Volumetric mapping of Breast Cancer Biomarkers using high-speed MR Spectroscopic

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DESCRIPTION (provided by applicant): This project is in direct response to "06-EB-104 - Fast MR Imaging for Routine Clinical Examinations". We will develop a novel ultra high-speed 3D MR spectroscopic imaging (MRSI) exam to map total Choline (tCho), a sensitive biomarker of breast tumor status. The much higher spatial resolution and shorter measurement time of our technology compared to conventional MR spectroscopic (MRS) methods will enable clinically feasible mapping of tCho to enhance the limited specificity of routine dynamic-contrast enhanced (DCE) MRI. Although magnetic resonance (MR) imaging plays an increasingly important role in screening, clinical diagnostics and treatment follow-up of breast cancer the overall specificity is still low, resulting in a considerable number of benign biopsies. Recent studies reported that adding quantitative MRS measurements of tCho to a DCE MRI exam produced improvements in the sensitivity, specificity, and accuracy for all readers, and improved the inter observer agreement between the readers. A second promising application of breast MRS involves predicting response to treatment, possibly within 24 hours after the first dose of chemotherapy for locally advanced breast cancer. In this study we will develop an ultra high-speed parallel MRSI technique for the human breast based on single-shot Proton Echo Planar Spectroscopic Imaging (PEPSI) and superresolution reconstruction (SURE-SENSE), a novel form of parallel imaging, which we have recently developed for the human brain. This methodology will be implemented using a novel 16 channel breast RF array coil that provides significantly higher sensitivity and enables much faster parallel imaging acceleration as compared to conventional RF coil designs. The objective is to add MRSI to a clinical MRI protocol to characterize increases in sensitivity and specificity for characterizing focal, as well as multicentric and multifocal disease. The specific aims are (1) Develop ultra high-speed 3D MR spectroscopic imaging for the breast at 3 T (2) Use high-speed 3D MR spectroscopic imaging at 3 T as a tool for breast cancer detection and treatment response assessment. If successful, the developed technique will be used as a tool for breast cancer diagnosis and treatment monitoring. The long-term goals are to utilize MRSI as an early predictor of treatment failure in women undergoing systemic therapy (i.e. chemotherapy) for breast cancer and to develop an improved screening protocol for high risk patients. In patient undergoing neoadjuvant therapies, accurate early identification of treatment failure or success could save significant time and resources, and minimize patient risk and exposure to potential side effects from medications that are not efficacious. This project is in direct response to "06-EB-104 - Fast MR Imaging for Routine Clinical Examinations". We will develop a novel ultra high-speed imaging method to map total Choline (tCho), a biochemical substance that is elevated in breast cancer. The much higher spatial resolution and shorter measurement time of our technology compared to conventional methods will enable clinically feasible mapping of tCho to enhance the limited specificity of routine magnetic resonance imaging (MRI) exams using contrast agent to visualize the tumor. PUBLIC HEALTH RELEVANCE: Although MRI imaging plays an increasingly important role in screening, clinical diagnostics and treatment follow-up of breast cancer the overall specificity is still low, resulting in a considerable number of benign biopsies. If successful, the developed technique will be used as a tool for breast cancer diagnosis and treatment monitoring. The long-term goals are to utilize the technique as an early predictor of treatment failure in women undergoing chemotherapy for breast cancer and to develop an improved screening protocol for high risk patients. In patient undergoing therapies, accurate early identification of treatment failure or success could save significant time and resources, and minimize patient risk and exposure to potential side effects from medications that are not efficacious.