Electronic Posters: Body Imaging



Electronic Posters: Body Imaging

Breast MR: Diffusion, Spectra & High Field

Hall B Monday 14:00-16:00 Computer 90

14:00 4534. Diffusion MR Breast Imaging: Correlation of ADC Values to the Prognostic Factors

Sunitha B. Thakur1, David D. Dershaw2, Dilip Giri3, Junting Zheng4, Chaya Moskowitz, Jessica Ferrara2, Jason A. Koutcher1, Elizabeth A. Morris2

1Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, United States; 2Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, United States; 3Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, United States; 4Epidemiology-Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, United States

Treatment decisions and determination of breast cancer prognosis have traditionally been based on pathologic parameters such as tumorsize and axillary-nodal status, tumor-grade, and the results of tumor markers mainly ER/PR and HER-2/neu. Here we present the clinical usefulness of Diffusion-weighted MRI and measurement of apparent diffusion coefficients (ADCs) to correlate traditional markers such as histology and molecular markers such as ER, PR and HER-2. Mean tumor size is significantly higher in patients with positive lymph nodes. Although ADC values represent a valuable biomarker for detecting malignant lesions, the ADC cannot be a prognostic indicator for patients with breast cancer.

14:30 4535. Post Lumpectomy MRI: Using Diffusion Weighted Imaging (DWI) to Distinguish Benign from Malignant Tissues

Frederick Kelcz1, Kendra S. Hain1

1Radiology, University of Wisconsin, Madison, WI, United States

We reviewed diffusion imaging results in post lumpectomy patients and preliminary results show a consisent ADC value in the benign range, despite persistent, occasionly concerning enhancement. DWI may be of great value in ruling in benignancy when differentiating enhancing scar from malignancy.

15:00 4536. Diffusion MR Breast Imaging: ADC Values for Differentiating of Malignant from Benign Breast Tumors

Sunitha B. Thakur1,2, David D. Dershaw2, Dilip Giri3, Junting Zheng4, Chaya Moskowitz, Jason A. Koutcher1,2, Elizabeth A. Morris2

1Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, United States; 2Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, United States; 3Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, United States; 4Epidemiology-Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, United States

Diffusion MRI is a noninvasive technique which provides information about early changes in morphology and physiology of tissues by monitoring changes in the local apparent diffusion coefficient (ADC) of water molecules. Recently, diffusion-imaging has demonstrated potential in discriminating malignant from benign breast tumors and in assessing progression of disease following therapy. In this work we present the clinical usefulness of DWI and ADC values. ADC measurements are useful to differentiate malignant lesions from benign lesions yielding 98.4 % specificity and 90.9 % sensitivity with ADC cut-off value of 1.28x10-3 mm2/s. ADC was less reliable for differentiating invasive and non-invasive carcinomas.

15:30 4537. Diffusion Weighted Imaging of the Breast: Can It Decrease the Number of Unneeded Biopsies?

Wafaa Raafat Abdel Hamid1, Lobna Rashed Ezz El Arab, Mona Ahmed Mohamed2, Yasser Abdel Azim Abbas

1Radiodiagnosis, Ain Shams University, Cairo, Egypt; 2Johns Hopkins University school of medicine

Classic magnetic resonance imaging is based on the enhancement pattern of lesions in dynamic breast MRI and morphologic changes. However, there is an overlap of these criteria with benign lesions. Accordingly, problematic cases have always been subjected to biopsies and histopathological verification. In our work we are shedding light on the added value of Diffusion Weighted Imaging and ADC values in differentiating between benign and malignant breast lesions, with a major goal of sparing patients the invasiveness and complications of unneeded biopsies.

Tuesday 13:30-15:30 Computer 90

13:30 4538. Motion and Distortion Correction in Diffusion-Weighted MRI of the Breast at 3T

Lori R. Arlinghaus1,2, E. Brian Welch1,3, A. Bapsi Chakravarthy4, Jaime S. Farley5, John C. Gore1,2, Thomas E. Yankeelov1,2

1Institute of Imaging Science, Vanderbilt University, Nashville, TN, United States; 2Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN, United States; 3MR Clinical Science, Philips Healthcare, Cleveland, OH, United States; 4Radiation Oncology, Vanderbilt University, Nashville, TN, United States; 5Vanderbilt University Medical Center, Vanderbilt University, Nashville, TN, United States

Diffusion-weighted imaging (DWI) is a promising surrogate biomarker for the characterization of human breast cancer. However, DWI acquisition sequences are susceptible to artifacts induced by subject motion and eddy currents. DWIs acquired with echo planar imaging (EPI) techniques are also prone to nonlinear distortion induced by B0 field inhomogeneities, which worsen as field strength increases. We present evidence that image registration and B0 field map correction improve the quality of apparent diffusion coefficient (ADC) maps derived from the DWI data and improve the registration of the DWI data with anatomical images for comparison with other parametric maps.

14:00 4539. Operator Performance of Voxel Placement for Single-Voxel MRS of Breast Lesions

Naomi R. Mraz1, Michael T. Nelson1, Jessica Kuehn-Hajder1, Greg John Metzger2, Patrick John Bolan2

1Radiology, University of Minnesota, Minneapolis, MN, United States; 2Radiology/CMRR, University of Minnesota, Minneapolis, MN, United States

In order for single-voxel MRS measurements to be a useful clinical tool for characterizing breast lesions, voxel placement must be accurate and consistent. This project tested the consistency of voxel placement between four different operators using a retrospective study to simulate voxel placement on a MR scanner. The relative geometric intersection was used as a measure of concordance between readers. Overall concordance was lower than expected (ranging 0%-82.5%, mean 31.2%). Concordance was higher for masses than for non-mass-like lesions. These results suggest that further training, guidance, or software support should be used to improve voxel placement consistency.

14:30 4540. 1H MR Spectroscopy of the Breast Cancer at 3.0-Tesla: Comparison Between Pre- And Post- Contrast Administration.

Hisashi Kawai1, Shinji Naganawa1, Hiroko Satake1, Satoko Ishigaki1

1Radiology, Nagoya University, Nagoya, Japan

The purpose of this study was to assess whether VOIs of MRS were located properly with non-contrast MRI and to compare the variability between pre- and post-contrast spectroscopic measurements at 3T-MRI.

Single-voxel MRS were performed in 92 breast cancer lesions. In 52 lesions, MRS was obtained before and after contrast-enhanced MRI. VOI were located in the lesion properly in 74 out of 92 breast cancers. The integral value of choline peak decreased significantly in post-contrast MRS compared to in pre-contrast MRS. MRS should be obtained before contrast administration not to be affected by Gadolinium contrast agents.

15:00 4541. The Impact of Gd-DTPA on Breast 1H MRS

Patrick John Bolan1, Eva H. Baker2, Lance Jay DelaBarre1, Hellmut Merkle3, Doug Yee4, Michael T. Nelson5, Lenore Everson5, Michael Garwood1

1Radiology/CMRR, University of Minnesota, Minneapolis, MN, United States; 2Diagnostic Radiology Department, NIH Clinical Center, Bethesda, MD, United States; 3National Institute Neurological Disorders and Stroke, NIH, Bethesda, MD, United States; 4Masonic Cancer Center, University of Minnesota, Minneapolis, MN, United States; 5Radiology, University of Minnesota, Minneapolis, MN, United States

While 1H MRS is increasingly being used in clinical studies of breast cancer, there has been some evidence that the use of Gadolinium-based contrast agents prior to MRS can affect the spectra, broadening the choline resonance and reducing its area. This work describes a study performing 1H MRS at 4T before and after a bolus of Gd-DTPA. It was found that after the contrast injection there was a small negative impact on both the choline and water peaks, with an effect size of 10-15%.

Wednesday 13:30-15:30 Computer 90

13:30 4542. Measurement of the Breast Density Using IDEAL-Dixon Imaging at 3T

Sungheon Kim1, Tess Clendenen2, Sherlin Lavianlivi1, Linda Moy1, Henry Rusinek1, Malcolm C. Pike3, Anne Zeleniuch-Jacquotte4

1Center for Biomedical Imaging, Radiology, NYU School of Medicine, New York, NY, United States; 2Epidemiology, NYU School of Medicine, New York, NY, United States; 3Preventive Medicine, USC Keck School of Medicine, Los Angeles, CA, United States; 4Environmental Medicine, NYU School of Medicine, New York, NY, United States

This study was to assess if Dixon water/fat images could be used to monitor breast volume and density changes during the menstrual cycle. Reproducibility of the volume and density measurement was assessed with data from four subjects. In addition, five healthy premenopausal women were scanned once a week for four weeks. The median breast volume was smallest in the ovulatory phase and largest in the late luteal phase. FG density was lowest at the follicular phase and highest in the late luteal phase. This result demonstrates the feasibility of using Dixon imaging to monitor the change in the breast.

14:00 4543. Quantitative Evaluation of Fat Suppression Techniques for Breast MRI at 3.0T

Chen Lin1, Laurie Owens1, Hal Kipfer1, Helmuth Schultze-Haakh2, Brian Dale2

1Department of Radiology and Imaging Science, Indiana University School of Medicine, Indianapolis, IN, United States; 2Siemens Healthcare, Marlven, PA

Quantitative assessment of the quality of fat suppression in breast MRI with four different techniques, conventional quick fat (QFS), spectrally selective adiabatic inversion recovery (SPAIR), water only excitation (WE) and two point dixon (2PT DIXON) was made at 3.0T. The result demonstrates similar but inferior performance for QFS, SPAIR and WE. While 2PT DIXON is shown to provide superior fat suppression, further development is needed.

14:30 4544. Determining the Sensitivity and Specificity of High Spatial Resolution 3.0T Breast MRI in a High Risk Familial Breast Cancer Screening Cohort

Martin D. Pickles1, Lindsay W. Turnbull1

1Centre for MR Investigations, University of Hull, Hull, East Yorkshire, United Kingdom

Theoretically breast MR examinations at 3.0T should be superior to 1.5T studies. However, breast imaging on higher field strength systems also pose problems such as larger chemical shift, susceptibility artefacts, B1 inhomogeneities and increased T1 relaxation times. The aim of this work was to compare the sensitivity and specificity achieved by a 3.0T MR breast screening programme against the published results of screening studies at 1.5T. In conclusion the diagnostic accuracy of MR breast screening at 3.0T does not seem to be adversely effected by high field strength related artefacts and the results are comparable to those published at 1.5T.

15:00 4545. Assessing the Accuracy of a Commercial Computer Aided Diagnosis Package (CADstream) in Determining the Level of Disease Post Neoadjuvant Chemotherapy in a Cohort of Breast Cancer Patients

Martin D. Pickles1, Lindsay W. Turnbull1

1Centre for MR Investigations, University of Hull, Hull, East Yorkshire, United Kingdom

CADstream is a computer aided diagnosis package developed to aid in the interpretation of breast MR. Reports have demonstrated that CADstream provides quicker interpretation, increased specificity and greater correlation with histological size. However, these reports are based on the assessment of pre-treatment lesions and not post chemotherapy lesions where a treatment induced vascular shutdown is anticipated. The aim of this study was to assess CADstream’s accuracy post chemotherapy. In conclusion this study demonstrated by reducing the enhancement and difference thresholds the sensitivity can be increased resulting in fewer false negative results.

Thursday 13:30-15:30 Computer 90

13:30 4546. Breast BOLD Correlates to Optical Breast Imaging During Respiratory Stimulus

Colin Morehouse Carpenter1,2, Rebecca Rakow-Penner3, Shudong Jiang2, Brian William Pogue2, Keith David Paulsen2, Gary H. Glover3

1Radiation Oncology, Stanford University School of Medicine, Stanford, CA, United States; 2Thayer School of Engineering at Dartmouth, Hanover, NH, United States; 3Radiology, Stanford University School of Medicine, Stanford, CA, United States

BOLD response in the breast was measured concurrently with MR-guided diffuse optical tomography (MRg-DOT) in 11 healthy volunteers during inspired gas changes. This approach utilized optical imaging to quantitatively identify the independent effects of oxy- and deoxyhemoglobin. A key factor in this study was characterization of the background physiological noise variations in individual subjects, which was measured via optical imaging during air breathing. The results from this work indicate that BOLD and optically-determined deoxyhemoglobin signals correlate significantly in the breast during an oxygen/carbogen respiratory stimulus, as long as only subjects that exhibit a significant response are included.

14:00 4547. MR Breast Density Measurement: Comparison of Two Anatomic Landmarks for Breast Segmentation

Jeon-Hor Chen1,2, Shih-Ting Chen2, Cheng-Ju Lin2, Daniel Chang1, Po-Pang Tsai2, Ke Nie1, Orhan Nalcioglu1, M-Y Lydia Su1

1Center for Functional Onco-Imaging, UC Irvine, Irvine, CA, United States; 2China Medical University Hospital, Taichung, Taiwan

Although breast density measurement showed high correlation using both anatomic landmarks, there was still an average of 20% difference for FV measurement. A significant number of women had the problem of being cut off of their fibroglandular tissue when the pectoris major muscle was used as the landmark. From our study, it was concluded that in women with dense breast such as the subjects included in this study, both anatomic landmarks, especially the one anterior to the pectoris major muscle, will have the problem of cut-off of the fibroglandular tissue, resulting in the acquired fibroglandular tissue underestimated.

14:30 4548. Comparison of Breast Density Measured on Fat-Suppressed Versus Non-Fat-Suppressed MRI

Daniel Han-en Chang1, Jeon-Hor Chen1,2, Shadfar Bahri1, Hon J. Yu1, Ke Nie1, Orhan Nalcioglu1, Min-Ying Lydia Su1

1Tu & Yuen Center for Functional Onco-Imaging, University of California, Irvine, CA, United States; 2Department of Radiology, China Medical University Hospital, Taichung, Taiwan

Mammographic density is known to be strongly associated with the risk of breast cancer development, but using mammography to characterize breast density does not provide true volumetric information. MRI-based methods on the other hand provide promising alternatives, but may be affected by technical factors such as the choice of pulse sequences. We imaged breasts with two commonly used pulse sequences, fat-suppression and non-fat-suppression, and calculated their densities with an MRI-based method developed previously by our lab. We found that their densities are highly correlated and that fat-saturated images tend to have stronger relative tissue contrast.

15:00 4549. Correction of Skin Volume in the Breast Density Measured by MRI

Ke Nie1, Daniel Chang1, Jeon-Hor Chen1,2, Tzh-Ching Shih1,2, Chieh-Chih Hsu2, Orhan Nalcioglu1, Min-Ying Lydia Su1

1Tu & Yuen Center for Functional Onco-Imaging, University of California, Irvine, Irvine, CA, United States; 2Department of Radiology, China Medical University, Taichung, Taiwan

There is a great interest to correlate between the density measured on MRI and mammogram, so the established role for mammographic density may be extended to MRI-based density. One problem specific to volumetric MRI analysis is the inclusion of skin as the dense tissue. In contrast this effect could be ignored on projection mammogram. In this study, we investigated the correlation between the volume of the skin and the breast on 3D MRI. We further provided two correction models aiming to provide an estimation of the skin volume and its effect on MRI based density measurement.

Breast MR

Hall B Monday 14:00-16:00 Computer 91

14:00 4550. Contrast-Enhanced 1.5-T MR Imaging of the Breast: Association Between Asymmetric Increase of Whole Breast Vascularity and Ipsilateral Cancer on a Series of 384 Studies

Luca Alessandro Carbonaro1, Nicola Verardi, Henrida Kule, Giovanni Di Leo, Francesco Sardanelli1

1Unit of Radiology, Università degli Studi di Milano, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy

We estimated the value of the breast vascular map asymmetry (BVMA) as a marker of ipsilateral tumors. Three-hundred-eighty-four patients underwent a dynamic study. We looked for BVMA. Pathologic examination or follow-up served as a reference standard. Pathology revealed 173 malignant lesions and 211 benign lesions. BVMA showed high diagnostic performance. Sensitivity was 76% for invasive cancers and 39% for in-situ cancers (P ................
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