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

描述(申请人提供)：该项目是直接响应“06-EB-104-常规临床检查的快速磁共振成像”。我们将开发一种新的超高速3D磁共振光谱成像(MRSI)检查来定位总胆碱(Tcho)，这是一种敏感的乳腺肿瘤状态生物标志物。与传统的磁共振波谱(MRS)方法相比，我们的技术具有更高的空间分辨率和更短的测量时间，这将使临床上能够对TCHO进行标测，以增强常规动态对比增强(DCE)MRI的有限特异性。虽然磁共振成像在乳腺癌的筛查、临床诊断和治疗随访中发挥着越来越重要的作用，但总体上特异性仍然较低，导致相当数量的良性活检。最近的研究报道，将TCHO的MRS定量测量添加到DCE MRI检查中可以提高所有读者的敏感度、特异度和准确性，并改善读者之间的观察者间一致性。乳房MRS的第二个有前景的应用包括预测治疗反应，可能在局部晚期乳腺癌第一剂化疗后24小时内。在这项研究中，我们将开发一种用于人类乳房的超高速并行磁共振成像技术，该技术基于单次质子回波平面光谱成像(Pepsi)和超分辨率重建(Sure-Sense)，这是我们最近为人脑开发的一种新的并行成像形式。这一方法将使用新型16通道乳房射频阵列线圈实施，与传统的射频线圈设计相比，该线圈提供显著更高的灵敏度，并实现更快的并行成像加速。其目的是将MRSI添加到临床MRI方案中，以表征对局灶性疾病以及多中心和多灶性疾病的敏感性和特异性的增加。其具体目标是(1)开发3T乳腺的超高速3D MR波谱成像。(2)将3T的高速3D MR波谱成像作为乳腺癌检测和治疗反应评估的工具。如果成功，这项开发的技术将被用作乳腺癌诊断和治疗监测的工具。长期目标是利用MRSI作为接受系统治疗(即化疗)的乳腺癌女性治疗失败的早期预测指标，并为高危患者开发改进的筛查方案。在接受新辅助治疗的患者中，准确地及早识别治疗的失败或成功可以节省大量的时间和资源，并将患者风险和暴露于无效药物的潜在副作用降至最低。本项目是对《06-EB-104-常规临床检查快速磁共振成像》的直接响应。我们将开发一种新的超高速成像方法来定位总胆碱(Tcho)，这是一种在乳腺癌中升高的生化物质。与传统方法相比，我们的技术具有更高的空间分辨率和更短的测量时间，这将使TCHO能够在临床上可行的标测，以增强使用造影剂可视化肿瘤的常规磁共振成像(MRI)检查的有限特异性。 公共卫生相关性：尽管MRI成像在乳腺癌的筛查、临床诊断和治疗随访中发挥着越来越重要的作用，但总体特异性仍然较低，导致相当数量的良性活检。如果成功，这项开发的技术将被用作乳腺癌诊断和治疗监测的工具。长期目标是利用这项技术作为乳腺癌化疗女性治疗失败的早期预测指标，并为高危患者开发一种改进的筛查方案。在接受治疗的患者中，准确地及早识别治疗的失败或成功可以节省大量的时间和资源，并将患者的风险和暴露于无效药物的潜在副作用降至最低。

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.