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Unlocking the rNOE-CEST Contrast for Breast Cancer MRI Using the FATLESS Approach.

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    A new software method, FATLESS, corrects fat artifacts in breast cancer imaging. This allows for accurate measurement of exchange-relayed nuclear Overhauser effect (rNOE) contrast, a biomarker for tumor proliferation.

    Keywords:
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    Area of Science:

    • Biomedical Imaging
    • Magnetic Resonance Imaging
    • Cancer Research

    Background:

    • Quantitative chemical exchange saturation transfer (CEST) breast imaging is hindered by fat artifacts, particularly around -3.5 ppm.
    • These artifacts obscure the exchange-relayed nuclear Overhauser effect (rNOE) signal, a critical biomarker for protein content and cellularity in tumors.
    • Accurate rNOE-CEST evaluation is challenging due to the overlap with fat signals.

    Purpose of the Study:

    • To evaluate rNOE-CEST contrast corrected for fat-related artifacts in breast cancer patients.
    • To assess a novel, software-based fat correction method called FATLESS.
    • To determine if corrected rNOE contrast can serve as a non-invasive biomarker for breast cancer characterization.

    Main Methods:

    • Developed FATLESS (Fat Attenuation Technique using Lipid signal Estimation and Simulated Saturations in postprocessing) for fat artifact correction in CEST MRI.
    • Applied FATLESS retrospectively to 7T CEST data from breast cancer patients.
    • Quantified fat-corrected MTRRex contrast values (rNOE, amide, guanidino) and analyzed correlations with Ki-67.

    Main Results:

    • FATLESS successfully corrected fat artifacts in phantom and in vivo data.
    • Fat-corrected MTRRex rNOE values were significantly higher in tumor regions compared to healthy tissue (+140% mean increase).
    • A strong positive correlation (R² = 0.71) was observed between fat-corrected MTRRex rNOE values and Ki-67, a proliferation marker.

    Conclusions:

    • The FATLESS method effectively enables the full utilization of CEST MRI contrasts in the human breast.
    • The significant elevation in rNOE contrast and its correlation with tumor proliferation suggest its potential as a non-invasive imaging biomarker.
    • This technique can improve breast cancer characterization and potentially guide treatment decisions.