ISMRM 24th Annual Meeting & Exhibition • 07-13 May 2016 • Singapore

Scientific Session: Breast Disease & Cancer

Tuesday, May 10, 2016
Room 334-336
13:30 - 15:30
Moderators: Ritse Mann, Katja Pinker

Assessment of tumor perfusion, oxygenation, and metabolism using DCE, BOLD, and hyperpolarized 13C MRI in a mouse model of breast cancer
Erin B Adamson1, Roberta M Strigel1,2,3, David J Niles1, Kai D Ludwig1, Ben L Cox1,4,5, Amy R Moser2,6, and Sean B Fain1,3,7
1Medical Physics, University of Wisconsin-Madison, Madison, WI, United States, 2Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI, United States, 3Radiology, University of Wisconsin-Madison, Madison, WI, United States, 4Morgridge Institute for Research, Madison, WI, United States, 5Laboratory for Optical and Computational Instrumentation, University of Wisconsin-Madison, Madison, WI, United States, 6Human Oncology, University of Wisconsin-Madison, Madison, WI, United States, 7Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, United States
Hyperpolarized (HP) 13C MRSI, dynamic contrast-enhanced (DCE) MRI, and blood-oxygen-level dependent (BOLD) MRI have the potential to non-invasively characterize tumor metabolism, perfusion, and oxygenation, respectively, and aid in the development of individualized treatment plans for cancer patients. However, a regional comparison of these non-invasive techniques for probing the tumor microenvironment has not been explored. This work aims to test the feasibility of performing quantitative, spatial analysis and comparison of HP 13C MRSI and BOLD and DCE MRI in a murine breast cancer model. 

3D Magnetic Resonance Fingerprinting for Quantitative Breast Imaging
Yong Chen1, Shivani Pahwa1, Jesse Hamilton2, Sara Dastmalchian1, Donna Plecha3, Nicole Seiberlich2, Mark Griswold1, and Vikas Gulani1
1Department of Radiology, Case Western Reserve University, Cleveland, OH, United States, 2Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, United States, 3Department of Radiology, University Hospitals Case Medical Center, Cleveland, OH, United States
In this study, a rapid relaxometry method was developed for breast imaging using the MRF technique, which allows simultaneous and volumetric quantification of T1 and T2 relaxation times for breast tissues.

Breast tissue lipid and metabolite deregulation precedes malignant transformation in women with BRCA gene mutations: a longitudinal study
Gorane Santamaria1, Jessica Buck2,3, Leah Best4, David Clark5, Judith Silcock5, Peter Lau4, Saadallah Ramadan6, Scott Quadrelli3,7, Peter Malycha3, and Carolyn Mountford3
1Hospital Clinic de Barcelona, Barcelona, Spain, 2Oxford University, Oxford, United Kingdom, 3Translational Research Institute, Brisbane, Australia, 4Hunter New England Area Health, Newcastle, Australia, 5The Breast and Endocrine Centre, Gateshead, Gateshead, Australia, 6University of Newcastle, Australia, Newcastle, Australia, 7Queensland University of Technology, Brisbane, Australia
Women carrying the BRCA1 and BRCA2 gene mutations exhibited lipid and metabolite profiles consistent with very early deregulation recorded earlier in cancer cell models. The deregulation was different for BRCA1 and BRCA2. Here we report a longitudinal study where these same women are monitored every six month using the L-COSY MRS method and every 12 month with contrast enhanced MRI.  For most women in the study the biomarkers remained relatively stable over time. Of the 6 BRCA1 and 10 BRCA2 patients examined, one BRCA1 patient and one BRCA2 patient showed further deregulation.

Fat-Based Registration of Breast DCE Water Images
Subashini Srinivasan1, Brian A Hargreaves1, and Bruce L Daniel1
1Radiology, Stanford University, Stanford, CA, United States
Three-dimensional breast dynamic contrast-enhanced imaging is susceptible to deformable motion and affects both semi-quantitative and pharmacokinetic parameters. B-Spline motion registration with a mutual information metric is often used to register DCE images but is sometimes susceptible to introduction of new motion. Here we have introduced a fat-based motion registration, using a mean-squared-difference signal metric, to register the water images without introducing new motion. The acquired images and both registration methods were qualitatively assessed in 16 breasts. Voxel-by-voxel pharmacokinetic mapping was also performed in 21 tumors. Our results show that fat-based registration can be used to register the water images with improved image quality and reduced errors in quantification.

gagCEST imaging in patients with breast tumors at 7 Tesla - preliminary results
Olgica Zaric1, Katja Pinker-Domenig2,3, Esau Poblador 1, Vadimir Mlynarik1, Thomas Helbich4, Siegfrid Trattnig1,5, and Wolfgang Bogner1
1High Field Magnetic Resonance Centre, Medical University of Vienna, Vienna, Austria, 2Department of Biomedical Imaging and Image-guided Therapy, Medical University Vienna, Vienna, Austria, 3Molecular Imaging and Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY, United States, 4Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria,5Christian Doppler Lab for Clinical Molecular MRI, Christian Doppler Forschungsgesellschaft, Vienna, Austria, Vienna, Austria
Proteoglycans content in malignant tumors may provide information regarding the altered metabolism and neoplastic cell behavior. The aim of this study was to investigate the feasibility of gagCEST imaging in patients with breast tumors at 7 Tesla. Eleven patients with 15 lesions were examined. gagCEST imaging was performed with 1.7mm in-plane resolution and nine minutes of measurement time. Results based on MTRasym showed excellent differentation between malignant and benign lesions (CI=95%, p=0.001) and insignificant difference between benign and healthy tissue (CI=95%, p=0.159). gagCEST has a great potential in breast tumors evaluations providing substantially different information obtained with standard MRI techniques.

Directional-gradient based radiogenomic descriptors on DCE-MRI appear to distinguish different PAM50-identified subtypes of HER2+ Breast Cancer
Prateek Prasanna1, Nathaniel Braman1, Salendra Singh1, Donna Plecha2, Hannah Gilmore2, Lyndsay Harris2, Tao Wan3, Vinay Varadan1, and Anant Madabhushi1
1Case Western Reserve University, Cleveland, OH, United States, 2University Hospitals, Cleveland, OH, United States, 3Beihang University, Beijing, China, People's Republic of
  We present the initial results of using a novel radiogenomic descriptor, CoLlAGe, on breast DCE-MRI to identify associations with HER2+ breast cancer subtypes. Current method involves using a PAM50 assay to analyze primary tumor tissues. CoLlAGe is a quantitative measurement of the degree of order/disorder of localized image gradient orientations. We extract CoLlAGe entropy from the regions of interest. Unsupervised hierarchical clustering of the entropy statistics show that we can segregate the cohort into three distinct subtypes (enriched, basal and luminal), as identified by PAM50 assay. CoLlAGe resulted in higher clustering accuracy as compared to pharmacokinetic parameters and signal intensities.

Rapid high-resolution sodium relaxometry in human breast
Glen Morrell1, Josh Kaggie2, Matthew Stein1, Scott Parker1, and Neal Bangerter3
1Radiology, University of Utah, Salt Lake City, UT, United States, 2Radiology, University of Cambridge, Cambridge, United Kingdom, 3Electrical and Computer Engineering, Brigham Young University, Provo, UT, United States
We have performed rapid high-resolution breast sodium MRI relaxometry using a custom sodium breast phased array coil.  Clear delineation of short- and long-T2* components of the sodium signal is possible with a spatial resolution of 3.75 x 3.75 x 4mm over the entire breast with a total imaging time of under 10 min.  This method will allow the investigation of the potential of sodium relaxometry to improve the specificity of breast MRI for the detection of breast cancer.

The performance of MRI screening in the detection of breast cancer in an intermediate and high risk screening program
Suzan Vreemann1, Albert Gubern-Merida1, Susanne Lardenoije1, Nico Karssemeijer1, and Ritse M. Mann1
1Radiology and Nuclear Medicine, Radboudumc, Nijmegen, Netherlands
Women at increased risk for breast cancer require annual mammography and MRI. The purpose of this study is to evaluate cancers detected in MRI screening and assess the visibility on prior MRI-examinations. MRI-scans of breast cancers detected in our MRI screening program were re-evaluated and lesions on the diagnostic MRI and prior MRI were scored according to Breast Imaging Reporting and Data (BI-RADS) MR-lexicon. The visibility of the lesions on the prior MRI was rated as visible, minimal sign and invisible. Our results show that almost one third of the breast cancers should have been recalled based on consensus review. 

Comparison of Conventional DCE-MRI and a Novel Golden-Angle Radial Compressed-Sensing and Parallel Imaging Method for the Evaluation of Breast Lesion Conspicuity and Morphology
Laura Heacock1, Yiming Gao1, Samantha Heller1, Amy Melsaether1, Sungheon Kim1,2, and Linda Moy1
1Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY, United States, 2Center for Advanced Imaging Innovation and Research (CAI2R), New York University School of Medicine, New York, NY, United States
GRASP DCE-MRI (Golden-angle Radial Sparse Parallel) DCE-MRI allows simultaneous high spatial and temporal resolution. The purpose of this study was to evaluate breast lesion conspicuity between GRASP and conventional Cartesian sampling DCE-MRI. Readers assessed conspicuity of 48 biopsy-proven lesions on conventional DCE-MRI and subsequent GRASP biopsy. No significant difference was found between the two techniques for all lesions (p=0.21, p=0.19, p=0.46), masses (p=1.0, p=0.48, p=0.7) or NME (p=0.18,p=0.08, p=0.64). There was strong reader agreement in evaluating conspicuity (ICC=0.735). GRASP DCE-MRI is comparable to conventional DCE-MRI imaging for masses and NME with diagnostic-quality high spatial resolution and flexibility of temporal resolution. 

Different anti-angiogenic drugs have different effects on the relationship between vascular structure and function in a patient-derived breast cancer model
Eugene Kim1, Jana Cebulla1, Astrid Jullumstrø Feuerherm2, Berit Johansen2, Olav Engebråten3, Gunhild Mari Mælandsmo3, Tone Frost Bathen1, and Siver Andreas Moestue1
1MR Cancer Group, Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway, 2Avexxin AS, Department of Biology, Norwegian University of Science and Technology, Trondheim, Norway, 3Department of Tumor Biology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway
This study investigated the relationship between tumor vascular function (DCE-MRI) and structure (ex vivo micro-CT). Control tumors did not exhibit any significant correlations between micro-CT and DCE-MRI parameters. Tumors treated with bevacizumab or a cPLA2 inhibitor (AVX235), both anti-angiogenic drugs, displayed reduced perfusion and vascularization. But interestingly, there was a significant positive correlation between vascular surface area and Ktrans in AVX235-treated tumors, whereas the corresponding correlation was negative in bevacizumab-treated tumors. This suggests that different therapies can differentially modulate the vascular structure-function relationship, which highlights the challenge in interpreting DCE-MRI measurements and adopting them as clinical biomarkers of therapeutic response.

The International Society for Magnetic Resonance in Medicine is accredited by the Accreditation Council for
Continuing Medical Education to provide continuing medical education for physicians.