Magnetic resonance imaging (MRI) of the breasts, which uses radio waves and magnets rather than x-rays, identifies abnormalities by their appearance and their response to an injected substance, and can detect cancers not visible on x-ray mammography. However, like the latter, it is often unable to distinguish a cancer from a non-cancerous lesion. Non-cancerous biopsies cause anxiety, risk and are costly. Reducing the large number of biopsies of benign-lesions performed today is an important goal of breast imaging research. Proton (1H) magnetic resonance spectroscopy (MRS) non-invasively looks at tissue metabolism using the same equipment as MRI but provides completely independent biochemical information. Breast cancers have been distinguished from benign lesions and from normal breast tissue by dramatic increase of a choline (Cho) signal on 1H MRS, which is consistent with evidence from in vitro MRS of breast cell lines that Cho levels increase with progression from normal to immortalized to oncogene-transformed to tumor-derived cells. The challenge of routinely applying in vivo breast 1H MRS is the need for high spatial resolution, powerful lipid/water suppression, and robust technique, all in a clinically acceptable acquisition time. We hypothesize that the double echo-filter metabolite imaging (DEFMI) technique can overcome all obstacles associated with current 1H MRS methods. Our long-term goal is to allow high spatial resolution 1H molecular imaging to be performed whenever a breast MRI is ordered.
Our specific aims are: 1) to develop and optimize DEFMI for human breast cancer; 2) to determine whether DEFMI shows promise in reducing the false positive rate of MRI in a sample of women with positive or indeterminate MRI findings. The technical aspect of this proposal will further develop the DEFMI technique so that ultra high spatial resolution can be acquired within clinically acceptable acquisition time. The clinical aspect of this proposal will demonstrate that DEFMI improves specificity in detection of new, residual or recurrent breast cancer in a statistically meaningful number of breast cancer patients. Biopsy will be the gold standard. In summary, we will develop a 1H molecular imaging technique that 1) provides ultra high spatial resolution metabolite images using a short TE and high field, 2) allows direct metabolite imaging, 3) is fast and robust, 4) can be readily integrated into a standard breast MRI protocol operable by an MRI technologist, and 5) makes metabolite images immediately available to a radiologist just like a conventional MRI. If successful, it should become part of the routine clinical breast MRI protocol and thereby 1) improve diagnosis by providing independent biochemical information on lesions, detecting """"""""hidden"""""""" cancer, helping selection of a biopsy site, and examining multiple lesions simultaneously, 2) reduce the number of biopsies of benign lesions and their concomitant anxiety, risk and cost, and 3) help early identification of chemotherapy responders, thereby improving the management of locally advanced breast tumors. An ultra high spatial resolution proton (1H) metabolite imaging technique will be developed to overcome obstacles associated with current methods. If successful, it should become part of the routine clinical breast MRI exams, and thereby reduce the high incidence of false positive MRI and associated anxiety, risk and cost of benign biopsies. ? ? ?
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| Hu, Jiani; Feng, Wenzheng; Hua, Jia et al. (2009) A high spatial resolution in vivo 1H magnetic resonance spectroscopic imaging technique for the human breast at 3 T. Med Phys 36:4870-7 |
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| Hu, Jiani; Yu, Yingjian; Kou, Zhifeng et al. (2008) A high spatial resolution 1H magnetic resonance spectroscopic imaging technique for breast cancer with a short echo time. Magn Reson Imaging 26:360-6 |
