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：导管原位癌 (DCIS) 约占每年诊断的乳腺癌的 20% 在美国，导管原位癌目前采用手术和放射治疗或乳房切除术进行积极治疗。 许多 DCIS 患者的长期结果表明 DCIS 存在严重的过度治疗，并且试验 的主动监视正在开始。 相关性：关键问题是哪些 DCIS 病例可以安全随访而不需切除？ 主要未满足的需求是，通过空心针活检诊断出的 DCIS 病例中，有 1/4 实际上存在隐匿性侵入性病变 准确识别 DCIS 病例以排除这些浸润性癌症。 目前，MRI 被认为是主动监测的主要障碍之一。 然而，虽然 MRI 对乳腺癌的敏感性是乳房 X 光检查的两倍。 总体而言，它对于选择性检测 DCIS 背景下的侵袭性癌症并不那么准确。 方法：在之前的两个融资周期中，我们在高时空分辨率方面取得了关键进展 乳腺 MRI 已成为行业标准，其他乳腺 MRI 序列也取得了许多进步，包括 在这里，我们建议研究和测试 MRI 技术的两个有前景的领域。 目标 1 中，我们将开发动态对比度增强技术。 具有高时空分辨率采样的 MRI、时空稀疏压缩感知重建、 我们还将结合新的药代动力学。 在目标 2 中，我们将进行包括动脉团注分散建模在内的映射。 开发具有多镜头方法的扩散加权 MRI，该方法使用新颖的镜头间运动校正、快速旋转 回声扩散成像可在活检标记周围提供更好的性能，而稳态扩散则可实现 3D 成像。 最后，在目标 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，以证明 与传统 ACR 标准乳腺 MRI 相比，它们对于 DCIS 患者的侵袭性肿瘤检测具有优势。 摘要：我们在本提案中建议开发、验证和测试的先进 MRI 技术具有 确定哪些 DCIS 患者可以安全地选择主动监测以及哪些需要明确 浸润性癌症的高精度治疗将提供该值，并且假阳性活检会少得多。 与传统乳腺 MRI 相比。