MRI Background Parenchymal Enhancement as a Risk Factor for Breast Cancer

MRI 背景实质增强是乳腺癌的危险因素

基本信息

批准号：
8776507
负责人：
JONINE L. BERNSTEIN
金额：
$ 71.59万
依托单位：
SLOAN-KETTERING INST CAN RESEARCH
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-08-01 至 2017-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8776507
关键词：
Age American College of Radiology Area Blinded Breast Breast Cancer Detection Breast Cancer Risk Factor Cancer Patient Case-Control Studies Categories Characteristics Classification Clinical Clinical Data Clinical Management Clinical Research Computerized Medical Record Computers Contrast Media Diagnosis Epidemiology Ethnic Origin Goals High Risk Woman Hospitals Image Information Systems Interview Joints Magnetic Resonance Imaging Malignant Neoplasms Mammary Gland Parenchyma Mammographic Density Mammography Measures Medical Records Memorial Sloan-Kettering Cancer Center Menopausal Status Methods Modeling Outcome Participant Patients Phase Preventive Intervention Preventive screening Quality Control Questionnaires Race Reader Recruitment Activity Reporting Research Risk Risk Assessment Risk Estimate Risk Factors Running Staging Subgroup Telephone Interviews Time Tissues Woman abstracting base cancer risk computerized density follow-up high risk improved malignant breast neoplasm novel public health relevance screening tool tumor

项目摘要

DESCRIPTION (provided by applicant): Contrast-enhanced breast magnetic resonance imaging (MRI) is a clinically useful tool for breast cancer screening in high-risk women and the diagnosis, staging, and clinical management of breast cancer patients, and may also have utility in the determination of breast cancer risk. Normal breast fibroglandular tissue (FGT), which appears white on mammography (i.e. mammographic density (MD)), is a well-established risk factor for breast cancer. FGT is also visible on breast MRI (MRI-FGT) and enhances (becomes brighter) to varying extents after administration of MRI-contrast medium. Background parenchymal enhancement (MRI-BPE) is a measure of the volume and intensity of this enhancement. In a study of 39 breast cancer cases and 78 cancer- free controls undergoing breast screening with MRI, MRI-BPE was strongly associated with breast cancer risk; women in the highest MRI-BPE category had a 7.5-fold higher risk of breast cancer compared with those in the lowest MRI-BPE groups. MRI-BPE only weakly correlated with MRI-FGT, which is strongly correlated with MD, indicating that MRI-BPE may be an independent marker of breast cancer risk. We propose to confirm these findings by conducting a multi-center, hospital-based, case-control study examining MRI-BPE and MRI-FGT as markers of breast cancer risk. Across three centers we will recruit, interview, and collect medical records and pre-treatment MRIs and mammograms from 1,110 women with invasive breast cancer (cases) and 1,110 high- risk women who are cancer-free and are undergoing MRI breast cancer screening (controls). Clinical data and tumor characteristics (for cases) will be abstracted through electronic medical record review. MRI-BPE and MRI-FGT will be scored by a single reader using standard clinical measures and mammographic percent density (MPD) using Cumulus. We also propose to measure both MRI-BPE and MRI-FGT using a new fully automated method. Our hypothesis is that while MRI-FGT and MPD measure the amount of FGT, MRI-BPE is a marker of breast tissue activity, contributing to breast cancer risk independently of the amount of FGT present. Our Primary Aim is to examine the relationship between MRI-BPE and MRI-FGT measured by Breast Imaging-Reporting and Data System (BI-RADS) categories, and breast cancer risk. Our Secondary Aims are: 1) to determine whether the inclusion of MRI-BPE improves breast cancer risk assessment over that achieved by MPD alone; and 2) to examine the association between MRI-BPE and MRI-FGT, measured on a continuous scale by a novel automated computerized method, and breast cancer risk. In the long-run MRI-BPE could greatly improve the accuracy of breast cancer risk prediction among high-risk women undergoing breast MRI screening by identifying a subgroup of women who would benefit the most from heightened screening and preventive measures and possibly a subgroup of women at lower risk who may benefit from less intensive screening. The automated quantitative measures of MRI-BPE and MRI-FGT would greatly facilitate the incorporation of these measures into widespread clinical and research practice.

描述（由申请人提供）：对比增强乳腺磁共振成像 (MRI) 是临床上有用的工具，可用于高危女性乳腺癌筛查以及乳腺癌患者的诊断、分期和临床管理，并且也可能具有实用性确定乳腺癌风险。正常乳腺纤维腺组织 (FGT) 在乳房 X 光检查中呈白色（即乳房 X 光密度 (MD)），是乳腺癌的一个公认的危险因素。 FGT 在乳腺 MRI (MRI-FGT) 上也可见，并且在给予 MRI 造影剂后不同程度地增强（变得更亮）。背景实质增强 (MRI-BPE) 是对这种增强的体积和强度的测量。在一项对 39 名乳腺癌病例和 78 名接受 MRI 乳腺筛查的无癌对照者进行的研究中，MRI-BPE 与乳腺癌风险密切相关。与最低 MRI-BPE 类别的女性相比，最高 MRI-BPE 类别的女性患乳腺癌的风险高出 7.5 倍。 MRI-BPE 仅与 MRI-FGT 弱相关，而 MRI-FGT 与 MD 强相关，表明 MRI-BPE 可能是乳腺癌风险的独立标志物。我们建议通过开展一项多中心、以医院为基础的病例对照研究来证实这些发现，该研究检查 MRI-BPE 和 MRI-FGT 作为乳腺癌风险标志物。我们将在三个中心招募、访谈并收集 1,110 名患有浸润性乳腺癌的女性（病例）和 1,110 名未患癌症且正在接受 MRI 乳腺癌筛查的高危女性（对照）的医疗记录以及治疗前 MRI 和乳房 X 光检查。）。临床数据和肿瘤特征（针对病例）将通过电子病历审查来提取。 MRI-BPE 和 MRI-FGT 将由单个读取器使用标准临床测量和使用 Cumulus 的乳房 X 线摄影百分比密度 (MPD) 进行评分。我们还建议使用新的全自动方法来测量 MRI-BPE 和 MRI-FGT。我们的假设是，虽然 MRI-FGT 和 MPD 测量 FGT 的量，但 MRI-BPE 是乳腺组织活动的标志物，无论 FGT 的存在量如何，都会导致乳腺癌风险。我们的主要目的是检查通过乳腺成像报告和数据系统 (BI-RADS) 类别测量的 MRI-BPE 和 MRI-FGT 与乳腺癌风险之间的关系。我们的次要目标是： 1) 确定 MRI-BPE 的纳入是否比单独 MPD 更能改善乳腺癌风险评估； 2) 检查 MRI-BPE 和 MRI-FGT 之间的关联（通过新型自动化计算机方法连续测量）与乳腺癌风险之间的关联。从长远来看，MRI-BPE 可以通过确定从加强筛查和预防措施中受益最多的女性亚组以及可能的女性亚组，从而大大提高接受乳腺 MRI 筛查的高危女性乳腺癌风险预测的准确性风险较低的人可能会受益于强度较低的筛查。 MRI-BPE 和 MRI-FGT 的自动定量测量将极大地促进将这些测量纳入广泛的临床和研究实践。