MR Diffusion Tensor Imaging for Detection and Characterization of Breast Lesions

用于乳腺病变检测和表征的 MR 扩散张量成像

基本信息

批准号：
8268538
负责人：
Savannah Corrina Partridge
金额：
$ 25.85万
依托单位：
UNIVERSITY OF WASHINGTON
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-07-16 至 2015-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8268538
关键词：
Abnormal Cell Accounting Address Affect Algorithms American American Cancer Society Anisotropy Appearance Benign Biopsy Blinded Brain Breast Breast Cancer Detection Cancer Diagnostics Cancer Etiology Cellular Structures Cellularity Cessation of life Characteristics Clinical Complement Contralateral Contrast Media Cystic Neoplasm Data Data Set Detection Diagnostic Diffusion Diffusion Magnetic Resonance Imaging Diffusion weighted imaging Disease Early Diagnosis Employee Strikes Epithelial Exhibits Fibrosis Gadolinium Goals Guidelines High Risk Woman Histologic Histology Image Imaging Techniques Lead Lesion Light Magnetic Resonance Imaging Malignant - descriptor Malignant Neoplasms Mammary Gland Parenchyma Mammary Neoplasms Mammography Mastectomy Measures Methodology Methods Metric Modeling Necrosis Neurologic Outcome Outcome Study Pathologic Patients Performance Predictive Value Protocols documentation Public Health Reader Research Risk Role Safety Scanning Screening procedure Sensitivity and Specificity Solutions Specificity Stromal Neoplasm Subgroup Techniques Testing Time Tissues Toxic effect Water Woman Work base breast cancer diagnosis breast lesion breast lumpectomy cancer imaging cost diagnostic accuracy diffusion anisotropy experience gadolinium oxide high risk improved indexing innovation killings malignant breast neoplasm neoplastic neuroimaging prognostic programs public health relevance radiologist tool tumor

项目摘要

DESCRIPTION (provided by applicant): Breast cancer is extremely common, striking 1 in 8 American women, and is the second leading cause of cancer death among women in the U.S. Earlier detection through screening is a fundamental way to improve survival. Dynamic contrast enhanced MRI (DCE-MRI) of the breast has a high sensitivity for breast cancer detection and is the most sensitive technique for screening high risk women and detecting contralateral or multifocal disease in patients with recently diagnosed breast cancer. However, overlap in the appearance of benign and malignant breast lesions on DCE-MRI can produce many false positives. Particularly in light of recent American Cancer Society guidelines recommending annual MRI screening for high risk women, estimated to affect up to 1.8 million women in the US, there is a clear and quickly growing need to improve the specificity of breast MRI in order to limit the number of unnecessary biopsies that will result from expanded use of this highly sensitive screening tool. Furthermore, the high costs and safety concerns of gadolinium-based contrast agents limit the accessibility of breast MRI screening for many women, so identifying a non-contrast alternative to DCE-MRI for detecting breast cancer would have strong clinical impact. A promising adjunct MRI technique is Diffusion Tensor Imaging (DTI), which indirectly assesses tissue microstructure and can provide complementary information to DCE-MRI for lesion characterization. Our group and others have demonstrated notable differences in apparent diffusion coefficient (ADC) values between benign and malignant lesions. Moreover, we have promising preliminary data suggesting apparent diffusion coefficient (ADC) measures can increase the positive predictive value of conventional breast MRI assessment, and that DTI fractional anisotropy (FA) adds complementary information to ADC measures in discriminating malignancies. We have also observed that many mammographically and clinically-occult cancers are visible on diffusion-weighted images and can be detected on MRI without using a contrast agent. The aims of this work are: (1) to validate DTI as a valuable adjunct to improve lesion characterization on breast MRI and determine the optimal way to incorporate DTI measures into the clinical breast MRI assessment, (2) to better understand the effects of tumor histology on DTI measures, and (3) to evaluate the potential role of DTI as an alternative non-contrast breast screening technique. The outcomes of this study are potentially significant because DTI could provide a quickly translatable solution to improve the specificity of conventional breast MRI and reduce the number of unnecessary biopsies, and alternatively, DTI could provide a faster, less expensive, and safer screening option than DCE-MRI. PUBLIC HEALTH RELEVANCE: Relevance to Public Health: (1) Improving the characterization of suspicious lesions on conventional breast MRI would significantly reduce the resulting number of unnecessary biopsies performed, and (2) Identifying a non-contrast technique for detecting cancer would reduce costs and toxicity of breast MRI screening and increase accessibility to more women.

描述（由申请人提供）：乳腺癌极为普遍，在美国妇女中占据了八分之一的袭击，这是美国妇女癌症死亡的第二大主要原因。乳腺癌的动态对比增强了MRI（DCE-MRI）对乳腺癌检测的敏感性很高，并且是筛查高风险女性并检测最近诊断为乳腺癌患者的对侧或多灶性疾病的最敏感技术。但是，DCE-MRI上的良性和恶性乳房病变的出现重叠会产生许多假阳性。特别是鉴于最近美国癌症协会的指南建议对高风险女性进行年度MRI筛查，估计会影响美国的180万妇女，因此，明确而迅速的需求需要提高乳房MRI的特异性，以限制这种高度敏感的筛选工具的扩大使用而导致的不必要的活检数量。此外，基于Gadolinium的对比剂的高成本和安全问题限制了许多女性乳房MRI筛查的可及性，因此确定DCE-MRI替代DCE-MRI以检测乳腺癌的替代品将对临床产生巨大影响。有希望的辅助MRI技术是扩散张量成像（DTI），该技术间接评估组织微观结构，并可以为DCE-MRI提供互补信息以进行病变表征。我们的小组和其他人在良性病变和恶性病变之间表现出明显的扩散系数（ADC）值的显着差异。此外，我们拥有有希望的初步数据，表明明显的扩散系数（ADC）措施可以增加常规乳腺MRI评估的正预测价值，并且DTI分数各向异性（FA）在歧视恶性肿瘤中为ADC措施增加了补充信息。我们还观察到，在扩散加权图像上可以看到许多乳腺X线乳腺乳腺癌和临床杂质癌，并且可以在MRI上检测到而无需使用对比剂。这项工作的目的是：（1）验证DTI作为改善乳房MRI病变表征的有价值的辅助手段，并确定将DTI测量纳入临床乳房MRI评估中的最佳方法，（2）更好地了解肿瘤组织学对DTI测量的影响，以及（3）攻击DTI的潜在角色替代术语，以替代DTI的潜在作用。这项研究的结果可能具有重要意义，因为DTI可以提供可快速翻译的解决方案，以提高常规乳房MRI的特异性并减少不必要的活检数量，或者，与DCE-MRI相比，DTI可以提供更快，更便宜和更安全的筛选选项。公共卫生相关性：与公共卫生的相关性：（1）提高对常规乳房MRI的可疑病变的表征将大大减少进行的不必要的活检数量，（2）确定检测到癌症的非对比度技术会降低乳房MRI筛查的成本和毒性，并增加对更多女性的障碍。