Abbreviated Non-Contrast-Enhanced MRI for Breast Cancer Screening

项目摘要 概述：2020年，超过27.6万名妇女将被诊断为浸润性乳腺癌，超过4.8万人将被诊断为浸润性乳腺癌 因此而死。该项目的最终目标是提供快速、准确、可访问的非增强磁共振成像 在高危人群中安全检测乳腺癌的筛查方法。 相关性：筛查乳房X光检查在降低乳腺癌死亡率方面是成功的，但漏掉了许多 重要的癌症，特别是在乳腺癌高危妇女中，以及在2700万患有密集癌症的妇女中 接受筛查的乳房。核磁共振已被证明在许多疾病筛查中的敏感性是前者的两倍以上。 场景，但成本高、不适感和依从性差，这是因为需要静脉注射格拉基对比剂 有副作用的药物限制了其对筛查的影响。该项目旨在通过开发一种 快速、廉价、舒适、无对比增强的乳腺MRI筛查检查。 方法：在大量前期工作的基础上，我们团队将开发高分辨率3D和2D扩散磁共振成像 能够描述乳腺病变的重要形态特征和量化扩散异质性的方法。 为了支持这些方法，我们将首先实施fifl可伸缩的、紧密连接的软乳房线圈阵列，以最大限度地提高 SNR和并行成像功能，同时减少定位时间和增加舒适性。我们将联合起来 非笛卡尔三维锥体双回波稳态差成像的EFfi精度和运动不敏感度 融合方法提供有效的fi三维扩散加权成像(DWI)。此外，我们将重新设计回声平面 成像(EPI)DWI，包括具有块运动不敏感性的非对称编码、全k空间读出和新颖 局部低阶重建，以提供高分辨率定量弥散加权成像，对小的患者运动是稳健的。 最后，我们将与另外两个主要中心合作，研究这些方法在高危患者筛查中的作用， 旨在证明在患有以下疾病的女性中，非对比增强敏感度从45%提高到70%以上 乳房X光检查阴性，同时保留了fi市91%以上的物种。如果成功，这些比率是不可能达到的(fi 无对比增强MRI筛查具有临床应用价值。 摘要：利用2D和3D DWI的先进技术，结合fl可伸缩线圈阵列，我们的目标是提供准确、 低成本、舒适、无需静脉造影剂的MRI筛查，只需10分钟的检查。这最终将- 能够为数百万接受X光乳房X光检查的女性提供更有效和舒适的乳腺癌筛查 是不明智的fi。

Project Abstract Overview: In 2020, over 276,000 women will be diagnosed with invasive breast cancer, and over 48,000 will die from it. The ultimate goal of this project is to provide fast, accurate, accessible non-contrast-enhanced MRI screening methods to safely detect breast cancer in the high-risk population. Relevance: Screening mammography is successful in reducing breast cancer mortality, but misses many important cancers, especially in women with a high risk of breast cancer, and in the 27 million women with dense breasts who undergo screening. MRI has been shown to be more than twice as sensitive for screening in many scenarios, but high cost, discomfort, and poor compliance due to the need for IV gadolinium-based contrast agents with side effects limit its impact for screening. This project aims to change this paradigm by developing a rapid, inexpensive, comfortable, non-contrast-enhanced breast MRI screening exam. Approach: Based on substantial prior work, our group will develop high-resolution 3D and 2D diffusion MRI methods that can depict important morphologic features and quantify diffusion heterogeneity in breast lesions. To support these methods, we will first implement flexible, closely-fitting soft breast coil arrays that maximize SNR and parallel imaging capabilities while reducing positioning time and increasing comfort. We will combine the efficiency and motion-insensitivity of non-Cartesian 3D cones imaging with the double-echo steady-state dif- fusion approach to offer efficient 3D diffusion-weighted imaging (DWI). Additionally, we will redesign echo-planar imaging (EPI) DWI including asymmetric encoding with bulk motion insensitivity, full k-space readouts, and novel locally low-rank reconstruction to provide high-resolution quantitative DWI that is robust to small patient motion. Finally, collaborating with two other major centers, we will study these methods in high-risk screening patients, aiming to demonstrate improved non-contrast-enhanced sensitivity from 45% to over 70% among women with negative mammograms, while retaining specificity over 91%. If successful, these rates are sufficient to make non-contrast-enhanced MRI screening viable for clinical use. Summary: Using advances to 2D and 3D DWI, combined with flexible coil arrays, we aim to provide accurate, low-cost, comfortable, MRI screening without intravenous contrast, in a 10 minute exam. This will ultimately en- able more effective and comfortable breast cancer screening for millions women for whom x-ray mammography is insufficient.