Elsevier

Academic Radiology

Volume 17, Issue 4, April 2010, Pages 456-463
Academic Radiology

Original investigation
The Role of Parallel Diffusion-Weighted Imaging and Apparent Diffusion Coefficient (ADC) Map Values for Evaluating Breast Lesions: Preliminary Results

https://doi.org/10.1016/j.acra.2009.12.004Get rights and content

Rationale and Objectives

To evaluate the feasibility of using diffusion-weighted imaging (DWI) with an array spatial sensitivity encoding technique (ASSET) and apparent diffusion coefficient (ADC) map values with different b values to distinguish benign and malignant breast lesions.

Materials and Methods

Fifty-six female patients with 60 histologically proven breast lesions and 20 healthy volunteers underwent magnetic resonance imaging. A subset of normal volunteers (n = 7) and patients (n = 16) underwent both conventional DWI and ASSET-DWI, and the image quality between the two methods was compared. Finally, ASSET-DWI with b = 0, 600 s/mm2, and b = 0, 1000 s/mm2, were compared for their ability to distinguish benign and malignant breast lesions.

Results

The ASSET-DWI method had less distortion, fewer artifacts, and a lower acquisition time than other methods. No significant difference (P > .05) was detected in ADC map values between ASSET-DWI and conventional DWI. For ASSET-DWI, the sensitivity of ADC values for malignant lesions with a threshold of less than 1.44 × 10−3 mm2/s (b = 600 s/mm2) and 1.18 × 10−3 mm2/s (b = 1000 s/mm2) was 80% and 77.5%, respectively. The specificity of both groups was 95%.

Conclusion

ASSET-DWI evaluation of breast tissue offers decreased distortion, susceptibility to artifacts, and acquisition time relative to other methods. The use of ASSET-DWI is feasible with b values ranging from 600 to 1000 s/mm2 and provides increased specificity compared to other techniques. Thus, the ADC value of a breast lesion can be used to further characterize malignant lesions from benign ones.

Section snippets

Materials and methods

This was a retrospective study, and the Ethics Committee of our institution approved the study protocol. All subjects gave written informed consent before beginning the study.

Image artifacts

Among the 16 lesions in 16 patients studied, 3 lesions displayed distortion. The ADC values could not be measured in two of the three lesions. However, the distortion of normal breast tissue and lesions were reduced by ASSET-DWI, and artifacts resulting from ASSET around the breast did not influence the diagnostic ability of lesion visualization (Fig 1).

SNR and CNR

Because of distortion, the signals of two lesions could not be measured, so the CNR of 14 lesions were analyzed. The SNR of normal breast

The Study Demonstrated that using ASSET-DWI Decreased Known EPI Distortions and Provided Excellent Differentiation of Malignant from Benign Lesions

The usefulness of DWI has been established in the fields of neuroradiology (8) and in breast 12, 13, 14, 15, 16, 17, as mentioned in the introduction. However, traditional EPI-DWI has the disadvantages of susceptibility and phase encoding artifacts, such as chemical shift and ghosting. Parallel imaging techniques such as SENSE and ASSET, are the latest advancements in MRI technology, and they enable faster image acquisition time by reducing the number of phase-encoding steps. Our study

Conclusions

ASSET-DWI can be used to evaluate breast tissue with decreased distortion, susceptibility to artifacts, and acquisition time compared to other methods. The use of DWI is feasible and offers increased specificity with b values ranging from 600 to 1000 s/mm2. ADC map values of breast lesions can be used to further characterize malignant lesions from benign ones.

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    This work was supported in part by NIH 1R01CA100184.

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