Non-Contrast DWI for Supplemental Screening of Women with Dense Breasts

非对比 DWI 对致密乳房女性的补充筛查

• 批准号: 9493451
• 负责人: Savannah Corrina Partridge
• 金额: $ 37.75万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-06-01 至 2022-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9493451
• 关键词: Address; American; American Cancer Society; Assessment tool; Awareness; Benign; Biopsy; Brain; Breast; Breast Cancer Detection; Breast Cancer Risk Factor; Breast Magnetic Resonance Imaging; Cancer Detection; Cancer Etiology; Cessation of life; Clinical; Complement; Computer Assisted; Consensus; Contrast Media; DNA Sequence Alteration; Data; Deposition; Detection; Diagnostic; Diffusion; Diffusion Magnetic Resonance Imaging; Echo-Planar Imaging; Environment; Exhibits; Family; Gadolinium; Guidelines; Health; Imaging Techniques; Intravenous; Lesion; Magnetic Resonance Imaging; Malignant - descriptor; Malignant Neoplasms; Mammary Gland Parenchyma; Mammary Ultrasonography; Mammographic screening; Mammography; Methods; Microscopic; Noise; Outcome; Outcome Study; Performance; Population; Provider; Public Health; Reader; Receiver Operating Characteristics; Recording of previous events; Research; Resolution; Risk; Role; Scanning; Screening for cancer; Screening procedure; Sensitivity and Specificity; Standardization; Statutes and Laws; Techniques; Testing; Time; Toxic effect; Ultrasonography; Woman; Women' s Health; base; breast density; clinical implementation; contrast enhanced; cost; design; imaging approach; improved; lifetime risk; malignant breast neoplasm; novel; patient safety; performance tests; screening; tool

Abstract Breast cancer is extremely common, striking 1 in 8 American women, and is the second leading cause of cancer death among women in the U.S. Women with dense breasts on screening mammography have a two to five times increased risk of developing breast cancer, and increased breast density reduces the sensitivity of mammography for cancer detection. As a result, a growing number of states have passed legislation mandating that women have a right to know if their breast density is increased. Unfortunately, there are no clear guidelines as to what women should do with this information or appropriate supplemental screening strategies. Studies investigating the use of ultrasound in this role have not been convincing, generally showing low added cancer yield and high rate of false positives. On the other hand, contrast-enhanced MRI has the highest sensitivity for detecting cancers in dense breasts, but barriers to more widespread use of breast MRI include high costs, relatively lengthy scanning times, and contraindications related to administration of gadolinium-based contrast. Furthermore, new research providing evidence of accumulation of gadolinium- based contrast agents in the brain has raised awareness and concerns about the risk of long-term use of contrast-enhanced MRI for screening and surveillance. An effective, low cost, safe screening method is needed to detect mammographically occult cancers in women with dense breasts. Diffusion-weighted imaging (DWI) is a short (2-3 minutes) non-contrast MRI technique that has shown promise for the detection and characterization of breast cancer. Our preliminary data has shown that DWI holds potential for detecting mammographically and clinically-occult breast cancers. However, current technical limitations reduce the sensitivity of DWI for screening applications. We hypothesize that an optimized DWI approach will enable detection of mammographically occult breast cancer in women with dense breasts with high sensitivity and low false positive rate. Aims of the study will be to 1) optimize the DWI acquisition 2) develop an interpretation strategy and tools, and 3) test the performance of DWI for detecting mammographically-occult breast cancer in women with dense breasts. If successful, non-contrast DWI could provide a viable supplemental screening tool to improve early detection of cancer in women with dense breasts.

摘要 乳腺癌非常常见，每8名美国妇女中就有1人患上乳腺癌，是第二大病因 在美国女性中，乳腺癌死亡率为2.5%。 患乳腺癌的风险增加五倍，乳腺密度增加会降低乳腺癌的敏感性。 乳房X光检查用于癌症检测。因此，越来越多的州通过了立法 规定妇女有权知道她们的乳房密度是否增加。不幸的是，没有 明确的指导方针，妇女应该如何处理这些信息或适当的补充筛查 战略布局调查超声在这方面作用的研究并不令人信服，通常显示 低的附加癌症产量和高的假阳性率。另一方面，对比增强MRI具有 在致密乳腺中检测癌症的灵敏度最高，但阻碍了乳腺MRI的更广泛使用 包括高成本、相对较长扫描时间以及与施用 钆基对比度。此外，新的研究提供了钆积累的证据- 基于造影剂在大脑中的应用提高了人们对长期使用造影剂的风险的认识和关注。 对比增强MRI进行筛查和监测一种有效、低成本、安全的筛选方法， 需要在乳腺致密的女性中检测出乳腺X光检查的隐匿性癌症。 弥散加权成像（DWI）是一种短（2-3分钟）的非对比MRI技术， 为乳腺癌的检测和表征提供了希望。我们的初步数据显示DWI 具有检测乳房X线摄影和临床隐匿性乳腺癌的潜力。目前的技术 这些限制降低了DWI用于筛选应用的灵敏度。我们假设优化的DWI 该方法将能够检测乳腺致密女性的乳腺X线检查隐匿性乳腺癌， 灵敏度高，假阳性率低。本研究旨在1）优化DWI采集2） 开发一种解释策略和工具，3）测试DWI检测的性能 乳房致密的女性中的乳房X线检查隐性乳腺癌。如果成功，非对比DWI可以 提供一种可行的补充筛查工具，以改善高密度乳腺癌妇女的癌症早期发现。 乳房