• Milica Medved, Hui Li, Hiroyuki Abe, Deepa Sheth, Gillian M Newstead, Olufunmilayo I Olopade, Maryellen L Giger, and Gregory S Karczmar.
• Department of Radiology, University of Chicago, Chicago, Illinois, USA.
• J Magn Reson Imaging. 2017 Nov 1; 46 (5): 1341-1348.

PurposeTo develop and assess a full-coverage, sensitivity encoding (SENSE)-accelerated breast high spatial and spectral resolution (HiSS) magnetic resonance imaging (MRI) within clinically reasonable times as a potential nonenhanced MRI protocol for breast density measurement or breast cancer screening.Materials And MethodsSixteen women with biopsy-proven cancer or suspicious lesions, and 13 women who were healthy volunteers or were screened for breast cancer, received 3T breast MRI exams, including SENSE-accelerated HiSS MRI, which was implemented as a submillimeter spatial resolution echo-planar spectroscopic imaging (EPSI) sequence. In postprocessing, fat and water resonance peak height and integral images were generated from EPSI data. The postprocessing software was custom-designed, and new algorithms were developed to enable processing of whole-coverage axial HiSS datasets. Water peak height HiSS images were compared to pre- and postcontrast T1 -weighted images. Fat suppression was quantified as parenchymal-to-suppressed-fat signal ratio in HiSS water peak height and nonenhanced T1 -weighted images, and artifact levels were scored.ResultsApproximately a 4-fold decrease in acquisition speed, with a concurrent 2.5-fold decrease in voxel size, was achieved, with low artifact levels, and with spectral signal-to-noise ratio (SNR) of 45:1. Fat suppression was 1.9 times more effective (P < 0.001) in HiSS images than in T1 -weighted images (SPAIR), and HiSS images showed higher SNR in the axilla. HiSS MRI visualized 10 of 13 malignant lesions identified on dynamic contrast-enhanced (DCE)-MRI, and did not require skin removal in postprocessing to generate maximum intensity projection images.ConclusionWe demonstrate full-coverage, SENSE-accelerated breast HiSS MRI within clinically reasonable times, as a potential protocol for breast density measurement or breast cancer screening.Level Of Evidence2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2017;46:1341-1348.© 2017 International Society for Magnetic Resonance in Medicine.

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