Diffusion tensor imaging in the normal breast: influences of fibroglandular tissue composition and background parenchymal enhancement

Abstract

Objective To evaluate effects of fibroglandular tissue (FGT) composition and background parenchymal enhancement (BPE) on diffusion tensor imaging (DTI) parameters in normal breast tissue. Methods DTI analysis was performed on 35 breasts with regions of interest drawn to include only normal tissue. Breasts were dichotomized by FGT composition and by BPE; DTI parameters were compared. Results The λ1 principal diffusion coefficient was lower in breasts with moderate/marked BPE versus those with minimal/mild BPE (p=0.039). All other parameters were unaffected. Conclusion λ1 is sensitive to differences in BPE within normal breast tissue which should be taken into account in DTI evaluation.

Diffusion-weighted breast MRI: Clinical applications and emerging techniques

“…Subsequent studies confirmed no significant influence of menstrual phase on ADC values of healthy breast tissue or breast cancers, with one exception finding significant ADC elevation (14%) in the luteal phase. Moreover, neither ADC values of normal breast tissue nor breast cancer show correlation with BPE . Overall, the relative stability of breast ADC measures to cyclic variations suggests DWI may be used at any phase of the menstrual cycle.…”

“…Moreover, neither ADC values of normal breast tissue nor breast cancer show correlation with BPE. [74][75][76][77] Overall, the relative stability of breast ADC measures to cyclic variations suggests DWI may be used at any phase of the menstrual cycle.…”

“…It has been proposed that the mammary ductal network may impose diffusion anisotropy in healthy fibroglandular tissue, with less restricted water diffusion in directions parallel to the walls of the ducts, which has been investigated by several DTI studies. 77,[107][108][109][110] Malignant transformation may in turn cause blockage of the ducts by proliferating neoplastic cells and loss of structured organization, resulting in a concomitant reduction of anisotropy measures, Figure 11. Indeed, two studies demonstrated FA to be significantly reduced in malignancies versus normal breast tissue, 111,112 although several other DTI studies found no difference.…”

Multiparametric MRI of the breast: A review

“…On the contrary, Baltzer et al proved that DTI can visualize microanatomical differences between benign and malignant breast tumors, as well as healthy breast tissue. 69 This has also been recently supported by Plaza et al, 70 who also found that the degree of background parenchymal enhancement in normal breast tissue can influence, yet is completely independent from, fibroglandular tissue. Furthermore, published evidence has shown how DTI can discriminate between malignant and benign lesions and even be a prognostic factor due to its correlation with specific molecular breast cancer subtypes, such as ER and Ki-67.…”

Noncontrast Breast MRI During Pregnancy Using Diffusion Tensor Imaging: A Feasibility Study

“…Presumably, the nonrestricted diffusion in the direction of the ductal tissue is presented by λ1, whereas in the orthogonal directions (λ2 and λ3) the diffusion is restricted by the ductal walls, and in the fibrous tissue the diffusion is free in all directions . Recently, the DTI properties of the healthy breast were reported by several preliminary studies . Furthermore, DTI maps were utilized to provide a means of breast cancer characterization as well as for monitoring the response of breast cancer to neoadjuvant chemotherapy (NAC) …”