Technical recommendation on multiplex MR elastography for tomographic mapping of abdominal stiffness with a focus on the pancreas and pancreatic ductal adenocarcinoma

Jakob Schattenfroh, Salma Almutawakel, Jan Bieling, Johannes Castelein, Melanie Estrella, Philippe Garteiser, Viktor Hartung, Karl H. Hillebrandt, Adrian T. Huber, Laura Körner, Thomas Kröncke, Thomas Malinka, Hans-Jonas Meyer, Tom Meyer, Uwe Pelzer, Felix Pfister, Igor M. Sauer, Anna Speth, Bernard E. Van Beers, Carsten Warmuth, Nienke P. M. Wassenaar, Yanglei Wu, Rolf Reiter, Ingolf Sack

公開日: 2025/5/26

Abstract

Objectives: MR elastography (MRE) offers valuable mechanical tissue characterization, however, in deep abdominal organs like the pancreas conventional single-driver, single-frequency approaches often fail. This study evaluates whether multiplex MRE using multiple drivers and vibration frequencies can overcome these limitations. Methods: This study used single-shot spin-echo MRE in 18 healthy volunteers targeting the liver, pancreas, kidneys, and spleen. Each healthy volunteer underwent 16 MRE examinations with different sets of four vibration frequencies (30-60 Hz) and four driver combinations, and an additional null experiment without vibrations. Further, a cohort of 14 patients with pancreatic ductal adenocarcinoma (PDAC) were retrospectively assessed. The quality of shear-wave fields and stiffness maps was assessed by displacement amplitudes and image sharpness. Results: In healthy volunteers, abdominal coverage with displacement amplitudes above the pre-determined noise level of 4 {\mu}m varied between MRE configurations: 24.2% ([0.0%-56.2%], single-driver, 60 Hz), 66.9% ([24.8%-97.7%], single-driver, 30-60 Hz), 70.2% ([0.0%-92.5%], multi-driver, 60 Hz) and 99.9% ([89.4%-100%], multi-driver, 30-60 Hz). In the pancreas, >60% coverage was achieved in all subjects using four drivers and multiple frequencies. This was achieved in only 2/18 subjects using single-driver/single-frequency MRE. Patients with PDAC had 99.1% [91.4%-100%] coverage in the pancreas and 96.3% [63.1%-100%] abdominal coverage (multi-driver, 30-60 Hz). Conclusion: MRE with four drivers and multiple vibration frequencies between 30-60 Hz enables tomographic mapping of tissue stiffness across the entire abdomen, including the pancreas. Multiplex MRE offers a promising approach for generating detailed images of abdominal stiffness, potentially enhancing clinical diagnostics for abdominal and pancreatic diseases.