Hepatic Medicine: Evidence and Research (Mar 2020)

Improving the Detection of Cholangiocarcinoma: In vitro MRI-Based Study Using Local Coils and T2 Mapping

  • Khuntikeo N,
  • Titapun A,
  • Chamadol N,
  • Boonphongsathien W,
  • Sa-Ngiamwibool P,
  • Taylor-Robinson SD,
  • Wadsworth CA,
  • Zhang S,
  • Kardoulaki EM,
  • Young IR,
  • Syms RRA

Journal volume & issue
Vol. Volume 12
pp. 29 – 39

Abstract

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Narong Khuntikeo, 1 Attapol Titapun, 1 Nittaya Chamadol, 2 Wuttisak Boonphongsathien, 2 Prakasit Sa-Ngiamwibool, 3 Simon D Taylor-Robinson, 4 Christopher A Wadsworth, 4 Shuo Zhang, 5 Evdokia M Kardoulaki, 6 Ian R Young 6,†, Richard RA Syms 6 1Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand; 2Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand; 3Department of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand; 4Division of Surgery and Cancer, Imperial College London, Liver Unit, St. Mary’s Hospital, London W2 1NY, UK; 5Philips Healthcare Germany, Health Systems, Clinical Science, Hamburg 22335, Germany; 6EEE Department, Imperial College, London SW7 2AZ, UK†Ian R Young passed away on September 27, 2019Correspondence: Simon D Taylor-RobinsonDivision of Surgery and Cancer, Imperial College London, Liver Unit, St. Mary’s Hospital, South Wharf Road, Paddington, London W2 1NY, UKTel +44 20 3312 6199Email [email protected]: Cholangiocarcinoma is endemic in southeast Asia, generally developing from liver fluke infestation. However, diagnostic imaging of early-stage disease is challenging. The aim of this work is to investigate relaxometry (specifically, T2 mapping) as a method of exploiting the higher signal-to-noise ratio (SNR) of internal coils for improved reception of magnetic resonance signals, despite their non-uniform sensitivity.Methods: Ex vivo T2 mapping was carried out at 3T on fixed resection specimens from Thai cholangiocarcinoma patients using an mGRASE sequence and an endoscope coil based on a thin-film magneto-inductive waveguide and designed ultimately for internal use.Results: Disease-induced changes including granulomatous inflammation, intraepithelial neoplasia and intraductal tumours were correlated with histopathology, and relaxation data were compared with mono- and bi-exponential models of T2 relaxation. An approximately 10-fold local advantage in SNR compared to a 16-element torso coil was demonstrated using the endoscope coil, and improved tissue differentiation was obtained without contrast agents.Conclusion: The performance advantage above follows directly from the inverse relation between the component of the standard deviation of T2 due to thermal noise and the SNR, and offers an effective method of exploiting the SNR advantage of internal coils. No correction is required, avoiding the need for tracking, relaxing constraints on coil and slice orientation and providing rapid visualization.Keywords: cholangiocarcinoma, T2 mapping, internal coil

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