Breast Cancer Screening with Quantitative Ultra-Fast DCEMRI and Clinical Risk Assessment

使用定量超快速 DCEMRI 进行乳腺癌筛查和临床风险评估

• 批准号: 10174859
• 负责人: Gregory S. Karczmar
• 金额: $ 57.66万
• 依托单位: UNIVERSITY OF CHICAGO
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-06-15 至 2022-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10174859
• 关键词: Address; American College of Radiology Imaging Network; Anatomy; Biological; Blood Vessels; Blood capillaries; Breast; Breast Cancer Detection; Breast Cancer Risk Factor; Capillary Permeability; Carcinoma in Situ; Clinical Trials; Contrast Media; Data; Data Set; Detection; Diagnostic; Drug Kinetics; Eastern Cooperative Oncology Group; Eligibility Determination; Enhancing Lesion; Evaluation; General Population; Goals; High Risk Woman; Image; Injections; Kinetics; Lesion; Lesion by Morphology; Letters; MRI Scans; Magnetic Resonance Imaging; Malignant Neoplasms; Mammography; Measurement; Measures; Methods; Morbidity - disease rate; Patients; Physiological; Physiology; Protocols documentation; ROC Curve; Reader; Research; Research Personnel; Resolution; Risk Assessment; Roentgen Rays; Scanning; Sensitivity and Specificity; Specificity; Stress; Testing; Texture; Time; Training; Woman; aggressive breast cancer; base; blood flow measurement; breast density; cancer invasiveness; clinical risk; clinically significant; cost; design; diagnostic accuracy; high risk; improved; malignant breast neoplasm; mortality; neovasculature; novel; screening; temporal measurement; tumor; uptake

Abstract MRI has potential to significantly improve breast cancer screening, particularly for women with dense breasts and women who are at higher than average risk for breast cancer. However, improvements in diagnostic accuracy are needed before MRI can be used to screen large numbers of women. The abbreviated MRI scan (AB-MRI) designed by Kuhl and colleagues is a very promising approach to MRI- screening, but relies on a single T1-weighted scan post contrast injection to evaluate enhancement. The lack of information regarding contrast media uptake kinetics may reduce diagnostic accuracy. The research proposed here will test the hypothesis that addition of ultrafast MRI to AB-MRI improves diagnostic accuracy. We propose that AB-MRI combined with ultrafast DCE-MRI can provide effective screening with at a reasonable cost, and with minimal inconvenience for patients. This would result in reliable detection of clinically significant breast cancer years earlier than current screening methods, and thus significantly reduce morbidity and mortality due to breast cancer. A national ECOG-ACRIN clinical trial of AB-MRI screening will begin in late 2016. The basic protocol for this trial is a 10 minute scan with a single post-contrast T1-weighted scan. However, based on results from this lab, the leaders of the ECOG ACRIN trial strongly support inclusion of quantitative ultrafast DCE-MRI in AB-MRI at UChicago (please see the letter of support from the Chair). We propose to: 1. Optimize ultrafast DCE-MRI integrated into AB-MRI with total duration of less than 10 minutes. The ultrafast DCE-MRI scan will have time resolution of less than 3 seconds per image. 2. Develop quantitative analysis of ultrafast data to measure time of initial enhancement (TIE), quantitative Ktrans measurements based on a simplified computational approach, lesion transfer function (LTF) and lesion transit Time(LTT). In addition, we will measure the initial kinetics of lesion enhancement texture. 3. Evaluate the diagnostic accuracy of pharmacokinetic parameters from DCE-MRI. Data will be analyzed in two stages. First, we will use data that is currently being acquired at UChicago to identify the most promising parameters from ultrafast DCE-MRI for further evaluation. Second, we will evaluate the most promising parameters in a ‘testing group’. ROC analysis will be used to determine whether parameters from ultrafast imaging can increase the diagnostic accuracy of MRI screening. 4. Compare the diagnostic accuracy of AB-MRI with and without ultrafast DCE-MRI, using both a Reader study and quantitative analysis. New ultrafast DCE-MRI, integrated into AB-MRI scans will significantly reduce morbidity and mortality due to breast cancer, while significantly reducing costs and increasing efficiency.

抽象的 MRI 有可能显着改善乳腺癌筛查，特别是对于患有密集型乳腺癌的女性 乳房和患乳腺癌风险高于平均水平的女性。 在使用 MRI 对大量女性进行筛查之前，需要诊断准确性。 Kuhl 及其同事设计的简化 MRI 扫描（AB-MRI）是一种非常有前途的 MRI 方法。 筛查，但依靠造影剂注射后的单次 T1 加权扫描来评估增强情况。 缺乏有关造影剂摄取动力学的信息可能会降低诊断准确性。 这里提出的将检验以下假设：将超快 MRI 添加到 AB-MRI 可以改善诊断 我们结合建议 AB-MRI 与超快 DCE-MRI 可以提供有效的筛查。 以合理的成本，并且给患者带来最小的不便，这将导致可靠的检测。 具有临床意义的乳腺癌比目前的筛查方法早数年出现，因此显着 降低乳腺癌的发病率和死亡率。 AB-MRI 筛查的国家 ECOG-ACRIN 临床试验将于 2016 年底开始。 该试验是一次 10 分钟扫描，并进行一次对比后 T1 加权扫描。 在本实验室，ECOG ACRIN 试验的领导者强烈支持将定量超快 DCE-MRI 纳入 芝加哥大学的 AB-MRI（请参阅主席的支持信）我们建议： 1. 优化超快 DCE-MRI 集成到 AB-MRI 中，总持续时间小于 10 分钟。 超快 DCE-MRI 扫描每幅图像的时间分辨率不到 3 秒。 2. 对超快数据进行定量分析，以测量初始增强时间 (TIE)， 基于简化计算方法、病变传递函数的定量 Ktrans 测量 （LTF）和病变渡越时间（LTT） 此外，我们将测量病变的初始动力学。 增强纹理。 3. 评估 DCE-MRI 数据的药代动力学参数的诊断准确性。 首先，我们将使用芝加哥大学当前获取的数据来确定最重要的部分。 其次，我们将评估最有前途的超快 DCE-MRI 参数。 “测试组”中的有希望的参数将用于确定参数是否来自“测试组”。 超快成像可以提高 MRI 筛查的诊断准确性。 4. 使用 Reader 比较 AB-MRI 与超快 DCE-MRI 的诊断准确性 研究和定量分析。 集成到 AB-MRI 扫描中的新型超快 DCE-MRI 将显着降低由于 乳腺癌，同时显着降低成本并提高效率。

项目成果

Pharmacokinetic Analysis of Enhancement-Constrained Acceleration (ECA) reconstruction-based high temporal resolution breast DCE-MRI.

基于增强约束加速 (ECA) 重建的高时间分辨率乳腺 DCE-MRI 的药代动力学分析。

• 发表时间: 2023
• 影响因子: 3.7
• 作者: Ren, Zhen;Easley, Ty O;Pineda, Federico D;Guo, Xiaodong;Barber, Rina F;Karczmar, Gregory S
• 通讯作者: Karczmar, Gregory S

Parametric maps of spatial two-tissue compartment model for prostate dynamic contrast enhanced MRI - comparison with the standard Tofts model in the diagnosis of prostate cancer.

前列腺动态对比增强 MRI 空间两组织室模型的参数图 - 与诊断前列腺癌的标准 Tofts 模型进行比较。

• 发表时间: 2023-02-08
• 作者: Zhou, Xueyan;Fan, Xiaobing;Chatterjee, Aritrick;Yousuf, Ambereen;Antic, Tatjana;Oto, Aytekin;Karczmar, Gregory S
• 通讯作者: Karczmar, Gregory S

Ultrafast Bilateral DCE-MRI of the Breast with Conventional Fourier Sampling: Preliminary Evaluation of Semi-quantitative Analysis.

采用传统傅里叶采样的乳房超快双边 DCE-MRI：半定量分析的初步评估。

• 发表时间: 2016-09
• 影响因子: 4.8
• 作者: Pineda, Federico D;Medved, Milica;Wang, Shiyang;Fan, Xiaobing;Schacht, David V;Sennett, Charlene;Oto, Aytekin;Newstead, Gillian M;Abe, Hiroyuki;Karczmar, Gregory S
• 通讯作者: Karczmar, Gregory S

Enhancement-constrained acceleration: A robust reconstruction framework in breast DCE-MRI.

增强约束加速：乳腺 DCE-MRI 中的稳健重建框架。

• 发表时间: 2021
• 影响因子: 3.7
• 作者: Easley, Ty O;Ren, Zhen;Kim, Byol;Karczmar, Gregory S;Barber, Rina F;Pineda, Federico D
• 通讯作者: Pineda, Federico D

Dynamic field-of-view imaging to increase temporal resolution in the early phase of contrast media uptake in breast DCE-MRI: A feasibility study.

动态视场成像可提高乳腺 DCE-MRI 造影剂摄取早期阶段的时间分辨率：一项可行性研究。

• 发表时间: 2018-03
• 影响因子: 3.8
• 作者: Pineda, Federico D;Easley, Ty O;Karczmar, Gregory S
• 通讯作者: Karczmar, Gregory S