Magnetic resonance properties of ex vivo breast tissue at 1.5 T

High wavenumber Raman spectroscopy for intraoperative assessment of breast tumour margins

Optimal oncological results and patient outcomes are achieved in surgery for early breast cancer with breast conserving surgery (BCS) where this is appropriate. A limitation of BCS occurs when cancer is present at, or close, to the resection margin - termed a 'positive' margin - and re-excision is recommended to reduce recurrence rate. This is occurs in 17% of BCS in the UK and there is therefore a critical need for a way to assess margin status intraoperatively to ensure complete excision with adequate margins at the first operation. This study presents the potential of high wavenumber (HWN) Raman spectroscopy to address this. Freshly excised specimens from thirty patients undergoing surgery for breast cancer were measured using a surface Raman probe, and a multivariate classification model to predict normal versus tumour was developed from the data. This model achieved 77.1% sensitivity and 90.8% specificity following leave one patient out cross validation, with the defining features being differences in water content and lipid versus protein content. This demonstrates the feasibility of HWN Raman spectroscopy to facilitate future intraoperative margin assessment at specific locations. Clinical utility of the approach will require further research.

Pubertal mammary gland development is a key determinant of adult mammographic density

Mammographic density refers to the radiological appearance of fibroglandular and adipose tissue on a mammogram of the breast. Women with relatively high mammographic density for their age and body mass index are at significantly higher risk for breast cancer. The association between mammographic density and breast cancer risk is well-established, however the molecular and cellular events that lead to the development of high mammographic density are yet to be elucidated. Puberty is a critical time for breast development, where endocrine and paracrine signalling drive development of the mammary gland epithelium, stroma, and adipose tissue. As the relative abundance of these cell types determines the radiological appearance of the adult breast, puberty should be considered as a key developmental stage in the establishment of mammographic density. Epidemiological studies have pointed to the significance of pubertal adipose tissue deposition, as well as timing of menarche and thelarche, on adult mammographic density and breast cancer risk. Activation of hypothalamic-pituitary axes during puberty combined with genetic and epigenetic molecular determinants, together with stromal fibroblasts, extracellular matrix, and immune signalling factors in the mammary gland, act in concert to drive breast development and the relative abundance of different cell types in the adult breast. Here, we discuss the key cellular and molecular mechanisms through which pubertal mammary gland development may affect adult mammographic density and cancer risk.

The origins of breast cancer associated with mammographic density: a testable biological hypothesis

Background

Our purpose is to develop a testable biological hypothesis to explain the known increased risk of breast cancer associated with extensive percent mammographic density (PMD), and to reconcile the apparent paradox that although PMD decreases with increasing age, breast cancer incidence increases.

Methods

We used the Moolgavkar model of carcinogenesis as a framework to examine the known biological properties of the breast tissue components associated with PMD that includes epithelium and stroma, in relation to the development of breast cancer. In this model, normal epithelial cells undergo a mutation to become intermediate cells, which, after further mutation, become malignant cells. A clone of such cells grows to become a tumor. The model also incorporates changes with age in the number of susceptible epithelial cells associated with menarche, parity, and menopause. We used measurements of the radiological properties of breast tissue in 4454 healthy subjects aged from 15 to 80+ years to estimate cumulative exposure to PMD (CBD) in the population, and we examined the association of CBD with the age-incidence curve of breast cancer in the population.

Results

Extensive PMD is associated with a greater number of breast epithelial cells, lobules, and fibroblasts, and greater amounts of collagen and extracellular matrix. The known biological properties of these tissue components may, singly or in combination, promote the acquisition of mutations by breast epithelial cells specified by the Moolgavkar model, and the subsequent growth of a clone of malignant cells to form a tumor. We also show that estimated CBD in the population from ages 15 to 80+ years is closely associated with the age-incidence curve of breast cancer in the population.

Conclusions

These findings are consistent with the hypothesis that the biological properties of the breast tissue components associated with PMD increase the probability of the transition of normal epithelium to malignant cells, and that the accumulation of mutations with CBD may influence the age-incidence curve of breast cancer. This hypothesis gives rise to several testable predictions.

Electronic supplementary material

The online version of this article (10.1186/s13058-018-0941-y) contains supplementary material, which is available to authorized users.

Ultrasound Tomography Evaluation of Breast Density: A Comparison With Noncontrast Magnetic Resonance Imaging

OBJECTIVES

Ultrasound tomography (UST) is an emerging whole-breast 3-dimensional imaging technique that obtains quantitative tomograms of speed of sound of the entire breast. The imaged parameter is the speed of sound which is used as a surrogate measure of density at each voxel and holds promise as a method to evaluate breast density without ionizing radiation. This study evaluated the technique of UST and compared whole-breast volume averaged speed of sound (VASS) with MR percent water content from noncontrast magnetic resonance imaging (MRI).

MATERIALS AND METHODS

Forty-three healthy female volunteers (median age, 40 years; range, 29-59 years) underwent bilateral breast UST and MRI using a 2-point Dixon technique. Reproducibility of VASS was evaluated using Bland-Altman analysis. Volume averaged speed of sound and MR percent water were evaluated and compared using Pearson correlation coefficient.

RESULTS

The mean ± standard deviation VASS measurement was 1463 ± 29 m s (range, 1434-1542 m s). There was high similarity between right (1464 ± 30 m s) and left (1462 ± 28 m s) breasts (P = 0.113) (intraclass correlation coefficient, 0.98). Mean MR percent water content was 35.7% ± 14.7% (range, 13.2%-75.3%), with small but significant differences between right and left breasts (36.3% ± 14.9% and 35.1% ± 14.7%, respectively; P = 0.004). There was a very strong correlation between VASS and MR percent water density (r = 0.96, P < 0.0001).

CONCLUSIONS

Ultrasound tomography holds promise as a reliable and reproducible 3-dimensional technique to provide a surrogate measure of breast density and correlates strongly with MR percent water content.

Associations of Serum Levels of Sex Hormones in Follicular and Luteal Phases of the Menstrual Cycle with Breast Tissue Characteristics in Young Women

Background

In previous work in young women aged 15–30 years we measured breast water and fat using MR and obtained blood for hormone assays on the same day in the follicular phase of the menstrual cycle. Only serum growth hormone levels and sex hormone binding globulin (SHBG) were significantly associated with percent breast water after adjustment for covariates. The sex hormones estradiol, progesterone and testosterone were not associated with percent water in the breast in the follicular phase of the menstrual cycle. In the present study we have examined the association of percent breast water with serum levels of sex hormones in both follicular and luteal phase of the menstrual cycle.

Methods

In 315 healthy white Caucasian young women aged 15–30 with regular menstrual cycles who had not used oral contraceptives or other hormones in the previous 6 months, we used MR to determine percent breast water, and obtained blood samples for hormone assays within 10 days of the onset of the most recent menstrual cycle (follicular phase) of the cycle on the same day as the MR scan, and a second blood sample on days 19–24 of the cycle. Serum progesterone levels of > = 5 mmol/L in days 19–24 were used to define the 225 subjects with ovulatory menstrual cycles, whose data are the subject of the analyses shown here.

Results

SHBG was positively associated with percent water in both follicular and luteal phases of the menstrual cycle. Total and free estradiol and total and free testosterone were not associated with percent water in the follicular phase, but in young women with ovulatory cycles, were all negatively associated with percent water in the luteal phase.

Conclusions

Our results from young women aged 15–30 years add to the evidence that the extent of fibroglandular tissue in the breast that is reflected in both mammographic density and breast water is associated positively with higher serum levels of SHBG, but not with higher levels of sex hormones.

Characterization of tumor and adjacent peritumoral stroma in patients with breast cancer using high-resolution diffusion-weighted imaging: Correlation with pathologic biomarkers

PURPOSE

To assess whether ADC values of tumor and peritumoral stroma (PS) obtained on high-resolution diffusion-weighted imaging (HR DWI) were different according to pathologic biomarkers in patients with breast cancer.

METHODS

We retrospectively enrolled 96 patients (age range, 30-75 years; mean, 52 years) with breast cancer who underwent HR DWI at 3T MR scanner. We obtained the apparent diffusion coefficient (ADC) and ADC range of tumor and PS by drawing the region of interest (ROI) of entire tumor. We assessed histopathological features of tumors. ADC values of tumor and PS were compared according to pathologic biomarkers using student t-test and Mann-Whitney U test.

RESULTS

Mean ADC of tumor boundary was significantly higher in ER-negative tumors than in ER-positive tumors (P=0.005). The ADC ranges of tumor boundary and proximal PS were significantly higher in tumors with high nuclear grade, negative ER, positive HER2, positive Ki67, and lymph node metastasis than those with low nuclear grade, positive ER, negative HER2, negative Ki67, and without lymph node metastasis (P<0.05 for all). ADC range of tumor boundary and proximal PS was significantly lower in low risk tumor than in the others (P=0.004 and 0.002). Mean ADC of whole tumor was significantly higher in low-risk tumor than in non-low-risk tumor (P=0.030).

CONCLUSION

On HR DWI, ADC ranges of tumor boundary and adjacent proximal PS were significantly lower in low-risk tumor than in non-low-risk tumors.

Diffusion-weighted magnetic resonance imaging in cancer: Reported apparent diffusion coefficients, in-vitro and in-vivo reproducibility

There is considerable disparity in the published apparent diffusion coefficient (ADC) values across different anatomies. Institutions are increasingly assessing repeatability and reproducibility of the derived ADC to determine its variation, which could potentially be used as an indicator in determining tumour aggressiveness or assessing tumour response. In this manuscript, a review of selected articles published to date in healthy extra-cranial body diffusion-weighted magnetic resonance imaging is presented, detailing reported ADC values and discussing their variation across different studies. In total 115 studies were selected including 28 for liver parenchyma, 15 for kidney (renal parenchyma), 14 for spleen, 13 for pancreatic body, 6 for gallbladder, 13 for prostate, 13 for uterus (endometrium, myometrium, cervix) and 13 for fibroglandular breast tissue. Median ADC values in selected studies were found to be 1.28 × 10(-3) mm(2)/s in liver, 1.94 × 10(-3) mm(2)/s in kidney, 1.60 × 10(-3) mm(2)/s in pancreatic body, 0.85 × 10(-3) mm(2)/s in spleen, 2.73 × 10(-3) mm(2)/s in gallbladder, 1.64 × 10(-3) mm(2)/s and 1.31 × 10(-3) mm(2)/s in prostate peripheral zone and central gland respectively (combined median value of 1.54×10(-3) mm(2)/s), 1.44 × 10(-3) mm(2)/s in endometrium, 1.53 × 10(-3) mm(2)/s in myometrium, 1.71 × 10(-3) mm(2)/s in cervix and 1.92 × 10(-3) mm(2)/s in breast. In addition, six phantom studies and thirteen in vivo studies were summarized to compare repeatability and reproducibility of the measured ADC. All selected phantom studies demonstrated lower intra-scanner and inter-scanner variation compared to in vivo studies. Based on the findings of this manuscript, it is recommended that protocols need to be optimised for the body part studied and that system-induced variability must be established using a standardized phantom in any clinical study. Reproducibility of the measured ADC must also be assessed in a volunteer population, as variations are far more significant in vivo compared with phantom studies.

Imaging Breast Density: Established and Emerging Modalities

Mammographic density has been proven as an independent risk factor for breast cancer. Women with dense breast tissue visible on a mammogram have a much higher cancer risk than women with little density. A great research effort has been devoted to incorporate breast density into risk prediction models to better estimate each individual’s cancer risk. In recent years, the passage of breast density notification legislation in many states in USA requires that every mammography report should provide information regarding the patient’s breast density. Accurate definition and measurement of breast density are thus important, which may allow all the potential clinical applications of breast density to be implemented. Because the two-dimensional mammography-based measurement is subject to tissue overlapping and thus not able to provide volumetric information, there is an urgent need to develop reliable quantitative measurements of breast density. Various new imaging technologies are being developed. Among these new modalities, volumetric mammographic density methods and three-dimensional magnetic resonance imaging are the most well studied. Besides, emerging modalities, including different x-ray–based, optical imaging, and ultrasound-based methods, have also been investigated. All these modalities may either overcome some fundamental problems related to mammographic density or provide additional density and/or compositional information. The present review article aimed to summarize the current established and emerging imaging techniques for the measurement of breast density and the evidence of the clinical use of these density methods from the literature.

B1 and T1 mapping of the breast with a reference tissue method

PURPOSE

To develop a method for mapping the B1 field using a reference signal from a tissue with known T1.

METHODS

Flip angle correction factors were calculated in a region with a known "gold standard" T1; by comparing T1 values from a variable flip angle (VFA) sequence to the "gold standard" and correcting the value of the Ernst angle. The resulting partial B1 map was interpolated for all other regions. In the breast, fat is an ideal reference tissue because its T1 is spatially homogeneous and interpatient variability is low. This method was tested with scans of phantoms and patients (n = 4) on a 3T magnet. The performance of the method was evaluated by comparing the results of VFA T1 mapping with and without B1 correction to inversion recovery (IR) T1 maps.

RESULTS

Phantom data determined that a linear inverse distance weighted interpolation accurately recovered the full B1 map. Use of interpolated maps to correct the VFA data in vivo, reduced the average difference in the T1 of parenchyma between VFA and IR results from 58% to 8%.

CONCLUSION

This proof-of-principle study showed that it is possible to recover a full and accurate map of the B1 field in the breast by using a reference tissue (fat) with an accurately measured T1.

Mechanical stability analysis of carrageenan-based polymer gel for magnetic resonance imaging liver phantom with lesion particles

Medical imaging is an effective technique used to detect and prevent disease in cancer research. To optimize medical imaging, a calibration medium or phantom with tissue-mimicking properties is required. Although the feasibility of various polymer gel materials has previously been studied, the stability of the gels' properties has not been investigated. In this study, we fabricated carrageenan-based polymer gel to examine the stability of its properties such as density, conductivity, permittivity, elastic modulus, and [Formula: see text] and [Formula: see text] relaxation times over six weeks. We fabricated eight samples with different carrageenan and agar concentrations and found that the density, elastic modulus, and compressive strength fluctuated with no specific pattern. The elastic modulus in sample 4 with 3 wt. % carrageenan and 1.5 wt. % agar fluctuated from 0.51 to 0.64 MPa in five weeks. The [Formula: see text] and [Formula: see text] relaxation times also varied by 23% to 29%. We believe that the fluctuation of these properties is related to the change in water content of the sample due to cycles of water expulsion and absorption in their containers. The fluctuation of the properties should be minimized to achieve accurate calibration over the shelf life of the phantom and to serve as the standard for quality assurance. Furthermore, a full liver phantom with spherical lesion particles was fabricated to demonstrate the potential for phantom production.

Bilateral symmetry of breast tissue composition by magnetic resonance in young women and adults

BACKGROUND

Some reports suggest that there is a slightly higher frequency of breast cancer in the left breast compared with the right in middle-aged women. The reasons for this association are unknown. The water and fat content of both breasts was compared using magnetic resonance (MR). Breast water by MR reflects fibro-glandular tissue and is strongly positively correlated with percent mammographic density, a strong risk factor for breast cancer.

METHODS

Magnetic resonance was used to measure fat and water content of the breast in 400 young women aged 15-30 years and a random sample of 100 of their mothers. All MR examinations were carried out using a 1.5T MR system, and 45 contiguous slices were obtained in the sagittal plane. One reader identified the breast tissue in the image, and subsequently, fat and water content was calculated using a three-point Dixon technique. Left- and right-sided images were read independently in random order.

RESULTS

In young women, mean percent water was on average 0.84 % higher in the right compared with the left breast (p < 0.001) and total breast water was on average 6.42 cm(3) greater on the right side (p < 0.001). In mothers, there were no significant differences in any breast measure between right and left sides.

CONCLUSION

The small differences in breast tissue composition in young women are unlikely to be associated with large differences in breast cancer risk between sides. The reported excess of left-sided breast cancer in older women is unlikely to be explained by differences in breast tissue composition.

Breast density measurements with ultrasound tomography: a comparison with film and digital mammography

PURPOSE

To investigate the use of the whole-breast sound speed measurement as a marker of breast density (BD), a known risk factor for breast cancer.

METHODS

As part of an ongoing study of breast cancer detection, 249 patients were scanned with a clinical prototype that operates on the principles of ultrasound tomography. Typically, 40-100 sound speed tomograms were reconstructed from the scan data, corresponding to the entire volume of the breast of each patient. The data were used to estimate the volume averaged sound speed (VASS) of the breast for each patient. The corresponding mammograms were used to calculate mammographic percent density (MPD) using CUMULUS software. Film mammograms were available for 164 patients while 85 digital mammograms were available for the remaining patients. Standard statistical techniques were used to determine associations of breast sound speed with a variety of mammographic measures such as percent density, area of dense tissue, and area of nondense tissue. Furthermore, associations of breast sound speed with continuous variables such as age and weight and dichotomous variables such as parity and menopausal status were also assessed.

RESULTS

VASS was found to be significantly associated with MPD. The Spearman correlation coefficient (r(s)) between VASS and MPD was found to be 0.77 and 0.71 for film and digital mammography, respectively. VASS was positively correlated with dense areas by mammography, both digital (r(s) = 0.46) and film (r(s) = 0.56). VASS was negatively associated with nondense area by mammography, both digital (r(s) = -0.58) and film (r(s) = -0.63). BD by all methods was less in postmenopausal than in premenopausal women. The MPD was lower in the postmenopausal group (by 6.6%, p < 0.08, for the digital group and 7.73%, p < 0.007, for the film group). The VASS was also lower in the postmenopausal group (by 15 m∕s, p < 0.001 for the digital group and 8 m∕s, p < 0.08, for the film group). The association of MPD with age was characterized with r(s) = -0.06 (p < 0.6) for digital mammography and r(s) = -0.53 (p < 0.002) for film mammography. For weight, the MPD associations were characterized by r(s) = -0.53 (p < 0.0001) for digital mammography and -0.38 (p < 0.0001) for film mammography. The association of VASS with age was r(s) = -0.33 (p < 0.002) for the digital group and -0.17 (p < 0.03) for the film group. For weight, the relationship was characterized with r(s) = -0.45 (p < 0.001) for the digital group and -0.37 (p < 0.0001) for the film group.

CONCLUSIONS

The association between VASS and MPD is strong for both film and digital mammography, suggesting that VASS is a viable measure of breast density. This result sets the stage for future work that will focus on directly testing the association of VASS with breast cancer risk.

Quantitative mapping of total choline in healthy human breast using proton echo planar spectroscopic imaging (PEPSI) at 3 Tesla

PURPOSE

To quantitatively measure tCho levels in healthy breasts using Proton-Echo-Planar-Spectroscopic-Imaging (PEPSI).

MATERIALS AND METHODS

The two-dimensional mapping of tCho at 3 Tesla across an entire breast slice using PEPSI and a hybrid spectral quantification method based on LCModel fitting and integration of tCho using the fitted spectrum were developed. This method was validated in 19 healthy females and compared with single voxel spectroscopy (SVS) and with PRESS prelocalized conventional Magnetic Resonance Spectroscopic Imaging (MRSI) using identical voxel size (8 cc) and similar scan times (∼7 min).

RESULTS

A tCho peak with a signal to noise ratio larger than 2 was detected in 10 subjects using both PEPSI and SVS. The average tCho concentration in these subjects was 0.45 ± 0.2 mmol/kg using PEPSI and 0.48 ± 0.3 mmol/kg using SVS. Comparable results were obtained in two subjects using conventional MRSI. High lipid content in the spectra of nine tCho negative subjects was associated with spectral line broadening of more than 26 Hz, which made tCho detection impossible. Conventional MRSI with PRESS prelocalization in glandular tissue in two of these subjects yielded tCho concentrations comparable to PEPSI.

CONCLUSION

The detection sensitivity of PEPSI is comparable to SVS and conventional PRESS-MRSI. PEPSI can be potentially used in the evaluation of tCho in breast cancer. A tCho threshold concentration value of ∼0.7 mmol/kg might be used to differentiate between cancerous and healthy (or benign) breast tissues based on this work and previous studies.

An anthropomorphic phantom for quantitative evaluation of breast MRI

PURPOSE

In this study, the authors aim to develop a physical, tissue-mimicking phantom for quantitative evaluation of breast MRI protocols. The objective of this phantom is to address the need for improved standardization in breast MRI and provide a platform for evaluating the influence of image protocol parameters on lesion detection and discrimination. Quantitative comparisons between patient and phantom image properties are presented.

METHODS

The phantom is constructed using a mixture of lard and egg whites, resulting in a random structure with separate adipose- and glandular-mimicking components. T1 and T2 relaxation times of the lard and egg components of the phantom were estimated at 1.5 T from inversion recovery and spin-echo scans, respectively, using maximum-likelihood methods. The image structure was examined quantitatively by calculating and comparing spatial covariance matrices of phantom and patient images. A static, enhancing lesion was introduced by creating a hollow mold with stereolithography and filling it with a gadolinium-doped water solution.

RESULTS

Measured phantom relaxation values fall within 2 standard errors of human values from the literature and are reasonably stable over 9 months of testing. Comparison of the covariance matrices of phantom and patient data demonstrates that the phantom and patient data have similar image structure. Their covariance matrices are the same to within error bars in the anterior-posterior direction and to within about two error bars in the right-left direction. The signal from the phantom's adipose-mimicking material can be suppressed using active fat-suppression protocols. A static, enhancing lesion can also be included with the ability to change morphology and contrast agent concentration.

CONCLUSIONS

The authors have constructed a phantom and demonstrated its ability to mimic human breast images in terms of key physical properties that are relevant to breast MRI. This phantom provides a platform for the optimization and standardization of breast MRI imaging protocols for lesion detection and characterization.

Effects of frozen storage and sample temperature on water compartmentation and multiexponential transverse relaxation in cartilage

Multiexponential transverse relaxation in tissue has been interpreted as a marker of water compartmentation. Articular cartilage has been reported to exhibit such relaxation in several studies, with the relative contributions of tissue heterogeneity and tissue microstructure remaining unspecified. In bovine nasal cartilage, conflicting data regarding the existence of multiexponential relaxation have been reported. Imaging and analysis artifacts as well as rapid chemical exchange between tissue compartments have been identified as potential causes for this discrepancy. Here, we find that disruption of cartilage microstructure by freeze-thawing can greatly alter the character of transverse relaxation in this tissue. We conclude that fresh cartilage exhibits multiexponential relaxation based upon its microstructural water compartments, but that multiexponentiality can be lost or rendered undetectable by freeze-thawing. In addition, we find that increasing chemical exchange by raising sample temperature from 4°C to 37°C does not substantially limit the ability to detect multiexponential relaxation.

Mapping proteoglycan-bound water in cartilage: Improved specificity of matrix assessment using multiexponential transverse relaxation analysis

Association of MR parameters with cartilage matrix components remains an area of ongoing investigation. Multiexponential analysis of nonlocalized transverse relaxation data has previously been used to quantify water compartments associated with matrix macromolecules in cartilage. We extend this to mapping the proteoglycan (PG)-bound water fraction in cartilage, using mature and young bovine nasal cartilage model systems, toward the goal of matrix component-specific imaging. PG-bound water fraction from mature and young bovine nasal cartilage was 0.31 ± 0.04 and 0.22 ± 0.06, respectively, in agreement with biochemically derived PG content and PG-to-water weight ratios. Fourier transform infrared imaging spectroscopic-derived PG maps normalized by water content (IR-PG(ww) ) showed spatial correspondence with PG-bound water fraction maps. Extensive simulation analysis demonstrated that the accuracy and precision of our determination of PG-bound water fraction was within 2%, which is well-within the observed tissue differences. Our results demonstrate the feasibility of performing imaging-based multiexponential analysis of transverse relaxation data to map PG in cartilage.

Breast tissue composition and susceptibility to breast cancer

Breast density, as assessed by mammography, reflects breast tissue composition. Breast epithelium and stroma attenuate x-rays more than fat and thus appear light on mammograms while fat appears dark. In this review, we provide an overview of selected areas of current knowledge about the relationship between breast density and susceptibility to breast cancer. We review the evidence that breast density is a risk factor for breast cancer, the histological and other risk factors that are associated with variations in breast density, and the biological plausibility of the associations with risk of breast cancer. We also discuss the potential for improved risk prediction that might be achieved by using alternative breast imaging methods, such as magnetic resonance or ultrasound. After adjustment for other risk factors, breast density is consistently associated with breast cancer risk, more strongly than most other risk factors for this disease, and extensive breast density may account for a substantial fraction of breast cancer. Breast density is associated with risk of all of the proliferative lesions that are thought to be precursors of breast cancer. Studies of twins have shown that breast density is a highly heritable quantitative trait. Associations between breast density and variations in breast histology, risk of proliferative breast lesions, and risk of breast cancer may be the result of exposures of breast tissue to both mitogens and mutagens. Characterization of breast density by mammography has several limitations, and the uses of breast density in risk prediction and breast cancer prevention may be improved by other methods of imaging, such as magnetic resonance or ultrasound tomography.

Diffusion-weighted imaging of normal fibroglandular breast tissue: influence of microperfusion and fat suppression technique on the apparent diffusion coefficient

The influence of microperfusion and fat suppression technique on the apparent diffusion coefficient (ADC) values obtained with diffusion weighted imaging (DWI) of normal fibroglandular breast tissue was investigated. Seven volunteers (14 breasts) were scanned using diffusion weighting factors (b values) up to 1600 s/mm(2) and the four different fat suppression techniques: STIR, fat saturation, SPAIR, and Water Excitation. The relationship between the logarithmic DW attenuation curves and b was linear for b values up to 600 s/mm(2) (R(2) > 0.999). Small differences were noted between the ADC values obtained with the various fat suppression methods, especially at the higher b values. Water Excitation had the highest mean SNR, exceeding STIR (p = 0.03) though not significantly different from fat saturation and SPAIR. In conclusion, the ADC of fibroglandular breast tissue is not influenced by microperfusion and Water Excitation is recommended because it yielded the best SNR values. These factors may be crucial in the differentiation between benign and malignant lesions.

Quantitative multivoxel proton chemical shift imaging of the breast

The study of focal pathology by single-voxel magnetic resonance spectroscopy (MRS) is hampered by the impossibility to study tissue heterogeneity or compare the metabolite signals in breast lesion directly to those in unaffected tissue. Multivoxel MRS studies, while potentially allowing for truly quantitative tissue characterization, have up to now also been far from quantitative with, for example, the signal-to-noise ratio of the choline (Cho) signal serving as measure of tumor activity. Shown in this study is that in a standard clinical setting with a regular 1.5-T magnetic resonance scanner, it is possible to perform quantitative multivoxel MRS. With the use of literature values for the T1 and T2 relaxation times of Cho and water in fibroglandular breast tissue and tumors, one can determine the concentrations of Cho in different tumor compartments and surrounding tissues in two brief multivoxel MRS measurements. This opens excellent perspectives to quantitative diagnostic and follow-up studies of focal pathology such as lesions suspected of breast cancer.

Multicomponent T2 relaxation analysis in cartilage

MR techniques are sensitive to the early stages of osteoarthritis, characterized by disruption of collagen and loss of proteoglycan (PG), but are of limited specificity. Here, water compartments in normal and trypsin-degraded bovine nasal cartilage were identified using a nonnegative least squares multiexponential analysis of T(2) relaxation. Three components were detected: T(2,1)=2.3 ms, T(2,2)=25.2 ms, and T(2,3)=96.3 ms, with fractions w(1)=6.2%, w(2)=14.5%, and w(3)=79.3%, respectively. Trypsinization resulted in increased (P<0.01) values of T(2,2)=64.2 ms and T(2,3)=149.4 ms, supporting their assignment to water compartments that are bound and loosely associated with PG, respectively. The T(2) of the rapidly relaxing component was not altered by digestion, supporting assignment to relatively immobile collagen-bound water. Relaxation data were simulated for a range of TE, number of echoes, and SNR to guide selection of acquisition parameters and assess the accuracy and precision of experimental results. Based on this, the expected experimental accuracy of measured T(2)s and associated weights was within 2% and 4% respectively, with precision within 1% and 3%. These results demonstrate the potential of multiexponential T(2) analysis to increase the specificity of MR characterization of cartilage.

Breast-tissue composition and other risk factors for breast cancer in young women: a cross-sectional study

BACKGROUND

Mammographic density is a heritable quantitative trait and is a strong risk factor for breast cancer in middle-aged and older women. However, little is known about the development of mammographic density in early life. We used MRI to measure the water content of the breast, which provides a measurement of the fibro-glandular content of breast tissue with similar accuracy to mammography, but without the attendant exposure to radiation.

METHODS

Between December, 2003, and December, 2007, we recruited 400 young women, aged 15-30 years, and their mothers. We used MRI scans to measure daughters' breast water and fat, and on the same day obtained blood for hormone assays in the follicular phase of the menstrual cycle for each young woman. Mothers underwent mammography (n=356), and a random sample (n=100) also consented to have a breast MRI scan.

FINDINGS

In mothers, per cent water-as measured by MRI-was strongly correlated with per cent mammographic density (r=0.85). Per cent water in daughters (median 44.8%) was significantly higher than in mothers (median 27.8%; p<0.0001), and was independently inversely associated with both their age (p=0.04) and weight (p<0.0001), and positively associated with their height (p<0.0001) and their mothers' per cent mammographic density (p<0.0001). Serum growth hormone concentrations, adjusted for covariates, were positively associated with per cent breast water (p=0.001) in a subgroup of young women (n=280) who had not used oral contraceptives within 6 months.

INTERPRETATION

Per cent breast water was greatest during the ages when women are most susceptible to breast carcinogens, and was associated with weight, height, and mother's breast-tissue characteristics, and with serum concentrations of growth hormone: a breast mitogen that also mediates postnatal somatic growth. Mammographic density in middle age might partly be the result of genetic factors that affect growth and development in early life.

FUNDING

Canadian Breast Cancer Research Alliance.

Investigation of proton density for measuring tissue temperature

PURPOSE

To examine the temperature dependence of the proton density (PD) in both adipose and muscle tissues, and the application of the PD as a thermometry parameter in breast tissues.

MATERIALS AND METHODS

Porcine fat samples and bovine muscle samples were successively heated to temperatures ranging from 30 degrees C to 76 degrees C and then cooled. They were then imaged with a dual-echo spin-echo sequence. T1 and T2 effects were carefully corrected from the images. The apparent PD (APD) in regions of interest (ROIs) and the sum of the APD in all pixels (Sum_APD) were measured and analyzed by linear regression.

RESULTS

APD in adipose tissue is linear and reversible, and changes with a 0.3%/ degrees C to 0.45%/ degrees C temperature variation. The temperature coefficient of Sum_APD in adipose tissue is approximately 0.29%/ degrees C, as predicted from the Boltzmann distribution. However, the results in muscle tissue are more variable. There is an offset in both APD and Sum_APD between heating and cooling phases, as well as different temperature coefficients between these two phases.

CONCLUSION

The Sum_APD in adipose tissue validates the 1/T dependence on temperature. The APD is a potentially useful parameter for fat thermometry; however, its application in muscle tissue requires further investigation.

Composition of MRI phantom equivalent to human tissues

We previously developed two new MRI phantoms (called the CAG phantom and the CAGN phantom), with T1 and T2 relaxation times equivalent to those of any human tissue at 1.5 T. The conductivity of the CAGN phantom is equivalent to that of most types of human tissue in the frequency range of 1 to 130 MHz. In this paper, the relaxation times of human tissues are summarized, and the composition of the corresponding phantoms are provided in table form. The ingredients of these phantoms are carrageenan as the gelling agent, GdCl3 as a T1 modifier, agarose as a T2 modifier, NaCl (CAGN phantom only) as a conductivity modifier, NaN3 as an antiseptic, and distilled water. The phantoms have T1 values of 202-1904 ms and T2 values of 38-423 ms when the concentrations of GdCl3 and agarose are varied from 0-140 micromol/kg, and 0%-1.6%, respectively, and the CAGN phantom has a conductivity of 0.27-1.26 S/m when the NaCl concentration is varied from 0%-0.7%. These phantoms have sufficient strength to replicate a torso without the use of reinforcing agents, and can be cut by a knife into any shape. We anticipate the CAGN phantom to be highly useful and practical for MRI and hyperthermia-related research.

Estimation of the content of fat and parenchyma in breast tissue using MRI T1 histograms and phantoms

Mammographic breast density has been correlated with breast cancer risk. Estimation of the volumetric composition of breast tissue using three-dimensional MRI has been proposed, but accuracy depends upon the estimation methods employed. The use of segmentation based on T1 relaxation rates allows quantitative estimates of fat and parenchyma volume, but is limited by partial volume effects. An investigation employing phantom breast tissue composed of various combinations of chicken breast (to represent parenchyma) and cooking fats was carried out to elucidate the factors that influence MRI T1 histograms. Using the phantoms, T1 histograms and their known fat and parenchyma composition, a logistic distribution function was derived to describe the apportioning of the T1 histogram to fat and parenchyma. This function and T1 histograms were then used to predict the fat and parenchyma content of breasts from 14 women. Using this method, the composition of the breast tissue in the study population was as follows: fat 69.9+/-22.9% and parenchyma 30.1+/-22.9%.

A continuous-flow perfusion system for the maintenance and NMR study of small tissue samples in vitro

To describe and evaluate a novel perfusion system developed to maintain excised tissue in a flowing, oxygenated bathing solution during acquisition of nuclear magnetic resonance (NMR) data, and in addition allow precise data to be acquired continuously while altering the composition of the bathing solution surrounding the tissue. A chamber to house the tissue sample was constructed of interlocking sections of polyethylene tubing, and had approximate internal dimensions of 4 mm in diameter and 4 mm in height. Temperature-controlled, physiologically appropriate buffer solution was pumped via an infusion pump through the chamber, entering and exiting by way of small openings on either end. Immediately surrounding the polyethylene chamber was a tight-fitting four-loop solenoid RF coil. Measured proton NMR parameters were found to be fairly insensitive to the flow rate of the buffer if this coil was used only for reception and a larger-volume transmit-only coil was used for excitation. Temperature control of the sample was successfully implemented between 25 and 40 degrees C. The perfusion system was found to be resistant to the effects of flow rate, as well as a useful tool for the administration of drugs or agents to the tissue. Changes in buffer composition could be performed on the fly without the need to reposition the sample each time a change was made. This avoidance of repositioning was found to yield a fivefold improvement in the precision of T(2) spectral parameters (using frog sciatic nerve as a sample).

MR imaging relaxation times of abdominal and pelvic tissues measured in vivo at 3.0 T: preliminary results

PURPOSE

To measure T1 and T2 relaxation times of normal human abdominal and pelvic tissues and lumbar vertebral bone marrow at 3.0 T.

MATERIALS AND METHODS

Relaxation time was measured in six healthy volunteers with an inversion-recovery method and different inversion times and a multiple spin-echo (SE) technique with different echo times to measure T1 and T2, respectively. Six images were acquired during one breath hold with a half-Fourier acquisition single-shot fast SE sequence. Signal intensities in regions of interest were fit to theoretical curves. Measurements were performed at 1.5 and 3.0 T. Relaxation times at 1.5 T were compared with those reported in the literature by using a one-sample t test. Differences in mean relaxation time between 1.5 and 3.0 T were analyzed with a two-sample paired t test.

RESULTS

Relaxation times (mean +/- SD) at 3.0 T are reported for kidney cortex (T1, 1,142 msec +/- 154; T2, 76 msec +/- 7), kidney medulla (T1, 1,545 msec +/- 142; T2, 81 msec +/- 8), liver (T1, 809 msec +/- 71; T2, 34 msec +/- 4), spleen (T1, 1,328 msec +/- 31; T2, 61 msec +/- 9), pancreas (T1, 725 msec +/- 71; T2, 43 msec +/- 7), paravertebral muscle (T1, 898 msec +/- 33; T2, 29 msec +/- 4), bone marrow in L4 vertebra (T1, 586 msec +/- 73; T2, 49 msec +/- 4), subcutaneous fat (T1, 382 msec +/- 13; T2, 68 msec +/- 4), prostate (T1, 1,597 msec +/- 42; T2, 74 msec +/- 9), myometrium (T1, 1,514 msec +/- 156; T2, 79 msec +/- 10), endometrium (T1, 1,453 msec +/- 123; T2, 59 msec +/- 1), and cervix (T1, 1,616 msec +/- 61; T2, 83 msec +/- 7). On average, T1 relaxation times were 21% longer (P <.05) for kidney cortex, liver, and spleen and T2 relaxation times were 8% shorter (P <.05) for liver, spleen, and fat at 3.0 T; however, the fractional change in T1 and T2 relaxation times varied greatly with the organ. At 1.5 T, no significant differences (P >.05) in T1 relaxation time between the results of this study and the results of other studies for liver, kidney, spleen, and muscle tissue were found.

CONCLUSION

T1 relaxation times are generally higher and T2 relaxation times are generally lower at 3.0 T than at 1.5 T, but the magnitude of change varies greatly in different tissues.

Analysis of changes in MR properties of tissues after heat treatment

To characterize changes in the MR parameters of tissues due to thermal coagulation, a series of T(1), T(2), diffusion, and magnetization transfer measurements were performed on a variety of ex vivo tissues: murine slow twitch skeletal muscle, murine cardiac muscle, murine cerebral hemisphere, bovine white matter, murine liver tissue, bovine retroperitoneal adipose tissue, hen egg white, human prostate and human blood. Standardized heat treatments were performed for each tissue type, over the temperature range from 37 degrees C to 90 degrees C. For all tissues, changes in each MR measurement resulting from thermal coagulation were observed above a threshold temperature of approximately 60 degrees C. These changes are explained based on biophysical knowledge of thermal damage mechanisms and the MR properties of normal tissues, and are particularly relevant for interpreting the changes in image contrast that are observed when MRI is used to guide and monitor thermal coagulation therapy procedures. Magn Reson Med 42:1061-1071, 1999.