Breast magnetic resonance imaging: diffusion-weighted imaging.

More imaging centers are incorporating diffusion-weighted imaging (DWI) into the clinical breast magnetic resonance (MR) examination, with the potential of increasing the specificity of breast MR imaging. This article reviews the role of DWI in the evaluation of breast lesions. The principles, technique, and protocol of DWI are discussed, including the importance of the chosen b value. The interpretation strategy, including quantitative and qualitative analysis is described. Clinical applications of breast DWI are evaluated, such as distinguishing malignant from benign lesions, tumor characterization and monitoring treatment planning, and potential pitfalls such as false-negative and false-positive findings are discussed.

[1]  Ning-Yu An,et al.  Differentiation of clinically benign and malignant breast lesions using diffusion‐weighted imaging , 2002, Journal of magnetic resonance imaging : JMRI.

[2]  Claus Claussen,et al.  Current Status and New Developments in Breast MRI , 2011, Breast Care.

[3]  Eun-Kyung Kim,et al.  Triple-negative invasive breast cancer on dynamic contrast-enhanced and diffusion-weighted MR imaging: comparison with other breast cancer subtypes , 2012, European Radiology.

[4]  Shigeru Nawano,et al.  Detecting breast cancer with non-contrast MR imaging: combining diffusion-weighted and STIR imaging. , 2007, Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine.

[5]  Wendy B DeMartini,et al.  Improved diagnostic accuracy of breast MRI through combined apparent diffusion coefficients and dynamic contrast‐enhanced kinetics , 2011, Magnetic resonance in medicine.

[6]  Kaori Togashi,et al.  Apparent diffusion coefficient as an MR imaging biomarker of low-risk ductal carcinoma in situ: a pilot study. , 2011, Radiology.

[7]  H. Hatabu,et al.  Diffusion-weighted imaging of mucinous carcinoma of the breast: evaluation of apparent diffusion coefficient and signal intensity in correlation with histologic findings. , 2009, AJR. American journal of roentgenology.

[8]  Hiroshi Honda,et al.  Non-mass-like enhancement on contrast-enhanced breast MR imaging: lesion characterization using combination of dynamic contrast-enhanced and diffusion-weighted MR images. , 2010, European journal of radiology.

[9]  Bong Joo Kang,et al.  The Role of Diffusion-Weighted Imaging and the Apparent Diffusion Coefficient (ADC) Values for Breast Tumors , 2007, Korean journal of radiology.

[10]  Hiroshi Honda,et al.  Apparent diffusion coefficients of breast tumors: clinical application. , 2008, Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine.

[11]  Wendy B DeMartini,et al.  Nonmalignant breast lesions: ADCs of benign and high-risk subtypes assessed as false-positive at dynamic enhanced MR imaging. , 2012, Radiology.

[12]  Peter R Luijten,et al.  Quantitative diffusion weighted imaging for differentiation of benign and malignant breast lesions: The influence of the choice of b‐values , 2010, Journal of magnetic resonance imaging : JMRI.

[13]  A. Razek,et al.  Invasive ductal carcinoma: correlation of apparent diffusion coefficient value with pathological prognostic factors , 2010, NMR in biomedicine.

[14]  D. Le Bihan,et al.  Separation of diffusion and perfusion in intravoxel incoherent motion MR imaging. , 1988, Radiology.

[15]  L. Turnbull,et al.  Neoadjuvant chemotherapy in breast cancer: early response prediction with quantitative MR imaging and spectroscopy , 2006, British Journal of Cancer.

[16]  Davide Caramella,et al.  The role of mean diffusivity (MD) as a predictive index of the response to chemotherapy in locally advanced breast cancer: a preliminary study , 2010, European Radiology.

[17]  S. Gautam,et al.  Identification of residual breast carcinoma following neoadjuvant chemotherapy: diffusion-weighted imaging--comparison with contrast-enhanced MR imaging and pathologic findings. , 2010, Radiology.

[18]  Hiromu Nishitani,et al.  Comparison of 3.0-and 1.5-tesla diffusion-weighted imaging in the visibility of breast cancer , 2008, Radiation Medicine.

[19]  G C McKinnon,et al.  Menstrual cycle variation of apparent diffusion coefficients measured in the normal breast using MRI , 2001, Journal of magnetic resonance imaging : JMRI.

[20]  Peter Gibbs,et al.  Diffusion changes precede size reduction in neoadjuvant treatment of breast cancer. , 2006, Magnetic resonance imaging.

[21]  Masanori Ozaki,et al.  ADC mapping of benign and malignant breast tumors. , 2005, Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine.

[22]  R. Ponzone,et al.  Correlations between diffusion-weighted imaging and breast cancer biomarkers , 2012, European Radiology.

[23]  Jie Li,et al.  DW-MRI ADC values can predict treatment response in patients with locally advanced breast cancer undergoing neoadjuvant chemotherapy , 2011, Medical Oncology.

[24]  Hiroshi Honda,et al.  Detection of non-palpable breast cancer in asymptomatic women by using unenhanced diffusion-weighted and T2-weighted MR imaging: comparison with mammography and dynamic contrast-enhanced MR imaging , 2010, European Radiology.

[25]  Matthias Benndorf,et al.  Sensitivity and specificity of unenhanced MR mammography (DWI combined with T2-weighted TSE imaging, ueMRM) for the differentiation of mass lesions , 2010, European Radiology.

[26]  Sung Hun Kim,et al.  Correlation of the apparent diffusion coefficient value and dynamic magnetic resonance imaging findings with prognostic factors in invasive ductal carcinoma , 2011, Journal of magnetic resonance imaging : JMRI.

[27]  Conspicuity of breast lesions at different b values on diffusion-weighted imaging , 2012, BMC Cancer.

[28]  B. Naume,et al.  Neoadjuvant chemotherapy in breast cancer-response evaluation and prediction of response to treatment using dynamic contrast-enhanced and diffusion-weighted MR imaging , 2010, European Radiology.

[29]  U. Sharma,et al.  Longitudinal study of the assessment by MRI and diffusion‐weighted imaging of tumor response in patients with locally advanced breast cancer undergoing neoadjuvant chemotherapy , 2009, NMR in biomedicine.

[30]  Karel G M Moons,et al.  Meta-analysis of MR imaging in the diagnosis of breast lesions. , 2008, Radiology.

[31]  J. E. Tanner,et al.  Spin diffusion measurements : spin echoes in the presence of a time-dependent field gradient , 1965 .

[32]  Fernanda Philadelpho Arantes Pereira,et al.  Assessment of breast lesions with diffusion-weighted MRI: comparing the use of different b values. , 2009, AJR. American journal of roentgenology.

[33]  Yoshito Tsushima,et al.  Magnetic resonance (MR) differential diagnosis of breast tumors using apparent diffusion coefficient (ADC) on 1.5‐T , 2009, Journal of magnetic resonance imaging : JMRI.

[34]  Sibel Kul,et al.  Contribution of diffusion-weighted imaging to dynamic contrast-enhanced MRI in the characterization of breast tumors. , 2011, AJR. American journal of roentgenology.

[35]  R. Gillies,et al.  Changes in water mobility measured by diffusion MRI predict response of metastatic breast cancer to chemotherapy. , 2004, Neoplasia.

[36]  Yutaka Imai,et al.  Relation between cancer cellularity and apparent diffusion coefficient values using diffusion-weighted magnetic resonance imaging in breast cancer , 2008, Radiation Medicine.

[37]  Hiroshi Honda,et al.  Enhanced mass on contrast‐enhanced breast MR imaging: Lesion characterization using combination of dynamic contrast‐enhanced and diffusion‐weighted MR images , 2008, Journal of magnetic resonance imaging : JMRI.

[38]  Katsuhiro Nasu,et al.  Advances in breast MRI: diffusion-weighted imaging of the breast , 2008, Breast cancer.

[39]  T. Uematsu,et al.  Triple-negative breast cancer: correlation between MR imaging and pathologic findings. , 2009, Radiology.

[40]  Wendy B DeMartini,et al.  Quantitative diffusion-weighted imaging as an adjunct to conventional breast MRI for improved positive predictive value. , 2009, AJR. American journal of roentgenology.

[41]  Woo Kyung Moon,et al.  Diffusion-weighted MR imaging: pretreatment prediction of response to neoadjuvant chemotherapy in patients with breast cancer. , 2010, Radiology.

[42]  Katarzyna J Macura,et al.  Diffusion-weighted imaging improves the diagnostic accuracy of conventional 3.0-T breast MR imaging. , 2010, Radiology.

[43]  R. Birdwell.  1H MR Spectroscopy and Diffusion-Weighted Imaging of the Breast: Are They Useful Tools for Characterizing Breast Lesions Before Biopsy? , 2010 .

[44]  Oliver Geier,et al.  Diffusion-weighted magnetic resonance imaging for pretreatment prediction and monitoring of treatment response of patients with locally advanced breast cancer undergoing neoadjuvant chemotherapy , 2010, Acta oncologica.

[45]  L. Bonomo,et al.  Diffusion-weighted imaging in breast cancer: relationship between apparent diffusion coefficient and tumour aggressiveness. , 2010, Clinical radiology.

[46]  D. Collins,et al.  Diffusion-weighted MRI in the body: applications and challenges in oncology. , 2007, AJR. American journal of roentgenology.

[47]  Wendy B DeMartini,et al.  Differential diagnosis of mammographically and clinically occult breast lesions on diffusion‐weighted MRI , 2010, Journal of magnetic resonance imaging : JMRI.

[48]  T. Mochizuki,et al.  Comparison of breast cancer detection by diffusion-weighted magnetic resonance imaging and mammography , 2007, Radiation Medicine.

[49]  Fiona J Gilbert,et al.  Reading protocol for dynamic contrast-enhanced MR images of the breast: sensitivity and specificity analysis. , 2005, Radiology.

[50]  Wendy B DeMartini,et al.  In vivo assessment of ductal carcinoma in situ grade: a model incorporating dynamic contrast-enhanced and diffusion-weighted breast MR imaging parameters. , 2012, Radiology.

[51]  Kuncheng Li,et al.  The role of parallel diffusion-weighted imaging and apparent diffusion coefficient (ADC) map values for evaluating breast lesions: preliminary results. , 2010, Academic radiology.

[52]  N. Obuchowski,et al.  Assessment of suspected breast cancer by MRI: a prospective clinical trial using a combined kinetic and morphologic analysis. , 2005, AJR. American journal of roentgenology.

[53]  J. M. Taylor,et al.  Diffusion magnetic resonance imaging: an early surrogate marker of therapeutic efficacy in brain tumors. , 2000, Journal of the National Cancer Institute.

[54]  S. Sinha,et al.  Recent advances in breast MRI and MRS , 2009, NMR in biomedicine.