Advanced Diffusion Imaging of Breast Cancer

 描述(申请人提供)：对比增强磁共振成像(CE-MRI)已成为诊断乳腺癌和评估治疗反应的最准确和最敏感的成像方式。扩散加权成像(DWI)是一种越来越常用的定量成像技术，可以很容易地添加到CE-MRI检查中，以提高诊断性能，因为恶性病变的水表观扩散系数(ADC)往往低于良性病变。这些信息可以用来提高诊断的准确性，水ADC的变化可能有助于作为治疗反应的早期指标。虽然早期的研究很有希望，但由于使用单次激发自旋回波平面成像(EPI)进行图像编码，乳腺DWI的广泛采用受到了限制。单次激发EPI速度很快，但空间分辨率较低，而且容易因非共振信号和硬件缺陷而产生大量伪影。这项技术在神经成像中是可以接受的，但在乳房成像中，宽视野、大的B0不均匀、无处不在的脂肪信号和呼吸运动使这项技术不一致，而且质量普遍较差。缺乏一个强大的、高分辨率的乳腺DWI成像序列是这项有希望的技术在研究和临床实践中更广泛应用的关键障碍。在这项提案中，我们试图通过采用最初为人类连接组计划(HCP)开发的先进扩散成像方法来开发解剖质量的乳腺DWI成像。我们的初步数据显示，与临床上可用的替代方法相比，使用这种方法可以获得高空间分辨率的乳房DWI和改善的图像质量。我们建议纳入新的策略和优化，以进一步提高图像质量，并随后在真实的临床环境中评估我们新方法的成像性能。这项工作的总体目标是开发一种乳腺DWI方法，提供准确的定量信息，具有解剖分辨率和高图像质量。如果成功，这将产生更高分辨率和更好质量的乳腺DWI，可以整合到任何临床乳腺MR成像检查中。这些进展还将提高评估乳房弥散加权成像中更高级的扩散概念的可行性，例如模拟血流灌注、各向异性和限制。

 DESCRIPTION (provided by applicant): Contrast-enhanced magnetic resonance imaging (CE-MRI) has become the most accurate and sensitive imaging modality for diagnosing breast cancer and assessing treatment response. Diffusion-weighted imaging (DWI) is an increasingly used quantitative imaging technique that can be readily added to a CE-MRI exam to improve diagnostic performance, as malignant lesions tend to have a lower water apparent diffusion coefficient (ADC) than benign lesions. This information can be used to improve diagnostic accuracy, and changes in water ADC may be useful as an early indicator of treatment response. While early studies are promising, wider adoption of breast DWI has been limited by the use of single-shot spin-echo echo planar imaging (EPI) for image encoding. Single-shot EPI is very fast, but gives low spatial resolution and is prone to numerous artifacts from off-resonance signals and hardware imperfections. This technique works acceptably in neuroimaging, but in breast imaging, the wide field-of-views, large B0 inhomogeneities, ubiquitous lipid signals, and respiratory motion make this technique inconsistent and of generally poor quality. The lack of a robust, high-resolution imaging sequence for breast DWI is a critical barrier to greater use of thi promising technique in both research and clinical practice. In this proposal, we seek to develop anatomical-quality breast DWI imaging by adapting advanced diffusion imaging methods that were initially developed for the Human Connectome Project (HCP). Our initial data show that using the this approach can give breast DWI with high spatial resolution and improved image quality compared to clinically-available alternatives. We propose to incorporate new strategies and optimizations to further improve image quality, and subsequently assess the imaging performance of our new method in a true clinical setting. The overall goal of this work is develop a breast DWI method that gives accurate quantitative information with anatomical resolution and high image quality. If successful, this would produce higher resolution and better quality breast DWI that could be incorporated into any clinical breast MR imaging exam. These advances would also improve the feasibility of assessing more advanced diffusion concepts in breast DWI, such as modeling perfusion, anisotropy, and restriction.