High-Resolution Breast MRI at 3.0T

3.0T 高分辨率乳腺 MRI

• 批准号: 10311113
• 负责人: BRUCE L DANIEL
• 金额: $ 68.4万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-03-01 至 2023-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10311113
• 关键词: American; Area; Bilateral; Biopsy; Bolus Infusion; Breast; Breast Cancer Detection; Breast Cancer Treatment; Breast Magnetic Resonance Imaging; Breast Microcalcification; Carcinoma; Clip; Core Biopsy; Cost Savings; Data; Detection; Development; Diagnosis; Diagnostic; Diffusion; Diffusion Magnetic Resonance Imaging; Discrimination; Disease; Drops; Drug Kinetics; Early treatment; Ensure; Fatty acid glycerol esters; Funding; Genomics; Goals; Image; Image Enhancement; Imaging Techniques; Imaging technology; Industry Standard; Lesion; Literature; Magnetic Resonance Imaging; Mammographic screening; Mammography; Mastectomy; Measures; Meta-Analysis; Methods; Microcirculation; Modeling; Morbidity - disease rate; Morphologic artifacts; Motion; Noise; Noninfiltrating Intraductal Carcinoma; Observational Study; Operative Surgical Procedures; Outcome; Pathology; Patients; Performance; Phase; Radiation; Recurrence; Reporting; Resolution; Risk; Risk Assessment; Sampling; Scheme; Sensitivity and Specificity; Staging; Techniques; Technology; Testing; Three-Dimensional Imaging; Time; Training; Triage; Water; Woman; breast cancer diagnosis; breast surgery; cancer invasiveness; clinical imaging; clinically relevant; contrast enhanced; conventional therapy; cost; diagnostic accuracy; diffusion weighted; digital; feeding; follow-up; high risk; imaging modality; improved; innovation; malignant breast neoplasm; mortality; multidisciplinary; novel; oncotype; overtreatment; perfusion imaging; pharmacokinetic model; primary outcome; programs; prostate cancer risk; reconstruction; spatiotemporal; temporal measurement; tumor; validation studies

Project Abstract Overview: Ductal carcinoma in situ (DCIS) comprises approximately 20% of breast cancers diagnosed annually in the US. DCIS is currently treated aggressively with surgery and radiation, or mastectomy. Yet the excellent long-term outcome for many DCIS patients indicates that there is substantial over-treatment of DCIS, and trials of active surveillance are starting. Relevance: The critical question is which cases of DCIS can be safely followed without being removed? One major unmet need is that 1/4 of DCIS cases diagnosed by core needle biopsy actually harbor occult invasive cancers that merit definitive treatment. Accurate identification of DCIS cases to exclude these invasive cancers has been identified as one of the major roadblocks to active surveillance. Currently, MRI is viewed as the most promising staging strategy. However, while MRI is twice as sensitive as mammography for breast cancer detection overall, it is not that accurate for selectively detecting invasive cancers in a background of DCIS. Approach: Over two prior funding cycles, we have made key developments in high spatiotemporal resolu- tion breast MRI that are industry standards, with numerous advances in other breast MRI sequences including diffusion-weighted imaging (DWI). Here, we propose to investigate and test two promising areas of MRI technol- ogy to improve discrimination of invasive cancer from DCIS. In Aim 1, we will develop dynamic contrast enhanced MRI with high spatiotemporal resolution sampling, spatiotemporally-sparse compressed-sensing reconstruction, integrated fat-water separation and non-rigid motion correction. We will also incorporate novel pharmacokinetic mapping that includes modeling of arterial bolus dispersion for better lesion discrimination. In Aim 2, we will develop diffusion-weighted MRI with multi-shot methods that use novel shot-to-shot motion correction, fast-spin- echo diffusion imaging for better performance around biopsy markers, and steady-state diffusion for 3D imaging. Finally in Aim 3, we will validate and test the accuracy of these new techniques in large patient studies, to show their benefit for invasive tumor detection in DCIS patients compared to conventional ACR-standard breast MRI. Summary: The advanced MRI techniques that we propose to develop, validate and test in this proposal have tremendous potential to identify which DCIS patients can safely select active surveillance and which need defini- tive treatment. High accuracy for invasive cancer will provide this value with many fewer false-positive biopsies than conventional breast MRI.

项目摘要 概述：导管癌原位（DCIS）每年约有20％的乳腺癌 在美国。目前，DCI通过手术和放射线或乳房切除术对DCI进行积极治疗。但是很棒 许多DCIS患者的长期结局表明，DCI的大量过度治疗和试验 主动监视开始。 相关性：关键的问题是可以安全地遵循哪些DCI的情况而不会被删除？一 主要未满足的需求是，通过核心针头活检诊断的1/4病例实际上具有神秘的侵入性 值得定义治疗的癌症。准确识别DCIS病例以排除这些侵入性癌症 已被确定为主动监视的主要障碍之一。目前，MRI被视为 最有希望的分期策略。但是，虽然MRI对乳腺癌的乳房摄影是敏感的两倍 总体而言，在DCI的背景下选择性地检测入侵癌并不是那么准确。 方法：在两个先前的资金周期中，我们在高时空分辨率上做出了关键的发展 - 乳房MRI是行业标准，在其他乳房MRI序列中取得了许多进步 扩散加权成像（DWI）。在这里，我们建议调查和测试MRI技术的两个承诺领域 OGY可以改善DCIS侵入性癌症的歧视。在AIM 1中，我们将增强动态对比度 具有高空间时间分辨率采样的MRI，暂时性 - 平板压缩 - 感应重建， 综合脂肪 - 水分离和非刚性运动校正。我们还将结合新型药代动力学 映射，包括对动脉推注分散剂进行建模，以更好地病变歧视。在AIM 2中，我们将 开发扩散加权MRI采用多拍方法，使用新颖的射击运动校正，快速自旋 - 回声扩散成像，可在活检标记周围更好地性能，以及3D成像的稳态扩散。 最后，在AIM 3中，我们将在大型患者研究中验证和测试这些新技术的准确性，以表明 与常规的ACR-STARTARD MRI相比，DCIS患者对浸润性肿瘤检测的好处。 摘要：我们建议在此提案中开发，验证和测试的高级MRI技术已有 确定哪些DCIS患者可以安全选择主动监测以及需要定义的巨大潜力 治疗。侵入性癌症的高度精度将提供此值，而虚假阳性活检较少 比传统的乳房MRI。