Screening And Future Enhanced MRI

Introduction

SAFE-MRI aims to prevent needless mortality from breast cancer by optimizing the use and performance of dedicated breast MRI.

Objectives

First, SAFE-MRI aims at detecting breast cancer early in women that are currently deemed too young for population screening (age 45-50). Early diagnosis of breast cancer in these women will lead to a large gain in DALYs averted.

Screening Study

I will initiate a prospective screening study inviting women to a one-time only abbreviated breast MRI at the age of 45. The primary outcome will be the cancer detection rate per 1000 women actually screened. This will validate abbreviated breast MRI as a standalone screening technique.

Data Collection

Psycho-social and risk information will be collected from all participants. Cost-effectiveness modeling will be included. A 5-year follow-up will be performed in all women up to, and including, the first screening round at the age of 50.

Improvement of Breast MRI

Second, SAFE-MRI aims at improving breast MRI by reducing the need for contrast administration. This is a major downside of breast MRI for women (IV-cannulation and a small risk of allergic reactions) and the environment (pollution of surface water).

Enhanced Signal Changes

First, I aim to enhance signal changes using a strongly reduced dose of contrast with advanced deep learning (DL).

Unenhanced MRI Studies

Further studies are tailored at the assessment of unenhanced MRI. Particularly, I will validate novel diffusion weighted imaging (DWI) sequences capable of generating high-resolution diagnostic images within short scan times using DL-based reconstruction.

ASL Imaging Strategies

Furthermore, I will investigate arterial spin labeling (ASL) based breast imaging strategies that show perfusion without the need for contrast administration.

Synthetic Breast MRI Images

Finally, we will combine unenhanced MRI techniques in a generative adversarial network to construct synthetic breast MRI images. Repeated reader studies will be conducted to assess image quality and diagnostic value.

Conclusion

SAFE-MRI will thus consolidate my leading role in breast imaging and enable me to design the breast screening of the future.