Fast 3D MR Spectroscopic Imaging of Human Breast Cancer

描述（由申请人提供）： 恶性肿瘤的代谢包括脂质合成和过氧化作用，与正常乳腺组织和良性肿瘤不同。其中一些生化变化可以通过质子磁共振波谱成像（MRSI）检测，使用乳酸，胆碱和不饱和脂质作为乳腺癌的分子标志物，用于临床诊断和预后。 然而，乳腺组织中代谢物的质子NMR检测一直具有挑战性，因为强烈的脂质和水信号阻碍了乳腺组织中低浓度代谢物的观察。 近年来磁共振波谱技术的发展使乳腺恶性肿瘤中胆碱水平的检测成为可能，反映了肿瘤细胞的快速磷脂合成和高代谢活性。我们开发了Sel-MQC MRSI方法来观察临床乳腺癌中乳酸和不饱和脂质的变化，该方法通过多量子滤波在单次扫描中消除脂质和水信号。在此资助期间，我们将开发新的快速Sel-MQC技术，以提高Sel-MQC MRSI的时间分辨率，用于临床乳腺癌诊断。本研究将实现以下具体目标：（1）使用新型Sel-MQC序列同时映射胆碱、乳酸和不饱和脂质信号，以提高人类乳腺癌的临床MR诊断特异性;（2）开发快速3D MRSI方法，并提高乳腺组织中乳酸、胆碱和不饱和脂质定量Sel-MQC映射的时间分辨率。将开发临床方案，在3 T临床MRI扫描仪上使用Sel-MQC方法定量评估乳酸和胆碱以及不饱和脂质作为乳腺癌的分子标志物。我们将研究大约30例患者/年，这些患者正在接受乳腺MRI成像和随后的活检。将MRSI光谱数据与病理诊断进行比较，以确定该技术的潜力。该项目将证明MRSI作为一种非侵入性方法的临床有效性，该方法使用生物分子标记物用于早期检测乳腺癌，具有潜在的高诊断特异性和灵敏度。如果成功，质子MRSI还将提供一种方法来评估对乳腺癌治疗方案的反应，以及其他颅外癌症的诊断工具。

DESCRIPTION (provided by applicant): Malignant tumor metabolism including lipid sysnthesis and peroxidation differs from normal breast tissue and benign tumors. Some of these biochemical changes can be detected by proton MR spectroscopic imaging (MRSI) using lactate, choline, and unsaturated lipid as molecular markers of breast cancer for clinical diagnosis and prognosis. The proton NMR detection of metabolites in breast tissue, however, has been challenging due to the intense lipid and water signals that block the observation of low concentration of metabolites in breast tissue. The recent advances in magnetic resonance spectroscopy permits the detection of elevated choline level in malignant breast tumors, reflecting the rapid phosphblipid synthesis and high metabolic activities of the proliferating cells. We have developed the Sel-MQC MRSI methods to observe lactate and unsaturated lipid changes in clinical breast cancer, which eliminate lipid and water signals in a single scan by multiple quantum filtering. In this grant period, we will develop novel fast Sel-MQC techniques to improve the temporal resolution of the Sel-MQC MRSI for clinical breast cancer diagnosis. The following specific aims will be achieved: (1) To improve clinical MR diagnostic specificity of human breast cancer using the novel Sel-MQC sequences for simultaneous mapping of choline, lactate, and unsaturated lipid signals; (2) To develop fast 3D MRSI methods and improve the temporal resolution for quantitative Sel-MQC mapping of lactate, choline, and unsaturated lipid -in breast tissues. Clinical protocols will be developed to quantitatively evaluate lactate and choline, and unsaturated lipid as molecular markers of breast caner using the Sel-MQC methods on 3T clinical MRI scanners. We will studyapproximately 30 patients/yr for those who are undergoing breast MRI imaging and subsequent biopsy. The MRSI spectral data will be compared with the pathological diagnosis to determine the potential of the technique. This project will demonstrate the clinical effectiveness of MRSI as a non-invasive method using biomolecular markers for early detection of breast cancer with potentially high diagnostic specificity and sensitivity. If successful, the proton MRSI will also provide a method to evaluate responses to the breast cancer treatment regimens, as well as diagnostic tool for other extracranial cancers.