Improved tissue sodium concentration quantification in breast cancer by reducing partial volume effects: a preliminary study

Introduction: In sodium (23Na) MRI, partial volume effects (PVE) are one of the most common causes of errors in the quantification of tissue sodium concentration (TSC) in vivo. Advanced image reconstruction algorithms, such as compressed sensing (CS), have been shown to potentially reduce PVE. Therefore, we investigated the feasibility of CS-based methods for image quality and TSC quantification accuracy improvement in patients with breast cancer (BC). Subjects and Methods: Three healthy participants and 12 female participants with BC were examined on a 7T MRI scanner in this study. We reconstructed 23Na-MRI images using the weighted total variation (wTV) and directional total variation (dTV), anatomically guided total variation (AG-TV), and adaptive combine (ADC) reconstruction and performed image quality assessment. We evaluated agreement in tumor volumes delineated on sodium data using the Dice score and performed TSC quantification for different image reconstruction approaches. Results: All methods provided sodium images of the breast with good quality. The mean Dice scores for wTV, dTV, and AG-TV were 65%, 72%, and 75%, respectively. In the breast tumors, average TSC values were 83.0, 72.0, 80.0, and 84.0 mmol/L, respectively. There was a significant difference between dTV and wTV (p<0.001), as well as between dTV and AG-TV (p<0.001) and dTV and ADC algorithm (p<0.001). Conclusion: The results of this study showed that there are differences in tumor appearance and TSC estimations that might be depending on the type of image reconstruction and parameters used, most likely due to differences in their robustness in reducing PVE.