Specificity of MRI with optimal temporal, spatial, and spectral samp. for early B

常规磁共振成像对于检测非常早期的乳腺癌具有很好的敏感性，并且 这可能是筛查乳腺癌高危女性的一种有价值的方法。然而，它的特殊性是 这是不够的，特别是考虑到它的高度敏感性。因此，人们担心核磁共振扫描会导致 不必要的治疗。我们建议显著提高敏感度和特异度 光谱、时间和空间采样(MRITSS)。MRITSS有两个组成部分。高光谱和高空间 分辨率MRI提供了与每个图像体素相关联的高分辨率水光谱，以及水 频谱线型被分析以产生改进的解剖和功能MR图像。高度时态和 对比剂摄取和冲洗过程中的空间分辨率成像可以准确测量 血流灌注和其他生理参数。我们将检验这两者结合在一起的假设 方法-MRITSS-提高了将受益的高危人群的特异性和敏感度 大部分来自核磁共振检查。我们将研究在临床MRI筛查中发现的‘偶发’病变，因为这些 病变最容易被误诊。在活检前进行额外的研究扫描将获得 使用MRITSS的“意外损伤”的数据。常规数据和MRITSS数据将使用以下方法进行评估 标准的形态和功能参数，以得出诊断。我们将确定是否 MRITSS以病理学家的诊断为金标准，提高了特异性和敏感性。在……里面 此外，我们将确定MRI参数是否与 癌症风险，包括微血管密度、细胞增殖标记物、血管内皮生长因子受体和P53、HER2、 BRCA1和BRCA2。这项研究将包括非洲裔美国女性，她们患癌症的风险特别高。 侵袭性早期乳腺癌。我们将比较这些女性乳腺病变的MRI参数和 这些是给研究中的其他女性的。 这项研究将对乳腺癌的临床治疗产生重大影响。如果结果是 证明MRITSS对早期乳腺癌有很高的特异性-这将支持更多的临床应用 使用MRI对高危女性进行筛查，并将改进的光谱、空间和时间整合 抽样进入临床核磁共振。此外，这项研究提供了一个不同寻常的机会来关联核磁共振 早期乳腺癌恶性程度的生物学标志物参数。这可能会带来改进 磁共振成像方案的设计和磁共振图像的解释。这项研究是一项跨学科的合作 放射科医生、肿瘤学家、外科医生、病理学家、医学物理学家和统计学家之间的关系 在乳房成像和乳腺癌治疗方面的记录。

Conventional magnetic resonance imaging has good sensitivity for detecting very early breast cancers, and may be a valuable for screening women who are at high risk for breast cancer. However, its specificity is inadequate, particularly given its high sensitivity. As a result there is a concern that MRI scans lead to unnecessary treatment. We propose to significantly increase sensitivity and specificity with improved spectral, temporal and spatial sampling (MRITSS). MRITSS has two components. High spectral and spatial resolution MRI provides a high resolution water spectrum associated with each image voxel, and the water spectral lineshape is analyzed to produce improved anatomic and functional MR images. High temporal and spatial resolution imaging during contrast media uptake and washout allows accurate measurement of perfusion and other physiologic parameters. We will test the hypothesis that the combination of these two approaches - MRITSS - improves specificity and sensitivity in the high risk population that would benefit most from MRI. We will study 'incidental' lesions that are found during clinical MRI screening, since these lesions are most susceptible to incorrect diagnosis. An additional research scan before biopsy will acquire data from an 'incidental lesion', using MRITSS. Conventional and MRITSS data will be evaluated using standard morphologic and functional parameters to arrive at a diagnosis. We will determine whether MRITSS increases specificity and sensitivity, using the pathologist's diagnosis as the gold standard. In addition, we will determine whether MRI parameters are correlated with genetic and biologic markers for cancer risk, including microvessel density, cell proliferation markers, VEGF receptors, and P53, HER2, BRCA1 and BRCA2. The study will include African American women who are at particularly high risk for aggressive early breast cancer. We will compare the MRI parameters for breast lesions in these women with those for the other women in the study. The research will have a significant impact on clinical managements of breast cancer. If the results demonstrate that MRITSS has high specificity for early breast cancer- this will support increased clinical use of MRI for screening high risk women, and integration of improved spectral, spatial, and temporal sampling into clinical MRI. In addition, the research provides an unusual opportunity to correlate MRI parameters with biological markers for malignancy in early breast cancers. This could lead to improved design of MRI protocols and interpretation of MR images. The research is an interdisciplinary collaboration between Radiologists, Oncologists, Surgeons, Pathologists, Medical Physicists, and Statisticians with strong track records in breast imaging and breast cancer treatment.