High-Resolution Whole-Breast MRI at 3.0T

描述(申请人提供)：该项目将开发和测试新的MRI技术，比标准的乳腺MRI提前一年检测乳腺癌。这将通过与目前的方案相比时空分辨率提高14倍的动态对比增强成像以及提高已建立的乳腺癌定量成像生物标记物的空间分辨率来实现。所有方法的诊断效用将在乳腺癌患者的研究中进行测试。相关性：乳腺癌仍然是女性中第二致命的癌症，尽管由于乳房X光检查和更好的系统治疗，死亡率确实降低了。虽然MRI筛查发现的肿瘤是乳房X光检查的两倍，但MRI筛查的成本限制了它的使用，仅限于乳腺癌高危女性。通过显著提高MRI对小病变的诊断性能，这项提议中的技术将使乳腺MRI能够更早地可靠地检测乳腺癌。这可以使高危患者减少接受MRI筛查的频率，同时仍然确保在乳腺癌处于I期且可治疗且长期存活的可能性很高时被发现，每年节省高达10亿美元，并省去高达5万次昂贵而痛苦的活组织检查。它还可以根据风险启用定制的筛查间隔。我们将开发的高空间分辨率定量成像将提高小病变的特异性，以最大限度地减少假阳性。它还将提高现有M成像生物标记物的质量和可靠性，这些生物标记物正用于预后、治疗选择和治疗反应监测。方法：我们的方法建立在我们在高分辨率乳腺MRI方面的成功记录上，这是在我们之前的资助期间建立的，产生了大量的论文、专利和会议记录。在这项工作中，我们的目标是提供(1)时空分辨率的14倍增加，其可以在高空间分辨率静态(0.35±0.35 mm~3)和高时空分辨率(在15 S 15 mm~3中为0.5？1.0 mm~3)动态成像之间灵活地权衡，(2)基于高空间分辨率的定量体积3T磁共振生物标记物，包括T2、表观扩散系数和具有运动校正、B+1不均质性和T1效应的药代动力学灌注度量，以及(3)患者研究，以证明通过高分辨率成像能够提高对小肿瘤的检测，同时保持较低的活检率。摘要：通过使用先进的乳腺线圈、新的优化的3D脉冲序列、使用压缩传感和并行成像的先进的数据采样和图像重建技术提供更高空间分辨率的多参数定量信息，这项工作将使MRI成为一种更实用和更强大的筛查方法，能够在早期可靠地发现较小的乳腺肿瘤，进一步降低乳腺癌的死亡率。

DESCRIPTION (provided by applicant): This project will develop and test new MRI technology for detecting breast cancer one year earlier than standard breast MRI. This will be achieved through fourteen-fold higher spatio-temporal resolution dynamic contrast- enhanced imaging compared to current protocols, as well as improved spatial resolution of established quantitative imaging biomarkers of breast cancer. The diagnostic utility of all methods will be tested in studies of patients with breast cancer. Relevance: Breast cancer remains the second most lethal cancer amongst women, despite real reductions in mortality due to screening with mammography and better systemic therapy. While MRI screening detects twice as many tumors as mammography, the cost of MRI screening limits its use to women with a high risk of breast cancer. By significantly improving the diagnostic performance of MRI for small lesions, the technology in this proposal will enable breast MRI to reliably detect breast cancers much earlier. This could enable high-risk patients to undergo MRI screening less frequently while still ensuring detection of breast cancers when they are stage I and treatable with a high likelihood of long term survival, saving up to $1 billion and eliminating up to 50,000 costly, painful biopsie each year. It may also enable customized screening intervals depending on risk. The high spatial resolution quantitative imaging that we will develop will boost specificity among small lesions to minimize false positives. It will also improve the quality and reliability of existing M imaging biomarkers that are being used for prognosis, treatment selection and monitoring of treatment response. Approach: Our approach builds on our successful track record in high-resolution breast MRI established during our previous period of funding that generated numerous papers, patents and conference proceedings. In this work, we aim to offer (1) a fourteen-fold increase in spatio-temporal resolution that can be flexibly traded off between high spatial resolution static (0.35¿0.35¿0.7 mm3) and high spatio-temporal resolution (0.5¿0.5¿1.0 mm3 in 15 s) dynamic imaging, (2) high-spatial-resolution quantitative volumetric 3T MRI-based biomarkers including T2, apparent diffusion coefficient, and pharmacokinetic perfusion metrics with corrections for motion, B+1 inhomogeneity, and T1 effects, and (3) patient studies to demonstrate increased detection of small cancers, enabled by high-resolution imaging, while keeping the overall biopsy rate low. Summary: By offering multi-parametric quantitative information at higher spatial resolution using advanced breast coils, new optimized 3D pulse sequences, advanced data sampling and image reconstruction techniques using compressed sensing and parallel imaging, this work will make MRI a more practical and powerful screening method that reliably detects smaller breast tumors at earlier stages, further reducing mortality from breast cancer.