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AMMF’s Virtual 2021 European Cholangiocarcinoma Conference

Abstract No 7

T2 mapping of cholangiocarcinoma using internal coils

 Narong Khuntikeo1, Attapol Titapun1, Nittaya Chamadol1, Wuttisak Boonphongsathien1, Prakasit Sa-Ngiamwibool1, Simon D. Taylor-Robinson2, Christopher A. Wadsworth2, Shuo Zhang3, Evdokia M. Kardoulaki4, Richard R.A. Syms4*

1  Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
2  Division of Surgery and Cancer, Imperial College London, Liver Unit, St. Mary’s Hospital, South Wharf Road, Paddington, London, W2 1NY, UK
3  Philips Healthcare Germany, Health Systems, Clinical Science, Roentgenstraße 24, 22335 Hamburg, Germany
4  EEE Dept., Imperial College, Exhibition Road, London SW7 2AZ, UK
* Corresponding author: tel 07590 250543, email r.syms@imperial.ac.uk

Abstract

Improvements in soft-tissue imaging may assist in determining the extent of periductal and intraductal cholangiocarcinoma (CCA) prior to surgery. In magnetic resonance imaging (MRI), resolution is largely determined by the signal-to-noise ratio of the detected signal, which in turn is limited by the radiofrequency noise emitted from the human body. Local improvements might therefore be expected from small internal receivers with a small field-of-view for body noise, provided they may be placed inside the body near to the tissue of interest. The potential for internal receivers to improve resolution in MRI of CCA is being examined through laboratory experiments. The receivers are based on thin, flexible printed circuits mounted on duodenoscopes and catheters designed for imaging extra- and intra-hepatic ducts, respectively [1, 2]. Since the receivers have spatially non-uniform signal reception pattern, the resulting images are very different to conventional MRI scans. However, clear images with high-resolution detail are obtained by using a T2 mapping sequence, which measures the variation of the T2 relaxation time-constant, and by plotting this value instead of the signal amplitude. The procedure is demonstrated using images of excised tissue obtained from Thai patients with fluke induced CCA, and tissue changes including disease precursors, tumours and duct wall modifications are visualised and correlated with pathology [3, 4].

References

  1. Syms R.R.A. et al. “Magneto-inductive magnetic resonance imaging duodenoscope” PIER 159: 125-138 (2017)
  2. Syms R.R.A. et al. “Magneto-inductive catheter receiver for magnetic resonance imaging” IEEE Trans. Biomed. Engng. 60: 2421-31 (2013)
  3. Khuntikeo N. et al. “Improving the detection of cholangiocarcinoma: in vitro MRI study using local coils and T2 mapping” Hepatic Medicine Evidence and Research 12, 29-39 (2020)
  4. Khuntikeo N. et al. “In vitro intraductal MRI and T2 mapping using catheter coils” Hepatic Medicine Evidence and Research 12, 107-114 (2020)[298]

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