Abbreviated Non-Contrast-Enhanced MRI for Breast Cancer Screening

用于乳腺癌筛查的简化非对比增强 MRI

• 批准号: 10557922
• 负责人: BRUCE L DANIEL
• 金额: $ 66.85万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-02-01 至 2026-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10557922
• 关键词: 3-Dimensional; Abbreviations; Benefits and Risks; Biopsy; Breast; Breast Cancer Detection; Breast Cancer Risk Factor; Breast Magnetic Resonance Imaging; Cessation of life; Clinical; Collaborations; Cone; Contrast Media; Data; Development; Diagnosis; Diagnostic; Diffusion; Diffusion Magnetic Resonance Imaging; Disease; Early treatment; Echo-Planar Imaging; Gadolinium; Goals; Health; Heterogeneity; High Risk Woman; Image; Improve Access; Injections; International; Intravenous; Lesion; Lesion by Morphology; Magnetic Resonance Imaging; Malignant Neoplasms; Mammary Gland Parenchyma; Mammographic screening; Mammography; Measurement; Measures; Methods; Morphology; Motion; Observational Study; Oncologist; Operative Surgical Procedures; Pathologist; Patients; Performance; Phase; Population; Positioning Attribute; Predictive Value; Printing; Protocols documentation; Recommendation; Reporting; Resolution; Resources; Risk; Roentgen Rays; Role; Scanning; Sensitivity and Specificity; Site; Specificity; Speed; Techniques; Technology; Testing; Time; Tissues; Universities; Variant; Water; Wisconsin; Woman; Work; breast lesion; bulk motion; clinical practice; contrast enhanced; cost; density; design; diagnostic accuracy; experience; flexibility; follow-up; high risk; high risk population; imaging approach; imaging capabilities; imaging detection; imaging modality; improved; innovation; lifetime risk; malignant breast neoplasm; mortality; novel; patient screening; preservation; prospective; radiologist; reconstruction; research clinical testing; routine screening; screening; screening guidelines; side effect; time use; tumor

Project Abstract Overview: In 2020, over 276,000 women will be diagnosed with invasive breast cancer, and over 48,000 will die from it. The ultimate goal of this project is to provide fast, accurate, accessible non-contrast-enhanced MRI screening methods to safely detect breast cancer in the high-risk population. Relevance: Screening mammography is successful in reducing breast cancer mortality, but misses many important cancers, especially in women with a high risk of breast cancer, and in the 27 million women with dense breasts who undergo screening. MRI has been shown to be more than twice as sensitive for screening in many scenarios, but high cost, discomfort, and poor compliance due to the need for IV gadolinium-based contrast agents with side effects limit its impact for screening. This project aims to change this paradigm by developing a rapid, inexpensive, comfortable, non-contrast-enhanced breast MRI screening exam. Approach: Based on substantial prior work, our group will develop high-resolution 3D and 2D diffusion MRI methods that can depict important morphologic features and quantify diffusion heterogeneity in breast lesions. To support these methods, we will first implement flexible, closely-fitting soft breast coil arrays that maximize SNR and parallel imaging capabilities while reducing positioning time and increasing comfort. We will combine the efficiency and motion-insensitivity of non-Cartesian 3D cones imaging with the double-echo steady-state dif- fusion approach to offer efficient 3D diffusion-weighted imaging (DWI). Additionally, we will redesign echo-planar imaging (EPI) DWI including asymmetric encoding with bulk motion insensitivity, full k-space readouts, and novel locally low-rank reconstruction to provide high-resolution quantitative DWI that is robust to small patient motion. Finally, collaborating with two other major centers, we will study these methods in high-risk screening patients, aiming to demonstrate improved non-contrast-enhanced sensitivity from 45% to over 70% among women with negative mammograms, while retaining specificity over 91%. If successful, these rates are sufficient to make non-contrast-enhanced MRI screening viable for clinical use. Summary: Using advances to 2D and 3D DWI, combined with flexible coil arrays, we aim to provide accurate, low-cost, comfortable, MRI screening without intravenous contrast, in a 10 minute exam. This will ultimately en- able more effective and comfortable breast cancer screening for millions women for whom x-ray mammography is insufficient.

项目摘要 2020年，超过276，000名女性将被诊断患有浸润性乳腺癌，超过48，000名女性将被诊断患有浸润性乳腺癌。 该项目的最终目标是提供快速，准确，可访问的非对比增强MRI 在高危人群中安全检测乳腺癌的筛查方法。 相关性：筛查性乳房X光检查在降低乳腺癌死亡率方面是成功的，但错过了许多 重要的癌症，特别是在乳腺癌高风险的妇女中，以及在2700万患有乳腺癌的妇女中， 接受筛查的乳房。MRI已被证明是两倍以上的敏感性筛选在许多 但由于需要IV钆基造影剂，因此成本高、不适和依从性差 具有副作用的药剂限制了其对筛选的影响。该项目旨在通过开发一个 快速、廉价、舒适、非对比增强的乳腺MRI筛查检查。 方法：基于大量的前期工作，我们的团队将开发高分辨率3D和2D扩散MRI 方法，可以描述重要的形态学特征和量化扩散异质性乳腺病变。 为了支持这些方法，我们将首先实施灵活的、紧密贴合的软乳房线圈阵列， SNR和并行成像功能，同时减少定位时间并提高舒适度。我们将联合收割机 非笛卡尔三维锥成像的效率和运动不敏感性与双回波稳态差， 融合方法提供有效的3D弥散加权成像（DWI）。此外，我们将重新设计回波平面 成像（EPI）DWI，包括具有体运动不敏感性的非对称编码、全k空间读出和新的 局部低秩重建，以提供高分辨率定量DWI，对患者的微小运动具有鲁棒性。 最后，与其他两个主要中心合作，我们将研究这些方法在高风险筛查患者， 旨在证明在患有以下疾病的女性中，非造影剂增强敏感性从45%提高到70%以上 阴性乳房X线检查，同时保持特异性超过91%。如果成功，这些利率足以使 非对比增强MRI筛查可用于临床。 总结：利用2D和3D DWI的先进技术，结合灵活的线圈阵列，我们的目标是提供准确的， 低成本、舒适的MRI筛查，无需静脉注射造影剂，只需10分钟即可完成。这将最终实现- 能够为数百万妇女提供更有效和更舒适的乳腺癌筛查， 是不足的。