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

描述（由申请人提供）：该项目直接响应“06-EB-104 -常规临床检查的快速MR成像”。我们将开发一种新的超高速3D磁共振光谱成像（MRSI）检查来绘制总胆碱（tCho），这是一种敏感的乳腺肿瘤状态的生物标志物。与传统的磁共振光谱（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，这将使临床可行的tCho制图能够增强常规动态对比增强（DCE） MRI的有限特异性。尽管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，但总体特异性仍然较低，导致相当多的良性活检。最近的研究报道，在DCE MRI检查中加入tCho的定量MRS测量可以提高所有读取器的灵敏度、特异性和准确性，并改善读取器之间的观察者之间的一致性。乳房MRS的第二个有希望的应用是预测对治疗的反应，可能在局部晚期乳腺癌第一次化疗后24小时内。在这项研究中，我们将开发一种基于单次质子回波平面光谱成像（PEPSI）和超分辨率重建（SURE-SENSE）的超高速并行磁共振成像技术，这是我们最近为人脑开发的一种新型并行成像技术。该方法将使用一种新型的16通道乳房射频阵列线圈来实现，与传统的射频线圈设计相比，该线圈提供了更高的灵敏度，并且能够实现更快的并行成像加速。目的是将MRSI添加到临床MRI方案中，以表征局灶性以及多中心和多灶性疾病的敏感性和特异性的增加。具体目标是：(1)开发乳腺3t超高速3D磁共振光谱成像(2)将3t高速3D磁共振光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。长期目标是利用核磁共振成像作为接受全身治疗（即化疗）的女性乳腺癌治疗失败的早期预测指标，并为高风险患者制定改进的筛查方案。在接受新辅助治疗的患者中，准确的早期识别治疗失败或成功可以节省大量的时间和资源，并最大限度地降低患者的风险和暴露于无效药物的潜在副作用。本项目直接响应“06-EB-104 -常规临床检查的快速MR成像”。我们将开发一种新的超高速成像方法来绘制总胆碱（tCho），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，这将使临床可行的tCho制图能够增强常规磁共振成像（MRI）检查使用造影剂可视化肿瘤的有限特异性。

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.