High-Resolution Whole-Breast MRI at 3.0T

项目描述（由申请人提供）：本项目将开发和测试新的MRI技术，用于比标准乳房MRI提前一年检测乳腺癌。这将通过比当前方案高14倍的时空分辨率动态对比增强成像，以及提高已建立的乳腺癌定量成像生物标志物的空间分辨率来实现。所有方法的诊断效用都将在乳腺癌患者的研究中进行测试。相关性：乳腺癌仍然是女性中第二大致命癌症，尽管由于乳房x光检查和更好的全身治疗，死亡率确实有所下降。虽然核磁共振检查发现的肿瘤是乳房x光检查的两倍，但核磁共振检查的成本限制了它在乳腺癌高风险女性中的应用。通过显著提高MRI对小病变的诊断性能，本提案中的技术将使乳腺MRI能够更早地可靠地检测出乳腺癌。这可以使高风险患者减少接受MRI筛查的频率，同时仍然确保在乳腺癌处于第一阶段时检测到乳腺癌，并且有很高的长期生存可能性，每年可节省高达10亿美元的费用，并消除高达5万次昂贵而痛苦的活组织检查。它还可以根据风险定制筛查间隔。我们将开发的高空间分辨率定量成像将提高小病变的特异性，以尽量减少假阳性。它还将提高现有用于预后、治疗选择和治疗反应监测的M成像生物标志物的质量和可靠性。方法：我们的方法建立在我们在高分辨率乳房MRI方面的成功记录上，这是我们在之前的资助期间建立的，产生了大量的论文，专利和会议记录。在这项工作中，我们的目标是提供(1)将时空分辨率提高14倍，可以灵活地在高空间分辨率静态成像（0.35 ~ 0.35 ~ 0.7 mm3）和高时空分辨率动态成像（15秒内0.5 ~ 0.5 ~ 1.0 mm3）之间进行权衡；(2)基于高空间分辨率定量体积3T mri的生物标志物，包括T2、表观扩散系数和药代动力学灌注指标，并对运动、B+1不均匀性和T1效应进行校正；(3)患者研究表明，高分辨率成像技术提高了小肿瘤的检出率，同时保持了较低的总体活检率。摘要：通过使用先进的乳房线圈、新的优化3D脉冲序列、先进的数据采样和图像重建技术（压缩传感和并行成像）提供更高空间分辨率的多参数定量信息，这项工作将使MRI成为一种更实用和强大的筛查方法，可以在早期可靠地检测到较小的乳房肿瘤，进一步降低乳腺癌的死亡率。

DESCRIPTION (provided by applicant): This project will develop and test new MRI technology for detecting breast cancer one year earlier than standard breast MRI. This will be achieved through fourteen-fold higher spatio-temporal resolution dynamic contrast- enhanced imaging compared to current protocols, as well as improved spatial resolution of established quantitative imaging biomarkers of breast cancer. The diagnostic utility of all methods will be tested in studies of patients with breast cancer. Relevance: Breast cancer remains the second most lethal cancer amongst women, despite real reductions in mortality due to screening with mammography and better systemic therapy. While MRI screening detects twice as many tumors as mammography, the cost of MRI screening limits its use to women with a high risk of breast cancer. By significantly improving the diagnostic performance of MRI for small lesions, the technology in this proposal will enable breast MRI to reliably detect breast cancers much earlier. This could enable high-risk patients to undergo MRI screening less frequently while still ensuring detection of breast cancers when they are stage I and treatable with a high likelihood of long term survival, saving up to $1 billion and eliminating up to 50,000 costly, painful biopsie each year. It may also enable customized screening intervals depending on risk. The high spatial resolution quantitative imaging that we will develop will boost specificity among small lesions to minimize false positives. It will also improve the quality and reliability of existing M imaging biomarkers that are being used for prognosis, treatment selection and monitoring of treatment response. Approach: Our approach builds on our successful track record in high-resolution breast MRI established during our previous period of funding that generated numerous papers, patents and conference proceedings. In this work, we aim to offer (1) a fourteen-fold increase in spatio-temporal resolution that can be flexibly traded off between high spatial resolution static (0.35¿0.35¿0.7 mm3) and high spatio-temporal resolution (0.5¿0.5¿1.0 mm3 in 15 s) dynamic imaging, (2) high-spatial-resolution quantitative volumetric 3T MRI-based biomarkers including T2, apparent diffusion coefficient, and pharmacokinetic perfusion metrics with corrections for motion, B+1 inhomogeneity, and T1 effects, and (3) patient studies to demonstrate increased detection of small cancers, enabled by high-resolution imaging, while keeping the overall biopsy rate low. Summary: By offering multi-parametric quantitative information at higher spatial resolution using advanced breast coils, new optimized 3D pulse sequences, advanced data sampling and image reconstruction techniques using compressed sensing and parallel imaging, this work will make MRI a more practical and powerful screening method that reliably detects smaller breast tumors at earlier stages, further reducing mortality from breast cancer.