ISMRM 23rd Annual Meeting & Exhibition • 30 May - 05 June 2015 • Toronto, Ontario, Canada

Scientific Session • Breast Cancer: Clinical & Technical

Thursday 4 June 2015

Room 716 A/B

13:30 - 15:30


Linda Moy, M.D., Roberta M. Strigel, M.D., M.Sc.

13:30   Introduction
Savannah Partridge
13:42 0883.   
Stimulated Echo Diffusion Tensor Imaging with Varying Diffusion Times as a Probe of Breast Tissue
Jose R. Teruel1,2, Gene Y. Cho3,4, Jason Ostenson4, Melanie Moccaldi5, Joon Lee5, Pål E. Goa2,6, Tone F. Bathen1, Sungheon G. Kim3,4, Linda Moy4,5, and Eric E. Sigmund3,4
1Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway, 2St.Olavs Hospital, Trondheim, Norway, 3Center for Advanced Imaging Innovation and Research (CAI2R), New York University School of Medicine, New York, NY, United States, 4Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY, United States, 5Cancer Institute, New York University Langone Medical Center, New York, NY, United States, 6Department of Physics, Norwegian University of Science and Technology, Trondheim, Norway

The purpose of this study is to characterize the length scales of breast tissue using a stimulated echo acquisition mode (STEAM) diffusion tensor imaging (DTI) sequence with variable diffusion times. The evolution of the radial diffusivity with diffusion time was used to calculate the surface-to-volume ratio applying the Mitra early time limit model. This analysis may provide an in vivo non-invasive tool to probe diffusion lengths in healthy and pathological breast tissue.

13:54 0884.   Breast Diffusion Weighted Imaging with Reduced Artifacts using Multi-band Spin Echo EPI
Patrick J Bolan1, Steen Moeller1, Gregory J Metzger1, Edward J Auerbach1, Christophe Lenglet1, Dingxin Wang1,2, Peter Kollasch2, Vibhas Deshpande2, Sudhir Ramanna1, Michael T Nelson1, Kamil Ugurbil1, and Essa Yacoub1
1Radiology, University of Minnesota, Minneapolis, MN, United States, 2Siemens Healthcare, Minneapolis, MN, United States

Diffusion weighted imaging (DWI) is increasingly being used for diagnosing and monitoring treatment response in breast cancer. The spin-echo EPI sequence commonly used for DWI is, however, prone to artifacts from B0 offsets and fat, leading to distortions and artifacts in breast imaging. In this work we use a multi-band accelerated pulse sequence to acquire sagittally, and then reformat to produce the axial images desired for interpretation. This approach produces breast diffusion images with reduced distortion, chemical shift artifacts, and improved effective resolution in all three dimensions.

14:06 0885.   High-resolution Diffusion-Weighted Imaging of the Breast with Multiband 2D RF Pulses and a Generalized Parallel Imaging Reconstruction
Valentina Taviani1, Marcus T. Alley1, Suchandrima Banerjee2, Bruce L. Daniel1, and Brian A. Hargreaves1
1Radiology, Stanford University, Stanford, CA, United States, 2Global Applied Science Laboratory, GE Healthcare, Menlo Park, CA, United States

We developed a novel technique for high-resolution bilateral diffusion-weighted imaging (DWI) in the breast that allows the same resolution and similar image quality as clinically available reduced-FOV methods. The longer scan time necessary for the extended coverage was less than 5 minutes for aquisition of images with 2 b-values. With respect to conventional DWI, the proposed technique offers improved anatomical delineation, reduced distortion and more robust fat suppression.

14:18 0886.   Relative Enhanced Diffusivity (RED) as a Marker of Breast Tumor Microvasculature
Jose R. Teruel1,2, Pål E. Goa3,4, Torill E. Sjøbakk1, Agnes Østlie4, Hans E. Fjøsne5,6, and Tone F. Bathen1
1Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway, 2St.Olavs Hospital, Trondheim, Norway, 3Physics, Norwegian University of Science and Technology, Trondheim, Norway, 4Radiology, St.Olavs Hospital, Trondheim, Norway, 5Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway, 6Surgery, St.Olavs Hospital, Trondheim, Norway

In this study, we have explored the feasibility of obtaining a diffusion weighted imaging derived parameter sensitive to blood microcirculation employing only two non-zero b-values. This new parameter, relative enhanced diffusivity (RED), presented a high correlation with the initial area under the curve parameter derived from dynamic contrast enhanced MRI kinetic curve, and improved lesion differentiation compared with the standard apparent diffusion coefficient.

14:30 0887.   Texture Analysis of Parameter Maps in Breast MRI
Peter Gibbs1, Martin Pickles1, and Lindsay Turnbull1
1Centre for MR Investigations, University of Hull, Hull, East Yorkshire, United Kingdom

The efficacy of empirical parameter map based texture analysis as a method of predicting tumour response prior to neo-adjuvant chemotherapy is explored in a cohort of breast cancer patients with locally advanced disease. Analysis of washout slope maps revealed significant differences for 12 out of 16 textural parameters. Subsequent decision tree analysis utilised 5 parameters (f2, f3, f5, f11 and f16) obtaining a classification accuracy of 82%.

14:42 0888.   Robust Quantification of Background Parenchymal Enhancement (BPE) in Dynamic Contrast-Enhanced (DCE) MRI Breast Examinations
Araminta EW Ledger1, Maria A Schmidt1, Marco Borri1, Steven Allen2, Elizabeth AM O'Flynn2, Romney J Pope2, Erica D Scurr2, Nandita deSouza1, Robin Wilson2, and Martin O Leach1
1CR-UK Cancer Imaging Centre, The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton, Surrey, United Kingdom, 2Radiology, The Royal Marsden NHS Foundation Trust, Sutton, Surrey, United Kingdom

Background Parenchymal Enhancement (BPE) following contrast agent (CA) administration in DCE-MRI breast examinations may be related to breast cancer risk. However, BPE is typically evaluated via visual assessment of subtracted images where signal intensity changes are dependent on native T1 relaxation times. Instead, the difference in relaxivity (ΔR1) provides a measure directly proportional to CA uptake. We evaluated objective BPE measures, including ΔR1 and a normalized parenchymal enhancement coefficient (PEC), and compared these measures against relative enhancement (RE). Evaluation of ΔR1 provides an objective and translatable BPE measure which should be utilized for risk assessment in longitudinal and multicenter studies.

14:54 0889.   Prognostic Value of MR Parameters Obtained Prior to the Initiation of Neoadjuvant Chemotherapy: A Comparison with Traditinal Prognostic Indicators
Martin D Pickles1, Peter Gibbs1, Martin Lowry1, and Lindsay W Turnbull1
1Centre for Magnetic Resonance Investigations, Hull York Medical School at University of Hull, Hull, East Yorkshire, United Kingdom

The aims of this study were to determine if any associations exist between MR parameters and survival intervals; and to compare the prognostic value of MR parameters against traditional survival indicators. Size, vascular, texture and shape parameters were obtained from dynamic breast MR datasets in 81 individuals. Survival analysis demonstrated that MR parameters (textural and shape) can provide independent prognostic information that can complement traditional prognostic indicators. Further it seems that MR parameters may have a role to play in treatment stratification for breast cancer patients since these survival associations are evident prior to the initiation of neoadjuvant chemotherapy treatment.

15:06 0890.   7T Breast MRI to Visualize Proliferative Characteristics of Breast Cancer using DCE, DWI, and 31P-MRS
Alexander M. Th. Schmitz1, Wouter B. Veldhuis1, Marian B.E. Menke-Pluijmers2, Wybe J.M. van der Kemp1, Tijl A. van der Velden1, Marc C.J.M. Kock3, Pieter J. Westenend4, Dennis W.J. Klomp1, and Kenneth G.A. Gilhuijs1
1Department of Radiology/Image Sciences Institute, University Medical Center Utrecht, Utrecht, Netherlands, 2Department of Surgery, Albert Schweitzer Hospital, Dordrecht, Netherlands, 3Department of Radiology, Albert Schweitzer Hospital, Dordrecht, Netherlands, 4Department of Pathology, Albert Schweitzer Hospital, Dordrecht, Netherlands

Breast cancer therapy would benefit from more accurate tumor characterization early in therapy, especially concerning tumor proliferation. MRI may provide additional information early in treatment. In-vivo characterization using DWI and MRS may be beneficial, but the ability of 1.5 and 3T MRI systems to provide clinically useful information is limited by their sensitivity. In this study, a 7T breast MRI multi-protocol was developed including DCE-MRI, DWI and 31P-MRS. Fifteen women were included with 17 malignant lesions. First explorations in correlation with histopathology show potential of DWI and 31P-MRS to visualize biomarkers of tumor proliferation.

15:18 0891.   
Quantitative Sodium Imaging of Breast Tumors at 7 Tesla: preliminary results
Olgica Zaric1, Katja Pinker - Domenig2, Stefan Zbyn1, Thomas Helbich2, Alex Farr3, Christian Singer3, Siegfried Trattnig1, and Wolfgang Bogner1
1High Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria, 2Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria, 3Gynecology Department, Medical University of Vienna, Vienna, Austria, Austria

Tissue sodium concentration (TSC) could be considered as a sensitive biomarker that provides non-invasive information on the changes in malignant tissue such as angiogenesis and cellular proliferation. The aim of this study was to investigate the feasibility of quantitative high-resolution sodium (23Na)- MRI in breast tumor patients at 7.0 T. Reproducible good image quality in clinically feasible time was achieved. Our results showed excellent differentiation between breast lesions (TSC showed 40% higher values in malignant then in benign tumors). We believe that 23Na combined with other MRI techniques, has a great potential in breast tumors detection and characterization.