High-Resolution Whole-Breast MRI at 3.0T

项目概述：尽管磁共振成像（MRI）在检测多种类型的乳腺癌方面已经显示出临床准确性，但更高分辨率的MRI可能会提高小病变的可检出性、导管原位癌的诊断以及MRI对其他癌症的特异性。MRI技术的许多最新进展将使更高分辨率的检查成为可能，但尚未应用于完全优化乳腺癌成像。我们建议开发、实施和验证具有极高空间分辨率的乳腺MRI方法。意义：虽然乳腺MRI最近被证明在筛查高风险患者或对侧乳腺癌患者方面具有成本效益，但其对导管原位癌的敏感性、对小病变的评估能力以及阳性预测值限制了其使用。更高分辨率的MRI可以解决所有这些限制，为乳腺癌的评估提供更准确的工具。提高特异性可以减少不必要的活检率，同时也使MRI对筛查低风险患者有效。提高对小病变的敏感性可以使早期发现癌症，从而提高生存率和减少筛查频率。方法：作为第一个目标，我们将结合激发脉冲设计、成像和重建方面的众多进展，开发脂肪抑制的超高分辨率3D MRI脉冲序列，用于3T的t1加权和t2加权成像。我们将在一项小型患者研究中测试超高分辨率成像的临床应用。接下来，作为第二个目标，我们将扩展高分辨率成像方法，使用专门为患者安装的高密度相控阵线圈，以提供最大的信号水平、体积覆盖和平行成像能力，从而实现双侧乳房的全覆盖。我们还将应用软件和硬件技术来降低对3T磁场变化的灵敏度。整个双侧技术将在第二项患者研究中进行测试，以评估完整的高分辨率全乳成像方案的效用。磁共振成像（MRI）是一种准确检测乳腺癌的方法，最近被证明在筛查高危患者方面具有成本效益。这项研究将开发出更高分辨率的MRI，使其能够更好地对小病变进行分类，防止不必要的活检，并更早地发现癌症。

DESCRIPTION (provided by applicant): Project Summary Overview: Although magnetic resonance imaging (MRI) has shown clinical accuracy in detecting many types of breast cancer, higher-resolution MRI would potentially improve detectability of small lesions, diagnosis of ductal carcinoma in situ, and specificity of MRI for other cancers. Numerous recent advances in MRI technology will enable higher resolution exams, but have not yet been applied to fully optimize imaging for breast cancer. We propose to develop, implement and validate breast MRI methods with very high spatial-resolution at 3T. Significance: Although breast MRI has recently been shown to be cost-effective in screening high risk patients or patients with a contralateral breast cancer, its sensitivity to ductal carcinoma in situ, it's ability to assess small lesions, and its positive predictive value limit increased use. Higher resolution MRI could address all of these limitations, providing a more accurate tool for assessment of breast cancer. Improved specificity could reduce the rate of unnecessary biopsy while also making MRI effective for screening lower-risk patients. Increased sensitivity for small lesions could allow earlier detection of cancer resulting in increased survival rates and a reduced screening frequency. Approach: As a first aim, we will develop fat-suppressed ultra-high-resolution 3D MRI pulse sequences for T1-weighted and T2-weighted imaging at 3T, combining numerous advances in excitation pulse design, imaging and reconstruction. We will test the clinical utility of ultra-high-resolution imaging in a small patient study. Next, as a second aim, we will extend the high-resolution imaging methods for full bilateral breast coverage using high-density phased-array coils fitted specifically to the patient in order to provide maximal signal levels, volumetric coverage and parallel imaging capability. We will also apply software and hardware techniques to reduce sensitivity to magnetic field variations at 3T. The overall bilateral techniques will be tested in a second patient study to assess the utility of the complete high-resolution whole-breast imaging protocol. Project Narrative Magnetic resonance imaging (MRI) is an accurate method to detect breast cancer, and has recently been shown to be cost-effective in screening high-risk patients. This research will develop much higher resolution MRI, allowing it to better classify small lesions, prevent unnecessary biopsy, and detect cancer earlier.