Breast Cancer
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Wednesday 9 May 2012
Room 219-220  13:30 - 15:30 Moderators: Margaret A. Hall-Craggs, Linda Moy

13:30 0448.   
Background Parenchymal Enhancement (BPE) in Healthy Subjects and Breast Cancer Patients: A Quantitative Evaluation and Comparison with Diffusion-weighted Imaging
Gene Young Cho1,2, Linda Moy3, Scott DeGregorio3, Sungheon Kim1, Melanie Moccaldi3, Jane Kwon1, Steven Baete1, Daniel K Sodickson1, and Eric E Sigmund1
1Radiology, NYU School of Medicine - Schwartz Center for Biomedical Imaging, New York, NY, United States, 2NYU Sackler Institute of Biomedical Science, New York, NY, United States, 3Radiology, NYU School of Medicine, New York, NY, United States

Recent studies have used MRI biomarkers such as background parenchymal enhancement (BPE) and apparent diffusion coefficient (ADC) to correlate with prognostic factors of breast cancer and predict cancer odds. An increased BPE correlates significantly with higher odds ratios for developing breast cancer. In this study, BPE was measured from a cohort of healthy controls and breast cancer patients using dynamic contrast enhanced MRI. BPE values were compared between controls and patients, and with diffusion metrics of fibroglandular tissue (FGT) and in the patient lesions. Implications for the biophysical underpinnings of BPE and its interpretation are considered.

13:42 0449.   Differentiation between Intermingled and Central Type Breast Parenchymal Patterns Using Quantitative 3D Morphology and Texture Analysis on Segmented Dense Tissue
Peter T. Fwu1, Jeon-Hor. Chen1,2, Siwa Chan3, Dah-Cherng Yeh4, Chin-Kai Chang2, Julian Kao1, Muqing Lin1, Orhan Nalcioglu1, and Min-Ying L. Su1
1Center for Functional Onco-Imaging, Department of Radiological Sciences, University of California, Irvne, California, United States, 2Department of Radiology, China Medical University Hospital, Taichung, Taiwan, 3Department of Radiology, Taichung Veterans General Hospital, Taichung, Taiwan,4Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan

The purpose is to develop a quantitative method to characterize the breast density pattern using 3D morphology and texture analysis for investigating its role in cancer risk prediction. Morphology is characterized by circularity, convexity, and irregularity; texture is characterized by coefficient of variation in signal intensity distribution and the GLCM matrix. The ability of analyzed parameters to differentiate between the central and the intermingled breast density patterns is evaluated by the ROC analysis. The results show that morphology parameters can reach AUC of 0.95, texture parameters have a lower AUC of 0.90, but combining them can yield AUC of 0.98.

13:54 0450.   
Cyclooxygenase-2 mediates changes in the extracellular matrix in triple negative breast cancer
Samata M. Kakkad1, Ioannis Stasinopoulos1, Marie-France Penet1, Arvind P. Pathak1, Meiyappan Solaiyappan1, and Zaver M. Bhujwalla1
1JHU ICMIC Program, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, United States

COX-2 is a critically important mediator of inflammation that significantly influences tumor angiogenesis, invasion and metastasis. Here, we investigated the role of COX-2 in altering structure and function of the extracellular matrix (ECM) using MRI and second harmonic generation (SHG) imaging of tumors derived from triple negative MDA-MB-231 breast cancer cells and a derived clone stably expressing shRNA downregulating COX-2. MRI of albumin-GdDTPA was used to characterize macromolecular fluid transport and SHG imaging to quantify collagen I fiber morphology. COX-2 downregulation decreased fibrillar collagen and altered macromolecular fluid transport. These results identify new roles for COX-2 in altering the ECM.

14:06 0451.   3D Mapping of total Choline in Human Breast Cancer Using High-Speed MR Spectroscopic Imaging at 3T: Initial Experience during Neoadjuvant Therapy
Stefan Posse1,2, Tongsheng Zhang1, Melanie Royce3, Zoneddy Dayao3, Susan Lopez4, Laurel Sillerud5, Stephen Eberhardt6, Lesley Lomo7, Sang-Joon Lee8, Ashwani Rajput9, John Russell9, Linda Casey10, and Patrick Bolan11
1Neurology, University of New Mexico, Albuquerque, NM, United States, 2Electrical and Computer Engineering, Physics and Astronomy, University of New Mexico, Albuquerque, NM, United States, 3Medical Oncology, University of New Mexico, Albuquerque, NM, United States, 4Clinical Trials Office, University of New Mexico, Albuquerque, NM, United States, 5Biochemistry, University of New Mexico, Albuquerque, NM, United States, 6Radiology, University of New Mexico, Albuquerque, NM, United States, 7Pathology, University of New Mexico, Albuquerque, NM, United States, 8Internal Medicine, University of New Mexico, Albuquerque, NM, United States, 9Surgery, University of New Mexico, Albuquerque, NM, United States, 10New Mexico Cancer Center, Albuquerque, NM, United States, 11Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, United States

Eleven patients with biopsy-confirmed, infiltrating ductal carcinoma were studied at 3T using 3D lipid suppressed Proton-Echo-Planar-Spectroscopic-Imaging (PEPSI) with a 10 min scan protocol and 1 cc voxel size. Strongly elevated tCho with mean concentrations between 0.3 and 4.1 mmol/kg was measured in 8 of the 11 patients with single and multi-centric enhancing lesions. Decreases in tCho concentration and number of voxels with detectable tCho were measured in 3 patients who underwent neoadjuvant therapy. An increase was measured in one patient. At TE 60 ms an additional resonance was detected that was elevated in enhancing lesions and tentatively assigned to Taurine.

14:18 0452.   Mean Intracellular Water Molecule Lifetime: Another Useful Breast DCE-MRI Biomarker?
Wei Huang1, Xin Li1, Luminita A Tudorica1, Karen Y Oh1, Sunitha B Thakur2, Elizabeth A Morris2, Yiyi Chen1, Nicole Roy1, Mark D Kettler1, Jason A Koutcher2, and Charles S Springer1
1Oregon Health & Science University, Portland, Oregon, United States, 2Memorial Sloan Kettering Cancer Center, New York, New York, United States

157 patients with 172 suspicious breast lesions underwent research DCE-MRI prior to biopsies. DCE-MRI time-course data were subjected to both Standard model (SM) and Shutter-Speed Model (SSM) analyses. Though not a good diagnostic biomarker, the mean intracellular water molecule lifetime, ôi, derived only with the SSM, was significantly smaller in malignant compared to benign lesions. ôi was also inversely correlated with SM and SSM Ktrans. The inverse relationships of ôi with cellular metabolic activity and Ktrans indicate its potential use for detection of hypoxia/necrosis and evaluation of breast cancer response to therapy.

14:30 0453.   Thin slice high resolution breast DWI at 3T (RESOLVE): increased separation of benign from malignant tumors among BI-RADS 4/5 lesions
Dorota Jakubowski Wisner1, Nathan Rogers2, Vibhas Deshpande3, Gerhard Laub3, David Porter4, Bonnie Joe1, and Nola Hylton1
1Radiology, University of California, San Francisco, San Francisco, CA, United States, 2Radiology, University of California, San Francisco, San Francisco, California, United States, 3Siemens Medical Solutions USA, Inc., San Francisco, CA, United States, 4Siemens Medical Solutions USA, Inc., Erlangen, Germany

This study compares ADC values obtained by thin-slice RESOLVE (a readout segmented diffusion technique) to typical EPI diffusion imaging at 3T, as tested on suspicious breast MRI lesions prior to biopsy. We found that among malignant lesions, RESOLVE demonstrates lower mean ADC values, increasing separation between benign and malignant lesions.

14:42 0454.   Intravoxel Incoherent Motion in Breast Lesions at 3 Tesla
Sunitha Thakur1,2, Louisa Bokacheva1, Jennifer Kaplan2, Merlin Gnanasigamani2, Gregory Nyman2, and Elizabeth Morris2
1Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, New York, United States, 2Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York, United States

Thirty eight patients with breast cancer, suspicious lesions or family history of disease were studied with multiple b-value diffusion-weighted MRI at 3 T. The intravoxel incoherent motion (IVIM) effect was observed in 11/13 of malignant lesions, in 1/8 benign lesion and in none of the 17 normal fibroglandular tissue regions of interest. In malignant lesions, the mean vascular fraction was 0.16plus-or-minus sign0.04 and the pseudodiffusion coefficient was (8.5plus-or-minus sign2.5)x10-3 mm2/s. The IVIM effect in breast lesions is difficult to quantify reliably, but may add confidence in discrimination malignant lesions from benign lesions.

14:54 0455.   
Assessment of dynamic range in dynamic contrast-enhanced breast examinations
Araminta E. W. Ledger1, Marco Borri1, Maria Schmidt1, Romney Pope2, Erica Scurr1, Toni Wallace1, Cheryl Richardson2, Marianne Usher2, Steven Allen2, Nandita deSouza1, and Martin O. Leach1
1CR-UK and EPSRC Cancer Imaging Centre, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton, Surrey, United Kingdom,2Department of Radiology, Royal Marsden Hospital, Sutton, Surrey, United Kingdom

The classification of enhancement curves in dynamic contrast-enhanced (DCE) breast examinations requires image intensity approximately proportional to contrast agent concentration. We propose to evaluate the dynamic range in breast DCE retrospectively, by considering the enhancement of the internal mammary artery. This method was validated by comparing clinical examinations obtained with five different protocols (flip angles 10°, 14° and 18°, radial or linear k-space sampling). Significant differences were found between groups of 7-10 patients, in agreement with expected behaviour (greater dynamic range at higher flip angles, reduction in dynamic range for radial sampling protocols). Retrospective assessment is therefore a viable approach.

15:06 0456.   High Spatio-temporal Resolution Breast Dynamic Contrast Enhanced MRI at 3T
Manojkumar Saranathan1, Dan W Rettmann2, Brian A Hargreaves1, Jafi Lipson1, and Bruce Daniel1
1Radiology, Stanford University, Stanford, CA, United States, 2Global Applied Science Laboratory, GE Healthcare, Rochester, MN, United States

Dynamic-contrast enhanced (DCE) MRI is the primary approach for clinical breast imaging but is beset by the need for both high spatial and high temporal resolution [1-2], often resulting in suboptimal compromises. High temporal resolution is required for quantitative pharmacokinetic modeling whereas high spatial resolution is necessary for clear delineation of tumor morphology. We present clinical results from 20 patients of a new variable spatio-temporal resolution technique that seamlessly switches between the high temporal and high spatial resolution modes. Bilateral coverage with 0.9x0.9x1.2 mm spatial resolution was achieved, with the two modes having a temporal resolution of ~9s and ~120s respectively

15:18 0457.   The Utility of Sweep Imaging with Fourier Transform (SWIFT) in breast cancer.
Curtis Andrew Corum1, Andrew Babcock2, Djaudat Idiyatullin1, Angela L. Styczynski-Snyder1, Diane Hutter1, Lenore Everson2, Michael Nelson2, and Michael Garwood1
1CMRR, Radiology, Medical Shcool, University of Minnesota, Minneapolis, MN, United States, 2Radiology, Medical Shcool, University of Minnesota, Minneapolis, MN, United States

This paper is a feasibility study of SWeep Imaging with Fourier Transform (SWIFT) to detect breast pathology. An advantage of SWIFT is that the same scan data can be formatted into hight temporal resolution DCE and high spatial resolution morphological images. Three patients who underwent SWIFT imaging after clinical suspicion of breast pathology, but prior to biopsy, are presented. The following pathology was identified: ductal carcinoma in situ, fibroadenoma, and infiltrating ductal carcinoma. SWIFT MRI shows benign and malignant features similar to clinical DCE MRI and offers numerous advantages. Benefits include faster imaging with excellent spatial and temporal resolution, with reduced T2* effects.