Review
. 2013 Aug; 21(3):601-24.
doi: 10.1016/j.mric.2013.04.007.

Diffusion weighted magnetic resonance imaging of the breast: protocol optimization, interpretation, and clinical applications

Savannah C Partridge 1 Elizabeth S McDonald  
Affiliations
  • PMID: 23928248
  •     98 References
  •     46 citations

Abstract

Diffusion-weighted magnetic resonance (MR) imaging (DWI) has shown promise for improving the positive predictive value of breast MR imaging for detection of breast cancer, evaluating tumor response to neoadjuvant chemotherapy, and as a noncontrast alternative to MR imaging in screening for breast cancer. However, data quality varies widely. Before implementing DWI into clinical practice, one must understand the pertinent technical considerations and current evidence regarding clinical applications of breast DWI. This article provides an overview of basic principles of DWI, optimization of breast DWI protocols, imaging features of benign and malignant breast lesions, promising clinical applications, and potential future directions.

Keywords: Apparent diffusion coefficient; Breast MR imaging; Breast cancer; Diffusion-weighted imaging; Neoadjuvant chemotherapy; Oncologic imaging; b-value.

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Chao Ma, Yanjun Li, +5 authors, Jianping Lu.
Cancer Imaging, 2017 Apr 30; 17(1). PMID: 28454564    Free PMC article.
Monitoring In-Vivo the Mammary Gland Microstructure during Morphogenesis from Lactation to Post-Weaning Using Diffusion Tensor MRI.
Noam Nissan, Edna Furman-Haran, +2 authors, Hadassa Degani.
J Mammary Gland Biol Neoplasia, 2017 Jul 15; 22(3). PMID: 28707256
DWI in the Assessment of Breast Lesions.
Savannah C Partridge, Nita Amornsiripanitch.
Top Magn Reson Imaging, 2017 Sep 30; 26(5). PMID: 28961569    Free PMC article.
Background, current role, and potential applications of radiogenomics.
Katja Pinker, Fuki Shitano, +6 authors, Elizabeth A Morris.
J Magn Reson Imaging, 2017 Nov 03; 47(3). PMID: 29095543    Free PMC article.
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Diffusion weighted MRI and spectroscopy in invasive carcinoma of the breast at 3Tesla. Correlation with dynamic contrast enhancement and pathologic findings.
G Boulogianni, I Chryssogonidis, A Drevelegas.
Hippokratia, 2016 Jul 01; 20(3). PMID: 29097884    Free PMC article.
Clinical role of breast MRI now and going forward.
D Leithner, G J Wengert, +4 authors, K Pinker.
Clin Radiol, 2017 Dec 13; 73(8). PMID: 29229179    Free PMC article.
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Diffusion-weighted imaging in identifying breast cancer pathological response to neoadjuvant chemotherapy: A meta-analysis.
Wei Chu, Weiwei Jin, +4 authors, Xuequan Huang.
Oncotarget, 2018 Feb 23; 9(6). PMID: 29467952    Free PMC article.
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.
Predicting the response to neoadjuvant therapy for early-stage breast cancer: tumor-, blood-, and imaging-related biomarkers.
Wenyong Tan, Ming Yang, +2 authors, Weixi Shen.
Cancer Manag Res, 2018 Oct 24; 10. PMID: 30349367    Free PMC article.
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Additive value of diffusion-weighted MRI in the I-SPY 2 TRIAL.
Wen Li, David C Newitt, +10 authors, Nola M Hylton.
J Magn Reson Imaging, 2019 Apr 27; 50(6). PMID: 31026118    Free PMC article.
Preclinical Molecular Imaging for Precision Medicine in Breast Cancer Mouse Models.
M F Fiordelisi, L Auletta, +5 authors, A Greco.
Contrast Media Mol Imaging, 2019 Oct 11; 2019. PMID: 31598114    Free PMC article.
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Diffusion-weighted MRI for Unenhanced Breast Cancer Screening.
Nita Amornsiripanitch, Sebastian Bickelhaupt, +4 authors, Savannah C Partridge.
Radiology, 2019 Oct 09; 293(3). PMID: 31592734    Free PMC article.
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Diffusional kurtosis imaging for differentiation of additional suspicious lesions on preoperative breast MRI of patients with known breast cancer.
Vivian Youngjean Park, Sungheon G Kim, +3 authors, Min Jung Kim.
Magn Reson Imaging, 2019 Jul 20; 62. PMID: 31323316    Free PMC article.
Multiparametric MRI model with dynamic contrast-enhanced and diffusion-weighted imaging enables breast cancer diagnosis with high accuracy.
Michelle Zhang, Joao V Horvat, +7 authors, Katja Pinker.
J Magn Reson Imaging, 2018 Oct 31; 49(3). PMID: 30375702    Free PMC article.
The volumetric-tumour histogram-based analysis of intravoxel incoherent motion and non-Gaussian diffusion MRI: association with prognostic factors in HER2-positive breast cancer.
Chao You, Jianwei Li, +4 authors, Weijun Peng.
J Transl Med, 2019 Jul 03; 17(1). PMID: 31262334    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.
Feasibility and Diagnostic Performance of Voxelwise Computed Diffusion-Weighted Imaging in Breast Cancer.
Jiejie Zhou, Endong Chen, +7 authors, Meihao Wang.
J Magn Reson Imaging, 2018 Oct 18; 49(6). PMID: 30328211    Free PMC article.
Diffusion weighted imaging in breast cancer - Can it be a noninvasive predictor of nuclear grade?
R Rupa, R Thushara, +3 authors, Mathew P Cherian.
Indian J Radiol Imaging, 2020 Jun 02; 30(1). PMID: 32476745    Free PMC article.
Current and Emerging Magnetic Resonance-Based Techniques for Breast Cancer.
Apekshya Chhetri, Xin Li, Joseph V Rispoli.
Front Med (Lausanne), 2020 Jun 02; 7. PMID: 32478083    Free PMC article.
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Discrimination of benign from malignant breast lesions in dense breasts with model-based analysis of regions-of-interest using directional diffusion-weighted images.
Alan I Penn, Milica Medved, +7 authors, Hiroyuki Abe.
BMC Med Imaging, 2020 Jun 11; 20(1). PMID: 32517657    Free PMC article.
Recent Progress for the Techniques of MRI-Guided Breast Interventions and their applications on Surgical Strategy.
Peng Gao, Xiangyi Kong, +4 authors, Jing Wang.
J Cancer, 2020 Jul 07; 11(16). PMID: 32626513    Free PMC article.
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Current Landscape of Breast Cancer Imaging and Potential Quantitative Imaging Markers of Response in ER-Positive Breast Cancers Treated with Neoadjuvant Therapy.
Ella F Jones, Deep K Hathi, +6 authors, Nola M Hylton.
Cancers (Basel), 2020 Jun 13; 12(6). PMID: 32527022    Free PMC article.
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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.
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Advances in Breast MRI in the Setting of Ductal Carcinoma In Situ.
Nita Amornsiripanitch, Diana L Lam, Habib Rahbar.
Semin Roentgenol, 2018 Nov 20; 53(4). PMID: 30449344    Free PMC article.
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Role of perfusion parameters on DCE-MRI and ADC values on DWMRI for invasive ductal carcinoma at 3.0 Tesla.
Fei Liu, Mei Wang, Haige Li.
World J Surg Oncol, 2018 Dec 24; 16(1). PMID: 30577820    Free PMC article.
Correlation between apparent diffusion coefficient of magnetic resonance imaging and tumor-infiltrating lymphocytes in breast cancer.
Marco Fogante, Corrado Tagliati, +3 authors, Andrea Giovagnoni.
Radiol Med, 2019 Feb 27; 124(7). PMID: 30806920
Mean Apparent Diffusion Coefficient Is a Sufficient Conventional Diffusion-weighted MRI Metric to Improve Breast MRI Diagnostic Performance: Results from the ECOG-ACRIN Cancer Research Group A6702 Diffusion Imaging Trial.
Elizabeth S McDonald, Justin Romanoff, +20 authors, Savannah C Partridge.
Radiology, 2020 Nov 18; 298(1). PMID: 33201788    Free PMC article.
Diffusion-Weighted Magnetic Resonance Imaging of the Breast: Standardization of Image Acquisition and Interpretation.
Su Hyun Lee, Hee Jung Shin, Woo Kyung Moon.
Korean J Radiol, 2020 Sep 10; 22(1). PMID: 32901461    Free PMC article.
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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.
MRI-guided breast biopsy based on diffusion-weighted imaging: a feasibility study.
Stefania Montemezzi, Giuseppe Cardano, +3 authors, Lucia Camera.
Eur Radiol, 2020 Nov 01; 31(5). PMID: 33128183    Free PMC article.
Basics of magnetic resonance imaging and quantitative parameters T1, T2, T2*, T1rho and diffusion-weighted imaging.
Suraj D Serai.
Pediatr Radiol, 2021 Apr 16;. PMID: 33856502
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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.