Diffusion Magnetic Resonance Imaging of the Breast

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Clinical applications of diffusion imaging

Despite improvements in the detection of breast cancer as a result of the widespread application of mammography and ultrasound, breast lesions remain difficult to diagnose and characterize. The primary advantage of MR imaging of the breast is improvement of the detection and characterization of multiple and/or small lesions, even in dense fibroglandular breast tissue. However, the low specificity of MR imaging remains a significant problem.24

DWI has been increasingly recognized as a promising

Analysis of DWI at our institution

A preliminary study in our institution 17 confirmed the usefulness of DWI for the differential diagnosis of benign and malignant breast lesions. In addition, this study revealed no significant statistical difference between ADC values obtained using different b-value combinations, although b-values of 0 and 750 s/mm2 performed slightly better at differentiating between benign and malignant breast lesions than the other combinations analyzed. However, a further study using a larger population

Potential applications of diffusion imaging

Our results indicate that DWI can serve as a powerful tool for differentiating benign from malignant breast lesions. In addition to this use, DWI also shows potential for use in several additional diagnostic and therapeutic applications, including monitoring of neoadjuvant chemotherapy (NAC), evaluation of peritumor tissues, and assessment of axillary lymph nodes. These promising novel applications of DWI are discussed in the following sections.

Summary

Diffusion sequences can be used for characterization and differentiation of malignant and benign breast lesions. Use of DWI as a diagnostic tool can increase the specificity of breast MR imaging and can reduce the number of false-positive results and associated unnecessary biopsies. In addition, DWI can be performed without significantly increasing examination time and can easily be introduced into the standard breast MR imaging protocol. Furthermore, novel applications for DWI are under

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  • Cited by (50)

    • The role of diffusion weighted imaging as supplement to dynamic contrast enhanced breast MRI: Can it help predict malignancy, histologic grade and recurrence?

      2019, Academic Radiology
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      Signal intensity at B100, and B600 can significantly assist in distinguishing benign lesions from invasive ductal cancers which is the dominant cancer subtype. Prior studies have suggested that mean ADC values of breast cancer are significantly lower than benign lesions (4,14,21–25). This relationship was established regardless of number and strength of b values used to calculate ADC (18,21) and is reproducible (6) with high sensitivity, specificity, positive predictive value, and negative predictive value (25).

    • Comparison and Optimization of 3.0 T Breast Images Quality of Diffusion-Weighted Imaging with Multiple B-Values

      2017, Academic Radiology
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      B-value selection is closely related to the image quality of DWI and its ability to identify lesions. Currently, there are no widely accepted selection criteria for the optimal b-value for breast DWI at 3.0 T MR scanner (8–12). Therefore, the study of b-value optimization is of important clinical interest.

    • Role of diffusion weighted imaging and dynamic contrast enhanced MR mammography to detect recurrence in breast cancer patients after surgery

      2016, Egyptian Journal of Radiology and Nuclear Medicine
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      Quantitatively: By measuring ADC values on ADC maps for the positive cases at the site of suspected recurrence and for the negative cases at the site of the post operative changes. We considered 1.24 × 10−3 mm2/s to be our cutoff ADC value in differentiating benign from malignant breast lesions according to Pereira et al. (10). DWI positive lesions showed abnormal bright signal intensity ‘restriction’ that remains enhanced with increasing b values and showed intermediate/low signal intensity on the corresponding ADC map with ADC values lower than or equal to our cutoff point.

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