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Sanders JL, Biliroglu AO, Newsome IG, Adelegan OJ, Yamaner FY, Dayton PA, Oralkan O. A Handheld Imaging Probe for Acoustic Angiography With an Ultrawideband Capacitive Micromachined Ultrasonic Transducer (CMUT) Array. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2022; 69:2318-2330. [PMID: 35522635 PMCID: PMC9716577 DOI: 10.1109/tuffc.2022.3172566] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
This article presents an imaging probe with a 256-element ultrawideband (UWB) 1-D capacitive micromachined ultrasonic transducer (CMUT) array designed for acoustic angiography (AA). This array was fabricated on a borosilicate glass wafer with a reduced bottom electrode and an additional central plate mass to achieve the broad bandwidth. A custom 256-channel handheld probe was designed and implemented with integrated low-noise amplifiers and supporting power circuitry. This probe was used to characterize the UWB CMUT, which has a functional 3-dB frequency band from 3.5 to 23.5 MHz. A mechanical index (MI) of 0.33 was achieved at 3.5 MHz at a depth of 11 mm. These promising measurements are then combined to demonstrate AA. The use of alternate amplitude modulation (aAM) combined with a frequency analysis of the measured transmit signal demonstrates the suitability of the UWB CMUT for AA. This is achieved by measuring only a low level of unwanted high-frequency harmonics in both the transmit signal and the reconstructed image in the areas other than the contrast bubbles.
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Lin L, Wang LV. The emerging role of photoacoustic imaging in clinical oncology. Nat Rev Clin Oncol 2022; 19:365-384. [PMID: 35322236 DOI: 10.1038/s41571-022-00615-3] [Citation(s) in RCA: 98] [Impact Index Per Article: 49.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2022] [Indexed: 12/13/2022]
Abstract
Clinical oncology can benefit substantially from imaging technologies that reveal physiological characteristics with multiscale observations. Complementing conventional imaging modalities, photoacoustic imaging (PAI) offers rapid imaging (for example, cross-sectional imaging in real time or whole-breast scanning in 10-15 s), scalably high levels of spatial resolution, safe operation and adaptable configurations. Most importantly, this novel imaging modality provides informative optical contrast that reveals details on anatomical, functional, molecular and histological features. In this Review, we describe the current state of development of PAI and the emerging roles of this technology in cancer screening, diagnosis and therapy. We comment on the performance of cutting-edge photoacoustic platforms, and discuss their clinical applications and utility in various clinical studies. Notably, the clinical translation of PAI is accelerating in the areas of macroscopic and mesoscopic imaging for patients with breast or skin cancers, as well as in microscopic imaging for histopathology. We also highlight the potential of future developments in technological capabilities and their clinical implications, which we anticipate will lead to PAI becoming a desirable and widely used imaging modality in oncological research and practice.
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Affiliation(s)
- Li Lin
- Caltech Optical Imaging Laboratory, Andrew and Peggy Cherng Department of Medical Engineering, California Institute of Technology, Pasadena, CA, USA
| | - Lihong V Wang
- Caltech Optical Imaging Laboratory, Andrew and Peggy Cherng Department of Medical Engineering, California Institute of Technology, Pasadena, CA, USA. .,Department of Electrical Engineering, California Institute of Technology, Pasadena, CA, USA.
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Newsome IG, Dayton PA. Acoustic Angiography: Superharmonic Contrast-Enhanced Ultrasound Imaging for Noninvasive Visualization of Microvasculature. Methods Mol Biol 2022; 2393:641-655. [PMID: 34837204 DOI: 10.1007/978-1-0716-1803-5_34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Acoustic angiography is a contrast-enhanced ultrasound technique that relies on superharmonic imaging to form high-resolution, three-dimensional maps of the microvasculature. In order to obtain signal separation between tissue and contrast, acoustic angiography has been performed with dual-frequency transducers with nonoverlapping bandwidths. This enables a high contrast-to-tissue ratio, and the choice of a high frequency receiving element provides high resolution. In this chapter, we describe the technology behind acoustic angiography as well as the step-by-step implementation of this contrast enhanced microvascular imaging technique.
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Affiliation(s)
- Isabel G Newsome
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Raleigh, NC, USA
| | - Paul A Dayton
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Raleigh, NC, USA.
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High-Resolution DWI with Simultaneous Multi-Slice Readout-Segmented Echo Planar Imaging for the Evaluation of Malignant and Benign Breast Lesions. Diagnostics (Basel) 2021; 11:diagnostics11122273. [PMID: 34943509 PMCID: PMC8700489 DOI: 10.3390/diagnostics11122273] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/29/2021] [Accepted: 11/30/2021] [Indexed: 11/19/2022] Open
Abstract
To investigate the feasibility and effectiveness of high-resolution readout-segmented echo planar imaging (rs-EPI), diffusion-weighted imaging (DWI) is used simultaneously with multi-slice (SMS) imaging (SMS rs-EPI) for the differentiation of breast malignant and benign lesions in comparison to conventional rs-EPI on a 3T MR scanner. A total of 102 patients with 113 breast lesions underwent bilateral breast MRI using a prototype SMS rs-EPI sequence and a conventional rs-EPI sequence. Subjective image quality was assessed using a 5-point Likert scale (1 = poor, 5 = excellent). Signal-to-noise ratio (SNR), lesion contrast-to-noise ratio (CNR) and apparent diffusion coefficients (ADC) value of the lesion were measured for comparison. Receiver operating characteristic curve analysis was performed to evaluate the diagnosis performance of ADC, and the corresponding area under curve (AUC) was calculated. The image quality scores in anatomic distortion, lesion conspicuity, sharpness of anatomical details and overall image quality of SMS rs-EPI were significantly higher than those of conventional rs-EPI. CNR was enhanced in the high-resolution SMS rs-EPI acquisition (6.48 ± 1.71 vs. 4.23 ± 1.49; p < 0.001). The mean ADC value was comparable in SMS rs-EPI and conventional rs-EPI (benign 1.45 × 10−3 vs. 1.43 × 10−3 mm2/s, p = 0.702; malignant 0.91 × 10−3 vs. 0.89 × 10−3 mm2/s, p = 0.076). The AUC was 0.957 in SMS rs-EPI and 0.983 in conventional rs-EPI. SMS rs-EPI technique allows for higher spatial resolution and slight reduction of scan time in comparison to conventional rs-EPI, which has potential for better differentiation between malignant and benign lesions of the breast.
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Zhou X, Fan X, Mustafi D, Pineda F, Markiewicz E, Zamora M, Sheth D, Olopade OI, Oto A, Karczmar GS. Comparison of DCE-MRI of murine model cancers with a low dose and high dose of contrast agent. Phys Med 2021; 81:31-39. [PMID: 33373779 DOI: 10.1016/j.ejmp.2020.11.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 10/27/2020] [Accepted: 11/19/2020] [Indexed: 02/08/2023] Open
Abstract
There are increasing concerns regarding intracellular accumulation of gadolinium (Gd) after multiple dynamic contrast enhanced (DCE) MRI scans. We investigated whether a low dose (LD) of Gd-based contrast agent is as effective as a high dose (HD) for quantitative analysis of DCE-MRI data, and evaluated the use of a split dose protocol to obtain new diagnostic parameters. Female C3H mice (n = 6) were injected with mammary carcinoma cells in the hind leg. MRI experiments were performed on 9.4 T scanner. DCE-MRI data were acquired with 1.5 s temporal resolution before and after a LD (0.04 mmol/kg), then again after 30 min followed by a HD (0.2 mmol/kg) bolus injection of Omniscan. The standard Tofts model was used to extract physiological parameters (Ktrans and ve) with the arterial input function derived from muscle reference tissue. In addition, an empirical mathematical model was used to characterize maximum contrast agent uptake (A), contrast agent uptake rate (α) and washout rate (β and γ). There were moderate to strong correlations (r = 0.69-0.97, p < 0001) for parameters Ktrans, ve, A, α and β from LD versus HD data. On average, tumor parameters obtained from LD data were significantly larger (p < 0.05) than those from HD data. The parameter ratios, Ktrans, ve, A and α calculated from the LD data divided by the HD data, were all significantly larger than 1.0 (p < 0.003) for tumor. T2* changes following contrast agent injection affected parameters calculated from HD data, but this was not the case for LD data. The results suggest that quantitative analysis of LD data may be at least as effective for cancer characterization as quantitative analysis of HD data. In addition, the combination of parameters from two different doses may provide useful diagnostic information.
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Affiliation(s)
- Xueyan Zhou
- School of Technology, Harbin University, Harbin, China; Department of Radiology, The University of Chicago, Chicago, IL 60637, United States
| | - Xiaobing Fan
- Department of Radiology, The University of Chicago, Chicago, IL 60637, United States
| | - Devkumar Mustafi
- Department of Radiology, The University of Chicago, Chicago, IL 60637, United States
| | - Federico Pineda
- Department of Radiology, The University of Chicago, Chicago, IL 60637, United States
| | - Erica Markiewicz
- Department of Radiology, The University of Chicago, Chicago, IL 60637, United States
| | - Marta Zamora
- Department of Radiology, The University of Chicago, Chicago, IL 60637, United States
| | - Deepa Sheth
- Department of Radiology, The University of Chicago, Chicago, IL 60637, United States
| | | | - Aytekin Oto
- Department of Radiology, The University of Chicago, Chicago, IL 60637, United States
| | - Gregory S Karczmar
- Department of Radiology, The University of Chicago, Chicago, IL 60637, United States.
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Pharmacokinetic Analysis of Dynamic Contrast-Enhanced Magnetic Resonance Imaging at 7T for Breast Cancer Diagnosis and Characterization. Cancers (Basel) 2020; 12:cancers12123763. [PMID: 33327532 PMCID: PMC7765071 DOI: 10.3390/cancers12123763] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 12/05/2020] [Accepted: 12/09/2020] [Indexed: 12/21/2022] Open
Abstract
Simple Summary Confirming whether a breast lesion is benign or malignant usually involves an invasive tissue sample with an image-guided breast biopsy, which may cause substantial inconvenience to the patient. The purpose of this study was to investigate whether imaging biomarkers obtained from noninvasive dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) of the breast can help differentiate benign from malignant lesions and characterize breast cancers to the same extent as a biopsy. In a sample of 37 patients with suspicious findings on mammography or ultrasound, we found that the radiologists’ diagnostic accuracy was improved when subjective Breast Imaging-Reporting and Data System (BI-RADS) evaluation was augmented with the use of pharmacokinetic markers. This study serves as a starting point for future collaborative research with the potential of providing valuable noninvasive tools for improved breast cancer diagnosis. Abstract The purpose of this study was to investigate whether ultra-high-field dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) of the breast at 7T using quantitative pharmacokinetic (PK) analysis can differentiate between benign and malignant breast tumors for improved breast cancer diagnosis and to predict molecular subtypes, histologic grade, and proliferation rate in breast cancer. In this prospective study, 37 patients with 43 lesions suspicious on mammography or ultrasound underwent bilateral DCE-MRI of the breast at 7T. PK parameters (KTrans, kep, Ve) were evaluated with two region of interest (ROI) approaches (2D whole-tumor ROI or 2D 10 mm standardized ROI) manually drawn by two readers (senior reader, R1, and R2) independently. Histopathology served as the reference standard. PK parameters differentiated benign and malignant lesions (n = 16, 27, respectively) with good accuracy (AUCs = 0.655–0.762). The addition of quantitative PK analysis to subjective BI-RADS classification improved breast cancer detection from 88.4% to 97.7% for R1 and 86.04% to 97.67% for R2. Different ROI approaches did not influence diagnostic accuracy for both readers. Except for KTrans for whole-tumor ROI for R2, none of the PK parameters were valuable to predict molecular subtypes, histologic grade, or proliferation rate in breast cancer. In conclusion, PK-enhanced BI-RADS is promising for the noninvasive differentiation of benign and malignant breast tumors.
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MRI-guided breast biopsy based on diffusion-weighted imaging: a feasibility study. Eur Radiol 2020; 31:2645-2656. [PMID: 33128183 PMCID: PMC8043934 DOI: 10.1007/s00330-020-07396-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 08/13/2020] [Accepted: 10/08/2020] [Indexed: 11/24/2022]
Abstract
Objectives This study evaluated the feasibility of DWI for lesion targeting in MRI-guided breast biopsies. Furthermore, it assessed device positioning on DWI during biopsy procedures. Methods A total of 87 biopsy procedures (5/87 bilateral) consecutively performed between March 2019 and June 2020 were retrospectively reviewed: in these procedures, a preliminary DWI sequence (b = 1300 s/mm2) was acquired to assess lesion detectability. We included 64/87 procedures on lesions detectable at DWI; DWI sequences were added to the standard protocol to localize lesion and biopsy device and to assess the site marker correct positioning. Results Mass lesions ranged from 5 to 48 mm, with a mean size of 10.7 mm and a median size of 8 mm. Non-mass lesions ranged from 7 to 90 mm, with a mean size of 33.9 mm and a median size of 31 mm. Positioning of the coaxial system was confirmed on both T1-weighted and DWI sequences. At DWI, the biopsy needle was detectable in 62/64 (96.9%) cases; it was not visible in 2/64 (3.1%) cases. The site marker was always identified using T1-weighted imaging; a final DWI sequence was acquired in 44/64 cases (68.8%). In 42/44 cases (95.5%), the marker was recognizable at DWI. Conclusions DWI can be used as a cost-effective, highly reliable technique for targeting both mass and non-mass lesions, with a minimum size of 5 mm, detectable at pre-procedural DWI. DWI is also a feasible technique to localize the biopsy device and to confirm the deployment of the site marker. Key Points • MRI-guided breast biopsy is performed in referral centers by an expert dedicated staff, based on prior MR imaging; contrast agent administration is usually needed for lesion targeting. • DWI represents a feasible, highly reliable technique for lesion targeting, avoiding contrast agent administration. • DWI allows a precise localization of both biopsy needle device and site marker.
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Newsome IG, Dayton PA. Visualization of Microvascular Angiogenesis Using Dual-Frequency Contrast-Enhanced Acoustic Angiography: A Review. ULTRASOUND IN MEDICINE & BIOLOGY 2020; 46:2625-2635. [PMID: 32703659 PMCID: PMC7608693 DOI: 10.1016/j.ultrasmedbio.2020.06.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 05/25/2020] [Accepted: 06/14/2020] [Indexed: 05/07/2023]
Abstract
Cancerous tumor growth is associated with the development of tortuous, chaotic microvasculature, and this aberrant microvascular morphology can act as a biomarker of malignant disease. Acoustic angiography is a contrast-enhanced ultrasound technique that relies on superharmonic imaging to form high-resolution 3-D maps of the microvasculature. To date, acoustic angiography has been performed with dual-element transducers that can achieve high contrast-to-tissue ratio and resolution in pre-clinical small animal models. In this review, we first describe the development of acoustic angiography, including the principle, transducer design, and optimization of superharmonic imaging techniques. We then detail several preclinical applications of this microvascular imaging method, as well as the current and future development of acoustic angiography as a pre-clinical and clinical diagnostic tool.
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Affiliation(s)
- Isabel G Newsome
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill, North Carolina, USA
| | - Paul A Dayton
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill, North Carolina, USA.
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Del Bosque R, Cui J, Ogier S, Cheshkov S, Dimitrov IE, Malloy C, Wright SM, McDougall M. A 32-channel receive array coil for bilateral breast imaging and spectroscopy at 7T. Magn Reson Med 2020; 85:551-559. [PMID: 32820540 DOI: 10.1002/mrm.28425] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 06/19/2020] [Accepted: 06/22/2020] [Indexed: 11/09/2022]
Abstract
PURPOSE This work describes the construction and evaluation of a bilateral 32-channel receive array for breast imaging at 7T. METHODS The receive array consisted of 32 receive coils, placed on two 3D-printed hemispherical formers. Each side of the receive array consisted of 16 receive loops, each loop having a corresponding detachable board with match/tune capacitors, active detuning circuitry, and a balun. Coil performance was evaluated on homogeneous canola oil phantoms using a Philips Achieva 7T system. Array coil performance was compared with a bilateral forced current excitation volume coil in transmit/receive mode and with a previously reported 16-channel unilateral coil with a similar design. RESULTS The 32-channel array had an increase in average SNR throughout both phantoms by a factor of five as compared with the volume coil, with SNR increases up to 10 times along the periphery and three times in the center. Noise measurements showed low interelement noise correlation (average: 5.4%; maximum: 16.8%). Geometry factor maps were acquired for various acceleration factors and showed mean geometry factors <1.2, for combined acceleration factors of up to six. CONCLUSIONS The improvements achieved demonstrate the clear potential for use in dynamic contrast-enhanced or diffusion-weighted MR studies, while maintaining diagnostically relevant spatial and temporal resolutions.
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Affiliation(s)
- Romina Del Bosque
- Department of Biomedical Engineering, Texas A&M University, College Station, Texas, USA
| | - Jiaming Cui
- Department of Electrical and Computer Engineering, Texas A&M University, College Station, Texas, USA
| | - Stephen Ogier
- Department of Electrical and Computer Engineering, Texas A&M University, College Station, Texas, USA
| | - Sergey Cheshkov
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Center for Brain Health, University of Texas at Dallas, Dallas, Texas, USA
| | - Ivan E Dimitrov
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Philips Healthcare, Gainesville, Florida, USA
| | - Craig Malloy
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Steven M Wright
- Department of Biomedical Engineering, Texas A&M University, College Station, Texas, USA.,Department of Electrical and Computer Engineering, Texas A&M University, College Station, Texas, USA
| | - Mary McDougall
- Department of Biomedical Engineering, Texas A&M University, College Station, Texas, USA.,Department of Electrical and Computer Engineering, Texas A&M University, College Station, Texas, USA
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van Rijssel MJ, Pluim JPW, Chan HSM, van den Wildenberg L, Schmitz AMT, Luijten PR, Gilhuijs KGA, Klomp DWJ. Correcting time-intensity curves in dynamic contrast-enhanced breast MRI for inhomogeneous excitation fields at 7T. Magn Reson Med 2019; 84:1000-1010. [PMID: 31880346 PMCID: PMC7217168 DOI: 10.1002/mrm.28147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 12/05/2019] [Accepted: 12/06/2019] [Indexed: 12/13/2022]
Abstract
Purpose Inhomogeneous excitation at ultrahigh field strengths (7T and above) compromises the reliability of quantified dynamic contrast‐enhanced breast MRI. This can hamper the introduction of ultrahigh field MRI into the clinic. Compensation for this non‐uniformity effect can consist of both hardware improvements and post‐acquisition corrections. This paper investigated the correctable radiofrequency transmit (B1+) range post‐acquisition in both simulations and patient data for 7T MRI. Methods Simulations were conducted to determine the minimum B1+ level at which corrections were still beneficial because of noise amplification. Two correction strategies leading to differences in noise amplification were tested. The effect of the corrections on a 7T patient data set (N = 38) with a wide range of B1+ levels was investigated in terms of time‐intensity curve types as well as washin, washout and peak enhancement values. Results In simulations assuming a common amount of T1 saturation, the lowest B1+ level at which the SNR of the corrected images was at least that of the original precontrast image was 43% of the nominal angle. After correction, time‐intensity curve types changed in 24% of included patients, and the distribution of curve types corresponded better to the distribution found in literature. Additionally, the overlap between the distributions of washin, washout, and peak enhancement values for grade 1 and grade 2 tumors was slightly reduced. Conclusion Although the correctable range varies with the amount of T1 saturation, post‐acquisition correction for inhomogeneous excitation was feasible down to B1+ levels of 43% of the nominal angle in vivo.
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Affiliation(s)
| | - Josien P W Pluim
- Center for Image Sciences, UMC Utrecht, Utrecht, The Netherlands.,Department of Biomedical Engineering, Technische Universiteit Eindhoven, Eindhoven, The Netherlands
| | - Hui-Shan M Chan
- Center for Image Sciences, UMC Utrecht, Utrecht, The Netherlands
| | | | | | - Peter R Luijten
- Center for Image Sciences, UMC Utrecht, Utrecht, The Netherlands
| | | | - Dennis W J Klomp
- Center for Image Sciences, UMC Utrecht, Utrecht, The Netherlands
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He D, Fan X, Chatterjee A, Wang S, Medved M, Pineda FD, Yousuf A, Antic T, Oto A, Karczmar GS. A compact solution for estimation of physiological parameters from ultrafast prostate dynamic contrast enhanced MRI. Phys Med Biol 2019; 64:155012. [PMID: 31220816 PMCID: PMC7227457 DOI: 10.1088/1361-6560/ab2b62] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The Tofts pharmacokinetic model requires multiple calculations for analysis of dynamic contrast enhanced (DCE) MRI. In addition, the Tofts model may not be appropriate for the prostate. This can result in error propagation that reduces the accuracy of pharmacokinetic measurements. In this study, we present a compact solution allowing estimation of physiological parameters K trans and v e from ultrafast DCE acquisitions, without fitting DCE-MRI data to the standard Tofts pharmacokinetic model. Since the standard Tofts model can be simplified to the Patlak model at early times when contrast efflux from the extravascular extracellular space back to plasma is negligible, K trans can be solved explicitly for a specific time. Further, v e can be estimated directly from the late steady-state signal using the derivative form of Tofts model. Ultrafast DCE-MRI data were acquired from 18 prostate cancer patients on a Philips Achieva 3T-TX scanner. Regions-of-interest (ROIs) for prostate cancer, normal tissue, gluteal muscle, and iliac artery were manually traced. The contrast media concentration as function of time was calculated over each ROI using gradient echo signal equation with pre-contrast tissue T1 values, and using the 'reference tissue' model with a linear approximation. There was strong correlation (r = 0.88-0.91, p < 0.0001) between K trans extracted from the Tofts model and K trans estimated from the compact solution for prostate cancer and normal tissue. Additionally, there was moderate correlation (r = 0.65-0.73, p < 0.0001) between extracted versus estimated v e. Bland-Altman analysis showed moderate to good agreement between physiological parameters extracted from the Tofts model and those estimated from the compact solution with absolute bias less than 0.20 min-1 and 0.10 for K trans and v e, respectively. The compact solution may decrease systematic errors and error propagation, and could increase the efficiency of clinical workflow. The compact solution requires high temporal resolution DCE-MRI due to the need to adequately sample the early phase of contrast media uptake.
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Affiliation(s)
- Dianning He
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, People’s Republic of China,Department of Radiology, University of Chicago, Chicago, IL 60637, United States of America
| | - Xiaobing Fan
- Department of Radiology, University of Chicago, Chicago, IL 60637, United States of America
| | - Aritrick Chatterjee
- Department of Radiology, University of Chicago, Chicago, IL 60637, United States of America
| | - Shiyang Wang
- Department of Radiology, University of Chicago, Chicago, IL 60637, United States of America
| | - Milica Medved
- Department of Radiology, University of Chicago, Chicago, IL 60637, United States of America
| | - Federico D Pineda
- Department of Radiology, University of Chicago, Chicago, IL 60637, United States of America
| | - Ambereen Yousuf
- Department of Radiology, University of Chicago, Chicago, IL 60637, United States of America
| | - Tatjana Antic
- Department of Pathology, University of Chicago, Chicago, IL 60637, United States of America
| | - Aytekin Oto
- Department of Radiology, University of Chicago, Chicago, IL 60637, United States of America
| | - Gregory S Karczmar
- Department of Radiology, University of Chicago, Chicago, IL 60637, United States of America,Author to whom any correspondence should be addressed.
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Wang S, Fan X, Zhang Y, Medved M, He D, Yousuf A, Jamison E, Oto A, Karczmar GS. Use of Indicator Dilution Principle to Evaluate Accuracy of Arterial Input Function Measured With Low-Dose Ultrafast Prostate Dynamic Contrast-Enhanced MRI. ACTA ACUST UNITED AC 2019; 5:260-265. [PMID: 31245547 PMCID: PMC6588202 DOI: 10.18383/j.tom.2019.00004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Accurately measuring arterial input function (AIF) is essential for quantitative analysis of dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI). We used the indicator dilution principle to evaluate the accuracy of AIF measured directly from an artery following a low-dose contrast media ultrafast DCE-MRI. In total, 15 patients with biopsy-confirmed localized prostate cancers were recruited. Cardiac MRI (CMRI) and ultrafast DCE-MRI were acquired on a Philips 3 T Ingenia scanner. The AIF was measured at iliac arties following injection of a low-dose (0.015 mmol/kg) gadolinium (Gd) contrast media. The cardiac output (CO) from CMRI (COCMRI) was calculated from the difference in ventricular volume at diastole and systole measured on the short axis of heart. The CO from DCE-MRI (CODCE) was also calculated from the AIF and dose of the contrast media used. A correlation test and Bland–Altman plot were used to compare COCMRI and CODCE. The average (±standard deviation [SD]) area under the curve measured directly from local AIF was 0.219 ± 0.07 mM·min. The average (±SD) COCMRI and CODCE were 6.52 ± 1.47 L/min and 6.88 ± 1.64 L/min, respectively. There was a strong positive correlation (r = 0.82, P < .01) and good agreement between COCMRI and CODCE. The CODCE is consistent with the reference standard COCMRI. This indicates that the AIF can be measured accurately from an artery with ultrafast DCE-MRI following injection of a low-dose contrast media.
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Affiliation(s)
- Shiyang Wang
- Department of Radiology, University of Chicago, Chicago, IL and
| | - Xiaobing Fan
- Department of Radiology, University of Chicago, Chicago, IL and
| | - Yue Zhang
- Department of Radiology, University of Chicago, Chicago, IL and
| | - Milica Medved
- Department of Radiology, University of Chicago, Chicago, IL and
| | - Dianning He
- Department of Radiology, University of Chicago, Chicago, IL and.,Sino-Dutch Biomedical and Information Engineering School, Northeastern University, Shenyang, China
| | - Ambereen Yousuf
- Department of Radiology, University of Chicago, Chicago, IL and
| | - Ernest Jamison
- Department of Radiology, University of Chicago, Chicago, IL and
| | - Aytekin Oto
- Department of Radiology, University of Chicago, Chicago, IL and
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Zaric O, Farr A, Poblador Rodriguez E, Mlynarik V, Bogner W, Gruber S, Asseryanis E, Singer CF, Trattnig S. 7T CEST MRI: A potential imaging tool for the assessment of tumor grade and cell proliferation in breast cancer. Magn Reson Imaging 2019; 59:77-87. [PMID: 30880110 DOI: 10.1016/j.mri.2019.03.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 03/03/2019] [Accepted: 03/04/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To investigate the feasibility of chemical exchange saturation transfer (CEST) MRI in patients with breast carcinomas and possible correlations between magnetization transfer asymmetry (MTRasym) values and histological features, such as tumor grade and the Ki-67 proliferation index. MATERIALS AND METHODS Nine healthy subjects and 18 female patients were enrolled for this study. The imaging protocol for the patients consisted of diffusion-weighted imaging (DWI), CEST imaging, and T1-weighted, contrast-enhanced (CE)-MRI. CEST was performed using a 3D gradient echo (GRE) sequence, employing eight pre-saturation pulses of a duration of 50 ms and a duty cycle (DC) of 80%, with a mean amplitude of the saturation pulse train of 1 μT. The Z-spectrum was plotted and MTRasym values calculated for the frequency of the maximum of MTRasym curve, were correlated with the Ki-67 proliferation index and apparent diffusion coefficient (ADC). Patient data were statistically assessed using the Games-Howell post-hoc and Pearson's correlation test. RESULTS Different tumor types had asymmetry peaks at different positions of Z-spectrum. MTRasym (mean ± SD) (%) calculated for G1 (3.0 ± 0.3; range: 2.70-3.50) was not significantly lower than for G2 (4.50 ± 1.30; range: 3.20-6.50; p = 0.066). In contrast, the increase in MTRasym between G1 and G3 (6.40 ± 1.70; range: 4.80-9.80) lesions was significant (p = 0.007). No significant difference was observed between G2 and G3 with regard to MTRasym (p = 0.089). There was a strong positive correlation between the MTRasym, and Ki-67 proliferation index (r = 0.890; p = 0.001), while there was a moderate negative correlation between MTRasym and ADC values (r = -0.506; p = 0.027). CONCLUSIONS Calculated MTRasym demonstrates a strong positive correlation with tumor proliferation and has the potential to become a valuable biomarker for breast tumor characterization.
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Affiliation(s)
- Olgica Zaric
- High Field MR Centre, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Alex Farr
- Breast Health Centre, Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria.
| | - Esau Poblador Rodriguez
- High Field MR Centre, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Vladimir Mlynarik
- High Field MR Centre, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria; Karl Landsteiner Gesellschaft, St. Pölten, Austria
| | - Wolfgang Bogner
- High Field MR Centre, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Stephan Gruber
- High Field MR Centre, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Ella Asseryanis
- Breast Health Centre, Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | - Christian F Singer
- Breast Health Centre, Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | - Siegfried Trattnig
- High Field MR Centre, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria; Christian Doppler Laboratory for Clinical Molecular MRI, Christian Doppler Forschungsgesellschaft, Vienna, Austria
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Leithner D, Wengert GJ, Helbich TH, Thakur S, Ochoa-Albiztegui RE, Morris EA, Pinker K. Clinical role of breast MRI now and going forward. Clin Radiol 2018; 73:700-714. [PMID: 29229179 PMCID: PMC6788454 DOI: 10.1016/j.crad.2017.10.021] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 10/31/2017] [Indexed: 02/08/2023]
Abstract
Magnetic resonance imaging (MRI) is a well-established method in breast imaging, with manifold clinical applications, including the non-invasive differentiation between benign and malignant breast lesions, preoperative staging, detection of scar versus recurrence, implant assessment, and the evaluation of high-risk patients. At present, dynamic contrast-enhanced MRI is the most sensitive imaging technique for breast cancer diagnosis, and provides excellent morphological and to some extent also functional information. To compensate for the limited functional information, and to increase the specificity of MRI while preserving its sensitivity, additional functional parameters such as diffusion-weighted imaging and apparent diffusion coefficient mapping, and MR spectroscopic imaging have been investigated and implemented into the clinical routine. Several additional MRI parameters to capture breast cancer biology are still under investigation. MRI at high and ultra-high field strength and advances in hard- and software may also further improve this imaging technique. This article will review the current clinical role of breast MRI, including multiparametric MRI and abbreviated protocols, and provide an outlook on the future of this technique. In addition, the predictive and prognostic value of MRI as well as the evolving field of radiogenomics will be discussed.
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Affiliation(s)
- D Leithner
- University Hospital Frankfurt, Department of Diagnostic and Interventional Radiology, Frankfurt, Germany; Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Vienna, Austria
| | - G J Wengert
- Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Vienna, Austria
| | - T H Helbich
- Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Vienna, Austria
| | - S Thakur
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - R E Ochoa-Albiztegui
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - E A Morris
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - K Pinker
- Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Vienna, Austria; Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
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15
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van Rijssel MJ, Pluim JPW, Luijten PR, Gilhuijs KGA, Raaijmakers AJE, Klomp DWJ. Estimating B 1+ in the breast at 7 T using a generic template. NMR IN BIOMEDICINE 2018; 31:e3911. [PMID: 29570887 PMCID: PMC5947628 DOI: 10.1002/nbm.3911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 01/30/2018] [Accepted: 01/30/2018] [Indexed: 06/08/2023]
Abstract
Dynamic contrast-enhanced MRI is the workhorse of breast MRI, where the diagnosis of lesions is largely based on the enhancement curve shape. However, this curve shape is biased by RF transmit (B1+ ) field inhomogeneities. B1+ field information is required in order to correct these. The use of a generic, coil-specific B1+ template is proposed and tested. Finite-difference time-domain simulations for B1+ were performed for healthy female volunteers with a wide range of breast anatomies. A generic B1+ template was constructed by averaging simulations based on four volunteers. Three-dimensional B1+ maps were acquired in 15 other volunteers. Root mean square error (RMSE) metrics were calculated between individual simulations and the template, and between individual measurements and the template. The agreement between the proposed template approach and a B1+ mapping method was compared against the agreement between acquisition and reacquisition using the same mapping protocol. RMSE values (% of nominal flip angle) comparing individual simulations with the template were in the range 2.00-4.01%, with mean 2.68%. RMSE values comparing individual measurements with the template were in the range8.1-16%, with mean 11.7%. The agreement between the proposed template approach and a B1+ mapping method was only slightly worse than the agreement between two consecutive acquisitions using the same mapping protocol in one volunteer: the range of agreement increased from ±16% of the nominal angle for repeated measurement to ±22% for the B1+ template. With local RF transmit coils, intersubject differences in B1+ fields of the breast are comparable to the accuracy of B1+ mapping methods, even at 7 T. Consequently, a single generic B1+ template suits subjects over a wide range of breast anatomies, eliminating the need for a time-consuming B1+ mapping protocol.
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16
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A simulation study comparing nine mathematical models of arterial input function for dynamic contrast enhanced MRI to the Parker model. AUSTRALASIAN PHYSICAL & ENGINEERING SCIENCES IN MEDICINE 2018; 41:507-518. [DOI: 10.1007/s13246-018-0632-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 03/20/2018] [Indexed: 02/06/2023]
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17
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Liu HL, Zong M, Wei H, Lou JJ, Wang SQ, Zou QG, Shi HB, Jiang YN. Differentiation between malignant and benign breast masses: combination of semi-quantitative analysis on DCE-MRI and histogram analysis of ADC maps. Clin Radiol 2017; 73:460-466. [PMID: 29295753 DOI: 10.1016/j.crad.2017.11.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 11/30/2017] [Indexed: 12/20/2022]
Abstract
AIM To investigate the performance of combined semi-quantitative analysis on dynamic contrast enhanced (DCE) magnetic resonance imaging (MRI) and histogram analysis of diffusion-weighted imaging (DWI) for distinguishing malignant from benign breast masses. MATERIALS AND METHODS This study included 178 patients with breast masses (benign:malignant=88:9) who underwent both DCE-MRI and DWI. The semi-quantitative parameters, derived from DCE-MRI, included maximum slope of increase (MSI), signal intensity slope (SIslope), initial percentage of enhancement (Einitial), percentage of peak enhancement (Epeak), early signal enhancement ratio (ESER), and second enhancement percentage (SEP). Histogram parameters derived from apparent diffusion coefficient (ADC) maps included ADCmin, ADCmax, ADCmean, ADC10, ADC25, ADC50, ADC75, ADC90, skewness, and kurtosis. All parameters were compared between malignant and benign groups, and their differences were tested using independent-samples t-test or Mann-Whitney test. Receiver operating characteristic (ROC) curves were used to determine the diagnostic value of each significant parameter. RESULTS Among semi-quantitative parameters, SIslope exhibited the best diagnostic performance in predicting malignancy (cut-off value, 0.096; ROC, 0.756; sensitivity, 86.7%; specificity, 61.4%). Among histogram parameters, ADC10 exhibited the best diagnostic performance in predicting malignancy (cut-off value, 1.051; ROC, 0.885; sensitivity, 86.7%; specificity, 84.1%). The optimal diagnostic performance of combined ADC10 and SIslope (area under curve [AUC], 0.888; sensitivity, 82.2%; specificity, 95.5%) was significantly better than SIslope alone (p<0.001). Moreover, the combination showed higher AUC (0.888 versus 0.885) than ADC10 alone, but the difference was not statistically significant (p=0.914). CONCLUSION SIslope and ADC10 are significant predictors for breast malignancy. The combination of DCE-MRI and DWI improves differentiating performance.
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Affiliation(s)
- H-L Liu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing 210029, China
| | - M Zong
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing 210029, China
| | - H Wei
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing 210029, China
| | - J-J Lou
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing 210029, China
| | - S-Q Wang
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing 210029, China
| | - Q-G Zou
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing 210029, China
| | - H-B Shi
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing 210029, China
| | - Y-N Jiang
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing 210029, China.
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18
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Shelton SE, Lindsey BD, Dayton PA, Lee YZ. First-in-Human Study of Acoustic Angiography in the Breast and Peripheral Vasculature. ULTRASOUND IN MEDICINE & BIOLOGY 2017; 43:2939-2946. [PMID: 28982628 PMCID: PMC6267932 DOI: 10.1016/j.ultrasmedbio.2017.08.1881] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 08/20/2017] [Accepted: 08/21/2017] [Indexed: 05/07/2023]
Abstract
Screening with mammography has been found to increase breast cancer survival rates by about 20%. However, the current system in which mammography is used to direct patients toward biopsy or surgical excision also results in relatively high rates of unnecessary biopsy, as 66.8% of biopsies are benign. A non-ionizing radiation imaging approach with increased specificity might reduce the rate of unnecessary biopsies. Quantifying the vascular characteristics within and surrounding lesions represents one potential target for assessing likelihood of malignancy via imaging. In this clinical note, we describe the translation of a contrast-enhanced ultrasound technique, acoustic angiography, to human imaging. We illustrate the feasibility of this technique with initial studies in imaging the hand, wrist and breast using Definity microbubble contrast agent and a mechanically steered prototype dual-frequency transducer in healthy volunteers. Finally, this approach was used to image pre-biopsy Breast Imaging Reporting and Data System (BI-RADS) 4 and 5 lesions <2 cm in depth in 11 patients. Results indicate that sensitivity and spatial resolution are sufficient to image vessels as small as 0.2 mm in diameter at depths of ~15 mm in the human breast. Challenges observed include motion artifacts, as well as limited depth of field and sensitivity, which could be improved by correction algorithms and improved transducer technologies.
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Affiliation(s)
- Sarah E Shelton
- Joint Department of Biomedical Engineering, University of North Carolina-Chapel Hill and North Carolina State University, Raleigh, North Carolina, USA
| | - Brooks D Lindsey
- Joint Department of Biomedical Engineering, University of North Carolina-Chapel Hill and North Carolina State University, Raleigh, North Carolina, USA
| | - Paul A Dayton
- Joint Department of Biomedical Engineering, University of North Carolina-Chapel Hill and North Carolina State University, Raleigh, North Carolina, USA; Biomedical Research Imaging Center, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA.
| | - Yueh Z Lee
- Biomedical Research Imaging Center, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA; Department of Radiology, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA
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19
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Abstract
CLINICAL/METHODICAL ISSUE Magnetic resonance imaging (MRI) of the breast is an indispensable tool in breast imaging for many indications. Several functional parameters with MRI and positron emission tomography (PET) have been assessed for imaging of breast tumors and their combined application is defined as multiparametric imaging. Available data suggest that multiparametric imaging using different functional MRI and PET parameters can provide detailed information about the hallmarks of cancer and may provide additional specificity. STANDARD RADIOLOGICAL METHODS Multiparametric and molecular imaging of the breast comprises established MRI parameters, such as dynamic contrast-enhanced MRI, diffusion-weighted imaging (DWI), MR proton spectroscopy ((1)H-MRSI) as well as combinations of radiological and MRI techniques (e. g. PET/CT and PET/MRI) using radiotracers, such as fluorodeoxyglucose (FDG). METHODICAL INNOVATIONS Multiparametric and molecular imaging of the breast can be performed at different field-strengths (range 1.5-7 T). Emerging parameters comprise novel promising techniques, such as sodium imaging ((23)Na MRI), phosphorus spectroscopy ((31)P-MRSI), chemical exchange saturation transfer (CEST) imaging, blood oxygen level-dependent (BOLD) and hyperpolarized MRI as well as various specific radiotracers. ACHIEVEMENTS Multiparametric and molecular imaging has multiple applications in breast imaging. Multiparametric and molecular imaging of the breast is an evolving field that will enable improved detection, characterization, staging and monitoring for personalized medicine in breast cancer.
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20
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Marino MA, Helbich T, Baltzer P, Pinker-Domenig K. Multiparametric MRI of the breast: A review. J Magn Reson Imaging 2017. [DOI: 10.1002/jmri.25790] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Affiliation(s)
- Maria Adele Marino
- Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging; Medical University of Vienna; Austria
- Department of Biomedical Sciences and Morphologic and Functional Imaging, Policlinico Universitario G. Martino; University of Messina; Messina Italy
| | - Thomas Helbich
- Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging; Medical University of Vienna; Austria
| | - Pascal Baltzer
- Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging; Medical University of Vienna; Austria
| | - Katja Pinker-Domenig
- Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging; Medical University of Vienna; Austria
- Department of Radiology; Molecular Imaging and Therapy Service, Memorial Sloan Kettering Cancer Center; New York New York USA
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21
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Kim J, Santini T, Bae KT, Krishnamurthy N, Zhao Y, Zhao T, Ibrahim TS. Development of a 7 T RF coil system for breast imaging. NMR IN BIOMEDICINE 2017; 30:10.1002/nbm.3664. [PMID: 27859861 PMCID: PMC5943082 DOI: 10.1002/nbm.3664] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 09/23/2016] [Accepted: 10/06/2016] [Indexed: 06/06/2023]
Abstract
In ultrahigh-field MRI, such as 7 T, the signal-to-noise ratio (SNR) increases while transmit (Tx) field (B1+ ) can be degraded due to inhomogeneity and elevated specific absorption rate (SAR). By applying new array coil concepts to both Tx and receive (Rx) coils, the B1+ homogeneity and SNR can be improved. In this study, we developed and tested in vivo a new RF coil system for 7 T breast MRI. An RF coil system composed of an eight-channel Tx-only array based on a tic-tac-toe design (can be combined to operate in single-Tx mode) in conjunction with an eight-channel Rx-only insert was developed. Characterizations of the B1+ field and associated SAR generated by the developed RF coil system were numerically calculated and empirically measured using an anatomically detailed breast model, phantom and human breasts. In vivo comparisons between 3 T (using standard commercial solutions) and 7 T (using the newly developed coil system) breast imaging were made. At 7 T, about 20% B1+ inhomogeneity (standard deviation over the mean) was measured within the breast tissue for both the RF simulations and 7 T experiments. The addition of the Rx-only array enhances the SNR by a factor of about three. High-quality MR images of human breast were acquired in vivo at 7 T. For the in vivo comparisons between 3 T and 7 T, an approximately fourfold increase of SNR was measured with 7 T imaging. The B1+ field distributions in the breast model, phantom and in vivo were in reasonable agreement. High-quality 7 T in vivo breast MRI was successfully acquired at 0.6 mm isotropic resolution using the newly developed RF coil system.
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Affiliation(s)
- Junghwan Kim
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Tales Santini
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kyongtae Ty Bae
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Yujuan Zhao
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Tiejun Zhao
- MR Research Support, Siemens Healthcare, Pittsburgh, PA, USA
| | - Tamer S. Ibrahim
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA, USA
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22
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Pinker K, Helbich TH, Morris EA. The potential of multiparametric MRI of the breast. Br J Radiol 2016; 90:20160715. [PMID: 27805423 DOI: 10.1259/bjr.20160715] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
MRI is an essential tool in breast imaging, with multiple established indications. Dynamic contrast-enhanced MRI (DCE-MRI) is the backbone of any breast MRI protocol and has an excellent sensitivity and good specificity for breast cancer diagnosis. DCE-MRI provides high-resolution morphological information, as well as some functional information about neoangiogenesis as a tumour-specific feature. To overcome limitations in specificity, several other functional MRI parameters have been investigated and the application of these combined parameters is defined as multiparametric MRI (mpMRI) of the breast. MpMRI of the breast can be performed at different field strengths (1.5-7 T) and includes both established (diffusion-weighted imaging, MR spectroscopic imaging) and novel MRI parameters (sodium imaging, chemical exchange saturation transfer imaging, blood oxygen level-dependent MRI), as well as hybrid imaging with positron emission tomography (PET)/MRI and different radiotracers. Available data suggest that multiparametric imaging using different functional MRI and PET parameters can provide detailed information about the underlying oncogenic processes of cancer development and progression and can provide additional specificity. This article will review the current and emerging functional parameters for mpMRI of the breast for improved diagnostic accuracy in breast cancer.
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Affiliation(s)
- Katja Pinker
- 1 Department of Radiology, Molecular Imaging and Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,2 Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Vienna, Austria.,3 Department of Radiology, Breast Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Thomas H Helbich
- 2 Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Vienna, Austria
| | - Elizabeth A Morris
- 3 Department of Radiology, Breast Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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23
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Abstract
Breast MR imaging has increased in popularity over the past 2 decades due to evidence of its high sensitivity for cancer detection. Current clinical MR imaging approaches rely on the use of a dynamic contrast-enhanced acquisition that facilitates morphologic and semiquantitative kinetic assessments of breast lesions. The use of more functional and quantitative parameters holds promise to broaden the utility of MR imaging and improve its specificity. Because of wide variations in approaches for measuring these parameters and the considerable technical challenges, robust multicenter data supporting their routine use are not yet available, limiting current applications of many of these tools to research purposes.
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Affiliation(s)
- Habib Rahbar
- Breast Imaging Section, Department of Radiology, Seattle Cancer Care Alliance, University of Washington, 825 Eastlake Avenue East, PO Box 19023, Seattle, WA 98109-1023, USA
| | - Savannah C Partridge
- Breast Imaging Section, Department of Radiology, Seattle Cancer Care Alliance, University of Washington, 825 Eastlake Avenue East, PO Box 19023, Seattle, WA 98109-1023, USA.
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24
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Trattnig S, Bogner W, Gruber S, Szomolanyi P, Juras V, Robinson S, Zbýň Š, Haneder S. Clinical applications at ultrahigh field (7 T). Where does it make the difference? NMR IN BIOMEDICINE 2016; 29:1316-34. [PMID: 25762432 DOI: 10.1002/nbm.3272] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Revised: 01/20/2015] [Accepted: 01/22/2015] [Indexed: 05/11/2023]
Abstract
Presently, three major MR vendors provide commercial 7-T units for clinical research under ethical permission, with the number of operating 7-T systems having increased to over 50. This rapid increase indicates the growing interest in ultrahigh-field MRI because of improved clinical results with regard to morphological as well as functional and metabolic capabilities. As the signal-to-noise ratio scales linearly with the field strength (B0 ) of the scanner, the most obvious application at 7 T is to obtain higher spatial resolution in the brain, musculoskeletal system and breast. Of specific clinical interest for neuro-applications is the cerebral cortex at 7 T, for the detection of changes in cortical structure as a sign of early dementia, as well as for the visualization of cortical microinfarcts and cortical plaques in multiple sclerosis. In the imaging of the hippocampus, even subfields of the internal hippocampal anatomy and pathology can be visualized with excellent resolution. The dynamic and static blood oxygenation level-dependent contrast increases linearly with the field strength, which significantly improves the pre-surgical evaluation of eloquent areas before tumor removal. Using susceptibility-weighted imaging, the plaque-vessel relationship and iron accumulation in multiple sclerosis can be visualized for the first time. Multi-nuclear clinical applications, such as sodium imaging for the evaluation of repair tissue quality after cartilage transplantation and (31) P spectroscopy for the differentiation between non-alcoholic benign liver disease and potentially progressive steatohepatitis, are only possible at ultrahigh fields. Although neuro- and musculoskeletal imaging have already demonstrated the clinical superiority of ultrahigh fields, whole-body clinical applications at 7 T are still limited, mainly because of the lack of suitable coils. The purpose of this article was therefore to review the clinical studies that have been performed thus far at 7 T, compared with 3 T, as well as those studies performed at 7 T that cannot be routinely performed at 3 T. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- Siegfried Trattnig
- High Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
- CD Laboratory for Clinical Molecular MR Imaging
| | - Wolfgang Bogner
- High Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Stephan Gruber
- High Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Pavol Szomolanyi
- High Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
- Department of Imaging Methods, Institute of Measurement Sciences, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Vladimir Juras
- High Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
- Department of Imaging Methods, Institute of Measurement Sciences, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Simon Robinson
- High Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Štefan Zbýň
- High Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Stefan Haneder
- Vascular and Abdominal Imaging, Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Mannheim, Germany
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Zhou J, Li G, Sheng F, Qiao P, Zhang H, Xing X. Magnetic resonance imaging evaluation of residual tumors in breast cancer after neoadjuvant chemotherapy: surgical implications. Acta Radiol 2016; 57:529-37. [PMID: 26231950 DOI: 10.1177/0284185115597263] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 06/25/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND Magnetic resonance imaging (MRI) can be used to guide breast cancer surgery with breast conservation for large tumors with a substantially reduced size after neoadjuvant chemotherapy (NAC). PURPOSE To evaluate the value of dynamic contrast-enhanced MRI (DCE-MRI) for measuring residual tumor size and enhancement patterns following preoperative NAC. MATERIAL AND METHODS Eighty-nine patients with breast cancer underwent breast DCE-MRI; 38 patients (39 lesions) were treated with NAC and examined for residual disease following therapy. Two patients were excluded because surgery had been performed >2 weeks after the final MR examination. Thus, we correlated the DCE-MRI results of 36 patients (37 lesions) with postoperative histopathological findings. Residual disease was confirmed by more enhancement compared to normal glandular tissue at the initial tumor site. Residual tumor size on DCE-MRI was compared with postoperative pathology findings. Tumor enhancement patterns on DCE-MRI were analyzed and correlated with pathological classification. RESULTS MRI revealed 34 cases of residual tumors, with two false positives and one false negative. Pathological and MR measurements were correlated (r = 0.793). The correlation of mass enhancement size (r = 0.87, n = 14) with pathology and DCE-MRI was higher than for non-mass-like enhancement (NME) (r = 0.735, n = 23). The distribution of pathologic classification was significantly different between different MRI enhancement patterns (P = 0.006). Mass enhancement had higher cellularity than NME. CONCLUSION MRI is useful for evaluating residual carcinoma following NAC. Mass enhancement with higher cellularity after NAC can be evaluated more accurately, which is suitable for evaluating lumpectomy. However, other approaches are required for NME, which has lower cellularity.
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Affiliation(s)
- Juan Zhou
- Department of Radiology, Affiliated Hospital of the Academy of Military Medical Sciences, Beijing, PR China
| | - Gongjie Li
- Department of Radiology, Affiliated Hospital of the Academy of Military Medical Sciences, Beijing, PR China
| | - Fugeng Sheng
- Department of Radiology, Affiliated Hospital of the Academy of Military Medical Sciences, Beijing, PR China
| | - Penggang Qiao
- Department of Radiology, Affiliated Hospital of the Academy of Military Medical Sciences, Beijing, PR China
| | - Hongtao Zhang
- Department of Radiology, Affiliated Hospital of the Academy of Military Medical Sciences, Beijing, PR China
| | - Xudong Xing
- Department of Radiology, Affiliated Hospital of the Academy of Military Medical Sciences, Beijing, PR China
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Zaric O, Pinker K, Zbyn S, Strasser B, Robinson S, Minarikova L, Gruber S, Farr A, Singer C, Helbich TH, Trattnig S, Bogner W. Quantitative Sodium MR Imaging at 7 T: Initial Results and Comparison with Diffusion-weighted Imaging in Patients with Breast Tumors. Radiology 2016; 280:39-48. [PMID: 27007803 DOI: 10.1148/radiol.2016151304] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Purpose To investigate the clinical feasibility of a quantitative sodium 23 ((23)Na) magnetic resonance (MR) imaging protocol developed for breast tumor assessment and to compare it with 7-T diffusion-weighted imaging (DWI). Materials and Methods Written informed consent in this institutional review board-approved study was obtained from eight healthy volunteers and 17 patients with 20 breast tumors (five benign, 15 malignant). To achieve the best image quality and reproducibility, the (23)Na sequence was optimized and tested on phantoms and healthy volunteers. For in vivo quantification of absolute tissue sodium concentration (TSC), an external phantom was used. Static magnetic field, or B0, and combined transmit and receive radiofrequency field, or B1, maps were acquired, and image quality, measurement reproducibility, and accuracy testing were performed. Bilateral (23)Na and DWI sequences were performed before contrast material-enhanced MR imaging in patients with breast tumors. TSC and apparent diffusion coefficient (ADC) were calculated and correlated for healthy glandular tissue and benign and malignant lesions. Results The (23)Na MR imaging protocol is feasible, with 1.5-mm in-plane resolution and 16-minute imaging time. Good image quality was achieved, with high reproducibility (mean TSC values ± standard deviation for the test, 36 mmol per kilogram of wet weight ± 2 [range, 34-37 mmol/kg]; for the retest, 37 mmol/kg ± 1 [range, 35-39 mmol/kg]; P = .610) and accuracy (r = 0.998, P < .001). TSC values in normal glandular and adipose breast tissue were 35 mmol/kg ± 3 and 18 mmol/kg ± 3, respectively. In malignant lesions (mean size, 31 mm ± 24; range, 6-92 mm), the TSC of 69 mmol/kg ± 10 was, on average, 49% higher than that in benign lesions (mean size, 14 mm ± 12; range, 6-35 mm), with a TSC of 47 mmol/kg ± 8 (P = .002). There were similar ADC differences between benign ([1.78 ± 0.23] × 10(-3) mm(2)/sec) and malignant ([1.03 ± 0.23] × 10(-3) mm(2)/sec) tumors (P = .002). ADC and TSC were inversely correlated (r = -0.881, P < .001). Conclusion Quantitative (23)Na MR imaging is clinically feasible, may provide good differentiation between malignant and benign breast lesions, and demonstrates an inverse correlation with ADC. (©) RSNA, 2016 Online supplemental material is available for this article.
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Affiliation(s)
- Olgica Zaric
- From the MR Center of Excellence (MRCE), Department of Biomedical Imaging and Image-guided Therapy (O.Z., S.Z., B.S., S.R., L.M., S.G., S.T., W.B.), Division of Molecular and Gender Imaging, Department of Biomedical Imaging and Image-guided Therapy (K.P., T.H.H.), and Department of Obstetrics and Gynecology (A.F., C.S.), Medical University of Vienna, Lazarettgasse 14, A-1090, Vienna, Austria; and Christian Doppler Laboratory for Clinical Molecular MRI, Christian Doppler Forschungsgesellschaft, Vienna, Austria (S.T.)
| | - Katja Pinker
- From the MR Center of Excellence (MRCE), Department of Biomedical Imaging and Image-guided Therapy (O.Z., S.Z., B.S., S.R., L.M., S.G., S.T., W.B.), Division of Molecular and Gender Imaging, Department of Biomedical Imaging and Image-guided Therapy (K.P., T.H.H.), and Department of Obstetrics and Gynecology (A.F., C.S.), Medical University of Vienna, Lazarettgasse 14, A-1090, Vienna, Austria; and Christian Doppler Laboratory for Clinical Molecular MRI, Christian Doppler Forschungsgesellschaft, Vienna, Austria (S.T.)
| | - Stefan Zbyn
- From the MR Center of Excellence (MRCE), Department of Biomedical Imaging and Image-guided Therapy (O.Z., S.Z., B.S., S.R., L.M., S.G., S.T., W.B.), Division of Molecular and Gender Imaging, Department of Biomedical Imaging and Image-guided Therapy (K.P., T.H.H.), and Department of Obstetrics and Gynecology (A.F., C.S.), Medical University of Vienna, Lazarettgasse 14, A-1090, Vienna, Austria; and Christian Doppler Laboratory for Clinical Molecular MRI, Christian Doppler Forschungsgesellschaft, Vienna, Austria (S.T.)
| | - Bernhard Strasser
- From the MR Center of Excellence (MRCE), Department of Biomedical Imaging and Image-guided Therapy (O.Z., S.Z., B.S., S.R., L.M., S.G., S.T., W.B.), Division of Molecular and Gender Imaging, Department of Biomedical Imaging and Image-guided Therapy (K.P., T.H.H.), and Department of Obstetrics and Gynecology (A.F., C.S.), Medical University of Vienna, Lazarettgasse 14, A-1090, Vienna, Austria; and Christian Doppler Laboratory for Clinical Molecular MRI, Christian Doppler Forschungsgesellschaft, Vienna, Austria (S.T.)
| | - Simon Robinson
- From the MR Center of Excellence (MRCE), Department of Biomedical Imaging and Image-guided Therapy (O.Z., S.Z., B.S., S.R., L.M., S.G., S.T., W.B.), Division of Molecular and Gender Imaging, Department of Biomedical Imaging and Image-guided Therapy (K.P., T.H.H.), and Department of Obstetrics and Gynecology (A.F., C.S.), Medical University of Vienna, Lazarettgasse 14, A-1090, Vienna, Austria; and Christian Doppler Laboratory for Clinical Molecular MRI, Christian Doppler Forschungsgesellschaft, Vienna, Austria (S.T.)
| | - Lenka Minarikova
- From the MR Center of Excellence (MRCE), Department of Biomedical Imaging and Image-guided Therapy (O.Z., S.Z., B.S., S.R., L.M., S.G., S.T., W.B.), Division of Molecular and Gender Imaging, Department of Biomedical Imaging and Image-guided Therapy (K.P., T.H.H.), and Department of Obstetrics and Gynecology (A.F., C.S.), Medical University of Vienna, Lazarettgasse 14, A-1090, Vienna, Austria; and Christian Doppler Laboratory for Clinical Molecular MRI, Christian Doppler Forschungsgesellschaft, Vienna, Austria (S.T.)
| | - Stephan Gruber
- From the MR Center of Excellence (MRCE), Department of Biomedical Imaging and Image-guided Therapy (O.Z., S.Z., B.S., S.R., L.M., S.G., S.T., W.B.), Division of Molecular and Gender Imaging, Department of Biomedical Imaging and Image-guided Therapy (K.P., T.H.H.), and Department of Obstetrics and Gynecology (A.F., C.S.), Medical University of Vienna, Lazarettgasse 14, A-1090, Vienna, Austria; and Christian Doppler Laboratory for Clinical Molecular MRI, Christian Doppler Forschungsgesellschaft, Vienna, Austria (S.T.)
| | - Alex Farr
- From the MR Center of Excellence (MRCE), Department of Biomedical Imaging and Image-guided Therapy (O.Z., S.Z., B.S., S.R., L.M., S.G., S.T., W.B.), Division of Molecular and Gender Imaging, Department of Biomedical Imaging and Image-guided Therapy (K.P., T.H.H.), and Department of Obstetrics and Gynecology (A.F., C.S.), Medical University of Vienna, Lazarettgasse 14, A-1090, Vienna, Austria; and Christian Doppler Laboratory for Clinical Molecular MRI, Christian Doppler Forschungsgesellschaft, Vienna, Austria (S.T.)
| | - Christian Singer
- From the MR Center of Excellence (MRCE), Department of Biomedical Imaging and Image-guided Therapy (O.Z., S.Z., B.S., S.R., L.M., S.G., S.T., W.B.), Division of Molecular and Gender Imaging, Department of Biomedical Imaging and Image-guided Therapy (K.P., T.H.H.), and Department of Obstetrics and Gynecology (A.F., C.S.), Medical University of Vienna, Lazarettgasse 14, A-1090, Vienna, Austria; and Christian Doppler Laboratory for Clinical Molecular MRI, Christian Doppler Forschungsgesellschaft, Vienna, Austria (S.T.)
| | - Thomas H Helbich
- From the MR Center of Excellence (MRCE), Department of Biomedical Imaging and Image-guided Therapy (O.Z., S.Z., B.S., S.R., L.M., S.G., S.T., W.B.), Division of Molecular and Gender Imaging, Department of Biomedical Imaging and Image-guided Therapy (K.P., T.H.H.), and Department of Obstetrics and Gynecology (A.F., C.S.), Medical University of Vienna, Lazarettgasse 14, A-1090, Vienna, Austria; and Christian Doppler Laboratory for Clinical Molecular MRI, Christian Doppler Forschungsgesellschaft, Vienna, Austria (S.T.)
| | - Siegfried Trattnig
- From the MR Center of Excellence (MRCE), Department of Biomedical Imaging and Image-guided Therapy (O.Z., S.Z., B.S., S.R., L.M., S.G., S.T., W.B.), Division of Molecular and Gender Imaging, Department of Biomedical Imaging and Image-guided Therapy (K.P., T.H.H.), and Department of Obstetrics and Gynecology (A.F., C.S.), Medical University of Vienna, Lazarettgasse 14, A-1090, Vienna, Austria; and Christian Doppler Laboratory for Clinical Molecular MRI, Christian Doppler Forschungsgesellschaft, Vienna, Austria (S.T.)
| | - Wolfgang Bogner
- From the MR Center of Excellence (MRCE), Department of Biomedical Imaging and Image-guided Therapy (O.Z., S.Z., B.S., S.R., L.M., S.G., S.T., W.B.), Division of Molecular and Gender Imaging, Department of Biomedical Imaging and Image-guided Therapy (K.P., T.H.H.), and Department of Obstetrics and Gynecology (A.F., C.S.), Medical University of Vienna, Lazarettgasse 14, A-1090, Vienna, Austria; and Christian Doppler Laboratory for Clinical Molecular MRI, Christian Doppler Forschungsgesellschaft, Vienna, Austria (S.T.)
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Menezes GLG, Stehouwer BL, Klomp DWJ, van der Velden TA, van den Bosch MAAJ, Knuttel FM, Boer VO, van der Kemp WJM, Luijten PR, Veldhuis WB. Dynamic contrast-enhanced breast MRI at 7T and 3T: an intra-individual comparison study. SPRINGERPLUS 2016; 5:13. [PMID: 26759752 PMCID: PMC4700043 DOI: 10.1186/s40064-015-1654-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 12/21/2015] [Indexed: 01/01/2023]
Abstract
The aim of this study is to compare the current state of lesion identification, the BI-RADS classification and the contrast-enhancement behavior at 7T and 3T breast MRI in the same patient group. Twenty-seven patients with thirty suspicious lesions were selected for this prospective study and underwent both 7T and 3T MRI. All examinations were rated by two radiologists (R1 and R2) independently on image quality, lesion identification and BI-RADS classification. We assessed sensitivity, specificity, NPV and PPV, observer agreement, lesion sizes, and contrast-enhancement-to-noise ratios (CENRs) of mass lesions. Fifteen of seventeen histopathological proven malignant lesions were detected at both field strengths. Image quality of the dynamic series was good at 7T, and excellent at 3T (P = 0.001 for R1 and P = 0.88 for R2). R1 found higher rates of specificity, NPV and PPV at 7T when compared to 3T, while R2 found the same results for sensitivity, specificity, NPV and PPV for both field strengths. The observers showed excellent agreement for BI-RADS categories at 7T (κ = 0.86) and 3T (κ = 0.93). CENRs were higher at 7T (P = 0.015). Lesion sizes were bigger at 7T according to R2 (P = 0.039). Our comparison study shows that 7T MRI allows BI-RADS conform analysis. Technical improvements, such as acquisition of T2w sequences and adjustment of B1+ field inhomogeneity, are still necessary to allow clinical use of 7T breast MRI.
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Affiliation(s)
- Gisela L G Menezes
- Department of Radiology and Nuclear Medicine, University Medical Centre Utrecht, P.O. Box 85500, 3508 GA Utrecht, The Netherlands
| | - Bertine L Stehouwer
- Department of Radiology and Nuclear Medicine, University Medical Centre Utrecht, P.O. Box 85500, 3508 GA Utrecht, The Netherlands
| | - Dennis W J Klomp
- Department of Radiology and Nuclear Medicine, University Medical Centre Utrecht, P.O. Box 85500, 3508 GA Utrecht, The Netherlands
| | - Tijl A van der Velden
- Department of Radiology and Nuclear Medicine, University Medical Centre Utrecht, P.O. Box 85500, 3508 GA Utrecht, The Netherlands
| | - Maurice A A J van den Bosch
- Department of Radiology and Nuclear Medicine, University Medical Centre Utrecht, P.O. Box 85500, 3508 GA Utrecht, The Netherlands
| | - Floortje M Knuttel
- Department of Radiology and Nuclear Medicine, University Medical Centre Utrecht, P.O. Box 85500, 3508 GA Utrecht, The Netherlands
| | - Vincent O Boer
- Department of Radiology and Nuclear Medicine, University Medical Centre Utrecht, P.O. Box 85500, 3508 GA Utrecht, The Netherlands
| | - Wybe J M van der Kemp
- Department of Radiology and Nuclear Medicine, University Medical Centre Utrecht, P.O. Box 85500, 3508 GA Utrecht, The Netherlands
| | - Peter R Luijten
- Department of Radiology and Nuclear Medicine, University Medical Centre Utrecht, P.O. Box 85500, 3508 GA Utrecht, The Netherlands
| | - Wouter B Veldhuis
- Department of Radiology and Nuclear Medicine, University Medical Centre Utrecht, P.O. Box 85500, 3508 GA Utrecht, The Netherlands
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van der Velden TA, Schmitz AMT, Gilhuijs KGA, Veldhuis WB, Luijten PR, Boer VO, Klomp DWJ. Fat suppression techniques for obtaining high resolution dynamic contrast enhanced bilateral breast MR images at 7T. Magn Reson Imaging 2015; 34:462-8. [PMID: 26708033 DOI: 10.1016/j.mri.2015.12.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 12/13/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVES To compare water selective excitation (WSE) and Dixon fat suppression in the context of high-resolution dynamic contrast enhanced MRI of the breast at 7T. METHODS Ten healthy volunteers and one patient with a malignant breast lesion were scanned at 7T. The MRI protocol contained 3D T1-weighted gradient echo images obtained with both WSE fat suppression, multi echo Dixon fat suppression, and without fat suppression. Images were acquired at a (0.8mm)(3) or (0.7mm)(3) isotropic resolution with equal field of view and optimized such to obtain a maximal SNR. Image quality was scored qualitatively on overall image quality, sharpness of anatomical details, presence of artifacts, inhomogeneous fat suppression and the presence of water-fat shift. A quantitative scoring was obtained from the signal to noise ratio and contrast to noise ratio. RESULTS WSE scored significantly better in terms of overall image quality and the absence of artifacts. No significant difference in contrast to noise ratio was found between the two fat suppression methods. CONCLUSION When maximizing temporal and spatial resolution of high resolution DCE MRI of the breast, water selective excitation provides better image quality than multi echo Dixon at 7T.
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Affiliation(s)
- Tijl A van der Velden
- University Medical Center Utrecht, Department of Radiology, Heidelberglaan 100, 3584CX, Utrecht, the Netherlands.
| | - Alexander M Th Schmitz
- University Medical Center Utrecht, Department of Radiology, Heidelberglaan 100, 3584CX, Utrecht, the Netherlands; University Medical Center Utrecht, Image Sciences Institute, Heidelberglaan 100, 3584CX, Utrecht, the Netherlands
| | - Kenneth G A Gilhuijs
- University Medical Center Utrecht, Department of Radiology, Heidelberglaan 100, 3584CX, Utrecht, the Netherlands; University Medical Center Utrecht, Image Sciences Institute, Heidelberglaan 100, 3584CX, Utrecht, the Netherlands
| | - Wouter B Veldhuis
- University Medical Center Utrecht, Department of Radiology, Heidelberglaan 100, 3584CX, Utrecht, the Netherlands
| | - Peter R Luijten
- University Medical Center Utrecht, Department of Radiology, Heidelberglaan 100, 3584CX, Utrecht, the Netherlands
| | - Vincent O Boer
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Kettegaard Allé 30, DK-2650, Hvidovre, Denmark
| | - Dennis W J Klomp
- University Medical Center Utrecht, Department of Radiology, Heidelberglaan 100, 3584CX, Utrecht, the Netherlands
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Multiparametric MRI With Dynamic Contrast Enhancement, Diffusion-Weighted Imaging, and 31-Phosphorus Spectroscopy at 7 T for Characterization of Breast Cancer. Invest Radiol 2015; 50:766-71. [DOI: 10.1097/rli.0000000000000183] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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30
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Gruber S, Minarikova L, Pinker K, Zaric O, Chmelik M, Strasser B, Baltzer P, Helbich T, Trattnig S, Bogner W. Diffusion-weighted imaging of breast tumours at 3 Tesla and 7 Tesla: a comparison. Eur Radiol 2015; 26:1466-73. [PMID: 26310582 DOI: 10.1007/s00330-015-3947-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Revised: 07/13/2015] [Accepted: 07/27/2015] [Indexed: 12/27/2022]
Abstract
OBJECTIVES To compare bilateral diffusion-weighted MR imaging (DWI) at 3 T and 7 T in the same breast tumour patients. METHODS Twenty-eight patients were included in this IRB-approved study (mean age 56 ± 16 years). Before contrast-enhanced imaging, bilateral DWI with b = 0 and 850 s/mm(2) was performed in 2:56 min (3 T) and 3:48 min (7 T), using readout-segmented echo planar imaging (rs-EPI) with a 1.4 × 1.4 mm(2) (3 T)/0.9 × 0.9 mm(2) (7 T) in-plane resolution. Apparent diffusion coefficients (ADC), signal-to-noise (SNR) and contrast-to-noise ratios (CNR) were assessed. RESULTS Twenty-eight lesions were detected (18 malignant, 10 benign). CNR and SNR were comparable at both field strengths (p > 0.3). Mean ADC values at 7 T were 4-22% lower than at 3 T (p ≤ 0.03). An ADC threshold of 1.275 × 10(-3) mm(2)/s resulted in a diagnostic specificity of 90% at both field strengths. The sensitivity was 94% and 100% at 3 T and 7 T, respectively. CONCLUSION 7-T DWI of the breast can be performed with 2.4-fold higher spatial resolution than 3 T, without significant differences in SNR if compared to 3 T. KEY POINTS • 7 T provides a 2.4-fold higher resolution in breast DWI than 3 T • 7 T DWI has a high diagnostic accuracy comparable to that at 3 T • At 7 T malignant lesions had 22 % lower ADC than at 3 T (p < 0.001).
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Affiliation(s)
- S Gruber
- MRCE, Department of Biomedical imaging and Image-Guided Therapy, Medical University Vienna, Lazarettgasse 14, 1090, Vienna, Austria.,Christian Doppler Laboratory for Clinical Molecular MR Imaging, Vienna, Austria
| | - L Minarikova
- MRCE, Department of Biomedical imaging and Image-Guided Therapy, Medical University Vienna, Lazarettgasse 14, 1090, Vienna, Austria.,Christian Doppler Laboratory for Clinical Molecular MR Imaging, Vienna, Austria
| | - K Pinker
- Division of Molecular and Gender Imaging, Department of Biomedical imaging and Image-Guided Therapy, Medical University Vienna, Vienna, Austria
| | - O Zaric
- MRCE, Department of Biomedical imaging and Image-Guided Therapy, Medical University Vienna, Lazarettgasse 14, 1090, Vienna, Austria.,Christian Doppler Laboratory for Clinical Molecular MR Imaging, Vienna, Austria
| | - M Chmelik
- MRCE, Department of Biomedical imaging and Image-Guided Therapy, Medical University Vienna, Lazarettgasse 14, 1090, Vienna, Austria.,Christian Doppler Laboratory for Clinical Molecular MR Imaging, Vienna, Austria
| | - B Strasser
- MRCE, Department of Biomedical imaging and Image-Guided Therapy, Medical University Vienna, Lazarettgasse 14, 1090, Vienna, Austria.,Christian Doppler Laboratory for Clinical Molecular MR Imaging, Vienna, Austria
| | - P Baltzer
- Division of Molecular and Gender Imaging, Department of Biomedical imaging and Image-Guided Therapy, Medical University Vienna, Vienna, Austria
| | - T Helbich
- Division of Molecular and Gender Imaging, Department of Biomedical imaging and Image-Guided Therapy, Medical University Vienna, Vienna, Austria
| | - S Trattnig
- MRCE, Department of Biomedical imaging and Image-Guided Therapy, Medical University Vienna, Lazarettgasse 14, 1090, Vienna, Austria. .,Christian Doppler Laboratory for Clinical Molecular MR Imaging, Vienna, Austria.
| | - W Bogner
- MRCE, Department of Biomedical imaging and Image-Guided Therapy, Medical University Vienna, Lazarettgasse 14, 1090, Vienna, Austria.,Christian Doppler Laboratory for Clinical Molecular MR Imaging, Vienna, Austria
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Pinker K, Baltzer P, Bogner W, Leithner D, Trattnig S, Zaric O, Dubsky P, Bago-Horvath Z, Rudas M, Gruber S, Weber M, Helbich TH. Multiparametric MR Imaging with High-Resolution Dynamic Contrast-enhanced and Diffusion-weighted Imaging at 7 T Improves the Assessment of Breast Tumors: A Feasibility Study. Radiology 2015; 276:360-70. [DOI: 10.1148/radiol.15141905] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Intervertebral disc lesions: visualisation with ultra-high field MRI at 11.7 T. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2015. [DOI: 10.1007/s00586-015-4146-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Cui J, Bosshard JC, Rispoli JV, Dimitrov IE, Cheshkov S, McDougall MP, Malloy C, Wright SM. A Switched-Mode Breast Coil for 7 T MRI Using Forced-Current Excitation. IEEE Trans Biomed Eng 2015; 62:1777-83. [PMID: 25706501 DOI: 10.1109/tbme.2015.2403850] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
In high-field magnetic resonance imaging, the radio frequency wavelength within the human body is comparable to anatomical dimensions, resulting in B1 inhomogeneity and nonuniform sensitivity patterns. Thus, this relatively short wavelength presents engineering challenges for RF coil design. In this study, a bilateral breast coil for (1)H imaging at 7 T was designed and constructed using forced-current excitation. By forcing equal current through the coil elements, we reduce the effects of coupling between the elements to simplify tuning and to ensure a uniform field across both breasts. To combine the benefits of the higher power efficiency of a unilateral coil with the bilateral coverage of a bilateral coil, a switching circuit was implemented to allow the coil to be reconfigured for imaging the left, right, or both breasts.
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Kaiser CG, Reich C, Dietzel M, Baltzer PAT, Krammer J, Wasser K, Schoenberg SO, Kaiser WA. DCE-MRI of the breast in a stand-alone setting outside a complementary strategy - results of the TK-study. Eur Radiol 2015; 25:1793-800. [PMID: 25577524 DOI: 10.1007/s00330-014-3580-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Revised: 12/05/2014] [Accepted: 12/18/2014] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To evaluate the accuracy of MRI of the breast (DCE-MRI) in a stand-alone setting with extended indications. MATERIALS AND METHODS According to the inclusion criteria, breast specialists were invited to refer patients to our institution for DCE-MRI. Depending on the MR findings, patients received either a follow-up or biopsy. Between 04/2006 and 12/2011 a consecutive total of 1,488 women were prospectively examined. RESULTS Of 1,488 included patients, 393 patients were lost to follow-up, 1,095 patients were evaluated. 124 patients were diagnosed with malignancy by DCE-MRI (76 TP, 48 FP, 971 TN, 0 FN cases). Positive cases were confirmed by histology, negative cases by MR follow-ups or patient questionnaires over the next 5 years in 1,737 cases (sensitivity 100 %; specificity 95.2 %; PPV 61.3 %; NPV 100 %; accuracy 95.5 %). For invasive cancers only (DCIS excluded), the results were 63 TP; 27 FP; 971 TP and 0 FN (sensitivity 100 %; specificity 97.2 %; PPV 70 %; NPV 100 %; accuracy 97.5 %). CONCLUSION The DCE-MRI indications tested imply that negative results in DCE-MRI reliably exclude cancer. The results were achieved in a stand-alone setting (single modality diagnosis). However, these results are strongly dependent on reader experience and adequate technical standards as prerequisites for optimal diagnoses. KEY POINTS • DCE-MRI of the breast has a high accuracy in finding breast cancer. • The set of indications for DCE-MRI of the breast is still very limited. • DCE-MRI can achieve a high accuracy in a 'screening-like' setting. • Accuracy of breast DCE-MRI is strongly dependent on technique and reader experience. • A negative DCE-MRI effectively excludes cancer.
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Affiliation(s)
- Clemens G Kaiser
- Institute of Clinical Radiology and Nuclear Medicine, University Medical Centre Mannheim, Medical Faculty Mannheim-University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany,
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MedUni Wien Researcher of the month, Jänner 2015. Wien Klin Wochenschr 2015. [DOI: 10.1007/s00508-015-0698-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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By S, Rispoli JV, Cheshkov S, Dimitrov I, Cui J, Seiler S, Goudreau S, Malloy C, Wright SM, McDougall MP. A 16-channel receive, forced current excitation dual-transmit coil for breast imaging at 7T. PLoS One 2014; 9:e113969. [PMID: 25420018 PMCID: PMC4242663 DOI: 10.1371/journal.pone.0113969] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 11/02/2014] [Indexed: 11/18/2022] Open
Abstract
Purpose To enable high spatial and temporal breast imaging resolution via combined use of high field MRI, array coils, and forced current excitation (FCE) multi channel transmit. Materials and Methods A unilateral 16-channel receive array insert was designed for use in a transmit volume coil optimized for quadrature operation with dual-transmit RF shimming at 7T. Signal-to-noise ratio (SNR) maps, g-factor maps, and high spatial and temporal resolution in vivo images were acquired to demonstrate the utility of the coil architecture. Results The dual-transmit FCE coil provided homogeneous excitation and the array provided an increase in average SNR of 3.3 times (max 10.8, min 1.5) compared to the volume coil in transmit/receive mode. High resolution accelerated in vivo breast imaging demonstrated the ability to achieve isotropic spatial resolution of 0.5 mm within clinically relevant 90 s scan times, as well as the ability to perform 1.0 mm isotropic resolution imaging, 7 s per dynamics, with the use of bidirectional SENSE acceleration of up to R = 9. Conclusion The FCE design of the transmit coil easily accommodates the addition of a sixteen channel array coil. The improved spatial and temporal resolution provided by the high-field array coil with FCE dual-channel transmit will ultimately be beneficial in lesion detection and characterization.
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Affiliation(s)
- Samantha By
- Department of Biomedical Engineering, Texas A&M University, College Station, Texas, United States of America
| | - Joseph V. Rispoli
- Department of Biomedical Engineering, Texas A&M University, College Station, Texas, United States of America
| | - Sergey Cheshkov
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
| | - Ivan Dimitrov
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
- Philips Medical Systems, Cleveland, Ohio, United States of America
| | - Jiaming Cui
- Department of Electrical and Computer Engineering, Texas A&M University, College Station, Texas, United States of America
| | - Stephen Seiler
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
| | - Sally Goudreau
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
| | - Craig Malloy
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
- VA North Texas Health Care System, Dallas, Texas, United States of America
| | - Steven M. Wright
- Department of Biomedical Engineering, Texas A&M University, College Station, Texas, United States of America
- Department of Electrical and Computer Engineering, Texas A&M University, College Station, Texas, United States of America
| | - Mary Preston McDougall
- Department of Biomedical Engineering, Texas A&M University, College Station, Texas, United States of America
- Department of Electrical and Computer Engineering, Texas A&M University, College Station, Texas, United States of America
- * E-mail:
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Pinker K, Helbich TH, Magometschnigg H, Fueger B, Baltzer P. [Molecular breast imaging. An update]. Radiologe 2014; 54:241-53. [PMID: 24557495 DOI: 10.1007/s00117-013-2580-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
CLINICAL/METHODICAL ISSUE The aim of molecular imaging is to visualize and quantify biological, physiological and pathological processes at cellular and molecular levels. Molecular imaging using various techniques has recently become established in breast imaging. STANDARD RADIOLOGICAL METHODS Currently molecular imaging techniques comprise multiparametric magnetic resonance imaging (MRI) using dynamic contrast-enhanced MRI (DCE-MRI), diffusion-weighted imaging (DWI), proton MR spectroscopy ((1)H-MRSI), nuclear imaging by breast-specific gamma imaging (BSGI), positron emission tomography (PET) and positron emission mammography (PEM) and combinations of techniques (e.g. PET-CT and multiparametric PET-MRI). METHODICAL INNOVATIONS Recently, novel techniques for molecular imaging of breast tumors, such as sodium imaging ((23)Na-MRI), phosphorus spectroscopy ((31)P-MRSI) and hyperpolarized MRI as well as specific radiotracers have been developed and are currently under investigation. PRACTICAL RECOMMENDATIONS It can be expected that molecular imaging of breast tumors will enable a simultaneous assessment of the multiple metabolic and molecular processes involved in cancer development and thus an improved detection, characterization, staging and monitoring of response to treatment will become possible.
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Affiliation(s)
- K Pinker
- Abteilung für Molekulare Bildgebung, Universitätsklinik für Radiologie und Nuklearmedizin, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich
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Lesion type and reader experience affect the diagnostic accuracy of breast MRI: a multiple reader ROC study. Eur J Radiol 2014; 84:86-91. [PMID: 25466772 DOI: 10.1016/j.ejrad.2014.10.023] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Revised: 10/13/2014] [Accepted: 10/31/2014] [Indexed: 11/22/2022]
Abstract
PURPOSE To evaluate the influence of lesion type (mass versus non-mass) and reader experience on the diagnostic performance of breast MRI (BMRI) in a non-screening setting. MATERIALS AND METHODS Consecutive patients (mean age, 55 ± 12 years) with breast lesions that were verified by biopsy or surgery, and who had had BMRI as part of their diagnostic workup, were eligible for this retrospective single-center study. Cancers diagnosed by biopsy before BMRI were excluded to eliminate biological and interpretation bias due to biopsy or chemotherapy effects (n=103). Six blinded readers (experience level, high (HE, n=2); intermediate (IE, n=2); and low (LE, n=2)) evaluated all examinations and assigned independent MRI BI-RADS ratings. Lesion type (mass, non-mass, focal) was noted. Receiver operating characteristics (ROC) and logistic regression analysis was performed to compare diagnostic accuracies. RESULTS There were 259 histologically verified lesions (123 malignant, 136 benign) investigated. There were 169 mass (103 malignant, 66 benign) and 48 non-mass lesions (19 malignant, 29 benign). Another 42 lesions that met the inclusion criteria were biopsied due to conventional findings (i.e., microcalcifications, architectural distortions), but did not enhance on MRI (41 benign, one DCIS). ROC analysis revealed a total area under the curve (AUC) between 0.834 (LE) and 0.935 (HI). Logistic regression identified a significant effect of non-mass lesions (P<0.0001) and reader experience (P=0.005) on diagnostic performance. CONCLUSIONS Non-mass lesion type and low reader experience negatively affect the diagnostic performance of breast MRI in a non-screening setting.
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Effect of b value and pre-admission of contrast on diagnostic accuracy of 1.5-T breast DWI: a systematic review and meta-analysis. Eur Radiol 2014; 24:2835-47. [PMID: 25103535 DOI: 10.1007/s00330-014-3338-z] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Revised: 06/12/2014] [Accepted: 07/10/2014] [Indexed: 12/26/2022]
Abstract
OBJECTIVES To evaluate the effect of the choice of b values and prior use of contrast medium on apparent diffusion coefficients (ADCs) of breast lesions derived from diffusion-weighted imaging (DWI), and on the discrimination between benign and malignant lesions. METHODS A literature search of relevant DWI studies was performed. The accuracy of DWI to characterize lesions by using b value ≤600 s/mm(2) and b value >600 s/mm(2) was presented as pooled sensitivity and specificity, and the ADC was calculated for both groups. Lesions were pooled as pre- or post-contrast DWI. RESULTS Of 198 articles, 26 met the inclusion criteria. Median ADCs were significantly higher (13.2-35.1 %, p < 0.001) for the group of b values ≤600 s/mm(2) compared to >600 s/mm(2). The sensitivity in both groups was similar (91 % and 89 %, p = 0.495) as well as the specificity (75 % and 84 %, p = 0.237). Contrast medium had no significant effects on the ADCs (p ≥ 0.08). The differentiation between benign and malignant lesions was optimal (58.4 %) for the combination of b = 0 and 1,000 s/mm(2). CONCLUSIONS The wide variety of b value combinations applied in different studies significantly affects the ADC of breast lesions and confounds quantitative DWI. If only a couple of b values are used, those of b = 0 and 1,000 s/mm(2) are recommended for the best improvement of differentiating between benign and malignant lesions. KEY POINTS • The choice of b values significantly affects the ADC of breast lesions. • Sensitivity and specificity are not affected by the choice of b values. • b values 0 and 1,000 s/mm (2) are recommended for optimal differentiation between benign and malignant lesions. • Contrast medium prior to DWI does not significantly affect the ADC.
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Fat saturation in dynamic breast MRI at 3 Tesla: is the Dixon technique superior to spectral fat saturation? A visual grading characteristics study. Eur Radiol 2014; 24:2213-9. [DOI: 10.1007/s00330-014-3189-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Revised: 04/02/2014] [Accepted: 04/14/2014] [Indexed: 11/27/2022]
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