. 2014 Sep;74(17).
doi: 10.1158/0008-5472.CAN-13-3534.

Diffusion-weighted imaging in cancer: physical foundations and applications of restriction spectrum imaging

Nathan S White 1 Carrie McDonald  Carrie R McDonald 2 Niky Farid 3 Josh Kuperman 3 David Karow 3 Natalie M Schenker-Ahmed 3 Hauke Bartsch 3 Rebecca Rakow-Penner 3 Dominic Holland 3 Ahmed Shabaik 4 Atle Bjørnerud 5 Tuva Hope 6 Jona Hattangadi-Gluth 7 Michael Liss 8 J Kellogg Parsons 8 Clark C Chen 9 Steve Raman 10 Daniel Margolis 10 Robert E Reiter 11 Leonard Marks 11 Santosh Kesari 12 Arno J Mundt 7 Christopher J Kane  Christopher J Kaine 8 Bob S Carter 9 William G Bradley 3 Anders M Dale 13 
  • PMID: 25183788
  •     76 References
  •     46 citations


Diffusion-weighted imaging (DWI) has been at the forefront of cancer imaging since the early 2000s. Before its application in clinical oncology, this powerful technique had already achieved widespread recognition due to its utility in the diagnosis of cerebral infarction. Following this initial success, the ability of DWI to detect inherent tissue contrast began to be exploited in the field of oncology. Although the initial oncologic applications for tumor detection and characterization, assessing treatment response, and predicting survival were primarily in the field of neurooncology, the scope of DWI has since broadened to include oncologic imaging of the prostate gland, breast, and liver. Despite its growing success and application, misconceptions about the underlying physical basis of the DWI signal exist among researchers and clinicians alike. In this review, we provide a detailed explanation of the biophysical basis of diffusion contrast, emphasizing the difference between hindered and restricted diffusion, and elucidating how diffusion parameters in tissue are derived from the measurements via the diffusion model. We describe one advanced DWI modeling technique, called restriction spectrum imaging (RSI). This technique offers a more direct in vivo measure of tumor cells, due to its ability to distinguish separable pools of water within tissue based on their intrinsic diffusion characteristics. Using RSI as an example, we then highlight the ability of advanced DWI techniques to address key clinical challenges in neurooncology, including improved tumor conspicuity, distinguishing actual response to therapy from pseudoresponse, and delineation of white matter tracts in regions of peritumoral edema. We also discuss how RSI, combined with new methods for correction of spatial distortions inherent in diffusion MRI scans, may enable more precise spatial targeting of lesions, with implications for radiation oncology and surgical planning. See all articles in this Cancer Research section, "Physics in Cancer Research."

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Pol J Radiol, 2020 Aug 21; 85. PMID: 32817766    Free PMC article.
Ultrasound and radiological features of abdominal unicentric castleman's disease: A case series study.
Kun Lv, Yanan Zhao, +2 authors, Pintong Huang.
Medicine (Baltimore), 2020 May 03; 99(18). PMID: 32358399    Free PMC article.
Correlation between ADC values and Gleason score in evaluation of prostate cancer: multicentre experience and review of the literature.
Rosa Manetta, Pierpaolo Palumbo, +10 authors, Antonio Barile.
Gland Surg, 2019 Sep 29; 8(Suppl 3). PMID: 31559188    Free PMC article.
Noncontrast MRI with advanced diffusion weighted imaging for breast cancer detection in a lactating woman.
Ana E Rodríguez-Soto, Claire H Meriwether, +5 authors, Rebecca Rakow-Penner.
Radiol Case Rep, 2020 Oct 01; 15(11). PMID: 32994841    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.
Imaging features (CT, MRI, MRS, and PET/CT) of primary central nervous system lymphoma in immunocompetent patients.
Gang Cheng, Jianning Zhang.
Neurol Sci, 2018 Dec 24; 40(3). PMID: 30580380    Free PMC article.
Application of magnetic resonance diffusion kurtosis imaging for distinguishing histopathologic subtypes and grades of rectal carcinoma.
Ziqiang Wen, Yan Chen, +4 authors, Shenping Yu.
Cancer Imaging, 2019 Feb 13; 19(1). PMID: 30744694    Free PMC article.
Diffuse astrocytoma and the diagnostic dilemma of an unusual phenotype: A case report.
Sultan A Alshoabi, Amal A Alareqi, +2 authors, Tareef S Daqqaq.
Radiol Case Rep, 2020 Dec 12; 16(2). PMID: 33304444    Free PMC article.
Factors Affecting Image Quality and Lesion Evaluability in Breast Diffusion-weighted MRI: Observations from the ECOG-ACRIN Cancer Research Group Multisite Trial (A6702).
Jennifer G Whisenant, Justin Romanoff, +19 authors, Savannah C Partridge.
J Breast Imaging, 2021 Feb 06; 3(1). PMID: 33543122    Free PMC article.
Dynamic contrast enhanced-MRI and diffusion-weighted image as predictors of lymphovascular invasion in node-negative invasive breast cancer.
Bo Bae Choi.
World J Surg Oncol, 2021 Mar 17; 19(1). PMID: 33722246    Free PMC article.
Clinical and Pathological Evidence of Anti-GD2 Immunotherapy Induced Differentiation in Relapsed/Refractory High-Risk Neuroblastoma.
Jaume Mora, Alicia Castañeda, +11 authors, Mariona Suñol.
Cancers (Basel), 2021 Apr 04; 13(6). PMID: 33809255    Free PMC article.
Respiratory Motion Mitigation and Repeatability of Two Diffusion-Weighted MRI Methods Applied to a Murine Model of Spontaneous Pancreatic Cancer.
Jianbo Cao, Hee Kwon Song, +6 authors, Stephen Pickup.
Tomography, 2021 Mar 12; 7(1). PMID: 33704226    Free PMC article.