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High resolution 3D diffusion-weighted breast MRI

高分辨率 3D 扩散加权乳腺 MRI

基本信息

批准号：
8204616
负责人：
BRUCE L DANIEL
金额：
$ 19.75万
依托单位：
STANFORD UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-01-01 至 2013-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8204616
关键词：
Adverse reactions Area Biopsy Breast Breast Cancer Detection Breast Cancer Early Detection Cancer Center Characteristics Clinic Clinical Contrast Media Development Diagnosis Diffusion Diffusion weighted imaging Early Diagnosis Early treatment Echo-Planar Imaging Engineering Evaluation Event Extravasation Family Fatty acid glycerol esters Fibrosis Funding Future Gadolinium Genetic Goals Grant Headache High Risk Woman Human Resources Image Imaging Techniques Impaired Renal Function Intravenous Knee Laboratories Life Magnetic Resonance Imaging Mammography Maps Mastectomy Measures Methods Microscopic Modeling Monitor Morbidity - disease rate Morphologic artifacts Motion Nausea Pain Patients Phlebitis Physicians Physiologic pulse Population Process Prophylactic treatment Radiology Specialty Reaction Recording of previous events Reporting Resolution Risk Roentgen Rays Scanning Science Screening for cancer Screening procedure Signal Transduction Site Staging Structure Subgroup System Techniques Technology Testing Tissues Translations United States National Institutes of Health Validation Variant Water Weight Woman Work base cancer genetics cost cost effectiveness data acquisition density diagnostic accuracy experience gadolinium oxide heart motion hemodynamics high risk imaging modality improved intravenous administration intravenous injection lifetime risk magnetic field malignant breast neoplasm mortality novel programs prophylactic public health relevance research clinical testing respiratory success tumor water diffusion

项目摘要

DESCRIPTION (provided by applicant): Early detection of breast cancer reduces mortality. Contrast-enhanced Magnetic Resonance Imaging (MRI) is recommended for screening women at high risk for breast cancer because it is nearly twice as sensitive as X- ray mammography. Unfortunately, intravenous gadolinium-based contrast agents substantially increase the costs and potential risks of MRI. Our goal is effective breast MRI screening without IV contrast agents. The most promising approach for non-contrast breast MRI is diffusion-weighted imaging (DWI). Echo-planar imaging (EPI-) DWI reveals tumors because increased cellular density and altered microscopic structure restrict water diffusion. However, EPI-DWI suffers from low resolution and distortions due to magnetic field variations in the breast. We aim to create a robust alternative based on double echo in steady-state (DESS) imaging: First, we will develop and optimize the DESS-DWI technique. We will develop accurate signal models that use signal information in both DESS echoes to maximize diffusion weighting and to minimize sensitivity to confounding factors. We will modify data acquisition to correct motion artifacts, and develop post-processing methods to generate T2-weighted images and diffusion maps from two interleaved DESS-DWI acquisitions. Second, we will test DESS-DWI in patients. We propose to compare the sensitivity of DESS-DWI with X-ray mammography, standard EPI-DWI and DCE-MRI in patients undergoing clinical MRI for high-risk screening or breast cancer evaluation. We will compare the biopsy rate precipitated by DESS-DWI with that of standard DCE-MRI in the subgroup of patients who underwent MRI for high-risk screening. This will be the first use of steady-state diffusion-weighted MRI for breast cancer. The proposed DESS-DWI technique has several novel features. It offers 3D scanning with high spatial resolution to show morphologic features in detail. It provides both T2 imaging and diffusion sensitivity in a single 3D sequence with better accuracy than previous steady-state diffusion methods. It avoids the distortions of EPI-DWI, offering unprecedented ability to perform multiparametric, pixel-by-pixel analysis and correlation with other sequences. At the conclusion of this work, we will have developed and tested a new gadolinium-free approach for high-risk breast cancer screening. Future clinical validation of these techniques could make screening breast MRI available to a broader population and thus improve early detection and treatment of breast cancer. PUBLIC HEALTH RELEVANCE: The goal of this project is to create an accurate magnetic resonance imaging (MRI) technique for detecting breast cancer that does not require an intravenous injection of contrast material. The approach is to develop and test a three-dimensional, high-resolution, distortion-free pulse sequence that reveals the substantially restricted diffusion of water in tumors. Eliminating gadolinium contrast material will reduce the duration, cost, risk and invasiveness of breast MRI, enabling MRI to be used more widely to screen for occult, early-stage, treatable breast cancer.

描述(申请人提供)：早期发现乳腺癌可降低死亡率。对比度增强磁共振成像(MRI)被推荐用于筛查乳腺癌高危女性，因为它的敏感度几乎是X射线乳房X光照相的两倍。不幸的是，静脉注射的基于Gd的造影剂大大增加了MRI的成本和潜在的风险。我们的目标是在没有静脉造影剂的情况下进行有效的乳腺MRI筛查。弥散加权成像(DWI)是目前最有前景的乳腺MRI平扫方法。回声平面成像(EPI-)DWI显示肿瘤，因为细胞密度增加和微观结构改变限制了水的扩散。然而，EPI-DWI由于乳房内的磁场变化而存在分辨率低和失真的问题。我们的目标是创建一种基于双回波稳态(DESS)成像的稳健替代方案：首先，我们将开发和优化DESS-DWI技术。我们将开发准确的信号模型，使用两个DESS回波中的信号信息来最大化扩散加权，并将对混杂因素的敏感度降至最低。我们将修改数据采集以校正运动伪影，并开发后处理方法以从两个交错的DESS-DWI采集生成T2加权图像和扩散图。其次，我们将在患者身上测试DESS-DWI。我们建议将DESS-DWI与X线片、标准EPI-DWI和DCE-MRI在接受临床MRI检查的患者中的敏感性进行比较，以进行高危筛查或乳腺癌评估。我们将比较DESS-DWI和标准DCE-MRI在接受MRI进行高危筛查的患者亚组中的活检率。这将是第一次使用稳态扩散加权磁共振成像诊断乳腺癌。提出的DESS-DWI技术具有几个新的特征。它提供高空间分辨率的3D扫描，以详细显示形态特征。它在单个3D序列中提供T2成像和扩散敏感性，比以前的稳态扩散方法具有更好的准确性。它避免了EPI-DWI的失真，提供了前所未有的能力来执行多参数、逐个像素的分析以及与其他序列的关联。在这项工作结束时，我们将开发和测试一种用于高危乳腺癌筛查的新的无Gd方法。未来这些技术的临床验证可以使更广泛的人群获得筛查乳腺MRI，从而改善乳腺癌的早期发现和治疗。与公众健康相关：该项目的目标是创建一种准确的磁共振成像(MRI)技术，用于检测乳腺癌，而不需要静脉注射造影剂。该方法是开发和测试一种三维、高分辨率、无失真的脉冲序列，该序列揭示了水在肿瘤中的扩散基本上受到限制。消除Gd对比剂将减少乳腺MRI的持续时间、成本、风险和侵袭性，使MRI能够更广泛地用于筛查隐匿性的、早期的、可治疗的乳腺癌。