Diffusion-weighted MRI for unenhanced breast cancer screening Review


Authors: Amornsiripanitch, N.; Bickelhaupt, S.; Shin, H. J.; Dang, M.; Rahbar, H.; Pinker, K.; Partridge, S. C.
Review Title: Diffusion-weighted MRI for unenhanced breast cancer screening
Abstract: Diffusion-weighted (DW) MRI is a rapid technique that measures the mobility of water molecules within tissue, reflecting the cellular microenvironment. At DW MRI, breast cancers typically exhibit reduced diffusivity and appear hyperintense to surrounding tissues. On the basis of this characteristic, DW MRI may offer an unenhanced method to detect breast cancer without the costs and safety concerns associated with dynamic contrast material-enhanced MRI, the current reference standard in the setting of high-risk screening. This application of DW MRI has not been widely explored but is particularly timely given the growing health concerns related to the long-term use of gadolinium-based contrast material. Moreover, increasing breast density notification legislation across the United States is raising awareness of the limitations of mammography in women with dense breasts, emphasizing the need for additional cost-effective supplemental screening examinations. Preliminary studies suggest unenhanced MRI with DW MRI may provide higher sensitivity than screening mammography for the detection of breast malignancies. Larger prospective multicenter trials are needed to validate single-center findings and assess the performance of DW MRI for generalized breast cancer screening. Standardization of DW MRI acquisition and interpretation is essential to ensure reliable sensitivity and specificity, and an optimal approach for screening using readily available techniques is proposed here. © RSNA, 2019
Keywords: nuclear magnetic resonance imaging; sensitivity and specificity; breast cancer; image analysis; echomammography; differential diagnosis; cancer screening; clinical protocol; false negative result; statistical significance; mammography; contrast enhancement; intermethod comparison; image processing; false positive result; dynamic contrast-enhanced magnetic resonance imaging; diffusion weighted imaging; echo planar imaging; apparent diffusion coefficient; contrast to noise ratio; human; priority journal; article; water content; b value
Journal Title: Radiology
Volume: 293
Issue: 3
ISSN: 0033-8419
Publisher: Radiological Society of North America, Inc.  
Date Published: 2019-12-01
Start Page: 504
End Page: 520
Language: English
DOI: 10.1148/radiol.2019182789
PUBMED: 31592734
PROVIDER: scopus
PMCID: PMC6884069
DOI/URL:
Notes: Article -- Source: Scopus
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors