MO-C-17A-02: A Novel Method for Evaluating Hepatic Stiffness Based On 4D-MRI and Deformable Image Registration.

PURPOSE: Quantitative imaging of hepatic stiffness has significant potential in radiation therapy, ranging from treatment planning to response assessment. This study aims to develop a novel, noninvasive method to quantify liver stiffness with 3D strains liver maps using 4D-MRI and deformable image registration (DIR). METHODS: Five patients with liver cancer were imaged with an institutionally developed 4D-MRI technique under an IRB-approved protocol. Displacement vector fields (DVFs) across the liver were generated via DIR of different phases of 4D-MRI. Strain tensor at each voxel of interest (VOI) was computed from the relative displacements between the VOI and each of the six adjacent voxels. Three principal strains (E1 , E2 and E3 ) of the VOI were derived as the eigenvalue of the strain tensor, which represent the magnitudes of the maximum and minimum stretches. Strain tensors for two regions of interest (ROIs) were calculated and compared for each patient, one within the tumor (ROI1 ) and the other in normal liver distant from the heart (ROI2 ). RESULTS: 3D strain maps were successfully generated fort each respiratory phase of 4D-MRI for all patients. Liver deformations induced by both respiration and cardiac motion were observed. Differences in strain values adjacent to the distant from the heart indicate significant deformation caused by cardiac expansion during diastole. The large E1 /E2 (∼2) and E1 /E2 (∼10) ratios reflect the predominance of liver deformation in the superior-inferior direction. The mean E1 in ROI1 (0.12±0.10) was smaller than in ROI2 (0.15±0.12), reflecting a higher degree of stiffness of the cirrhotic tumor. CONCLUSION: We have successfully developed a novel method for quantitatively evaluating regional hepatic stiffness based on DIR of 4D-MRI. Our initial findings indicate that liver strain is heterogeneous, and liver tumors may have lower principal strain values than normal liver. Thorough validation of our method is warranted in future studies. NIH (1R21CA165384-01A1).

Duke Scholars

Author Manisha Palta Radiation Oncology

Author Mustafa Shadi Rifaat Bashir Radiology, Abdominal Imaging