Specificity of MRI with optimal temporal, spatial, and spectral samp. for early B

常规磁共振成像对于检测非常早期的乳腺癌具有良好的灵敏度， 可能是筛查乳腺癌高危女性的一个有价值的方法。然而，它的特殊性是 这是不够的，特别是考虑到它的高度敏感性。因此，有人担心MRI扫描会导致 不必要的治疗。我们建议用改进的方法显著提高灵敏度和特异性， 光谱、时间和空间采样（MRITSS）。MRITSS有两个组成部分。高光谱和空间 高分辨率MRI提供与每个图像体素相关联的高分辨率水光谱，并且水 分析谱线形状以产生改进的解剖和功能MR图像。高的时间和 在造影剂摄取和冲洗期间的空间分辨率成像允许精确测量 灌注和其他生理参数。我们将检验这两个因素的结合 方法- MRITSS -提高了高危人群的特异性和敏感性， 大多数来自MRI。我们将研究在临床MRI筛查中发现的“偶然”病变，因为这些病变 病变最容易被误诊。活检前进行额外的研究扫描， 使用MRITSS，从“偶发病变”中获得数据。常规和MRITSS数据将使用 标准的形态和功能参数来达到诊断。我们将决定 MRITSS增加了特异性和敏感性，使用病理学家的诊断作为金标准。在 此外，我们将确定MRI参数是否与遗传和生物标志物相关， 癌症风险，包括微血管密度，细胞增殖标志物，VEGF受体和P53，HER 2， BRCA 1和BRCA 2。这项研究将包括非洲裔美国妇女谁是特别高的风险， 侵袭性早期乳腺癌我们将比较这些女性乳腺病变的MRI参数， 研究中的其他女性。 该研究将对乳腺癌的临床治疗产生重大影响。如果结果 证明MRITSS对早期乳腺癌具有高特异性-这将支持增加临床 使用MRI筛查高危女性，并整合改进的频谱、空间和时间 进行临床MRI采样。此外，这项研究提供了一个不寻常的机会， 早期乳腺癌中恶性肿瘤的生物标志物参数。这可能会改善 MRI方案的设计和MR图像的解释。这项研究是一项跨学科的合作 放射科医生、肿瘤科医生、外科医生、病理学家、医学物理学家和统计学家之间有很强的 在乳腺成像和乳腺癌治疗方面的记录。

Conventional magnetic resonance imaging has good sensitivity for detecting very early breast cancers, and may be a valuable for screening women who are at high risk for breast cancer. However, its specificity is inadequate, particularly given its high sensitivity. As a result there is a concern that MRI scans lead to unnecessary treatment. We propose to significantly increase sensitivity and specificity with improved spectral, temporal and spatial sampling (MRITSS). MRITSS has two components. High spectral and spatial resolution MRI provides a high resolution water spectrum associated with each image voxel, and the water spectral lineshape is analyzed to produce improved anatomic and functional MR images. High temporal and spatial resolution imaging during contrast media uptake and washout allows accurate measurement of perfusion and other physiologic parameters. We will test the hypothesis that the combination of these two approaches - MRITSS - improves specificity and sensitivity in the high risk population that would benefit most from MRI. We will study 'incidental' lesions that are found during clinical MRI screening, since these lesions are most susceptible to incorrect diagnosis. An additional research scan before biopsy will acquire data from an 'incidental lesion', using MRITSS. Conventional and MRITSS data will be evaluated using standard morphologic and functional parameters to arrive at a diagnosis. We will determine whether MRITSS increases specificity and sensitivity, using the pathologist's diagnosis as the gold standard. In addition, we will determine whether MRI parameters are correlated with genetic and biologic markers for cancer risk, including microvessel density, cell proliferation markers, VEGF receptors, and P53, HER2, BRCA1 and BRCA2. The study will include African American women who are at particularly high risk for aggressive early breast cancer. We will compare the MRI parameters for breast lesions in these women with those for the other women in the study. The research will have a significant impact on clinical managements of breast cancer. If the results demonstrate that MRITSS has high specificity for early breast cancer- this will support increased clinical use of MRI for screening high risk women, and integration of improved spectral, spatial, and temporal sampling into clinical MRI. In addition, the research provides an unusual opportunity to correlate MRI parameters with biological markers for malignancy in early breast cancers. This could lead to improved design of MRI protocols and interpretation of MR images. The research is an interdisciplinary collaboration between Radiologists, Oncologists, Surgeons, Pathologists, Medical Physicists, and Statisticians with strong track records in breast imaging and breast cancer treatment.