoding directions and wave phase offsets). This study investigated motion correction strategies to resolve all breathing motion on sagittal free-breathing MRE acquisitions in a phantom, in healthy volunteers and showed feasibility in patients. Methods First, in silico experiments were performed on a static phantom dataset with simulated motion. Second, eight healthy volunteers underwent two sagittal MRE acquisitions in the pancreas and right kidney. The multi-frequency free-breathing spin-echo echo-planar-imaging (SE-EPI) MRE consisted of four frequencies (30, 40, 50, 60 Hz), eight wave-phase offsets, with 3 mm 3 isotropic voxel size. Following data re-sorting in different number of motion states (4 till 12) based on respiratory waveform signal, three intensity-based registration methods (monomodal, multimodal, and phase correlation) and non-rigid local registration were compared. A ranking method was used to determine the best registration method, based on seven signal-to-noise and image quality measures. Repeatability was assessed for no motion correction (Original) and the best performing method (Best) using Bland-Altman analysis. Lastly, the best motion correction method was compared to no motion correction on patient MRE data [pancreatic ductal adenocarcinoma (PDAC, n=5) and metabolic dysfunction-associated steatotic liver disease (MASLD) (n=1)]. Results In silico experiments showed a deviation of shear wave speed (SWS) with simulated motion to the ground truth, which was (partially) resolved using motion correction. In healthy volunteers ranking resulted in the best motion correction method of monomodal registration using nine motion states, while no motion correction was ranked last. Limits of agreement were (−0.18, 0.14), and (−0.25, 0.18) m/s for Best and Original, respectively. Using motion correction in patients resulted in a significant increase in SWS in the pancreas (Original: 1.39±0.10 and Best: 1.50±0.17 m/s). After motion correction PDAC had a mean SWS of 1.56±0.27 m/s (Original: 1.42±0.25 m/s). The fibrotic liver mean SWS was 2.07±0.20 m/s (Original: 2.12±0.18 m/s). Conclusions Motion correction in sagittal free-breathing abdominal MRE results in improved data quality, inversion precision, repeatability, and is feasible in patients.

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Section: Introductionmentioning

confidence: 99%

Free-breathing motion corrected magnetic resonance elastography of the abdomen

van Schelt,

Wassenaar,

Runge

et al. 2024

Quant Imaging Med Surg

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Prediction of clinically relevant postoperative pancreatic fistula after pancreatoduodenectomy based on multifrequency magnetic resonance elastography

Zhong,

Zhu,

Huang

et al. 2024

Journal of Gastrointestinal Surgery

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Assessment of structural heterogeneity and its correlation with early recurrence in hepatocellular carcinoma by diffusion weighted imaging based virtual MR elastography

Li,

Wang,

Zhai

et al. 2024

Preprint

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Background：The mechanical characteristics of tumors are closely related to their invasive growth, metastasis and diffusion. Virtual MR elastography(vMRE), which is based on diffusion weighted imaging (DWI), can quickly and reliably reflect the biomechanical properties of cancer without the need for invasive procedures. Aims: To explore the correlation between structural heterogeneity, early recurrence, and virtual shear modulus (mdiff) of hepatocellular carcinoma (HCC) measured by vMRE. Materials: A total of 40 HCC patients were retrospectively collected. All patients underwent routine MR sequence and DWI. The mdiff value was estimated by DWI with lower b values (b =200 s/mm2) and higher b values (b =1500 s/mm2). The mdiff inside the tumor(mdiff-tumor), at the tumor edge(mdiff-edge), and around the tumor (within 1cm) (mdiff-around) were measured, as well as the sum(mdiff-sum) of the above parameters. T test was used to compare the differences between groups, and ROC curves were drawn to evaluate the diagnostic efficacy of vMRE. Kaplan-Meier curve, Log-rank test and Cox regression were used for survival analysis. Results: The mdiff-tumor, mdiff-edge, mdiff-sum of low differentiation (4.968 kPa, 4.553 kPa, 27.822 kPa) are higher than those of medium-high differentiation (3.554 kPa, 2.858 kPa, 18.762 kPa) (P <0.050). The mdiff-sum shows the highest diagnostic efficiency, with sensitivity, specificity, and AUC of 77.8%, 90.6%, and 0.823, respectively. There were no significant differences of mdiff-tumor, mdiff-edge, mdiff-around, mdiff-sum in vascular invasion, hemorrhage, necrosis or size (P>0.050). Patients with mdiff-around greater than 5.060 kPa are at a higher risk of early recurrence (P=0.003), and the mdiff-around serves as an independent predictor of early recurrence (HR=0.155, 95%CI 0.031 ~ 0.770, P=0.023). Conclusion: vMRE can effectively differentiate the pathological grading of HCC, and the values around the tumor have certain early warning significance for the early recurrence of HCC.

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MRElastography of the Pancreas: Bowel Preparation and Repeatability Assessment in Pancreatic Cancer Patients and Healthy Controls

Cited by 3 publications

References 31 publications

Free-breathing motion corrected magnetic resonance elastography of the abdomen

Free-breathing motion corrected magnetic resonance elastography of the abdomen

Prediction of clinically relevant postoperative pancreatic fistula after pancreatoduodenectomy based on multifrequency magnetic resonance elastography

Assessment of structural heterogeneity and its correlation with early recurrence in hepatocellular carcinoma by diffusion weighted imaging based virtual MR elastography

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