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    Research Grants Awarded

    Whole-body MRI for Detecting Breast Cancer Metastases

    Study Section:
    Detection, Diagnosis and Prognosis

    Scientific Abstract:
    BACKGROUND Breast cancer metastasis may occur at different sites, thus often necessitating multiple and lengthy studies for detection. Recently, several research groups have shown that whole-body T2-weighted MRI images with fat suppression (FS) can be acquired using the turbo short-tau inversion recovery (STIR) technique in less than 15 minutes, and that the whole body STIR technique is not only more accurate than skeletal scintigraphy in detecting bone metastasis but also capable of detecting extraosseous metastasis. STIR images, however, suffer from reduced signal-to-noise ratio (SNR), are susceptible to motion artifacts, and do not permit differentiation between tumor and some commonly encountered benign lesions. OBJECTIVE/HYPOTHESIS The objective of the study is to develop and validate a novel fast spin-echo triple-echo Dixon (fTED) technique that can generate both T2-weighted images with FS and quantitative T2-maps of the entire body in less than 15 minutes. We hypothesize that because of its higher image quality and additional T2-map to help characterize lesions, fTED is more accurate than STIR in whole body screening for breast cancer metastasis. SPECIFIC AIMS 1) Develop the fTED technique and evaluate its performance in phantoms. 2) Determine the diagnostic accuracy of fTED and STIR for detecting breast cancer metastasis. STUDY DESIGN We will develop and implement the fTED technique by modifying a standard fast spin echo pulse sequence to acquire three raw images in a single scan. By exploiting the phase and amplitude differences in the three raw images, we will reconstruct a T2-weighted image with FS and a quantitative T2 map for each slice. The SNR, FS and T2-quantitation accuracy will be evaluated in water-fat-T2 phantoms. For clinical validation, we will acquire whole-body fTED and STIR images in 30 breast cancer patients with confirmed distant metastasis. The diagnostic accuracy of each technique will be determined using a standard of reference established with clinical and imaging follow-up for a minimum of six months. POTENTIAL OUTCOMES AND BENEFITS OF THE RESEARCH Once completed, the fully developed and validated fTED technique will provide a fast, accurate and economical approach to whole body detection of breast cancer metastases. The technique requires neither contrast agent injection nor use of ionizing radiation. It will thus be valuable for the management, prognosis and monitoring of breast cancer patients.

    Lay Abstract:
    BACKGROUND Accurate detection of breast cancer metastasis often requires multiple studies because breast cancer may spread to several different body locations. Recently, several research groups have shown that whole-body T2-weighted magnetic resonance images with fat suppression (FS) can be obtained using a turbo short-tau inversion recovery (STIR) technique in less than 15 minutes, and that the whole body STIR technique is not only more accurate than conventional skeletal scintigraphy in detecting bone metastasis but also capable of detecting metastasis to organs outside the bone. STIR images, however, have reduced signal-to-noise ratio (SNR), are prone to motion artifacts, and can not distinguish tumor from some common non-cancerous lesions. OBJECTIVE/HYPOTHESIS The objective of the study is to develop and validate a novel fast spin-echo triple-echo Dixon (fTED) technique that can generate both T2-weighted images with FS and quantitative T2-maps of the entire body in less than 15 minutes. We hypothesize that because of its higher image quality and additional T2-maps to help characterize lesions, fTED will be more accurate than STIR for whole body breast cancer screening. SPECIFIC AIMS 1) Develop and implement the fTED technique and evaluate its performance in phantoms. 2) Determine the diagnostic accuracy of the fTED and STIR techniques for detecting breast cancer metastasis. STUDY DESIGN We will develop and implement the fTED technique by modifying a standard fast spin echo technique to acquire three raw images in a single acquisition. Based on the differences in the three raw images, we will generate a T2-weighted image with FS and a quantitative T2-map for each image slice. The SNR, FS and T2-accuracy will be evaluated in phantoms. For clinical validation, we will acquire whole-body fTED and STIR images in 30 breast cancer patients with confirmed distant metastasis. Using a diagnostic standard of reference established with clinical and imaging follow-up for a minimum of 6 months, we will determine the diagnostic accuracy of each technique. POTENTIAL OUTCOMES AND BENEFITS OF THE RESEARCH Once completed, the fTED technique will provide a fast, accurate and economical approach to whole body screening for breast cancer metastases. The technique requires neither contrast agent injection nor use of ionizing radiation. It will thus be valuable for the management, prognosis and monitoring of breast cancer patients.