Diffusion-weighted breast MRI: Clinical applications and emerging techniques

Abstract

Diffusion weighted MRI (DWI) holds potential to improve the detection and biological characterization of breast cancer. DWI is increasingly being incorporated into breast MRI protocols to address some of the shortcomings of routine clinical breast MRI. Potential benefits include improved differentiation of benign and malignant breast lesions, assessment and prediction of therapeutic efficacy, and non-contrast detection of breast cancer. The breast presents a unique imaging environment with significant physiologic and inter-subject variations, as well as specific challenges to achieving reliable high quality diffusion weighted MR images. Technical innovations are helping to overcome many of the image quality issues that have limited widespread use of DWI for breast imaging. Advanced modeling approaches to further characterize tissue perfusion, complexity, and glandular organization may expand knowledge and yield improved diagnostic tools.

Diffusion-weighted imaging is helpful in the accurate non-invasive diagnosis of breast abscess: correlation with necrotic breast cancer

“…Diffusion-weighted imaging (DWI) is an MRI technique based on the random, microscopic motion of free water molecules in tissue (‘Brownian’ motion), and produces contrast related to the structure of tissues at microscopic level 1. It can be applied within a few minutes, and does not require intravenous contrast.…”

“…It can be applied within a few minutes, and does not require intravenous contrast. DWI allows estimation of cellularity and tissue structure quantitatively by calculating apparent diffusion coefficient (ADC) values of each pixel, and generating quantitative ADC maps that correlate with tissue cellularity 1. DWI can be used in the differential diagnosis of the brain masses with fluid components, because cystic brain tumours show, respectively, higher ADC values compared with abscesses 2 3.…”

Digital Analysis in Breast Imaging

“…DWI, on the other hand, is a technique that measures the diffusion of water molecules in tissue and does not require a contrast medium. Due to the water molecules’ mobility, DWI reflects biophysical properties such as cell density, integrity of the membrane, and tissue microstructure [25, 29]. MRI, however, is a method that requires a high level of experience, which may be limited [30, 31].…”

“…Functional information can be obtained using two different techniques: dynamic and morphological enhancement assessment [23] and diffusion-weighted imaging (DWI) [24, 25]. The contrast dynamic technique is based on different enhancement patterns of breast lesions over time after the administration of a contrast agent [26-28].…”

Dual-Phase ADC Modelling of Breast Masses in Diffusion-Weighted Imaging: Comparison with Histopathologic Findings

“…While DWI holds potential to improve the detection and biological characterization of breast cancer (13), apparent diffusion coefficient (ADC) is capable of reflecting breast tissue cellularity, fluid viscosity, membrane permeability, macromolecular structures, microvascularity and lesion blood flow (14). Benign lesions have higher ADC than malignant lesions, especially the invasive carcinomas mainly due to their less compact cellularity (15).…”