"PROJECT SUMMARY/ABSTRACT Dynamic contrast enhanced (DCE) MRI is the most sensitive imaging technique for detecting breast cancer. Unfortunately, breast DCE MRI is primarily recommended in patients at high risk for breast cancer. As a result, relatively few women benefit from breast MRI. Shortening MR breast imaging protocols is a key requirement to reduce cost and improve patient access to this powerful imaging tool for the detection of breast cancer. Our ultimate goal is to increase patient access to screening breast MRI by creating a single abbreviated imaging sequence. To achieve such an objective, two main barriers need to be overcome. First, the technical challenges must be surmounted to image both breasts with sub-millimeter spatial and 10 s or less temporal resolution. Second, the current methodology requires a long scan session to analyze the entire contrast enhancement profiles of breast tissue and potential lesions. We propose a new technology for breast imaging that learns and models temporal behaviors through a local low rank (LLR) constraint that differs from previous approaches in iterative image reconstruction. As a result, we will create an imaging method that will deliver simultaneously higher spatial and temporal resolution than any other previous methods and a robust technology whose performance will not depend on lesion size, morphology or heterogeneity. The second challenge to shorten exam times will be addressed by adopting an early enhancement phase approach inspire by Dr. Kuhl's exiting work in which we assume that the "loss" of the delayed dynamic contrast enhancement pattern through abbreviating a full protocol could possibly be balanced by detailed evaluation of the initial enhancement phase, potential providing similar or more valuable information than the current methodology with a much shorter scan time. We propose to create an ultra-fast (10 s) volumetric bilateral breast MRI exam with 0.8 mm isotropic resolution, surpassing today's standard clinical resolution while providing temporal resolutions three-to-six fold faster. By simultaneously providing high spatial and temporal information of the brief but important early enhancement phase, we will provide clinicians and researchers with the capability to extract all the diagnostic and lesion characterization data possible out of the early enhancement phase. The goal for this project is to develop (aim 1 & 2.1) and demonstrate the feasibility of a high performance sequence for abbreviated breast MRI. Though numerous accelerated methods have been proposed earlier, very little validation of the information they derive has been generated due to the complexity of testing reconstruction methods and lesion-dependent imaging performance without a reference standard for comparison. We will validate the effectiveness of the method to create high temporal fidelity in a digital phantom (aim 2.2) and demonstrate the feasibility of our proposed approach with 10 clinical subjects (aim 3). We anticipate that this new technology could be expanded to study the heterogeneity of tumor response during therapy, assess tumor biology, and ultimately predict prognosis and survival. However, we will first showcase it in a breast screening application, where we believe it can benefit a greater number of women in a shorter time frame." |