Sodium (23Na)-MRI is an emerging technique that is posited as enabling the differentiation of malignant and benign breast lesions and normal fibroglandular tissue based on increases in total tissue sodium concentration (TSC). 23Na-MRI, alongside other multiparametric MRI techniques such as diffusion-weighted imaging (DWI) and dynamic contrast-enhanced imaging (DCE-MRI), can provide complementary information about the physiological and biochemical state of tumours. Furthermore, as changes in sodium concentration are likely to occur before changes in cellularity or vascularity as measured by DWI and DCE-MRI, 23Na-MRI may provide more immediate information about changes in tumour physiology to assess the effects of therapy.
Our study, funded by Cancer Research UK, will follow women from their baseline MRI examination to their pathological reporting following surgery. This study aims to develop and optimise protocols for the imaging of intra- and extra-cellular 23Na in breast cancer. Secondary aims include the assessment of the reproducibility 23Na-MRI of in breast cancer, the investigation of the relationship between baseline 23Na-MRI and the grade of breast cancer malignancy, to correlate baseline tissue sodium concentration as measured by 23Na-MRI with tissue markers of metabolism obtained from histopathological analysis of diagnostic biopsies/specimens, and to assess changes in 23Na-MRI measurements in breast cancer patients undergoing neoadjuvant therapy.