Joint Annual Meeting ISMRM-ESMRMB 2014 10-16 May 2014 Milan, Italy

Breast Cancer: Clinical & Technical

Wednesday 14 May 2014
Yellow 1, 2 & 3  16:00 - 18:00 Moderators: Elizabeth A. Morris, M.D., F.A.C.R., Francesco Sardanelli, M.D.

16:00 0702.   
Spatiotemporal Encoding Diffusion Weighted Imaging of the Breast: Comparison with SE-EPI-based methodology
Eddy Solomon1, Noam Nissan1,2, Amir Seginer1, Edna Furman-Haran3, Myra Shapiro-Feinberg4, Hadassa Degani2, and Lucio Frydman1
1Chemical Physics, Weizmann Institute of Science, Rehovot, Israel, 2Biological Regulation, Weizmann Institute of Science, Rehovot, Israel, 3Biological Services, Weizmann Institute of Science, Rehovot, Israel, 4Radiology, Meir Hospital, Kfar Saba, Israel

A recently proposed MRI methodology, SPatio-temporal ENcoding (SPEN), was employed to quantify apparent diffusion coefficients in breast. SPEN is highly robust in terms of overcoming B0-inhomogeneities and heterogeneous chemical shift environments, and hence could present advantages in these challenging studies. Diffusion SPEN measurements were carried out at 3T and included healthy female volunteers and patients with biopsy-confirmed breast cancer. Substantial advantages in terms of both anatomical image qualities and diffusional information vis-à-vis EPI were observed, confirming SPEN’s ability to yield reliable ADC values and reveal a reduction of ADC in cancerous tissues.

16:12 0703.   CAIPIRINHA-DIXON-TWIST-VIBE-Based Dynamic Contrast-Enhanced Breast Imaging For High Temporal and Spatial Resolution: Scanning Time Optimization
Wen Hao1, Bin Zhao1, Hui Liu2, Marcel D. Nickel3, Elisabeth Weiland3, and Guangbin Wang1
1Magnetic resonance imaging, Shandong medical imaging research institution, Shandong University, Jinan, ShanDong, China, 2MR Collaboration NE Asia, Siemens Healthcare, Shanghai, China, 3MR Applications Development, Siemens AG, Healthcare Sector, Erlangen, Germany

We have investigated pharmacokinetic parameters for various bolus tracking time using CDT-VIBE sequence and drew the conclusion that a scanning time of 3 min after the injection of contrast might be adequate to yield reliable pharmacokinetic parameters and can be used for the evaluation of enhancing of breast lesions with reasonable accuracy in clinical setting.

16:24 0704.   
Breast Diffusion-weighted Imaging at 3 and 7 Tesla: Comparison Study
Lenka Minarikova1, Wolfgang Bogner1, Olgica Zaric1, Katja Pinker-Domenig1, Thomas Helbich1, Siegfried Trattnig1, and Stephan Gruber1
1High Field MR Centre, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria

The purpose of this study was to compare bilateral breast-DWI with sub-mm-resolution (0.9mm2) at 7T with 3T (1.4mm2) in the same patients. The results suggest that breast 7T DWI can be performed with significantly higher spatial resolution than at 3T, with comparable SNR. Therefore, 7T DWI in breast cancer has the potential to improve lesion detection and/or differentiation. In addition, the high resolution of 7T DWI at b=0s/mm2 has very similar contrast as STIR and could, therefore, potentially replace additional T2-weighted MRI and save measurement time.

16:36 0705.   Compression Effects in Breast MR Elastography
Jun Chen1, Kathleen Brandt1, Karthik Ghosh1, Roger Grimm1, Kevin Glaser1, Jennifer Kugel1, Kay Pepin1, and Richard Ehman1
1Mayo Clinic, Rochester, MN, United States

In conventional breast MR Elastography (MRE), the driver compresses the breasts to maintain mechanical coupling for wave transmission. This compression could introduce a significant bias into the measured stiffness of breast tissue. For the first time, this study reports strong evidence of breast compression effects in breast MRE. With 20% breast compression, glandular and adipose tissue stiffness increased by 53.8% and 103.8% respectively. Therefore, true breast tissue stiffness can be measured only when there is no compression, such as when using the noncompressive breast MRE technique utilized in this study.

16:48 0706.   
High resolution MRI and high sensitive 31P MRS of axillary lymph nodes at 7T
Debra S Rivera1, Jannie P Wijnen2, Wybe J. M. van der Kemp2, Alexander J Raaijmakers2, Peter R Luijten2, and Dennis WJ Klomp2
1Neurophysics, Max Planck Institute, Leipzig, Germany, 2Univercity Medical Center Utrecht, Netherlands

Lymph node treatment response predicts 5-year survival. Insufficient monitoring methods slow drug development and breakthroughs in individualized treatment. Phospholipid metabolism indicates malignant transformation, thus preclinical drug development uses spectroscopy. Combining specialized RF hardware with 7T, we shrink voxels to clinically relevant volumes in vivo (1.2 cm isotropic). The setup is safe and compatible with existing breast coils. We present images of <1 cm nodes, and the first 31P spectra from an axilla lymph node in vivo. With signal visible just above the noise floor in a healthy volunteer, the hardware holds potential for monitoring treatment response in malignant lymph nodes.

17:00 0707.   
Breast Cancer Heterogeneity via Intravoxel Incoherent Motion Histogram Analysis: Correlation with Prognostic Factors
Gene Young Cho1, Linda Moy1, Ana Paula Klautau Leite2, Steven Baete1, Jim Babb1, Sungheon Kim1, Daniel K Sodickson1, and Eric E Sigmund1
1Radiology - Bernard and Irene Schwartz Center for Biomedical Imaging, New York University School of Medicine, New York, Select, United States,2Radiology, Hospital das Clínicas, School of Medicine, University of São Paulo, São Paulo, SP, Brazil

Advanced imaging methods such as diffusion MRI with intravoxel incoherent motion (IVIM) analysis provide quantification of imaging biomarkers that relate to physiological tumor characteristics. In this study, advanced diffusion MRI parameters (ADC and IVIM) and heterogeneity markers from histogram analysis of the whole tumor (i.e. kurtosis, skewness, deviation) are correlated with molecular prognostic factors (i.e. ER, PR, Her2/Neu, and Ki-67) in breast cancer patients. Such an analysis may provide useful metrics for breast cancer heterogeneity, which may play a useful role in diagnosis.

17:12 0708.   Histogram analysis of intravoxel incoherent motion (IVIM)-MRI and FDG-PET parameters in breast cancer patients
Eric Edward Sigmund1, Linda Moy1, Jin Ah Kim1, Sungheon Kim1, Akshat Pujara1, Alana Amarosa1, Komal Jhaveri2, James Babb1, Christian Geppert3, Christopher Glielmi3, Gene Young Cho1, Thorsten Feiweier4, Kimberly Jackson1, and Amy Melsaether1
1Radiology, NYU Langone Medical Center, New York, NY, United States, 2Oncology, NYU Langone Medical Center, New York, NY, United States,3Siemens Medical Solutions, New York, NY, United States, 4Healthcare Sector, Siemens AG, Erlangen, Germany

Histogram analysis of intravoxel incoherent motion (IVIM)-MRI and FDG-PET parameters in breast cancer patients Diffusion-weighted MRI, particularly its vascular-sensitive variant intravoxel incoherent motion (IVIM), and 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) are powerful individual probes of aggressiveness in breast cancer, with potential synergies on the simultaneous MR/PET platform. To investigate their complementarity, we studied the relationships between metrics from full lesion histogram analysis (mean, maximum, minimum, standard deviation, skewness, and kurtosis) of their respective parametric maps, as well as with clinical tumor markers. A cohort of 14 breast cancer patients with a dedicated breast coil were included. Results confirm canonical malignancy trends such the inverse relation between minimum ADC and maximum SUV (r=0.5), relations between markers’ heterogeneity metrics. Multiple regression models suggest combinations of mean, extremal, and variance metrics improve correlation with tumor markers, suggesting potential for imaging surrogates to tumor profile evaluation.

17:24 0709.   
Beyond Histopathologic Prognostication: Can DCE-MRI improve Breast Cancer Recurrence Risk Prediction?
Dania Daye1, Brad Keller1, Ahmed Ashraf1, Sarah Gavenonis1, Carolyn Mies2, Mark Rosen1, Michael Feldman2, and Despina Kontos1
1Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, United States, 2Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States

Emerging studies suggest that imaging features could complement standard pathologic variables in cancer prognostic assessment. However, studies on the role of DCE-MRI in improving breast cancer prognostication are still limited. The goal of this study was to investigate the complementary value of morphologic breast DCE-MRI tumor characteristics as prognostic markers for breast cancer recurrence risk assessment. DCE-MRI images were retrospectively analyzed from 57 women with breast cancer. Oncotype DX score was used as a surrogate for cancer recurrence. Our results suggest that DCE-MRI could complement histopathologic factors in predicting breast cancer recurrence risk and could potentially improve breast cancer prognostication.

17:36 0710.   Early Responses of Breast Cancer Patients to Chemotherapy with and without Anti-angiogenic Pre-treatment Monitored by Diffusion Tensor Imaging
Limiao Jiang1, Bo Zhang2, Dennis Lai-Hong Cheong2, Soo Chin Lee3, and Thian C Ng1,2
1Department of Diagnostic Radiology, National University of Singapore, Singapore, Singapore, 2Clinical Imaging Research Center, A*STAR & National University of Singapore, Singapore, 3Department of Haematology-Oncology, National University Health System, Singapore

DTI can be used to probe tissue microstructure in vivo. We used DTI to study vasculature alteration including “normalization” for enhancing the drug(s) delivery to breast carcinoma cells in 35 patients pre-treated with low dose Sunitinib. It showed that patients pre-treated with anti-angiogenic agent had a more significant increase in ADC compared to sole chemotherapy group. This implies that Sunitinib may have enhanced the chemotherapy effectiveness. The pre-treatment ADC values and the relative changes in tumor volume after chemotherapy were also highly correlated, suggesting that the breast carcinoma with lower pre-treatment ADCs are likely going to respond better to chemotherapy.

17:48 0711.   Use of DW Imaging as an Adjunct to Dynamic Contrast Enhanced MRI in Breast Cancer at 3T
Sunitha Thakur1, Soledad Milans2, Sujata Patil3, and Elizabeth Morris3
1Memorial Sloan-Kettering Cancer Center, New York, NY, United States, 2Memorial Sloan-Kettering Cancer Center, New York, United States, 3Memorial Sloan-Kettering Cancer Center, NY, United States

DWI has demonstrated potential in discriminating malignant from benign lesions. In this work we explored if DWI can improve PPV of contrast-enhanced MRI at 3.0 T. ADC values are significantly lower in malignant lesions compared to benign lesions yielding 86% sensitivity, 73% specificity, 86% PPV and 73% NPV with the optimal ADC threshold of 1.3x10-3 mm2/s derived from ROC analysis. Higher mean ADC values were observed in DCIS lesions compared to invasive lesions, and low-risk benign compared with high risk benign lesions. DWI of lesion assessment improves the PPV of breast malignancy and can be used as an adjunct to MRI (PPV=34%) to avoid unnecessary benign biopsies.