Feasibility of Velocity-Selective Arterial Spin Labeling in Breast Cancer Patients for Noncontrast-Enhanced Perfusion Imaging
Franklin, Suzanne L; Voormolen, Nora; Bones, Isabell K; Korteweg, Tijmen; Wasser, Martin N J M; Dankers, Henrike G; Cohen, Daniele; van Stralen, Marijn; Bos, Clemens; van Osch, Matthias J P
(2021) Journal of Magnetic Resonance Imaging, volume 54, issue 4, pp. 1282 - 1291
(Article)
Abstract
BACKGROUND: Dynamic contrast-enhanced (DCE) MRI is the most sensitive method for detection of breast cancer. However, due to high costs and retention of intravenously injected gadolinium-based contrast agent, screening with DCE-MRI is only recommended for patients who are at high risk for developing breast cancer. Thus, a noncontrast-enhanced alternative to
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DCE is desirable. PURPOSE: To investigate whether velocity selective arterial spin labeling (VS-ASL) can be used to identify increased perfusion and vascularity within breast lesions compared to surrounding tissue. STUDY TYPE: Prospective. POPULATION: Eight breast cancer patients. FIELD STRENGTH/SEQUENCE: A 3 T; VS-ASL with multislice single-shot gradient-echo echo-planar-imaging readout. ASSESSMENT: VS-ASL scans were independently assessed by three radiologists, with 3-25 years of experience in breast radiology. Scans were scored on lesion visibility and artifacts, based on a 3-point Likert scale. A score of 1 corresponded to "lesions being distinguishable from background" (lesion visibility), and "no or few artifacts visible, artifacts can be distinguished from blood signal" (artifact score). A distinction was made between mass and nonmass lesions (based on BI-RADS lexicon), as assessed in the standard clinical exam. STATISTICAL TESTS: Intra-class correlation coefficient (ICC) for interobserver agreement. RESULTS: The ICC was 0.77 for lesion visibility and 0.84 for the artifact score. Overall, mass lesions had a mean score of 1.27 on lesion visibility and 1.53 on the artifact score. Nonmass lesions had a mean score of 2.11 on lesion visibility and 2.11 on the artifact score. DATA CONCLUSION: We have demonstrated the technical feasibility of bilateral whole-breast perfusion imaging using VS-ASL in breast cancer patients. EVIDENCE LEVEL: 1 TECHNICAL EFFICACY: Stage 1.
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Keywords: arterial spin labeling, ASL, breast cancer, DCE-MRI, noncontrast enhanced, screening, Radiology Nuclear Medicine and imaging, Journal Article
ISSN: 1053-1807
Publisher: John Wiley and Sons Inc.
Note: Funding Information: The authors thank MeVis Medical Solutions AG (Bremen, Germany) for providing MeVisLab medical image processing and visualization environment, which was used for image analysis. The authors thank E. M. M. Krol‐Warmerdam, J. van Leeuwen‐Bϋttner, and G.M.C. Ranke for their valuable help in recruitments of patients. This work is part of the research program Drag and Drop ASL with project number 14951, which is (partly) financed by the Netherlands Organization for Scientific Research (NWO). Funding Information: The authors thank MeVis Medical Solutions AG (Bremen, Germany) for providing MeVisLab medical image processing and visualization environment, which was used for image analysis. The authors thank E. M. M. Krol-Warmerdam, J. van Leeuwen-Bϋttner, and G.M.C. Ranke for their valuable help in recruitments of patients. This work is part of the research program Drag and Drop ASL with project number 14951, which is (partly) financed by the Netherlands Organization for Scientific Research (NWO). Publisher Copyright: © 2021 The Authors. Journal of Magnetic Resonance Imaging published by Wiley Periodicals LLC. on behalf of International Society for Magnetic Resonance in Medicine.
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