Journal Article
. 2011 Jul; 31(4):1059-84.
doi: 10.1148/rg.314105160.

Diffusion-weighted imaging of the breast: principles and clinical applications

Reiko Woodhams 1 Saadallah Ramadan  Peter Stanwell  Satoko Sakamoto  Hirofumi Hata  Masanori Ozaki  Shinichi Kan  Yusuke Inoue  
Affiliations
  • PMID: 21768239
  •     56 citations

Abstract

Diffusion-weighted imaging provides a novel contrast mechanism in magnetic resonance (MR) imaging and has a high sensitivity in the detection of changes in the local biologic environment. A significant advantage of diffusion-weighted MR imaging over conventional contrast material-enhanced MR imaging is its high sensitivity to change in the microscopic cellular environment without the need for intravenous contrast material injection. Approaches to the assessment of diffusion-weighted breast imaging findings include assessment of these data alone and interpretation of the data in conjunction with T2-weighted imaging findings. In addition, the analysis of apparent diffusion coefficient (ADC) value can be undertaken either in isolation or in combination with diffusion-weighted and T2-weighted imaging. Most previous studies have evaluated ADC value alone; however, overlap in the ADC values of malignant and benign disease has been observed. This overlap may be partly due to selection of b value, which can influence the concomitant effect of perfusion and emphasize the contribution of multicomponent model influences. The simultaneous assessment of diffusion-weighted and T2-weighted imaging data and ADC value has the potential to improve specificity. In addition, the use of diffusion-weighted imaging in a standard breast MR imaging protocol may heighten sensitivity and thereby improve diagnostic accuracy. Standardization of diffusion-weighted imaging parameters is needed to allow comparison of multicenter studies and assessment of the clinical utility of diffusion-weighted imaging and ADC values in breast evaluation.

Pre-treatment differences and early response monitoring of neoadjuvant chemotherapy in breast cancer patients using magnetic resonance imaging: a systematic review.
R Prevos, M L Smidt, +4 authors, M B I Lobbes.
Eur Radiol, 2012 Sep 18; 22(12). PMID: 22983282
Systematic Review.
Nonmalignant breast lesions: ADCs of benign and high-risk subtypes assessed as false-positive at dynamic enhanced MR imaging.
Sana Parsian, Habib Rahbar, +4 authors, Savannah C Partridge.
Radiology, 2012 Oct 04; 265(3). PMID: 23033500    Free PMC article.
Diffusion-weighted MRI in pretreatment prediction of response to neoadjuvant chemotherapy in patients with breast cancer.
Raphael Richard, Isabelle Thomassin, +7 authors, Cedric de Bazelaire.
Eur Radiol, 2013 May 09; 23(9). PMID: 23652844
[Improved breast MRI specificity in nonmalignant breast lesions using additional diffusion-weighted sequences without significant increases in examination time].
E Wenkel.
Strahlenther Onkol, 2013 May 10; 189(6). PMID: 23657461
Parameterizing the Logistic Model of Tumor Growth by DW-MRI and DCE-MRI Data to Predict Treatment Response and Changes in Breast Cancer Cellularity during Neoadjuvant Chemotherapy.
Nkiruka C Atuegwu, Lori R Arlinghaus, +4 authors, Thomas E Yankeelov.
Transl Oncol, 2013 Jun 05; 6(3). PMID: 23730404    Free PMC article.
Detection of invasive components in cases of breast ductal carcinoma in situ on biopsy by using apparent diffusion coefficient MR parameters.
Naoko Mori, Hideki Ota, +6 authors, Shoki Takahashi.
Eur Radiol, 2013 Jun 05; 23(10). PMID: 23732688
Diffusion weighted magnetic resonance imaging of the breast: protocol optimization, interpretation, and clinical applications.
Savannah C Partridge, Elizabeth S McDonald.
Magn Reson Imaging Clin N Am, 2013 Aug 10; 21(3). PMID: 23928248    Free PMC article.
Review.
Intravoxel incoherent motion diffusion-weighted MRI at 3.0 T differentiates malignant breast lesions from benign lesions and breast parenchyma.
Louisa Bokacheva, Jennifer B Kaplan, +6 authors, Sunitha B Thakur.
J Magn Reson Imaging, 2013 Nov 26; 40(4). PMID: 24273096    Free PMC article.
MR scanner systems should be adequately characterized in diffusion-MRI of the breast.
Marco Giannelli, Roberto Sghedoni, +6 authors, Stefano Diciotti.
PLoS One, 2014 Feb 04; 9(1). PMID: 24489711    Free PMC article.
Diffusion-weighted MRI: association between patient characteristics and apparent diffusion coefficients of normal breast fibroglandular tissue at 3 T.
Elizabeth S McDonald, Jennifer G Schopp, +5 authors, Savannah C Partridge.
AJR Am J Roentgenol, 2014 Apr 25; 202(5). PMID: 24758685    Free PMC article.
Diffusion-weighted imaging: determination of the best pair of b-values to discriminate breast lesions.
L Nogueira, S Brandão, +4 authors, I Ramos.
Br J Radiol, 2014 May 17; 87(1039). PMID: 24834475    Free PMC article.
Diagnostic assessment by dynamic contrast-enhanced and diffusion-weighted magnetic resonance in differentiation of breast lesions under different imaging protocols.
Hongmin Cai, Lizhi Liu, +2 authors, Li Li.
BMC Cancer, 2014 Jun 03; 14. PMID: 24885156    Free PMC article.
Comparison of fitting methods and b-value sampling strategies for intravoxel incoherent motion in breast cancer.
Gene Young Cho, Linda Moy, +7 authors, Eric E Sigmund.
Magn Reson Med, 2014 Oct 11; 74(4). PMID: 25302780    Free PMC article.
Value of 3 Tesla diffusion-weighted magnetic resonance imaging for assessing liver fibrosis.
Lavrentios Papalavrentios, Emmanouil Sinakos, +6 authors, Evangelos Akriviadis.
Ann Gastroenterol, 2015 Jan 23; 28(1). PMID: 25608776    Free PMC article.
Fat suppression techniques (STIR vs. SPAIR) on diffusion-weighted imaging of breast lesions at 3.0 T: preliminary experience.
Sofia Brandão, Luísa Nogueira, +4 authors, Isabel Ramos.
Radiol Med, 2015 Feb 11; 120(8). PMID: 25665796
Differential diagnosis of benign and malignant breast masses using diffusion-weighted magnetic resonance imaging.
Qinghua Min, Kangwei Shao, +4 authors, Jun Yang.
World J Surg Oncol, 2015 Apr 19; 13. PMID: 25889380    Free PMC article.
Differentiation between Graves' disease and painless thyroiditis by diffusion-weighted imaging, thyroid iodine uptake, thyroid scintigraphy and serum parameters.
Zhaowei Meng, Guizhi Zhang, +9 authors, Shugao Han.
Exp Ther Med, 2015 Jul 03; 9(6). PMID: 26136954    Free PMC article.
Is there a systematic bias of apparent diffusion coefficient (ADC) measurements of the breast if measured on different workstations? An inter- and intra-reader agreement study.
Paola Clauser, Magda Marcon, +3 authors, Pascal A T Baltzer.
Eur Radiol, 2015 Oct 08; 26(7). PMID: 26443604
Reproducibility of Apparent Diffusion Coefficient Measurements in Malignant Breast Masses.
Mijung Jang, Sun Mi Kim, +4 authors, Sung-Won Kim.
J Korean Med Sci, 2015 Nov 06; 30(11). PMID: 26539016    Free PMC article.
Qualitative and quantitative diffusion-weighted imaging of the breast at 3T - A useful adjunct to contrast-enhanced MRI in characterization of breast lesions.
Richa Bansal, Viral Shah, Bharat Aggarwal.
Indian J Radiol Imaging, 2016 Jan 12; 25(4). PMID: 26751011    Free PMC article.
[Selected clinically established and scientific techniques of diffusion-weighted MRI. In the context of imaging in oncology].
M T Freitag, S Bickelhaupt, +6 authors, F B Laun.
Radiologe, 2016 Jan 24; 56(2). PMID: 26801187
Review.
Diffusion-weighted magnetic resonance imaging in cancer: Reported apparent diffusion coefficients, in-vitro and in-vivo reproducibility.
Maysam M Jafar, Arman Parsai, Marc E Miquel.
World J Radiol, 2016 Feb 03; 8(1). PMID: 26834942    Free PMC article.
Review.
Intravoxel incoherent motion diffusion-weighted MR imaging of breast cancer: association with histopathological features and subtypes.
Yunju Kim, Kyounglan Ko, +4 authors, Boram Park.
Br J Radiol, 2016 May 21; 89(1063). PMID: 27197744    Free PMC article.
Potential of Diffusion-Weighted Imaging in the Characterization of Malignant, Benign, and Healthy Breast Tissues and Molecular Subtypes of Breast Cancer.
Uma Sharma, Rani G Sah, +5 authors, Naranamangalam R Jagannathan.
Front Oncol, 2016 Jun 01; 6. PMID: 27242965    Free PMC article.
Diffusion-weighted imaging reflects variable cellularity and stromal density present in breast fibroadenomas.
Sana Parsian, Nadia V Giannakopoulos, +3 authors, Savannah C Partridge.
Clin Imaging, 2016 Jul 06; 40(5). PMID: 27379441    Free PMC article.
Assessment of early treatment response to neoadjuvant chemotherapy in breast cancer using non-mono-exponential diffusion models: a feasibility study comparing the baseline and mid-treatment MRI examinations.
Reem Bedair, Andrew N Priest, +7 authors, Fiona J Gilbert.
Eur Radiol, 2016 Nov 01; 27(7). PMID: 27798751    Free PMC article.
Clinical Breast MR Using MRS or DWI: Who Is the Winner?
Francesco Sardanelli, Luca Alessandro Carbonaro, +2 authors, Rubina Manuela Trimboli.
Front Oncol, 2016 Nov 15; 6. PMID: 27840809    Free PMC article.
Review.
Diagnostic Performance of Diffusion Tensor Imaging with Readout-segmented Echo-planar Imaging for Invasive Breast Cancer: Correlation of ADC and FA with Pathological Prognostic Markers.
Ken Yamaguchi, Takahiko Nakazono, +4 authors, Hiroyuki Irie.
Magn Reson Med Sci, 2016 Nov 18; 16(3). PMID: 27853053    Free PMC article.
Validation of surface-to-volume ratio measurements derived from oscillating gradient spin echo on a clinical scanner using anisotropic fiber phantoms.
Gregory Lemberskiy, Steven H Baete, +2 authors, Els Fieremans.
NMR Biomed, 2017 Mar 23; 30(5). PMID: 28328013    Free PMC article.
Is the necrosis/wall ADC ratio useful for the differentiation of benign and malignant breast lesions?
Irmak Durur-Subasi, Afak Durur-Karakaya, +3 authors, Fatih Alper.
Br J Radiol, 2017 Mar 25; 90(1073). PMID: 28339285    Free PMC article.
Impact of Different Analytic Approaches on the Analysis of the Breast Fibroglandular Tissue Using Diffusion Weighted Imaging.
Yoon Jung Choi, Jeon-Hor Chen, +2 authors, Min-Ying Su.
Biomed Res Int, 2017 Mar 30; 2017. PMID: 28349054    Free PMC article.
Optimization of intra-voxel incoherent motion measurement in diffusion-weighted imaging of breast cancer.
Wenjing Chen, Juan Zhang, +2 authors, Jian-Ming Zhu.
J Appl Clin Med Phys, 2017 Mar 30; 18(3). PMID: 28349630    Free PMC article.
Correlation of Prognostic Factors of Invasive Lobular Carcinoma with ADC Value of DWI and SUVMax of FDG-PET.
Bo Bae Choi, Sung Hun Kim, Chang Suk Park, Na Young Jung.
Chonnam Med J, 2017 Jun 07; 53(2). PMID: 28584792    Free PMC article.
Preliminary study of diffusion kurtosis imaging in thyroid nodules and its histopathologic correlation.
Ruo-Yang Shi, Qiu-Ying Yao, +7 authors, Jian-Rong Xu.
Eur Radiol, 2017 Jun 16; 27(11). PMID: 28616727
Role of exponential apparent diffusion coefficient in characterizing breast lesions by 3.0 Tesla diffusion-weighted magnetic resonance imaging.
Shweta Kothari, Archana Singh, +3 authors, Avijit Hazra.
Indian J Radiol Imaging, 2017 Jul 27; 27(2). PMID: 28744085    Free PMC article.
Can diffusion-weighted imaging add information in the evaluation of breast lesions considered suspicious on magnetic resonance imaging?
Camila Souza Guatelli, Almir Galvão Vieira Bitencourt, +5 authors, Rubens Chojniak.
Radiol Bras, 2017 Nov 01; 50(5). PMID: 29085162    Free PMC article.
Variability of non-Gaussian diffusion MRI and intravoxel incoherent motion (IVIM) measurements in the breast.
Mami Iima, Masako Kataoka, +7 authors, Kaori Togashi.
PLoS One, 2018 Mar 02; 13(3). PMID: 29494639    Free PMC article.
Correlation between electrical conductivity and apparent diffusion coefficient in breast cancer: effect of necrosis on magnetic resonance imaging.
Soo-Yeon Kim, Jaewook Shin, +5 authors, Min Jung Kim.
Eur Radiol, 2018 Mar 08; 28(8). PMID: 29511804
Dual-Phase ADC Modelling of Breast Masses in Diffusion-Weighted Imaging: Comparison with Histopathologic Findings.
Gökhan Ertaş, Can Onaygil, Onur Buğdaycı, Erkin Arıbal.
Eur J Breast Health, 2018 May 19; 14(2). PMID: 29774316    Free PMC article.
Intravoxel incoherent motion magnetic resonance imaging for breast cancer: A comparison with benign lesions and evaluation of heterogeneity in different tumor regions with prognostic factors and molecular classification.
Ming Zhao, Kuang Fu, +6 authors, Jiawei Tian.
Oncol Lett, 2018 Sep 27; 16(4). PMID: 30250578    Free PMC article.
Application of Radiomics and Decision Support Systems for Breast MR Differential Diagnosis.
Ioannis Tsougos, Alexandros Vamvakas, +2 authors, Katerina Vassiou.
Comput Math Methods Med, 2018 Oct 23; 2018. PMID: 30344618    Free PMC article.
Review.
Correlation between apparent diffusion coefficient values in breast magnetic resonance imaging and prognostic factors of breast invasive ductal carcinoma.
Ricardo Moutinho-Guilherme, Janeth Hercilia Oyola, +4 authors, Vicente Martínez de Vega.
Porto Biomed J, 2018 Aug 03; 4(1). PMID: 31595254    Free PMC article.
Diffusion-Weighted Imaging of Breast Cancer: Correlation of the Apparent Diffusion Coefficient Value with Pathologic Prognostic Factors.
Şehnaz Tezcan, Nihal Uslu, +2 authors, Tugan Tezcaner.
Eur J Breast Health, 2019 Oct 18; 15(4). PMID: 31620686    Free PMC article.
Measurement of apparent diffusion coefficient in discrimination of benign and malignant axillary lymph nodes.
Ebru Yılmaz, Berrin Erok, Ali Önder Atca.
Pol J Radiol, 2020 Feb 23; 84. PMID: 32082458    Free PMC article.
Differentiation of Breast Lesions and Distinguishing Their Histological Subtypes Using Diffusion-Weighted Imaging and ADC Values.
Jelena Maric, Jasmina Boban, +3 authors, Dragana Bogdanovic-Stojanovic.
Front Oncol, 2020 Apr 02; 10. PMID: 32232007    Free PMC article.
Association among T2 signal intensity, necrosis, ADC and Ki-67 in estrogen receptor-positive and HER2-negative invasive ductal carcinoma.
Soo-Yeon Kim, Eun-Kyung Kim, +4 authors, Min Jung Kim.
Magn Reson Imaging, 2018 Sep 03; 54. PMID: 30172938    Free PMC article.
Diffusion-Weighted Imaging of the Head and Neck: Influence of Fat-Suppression Technique and Multishot 2D Navigated Interleaved Acquisitions.
Y J Bae, B S Choi, +3 authors, J H Kim.
AJNR Am J Neuroradiol, 2017 Nov 11; 39(1). PMID: 29122759    Free PMC article.
Patient-Specific Characterization of Breast Cancer Hemodynamics Using Image-Guided Computational Fluid Dynamics.
Chengyue Wu, David A Hormuth, +5 authors, Thomas E Yankeelov.
IEEE Trans Med Imaging, 2020 Feb 23; 39(9). PMID: 32086203    Free PMC article.
DW-MRI of the breast: a pictorial review.
Irmak Durur-Subasi.
Insights Imaging, 2019 Jun 05; 10(1). PMID: 31161458    Free PMC article.
Diffusion-weighted imaging of the breast: current status as an imaging biomarker and future role.
Julia Camps-Herrero.
BJR Open, 2019 Mar 08; 1(1). PMID: 33178933    Free PMC article.
Review.
Three-dimensional simultaneous brain T1 , T2 , and ADC mapping with MR Multitasking.
Sen Ma, Christopher T Nguyen, +6 authors, Debiao Li.
Magn Reson Med, 2019 Nov 26; 84(1). PMID: 31765496    Free PMC article.
Two Different Methods of Region-of-Interest Placement for Differentiation of Benign and Malignant Breast Lesions by Apparent Diffusion Coefficient Value
Masoumeh Gity, Behnaz Moradi, +2 authors, Mohamad Ali Kazemi.
Asian Pac J Cancer Prev, 2018 Oct 27; 19(10). PMID: 30360604    Free PMC article.
Apparent diffusion coefficient magnetic resonance imaging (ADC-MRI) in the axillary breast cancer lymph node metastasis detection: a narrative review.
Camilla De Cataldo, Federico Bruno, +10 authors, Ernesto Di Cesare.
Gland Surg, 2021 Jan 16; 9(6). PMID: 33447575    Free PMC article.
Review.
Performance of DWI as a Rapid Unenhanced Technique for Detecting Mammographically Occult Breast Cancer in Elevated-Risk Women With Dense Breasts.
Elizabeth S McDonald, Jill A Hammersley, +6 authors, Savannah C Partridge.
AJR Am J Roentgenol, 2016 Apr 15; 207(1). PMID: 27077731    Free PMC article.
Pediatric skeletal diffusion-weighted magnetic resonance imaging: part 1 - technical considerations and optimization strategies.
Apeksha Chaturvedi.
Pediatr Radiol, 2021 Apr 02;. PMID: 33792751
Review.
Apparent diffusion coefficient values in borderline breast lesions upgraded and not upgraded at definitive histopathological examination after surgical excision.
Corrado Tagliati, Paola Piccinni, +4 authors, Andrea Giovagnoni.
Pol J Radiol, 2021 Jun 08; 86. PMID: 34093923    Free PMC article.