Non-contrast MRI Breast Cancer Screening
Creators: name: University Of California Office Of The President
Publisher: name: University of California Office of the President
publisherIdentifier: https://ror.org/00dmfq477
publisherIdentifierScheme: ROR
Year: 2025

description: Women at high risk for breast cancer are screened annually with breast MRI. MRI is the most sensitive imaging technique for breast cancer detection. However, there are several challenges and concerns involved with MRI screening for breast cancer. MRI screening involves the injection of a contrast agent, and there is a concern that long-term exposure to the contrast agent can have unforeseen side effects. This is especially a concern for high risk women who begin screening at an early age, and then annually thereafter. Contrast also has limited ability to convey diagnostic information about certain types of lesions. These lesions, called non-mass enhancing lesions, make up a significant proportion of cancers diagnosed in women. Additionally, MRI screening with contrast can be so sensitive that it may lead to many biopsies with benign outcomes. This leads to a high number of unnecessary biopsies and stress for the patient. Due to these concerns, researchers are developing new MRI screening techniques, some of which are based on identifying a concerning lesion more accurately without the need to inject contrast, specifically by evaluating the motion of water within cancer cells. This non-contrast approach is called diffusion imaging. To date, these methods have had their own challenges and are used in conjunction with, but not instead of, contrast enhanced MRI screening. We have developed a non-contrast MRI diffusion technique, called Restriction Spectrum Imaging (RSI), that potentially improves upon prior non-contrast techniques and may serve as a comprehensive method to accurately identify concerning lesions without the need for intravenous contrast. We propose that Restriction Spectrum Imaging may improve upon prior non-contrast diffusion techniques due to its ability to more specifically detect cancer cells as demonstrated in prior brain and prostate applications. In preliminary studies, we have also demonstrated this technique is equivalent to contrast enhanced MRI in evaluating response to chemotherapy in breast cancers. We hypothesize that this technique may be superior to standard diffusion non-contrast imaging on MRI, and adapted as a screening protocol for women at high risk for breast cancer. The question(s) or central hypotheses of the research: Goal: Determine an optimal non-contrast MRI protocol for detecting breast cancer for women at high risk for the disease. Hypothesis: Restriction Spectrum Imaging (non-contrast technique) will detect breast cancers as well as standard contrast enhanced MRI. The general methodology: Initial development will be performed in a cohort of 60 women, where half the patients will have benign findings and half the patients will have malignant lesions. This cohort will be used for methodology and protocol development in tuning the RSI-MRI technique for breast cancer detection. After the initial protocol is developed on patients with biopsy proven benign or malignant lesions, the protocol will be applied to a cohort of 125 women at high risk for breast cancer. This will allow for initial evaluation of RSI in a high-risk screening population. Innovative elements of the project and potential impact: The project will develop a non-contrast MRI technique for breast cancer screening that will increase specificity of MRI for breast cancer, eliminate unknown risks of repeated MRI contrast delivery and unknown consequences of Gadolinium depositing in the brain, and decrease costs of screening breast MRI.