| Breast MRI Gets Better! |
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Thursday 23 April 2009 |
| Room 312 |
10:30-12:30 |
Moderators: |
Eva C. Gombos and Ingrid S. Gribbestad |
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10:30 |
579. |
Fat Suppression with
Independent Shims for Bilateral Breast MRI |
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Misung Han1,2,
Sandra Rodriguez1, Anne M. Sawyer1,
Bruce L. Daniel1, Charles Cunningham3,
John M. Pauly2, Brian A. Hargreaves1
1Radiology, Stanford University, Stanford, CA,
USA; 2Electrical Engineering, Stanford
University, Stanford, CA, USA; 3Medical
Biophysics, University of Toronto, Toronoto, ON,
Canada |
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There exists a
significant static field inhomogeneity for breast
MRI related to the shape of the breast and the
susceptibility difference at air/tissue interfaces.
Field inhomogeneity can cause imaging artifacts or
failure in fat suppression, especially when
spectral-selective fat suppression methods are used.
For bilateral breast MRI, the large field variation
over the two breast volumes makes robust fat
suppression more difficult. We compared fat
suppression by using standard shims and independent
shims of each breast, incorporated with a dual-band
spectral-spatial pulse. Our experiments show that
independent shims provide improved fat suppression
compared to standard shims. |
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10:42 |
580. |
Preoperative Breast MRI in
Patients with Invasive Lobular Carcinoma Reduces the
Rate of Surgical Re-Excision |
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Ritse Maarten Mann1,
Claudette E. Loo2, Jelle O. Barentsz1,
Kenneth G.A. Gilhuijs2, Theo Wobbes3,
Carla Boetes1,4
1Radiology, Radboud University Nijmegen
Medical Centre, Nijmegen, Netherlands; 2Radiology,
The Netherlands Cancer Institute \ Antoni van
Leeuwenhoek Hospital, Amsterdam, Netherlands; 3Surgery,
Radboud University Nijmegen Medical Centre, Nijmegen,
Netherlands; 4Radiology, Maastricht
University Medical Centre, Maastricht, Netherlands |
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In invasive lobular
carcinoma of the breast (ILC), conventional imaging
is unable to assess tumor size. Though preoperative
MRI has been shown more reliable, the use of
preoperative MRI is disputed. We assessed the need
for surgical re-excision and the rate of
mastectomies in patients treated for ILC with or
without preoperative breast MRI. Our results clearly
show that preoperative MRI reduces the rate of
re-excisions without increasing the rate of
mastectomies and should thus be performed in all
patients. |
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10:54 |
581. |
MRI Characterization of Ex
Vivo Healthy Human Lymph Nodes at 7T |
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Mies Andrea Korteweg1, Jaco J.M.
Zwanenburg1, Paul van Diest2,
I. H. Borel Rinkes3, Willem P. Mali1,
Peter R. Luijten1, Wouter B. Veldhuis1
1Radiology, University Medical Center Utrecht,
Utrecht, Netherlands; 2Pathology,
University Medical Center Utrecht, Utrecht,
Netherlands; 3Surgery, University Medical
Center Utrecht, Utrecht, Netherlands |
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Nodal status strongly
determines prognosis in breast cancer patients. We
analyzed morphology and relaxation times of healthy
human axillary nodes at 7T, with pathologic
examination as the gold standard. Of two axillary
lymph node dissection specimens the mean nodal T1,
T2*, and T2 relaxation times, as well as the
apparent diffusion coefficients (ADC) were
determined. Results: Mean T1; 1387.22±114.81ms, mean
T2*; 18.38±7.33ms, mean T2; 72.05±14.55ms, mean ADC;
0.40±0.11•10-3 s/mm2. MRI allowed detailed
identification of B-cell follicles as well as blood-
and lymph vessels. MRI correlated well with
pathology. |
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11:06 |
582. |
Quantitative DWI for
Differentiation of Benign and Malignant Breast
Lesions: The Influence of the Choice of B-Values |
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Nicky HGM Peters1,
Koen L. Vincken2, Maurice A.A.J. van den
Bosch1, Peter R. Luijten2,
Willem PThM Mali1, Lambertum W. Bartels2
1Radiology, University Medical Center Utrecht,
Utrecht, Netherlands; 2Image Sciences
Institute, University Medical Center Utrecht,
Utrecht, Netherlands |
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The ADC varies with the
choice of different b-values. However, the
diagnostic performance is not affected by the choice
of b-values. The results imply that to differentiate
benign from malignant breast lesions, the choice of
b-values is not important. However, when the ADC
value is compared to reported ADC threshold values
in literature, the b-values should be taken into
account. |
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11:18 |
583. |
Comparison of Different
Diffusion Parameters in DWI for Differentiation of
Breast Lesions at 3.0 Tesla – Effects of Perfusion
and Diffusion Compartments on ADC |
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Wolfgang Bogner1,2,
Stephan Gruber1,2, Katja Pinker1,2,
Günther Grabner1,2, Andreas Stadlbauer3,
Ewald Moser2, Thomas Helbich1,
Siegfried Trattnig1,2
1Department of Radiology, Medical University
Vienna, Vienna, Austria; 2MR Center of
Excellence, Medical University Vienna, Vienna,
Austria; 3Landesklinikum St.Pölten,
St.Pölten, Austria |
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Seventy-four patients
suspect for breast cancer were examined on a 3T MR
system with an additional DWI protocol. The impact
of different diffusion schemes on diagnostically
relevant parameters such as CNR and ADC
precision/accuracy was investigated. The influence
of perfusion and compartment effects on the ADC were
studied in the breast. The diagnostic accuracy of an
optimized diffusion scheme were determined. The
application of such an optimized DWI protocol at 3T
provided a diagnostic sensitivity of 96% and
specificity of 94% in our patient group of 69 women. |
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11:30 |
584. |
Statistical Modeling of
Longitudinal Total Choline Measurements During
Chemotherapy |
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Ann M. Brearley1,
Lynn E. Eberly1, Naomi R. Mraz2,
Michael T. Nelson2, Douglas Yee3,
Michael Garwood4, Patrick J. Bolan5
1Biostatistics, University of Minnesota,
Minneapolis, MN, USA; 2Radiology,
University of Minnesota, Minneapolis, MN, USA;
3Masonic Cancer Center, University of
Minnesota, Minneapolis, MN, USA; 4Center
for MR Research / Radiology, University of
Minnesota, Minneapolis, MN, USA; 5Center
for MR Research / Radiology, University of
Minnesota, Minneapolis, MN, USA |
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In this work we describe
a retrospective analysis of choline measurements
acquired in breast cancer subjects undergoing
neoadjuvant chemotherapy. We proposed a series of
models to describe the time-course of the choline
response during therapy, and selected an optimal
model based on Akaike and Bayesian information
criteria. The model fits, and the relative
suitability of the various models, were then used to
infer important characteristics of the total choline
response that are useful for designing future
clinical trials. |
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11:42 |
585. |
The Association Between
Choline Concentration Measured by 1H MR Spectroscopy
with Clinical Characteristics and Biomarkers of
Breast Cancer |
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Hui Liu1,
Jeon-Hor Chen1,2, Hyeon-Man Baek1,
Ke Nie1, Hon J. Yu1, Orhan
Nalcioglu1, Min-Ying Lydia Su1
1Tu & Yuen Center for Functional Onco-Imaging,
University of California, Irvine, CA, USA; 2Department
of Radiology, China Medical University, Taichung,
Taiwan |
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We investigated the
association between tCho measured by single-voxel
MRS (using the internal reference method) and other
clinical characteristics in different breast
lesions. A total of 63 patients were included. A
higher choline concentration was significantly
correlated with younger age (p<0.05), and was
associated with DCE washout pattern (higher
angiogenesis), higher tumor grade, and in patients
with triple negative breast cancer, but not reaching
significance level (p<0.1). We also found other
well-known relationships such as a high correlation
between ER and PR (p < 0.001), and that mass lesions
are more likely to show washout DCE pattern
(p<0.017). |
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11:54 |
586. |
Diagnostic Value of Breast
Proton Magnetic Resonance Spectroscopy at 1.5T in
Different Histological Types |
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Hyeon-Man Baek1,2,
Jeon-Hor Chen3,4, Orhan Nalcioglu3,
Min-Ying Su3
1Department of Radiology, UT Southwestern
Medical Center, Dallas, TX, USA; 2Center
for Function Onco-Imaging , University of
California-Irvine, Irvine, CA, USA; 3Center
for Function Onco-Imaging, University of
California-Irvine, Irvine, CA, USA; 4Department
of Radiology, China Medical University Hospital,
Taichung 404, Taiwan |
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The impact of tumor size
and histological types on the diagnostic performance
of in vivo 1H MR spectroscopy was
investigated in 105 biopsy-confirmed breast tumors.
The sensitivity was only 46% in tumors of 1.0-1.9
cm, then increased to 70% in 2.0-2.9 cm group, and
82% in 3.0 cm & above group. The detection
sensitivity was higher for invasive cancer (71%)
than for DCIS (27%), and higher for invasive ductal
cancer (74%) or mixed type (67%) than for invasive
lobular cancer (50%). Further improvement in the
signal-to-noise ratio (SNR) may enhance the
detection of tCho and improve the diagnostic
sensitivity. One approach is to use the scanner at
higher magnetic fields (3.0T and 7.0T). |
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12:06 |
587. |
Dynamic Imaging of Dual
Contrast-Enhancement Using a Combined MR-Optical
Imaging System |
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Mehmet Burcin Unlu1,
Yuting Lin1, Orhan Nalcioglu1,
Gultekin Gulsen1
1John Tu & Thomas Yuen Center for Functional
Onco-Imaging, University of California, Irvine, CA,
USA |
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We measure the
enhancement kinetics of an optical and an MR
contrast agent in a small animal breast tumor model
(R3230 ac) simultaneously using a combined magnetic
resonance-diffuse optical tomographic imaging
system. A mixture of a small molecular-weight MR
contrast agent Gd-DTPA and a large molecular-weight
optical contrast agent indocyanine green was
administered intravenously for multimodal dynamic
imaging. |
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12:18 |
588. |
Image-Guided Combined SiRNA
and Enzyme/Prodrug Cancer Therapy |
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Cong Li1,
Marie-France Penet1, Flonné Wildes1,
Tomoyo Takagi1, Paul Winnard Jr. 1,
Dmitri Artemov1, Zaver M. Bhujwalla1
1Radiology, Medical School of Johns Hopkins
Univ., Baltimore, MD, USA |
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The ability to
downregulate specific pathways that are
overexpressed and critically important in cancer
using small interfering RNA (siRNA) technology
provides unprecedented opportunities to develop
novel cancer-cell specific treatments. The ability
to detect the delivery of the siRNA and combine it
with the delivery of a chemotherapeutic agent
primarily localized within the tumor would be of
significant advantage in this quest. Here we have
developed a prototype agent to image the delivery of
a prodrug enzyme, bacterial cytosine deaminase, that
converts a nontoxic prodrug 5-fluorocytosine to
5-fluorouracil, in combination with siRNA targeting
of choline kinase, an enzyme critically important in
breast cancer. |
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