Evaluation of 3D MRI-Based Quantitative Breast Density for Chemoprevention

基于 3D MRI 的定量乳腺密度对化学预防的评估

• 批准号: 7778380
• 负责人: Jeon-Hor Chen
• 金额: $ 7.65万
• 依托单位: UNIVERSITY OF CALIFORNIA-IRVINE
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-03-01 至 2012-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7778380
• 关键词: 3-Dimensional; Adipose tissue; Adverse effects; Aftercare; Algorithms; Blood Clot; Blood coagulation; Breast; Breast Cancer Risk Factor; Calibration; Cancer Patient; Chemistry; Chemoprevention; Clinical; Computer Assisted; Contralateral; Control Groups; Data; Development; Diagnosis; Early Diagnosis; Enrollment; Estrogen receptor positive; Evaluation; Event; Film; Follow-Up Studies; Foundations; Future; Goals; High Risk Woman; Hormonal; Image; Incidence; Individual; Lead; Magnetic Resonance Imaging; Malignant Neoplasms; Mammographic Density; Mammography; Measurement; Measures; Medicine; Methods; Monitor; NIH Program Announcements; Nature; Operative Surgical Procedures; Patients; Pharmaceutical Preparations; Population Study; Positioning Attribute; Postmenopause; Premenopause; Prevention; Radiation therapy; Recruitment Activity; Replacement Therapy; Reporting; Research; Research Methodology; Risk; Risk Assessment; Risk Factors; Roentgen Rays; Second Primary Cancers; Source; Specific qualifier value; Surrogate Markers; Tamoxifen; Techniques; Technology; Testing; Three-Dimensional Image; Time; Translational Research; Uterine Cancer; Variant; Woman; Work; base; breast cancer diagnosis; breast density; cancer risk; density; imaging modality; malignant breast neoplasm; new technology; novel; patient population; pressure; risk benefit ratio; soft tissue; standard of care; success

DESCRIPTION (provided by applicant): Mammographic density is well accepted as a risk factor for breast cancer. Many drawbacks exist for mammographic density measurements. Mammography is a projection 2D image, not a 3D image. Mammography suffers from imperfect calibration of parameters and variation in film exposure factors. Changes in exposure, compression, and processor chemistry may influence the background density of the film and potentially the measured breast density in each study, making comparison between subjects or longitudinally unreliable. Density measured on breast MRI has a great potential to provide a sensitive, quantitative method for evaluating breast density. MRI provides a great soft tissue contrast distinguishing between fibroglandular and fatty tissues; also it provides the 3-dimensional breast coverage; thus is an optimal imaging modality for evaluating fibroglandular density. Despite several studies used MRI aiming for developing automated computer-aided mammographic density analysis, there is little effort to develop a reliable method for monitoring the change breast density over time for individual woman. A quantitative MRI-based measure of "percent fibroglandular density" may be used to evaluate the changes induced by the chemoprevention drug. Secondary chemoprevention is commonly used for high-risk women who already had diagnosis of breast cancer. Incidence of breast cancer in the contralateral breast increases after treatment of breast caner. The cumulative incidence at 20 years was 15.4%. Tamoxifen was proven effective, and prescribed widely to pre-menopausal patients diagnosed with estrogen receptor positive breast cancer. Despite the promising results, whether to offer chemoprevention, or which drug to give, is solely based on population study results. There is not an individualized method that can be used for a woman to determine whether the chemoprevention is working on her, thus is beneficial over the possible side effects and risks. In this application we propose to use our developed 3D MRI-based quantitative breast density evaluation method to test the specific hypothesis that secondary chemoprevention with tamoxifen (for pre-menopausal women) will reduce the breast density compared to controls. We will also follow all enrolled subjects for future events of breast cancer development. When the data is available we will be able to directly test the hypothesis that reduced density is correlated with lower future cancer events. Two aims are proposed in this study 1) Aim-1: To evaluate the changes of breast density in pre-menopausal women receiving tamoxifen vs. controls using MRI-based analysis. 2) Aim-2: To obtain mammograms of all patients for density analysis, and compare the results to that based on MRI in terms of measurement variation and changes of density between tamoxifen vs. controls.

描述（由申请人提供）： 乳腺X线摄影密度被广泛接受为乳腺癌的危险因素。乳房X线摄影密度测量存在许多缺点。乳房X线摄影是投影2D图像，而不是3D图像。乳房X线摄影受到参数不完善的校准，并且膜暴露因子的变化。暴露，压缩和处理器化学的变化可能会影响膜的背景密度以及每个研究中测量的乳房密度，从而比较受试者或纵向不可靠。在乳房MRI上测量的密度具有巨大的潜力，可以提供一种评估乳房密度的敏感，定量方法。 MRI提供了良好的软组织对比度，以区分纤维状组织和脂肪组织。它还提供3维乳房覆盖范围；因此，是评估纤维界密度的最佳成像方式。尽管有多项研究使用了MRI旨在开发自动化的计算机辅助乳腺X线X线摄影密度分析，但几乎没有努力开发一种可靠的方法来监测单个女性随时间的变化乳房密度。基于定量MRI的“纤维球密度百分比”的度量可用于评估化学预防药物诱导的变化。次级化学预防通常用于已经诊断为乳腺癌的高危女性。乳腺癌治疗后对侧乳腺癌中乳腺癌的发生率增加。 20年的累积发生率为15.4％。他莫昔芬被证明是有效的，并被广泛针对被诊断为雌激素受体阳性乳腺癌的绝经前患者。尽管结果有很有希望的结果，是提供化学预防还是要提供的药物，仅基于人口研究结果。没有一种个性化的方法可用于确定化学预防是否在她身上的女性，因此对可能的副作用和风险是有益的。在此应用中，我们建议使用我们开发的基于3D MRI的定量乳房密度评估方法来测试特定假设，即与对照组相比，使用他莫昔芬（用于育前女性妇女）的二次化学预防（用于绝经前女性）将减少乳房密度。我们还将跟随所有注册受试者，以进行未来的乳腺癌发展事件。当数据可用时，我们将能够直接测试降低密度与较低的未来癌症事件相关的假设。在这项研究中提出了两个目的1）目标1：评估使用基于MRI的分析接受他莫昔芬与对照的绝经前妇女的乳房密度变化。 2）AIM-2：获取所有患者的乳房X线照片进行密度分析，并根据MRI的测量变化和他莫昔芬与对照之间的密度变化进行比较。

项目成果

Consistency of breast density measured from the same women using different MR scanners.

使用不同 MR 扫描仪对同一女性测量的乳腺密度的一致性。

• DOI: 10.1093/annonc/mdr456
• 发表时间: 2011
• 期刊: Annals of oncology : official journal of the European Society for Medical Oncology
• 作者: Chen,J-H;Chan,S;Chang,DH-E;Lin,M;Su,M-Y
• 通讯作者: Su,M-Y