Top

Published in:

01-01-2011 | Breast

Diffusion tensor magnetic resonance imaging of the breast: a pilot study

Authors: Pascal A. T. Baltzer, Anja Schäfer, Matthias Dietzel, David Grässel, Mieczyslaw Gajda, Oumar Camara, Werner A. Kaiser

Published in: European Radiology | Issue 1/2011

Abstract

Objectives

Diffusion-weighted MR imaging has shown diagnostic value for differential diagnosis of breast lesions. Diffusion tensor imaging (DTI) adds information about tissue microstructure by addressing diffusion direction. We have examined the diagnostic application of DTI of the breast.

Methods

A total of 59 patients (71 lesions: 54 malignant, 17 benign) successfully underwent prospective echo planar imaging–DTI (EPI-DTI) (1.5 T). First, diffusion direction both of parenchyma as well as lesions was assessed on parametric maps. Subsequently, apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values were measured. Statistics included univariate (Mann–Whitney U test, receiver operating analysis) and multivariate (logistic regression analysis, LRA) tests.

Results

Main diffusion direction of parenchyma was anterior–posterior in the majority of cases (66.1%), whereas lesions (benign, malignant) showed no predominant diffusion direction in the majority of cases (23.9%). ADC values showed highest differences between benign and malignant lesions (P < 0.001) with resulting area under the curve (AUC) of 0.899. FA values were lower in benign (interquartile range, IR, 0.14–0.24) compared to malignant lesions (IR 0.21–0.35, P < 0.002) with an AUC of 0.751–0.770. Following LRA, FA did not prove to have incremental value for differential diagnosis over ADC values.

Conclusions

Microanatomical differences between benign and malignant breast lesions as well as breast parenchyma can be visualized by using DTI.

Peters NH, Borel Rinkes IH, Zuithoff NP et al (2008) Meta-analysis of MR imaging in the diagnosis of breast lesions. Radiology 246:116–124CrossRefPubMed

Warner E, Messersmith H, Causer P et al (2008) Systematic review: using magnetic resonance imaging to screen women at high risk for breast cancer. Ann Intern Med 148:671–679PubMed

Kaiser WA, Zeitler E (1989) MR imaging of the breast: fast imaging sequences with and without Gd-DTPA. Preliminary observations. Radiology 170:681–686PubMed

Kuhl C (2007) The current status of breast MR imaging. Part I. Choice of technique, image interpretation, diagnostic accuracy, and transfer to clinical practice. Radiology 244:356–378CrossRefPubMed

Naumov GN, Bender E, Zurakowski D et al (2006) A model of human tumor dormancy: an angiogenic switch from the nonangiogenic phenotype. J Natl Cancer Inst 98:316–325CrossRefPubMed

Baltzer PA, Freiberg C, Beger S et al (2009) Clinical MR-mammography: are computer-assisted methods superior to visual or manual measurements for curve type analysis? A systematic approach. Acad Radiol 16:1070–1076CrossRefPubMed

Gibbs P, Liney GP, Lowry M et al (2004) Differentiation of benign and malignant sub-1 cm breast lesions using dynamic contrast enhanced MRI. Breast 13:115–121CrossRefPubMed

Siegmann KC, Muller-Schimpfle M, Schick F et al (2002) MR imaging-detected breast lesions: histopathologic correlation of lesion characteristics and signal intensity data. AJR Am J Roentgenol 178:1403–1409PubMed

Zwick S, Brix G, Tofts PS et al (2009) Simulation-based comparison of two approaches frequently used for dynamic contrast-enhanced MRI. Eur Radiol 20:432–442CrossRefPubMed

10.

Tofts PS, Berkowitz B, Schnall MD (1995) Quantitative analysis of dynamic Gd-DTPA enhancement in breast tumors using a permeability model. Magn Reson Med 33:564–568CrossRefPubMed

11.

Ikeda DM, Hylton NM, Kuhl CK et al (2003) MRI breast imaging reporting and data system atlas, 1st edn. American College of Radiology, Reston

12.

Malich A, Fischer DR, Wurdinger S et al (2005) Potential MRI interpretation model: differentiation of benign from malignant breast masses. AJR Am J Roentgenol 185:964–970CrossRefPubMed

13.

Mountford C, Ramadan S, Stanwell P et al (2009) Proton MRS of the breast in the clinical setting. NMR Biomed 22:54–64CrossRefPubMed

14.

Schnall MD, Blume J, Bluemke DA et al (2006) Diagnostic architectural and dynamic features at breast MR imaging: multicenter study. Radiology 238:42–53CrossRefPubMed

15.

Tsushima Y, Takahashi-Taketomi A, Endo K (2009) Magnetic resonance (MR) differential diagnosis of breast tumors using apparent diffusion coefficient (ADC) on 1.5-T. J Magn Reson Imaging 30:249–255CrossRefPubMed

16.

Baltzer PA, Benndorf M, Dietzel M et al (2009) Sensitivity and specificity of unenhanced MR mammography (DWI combined with T2-weighted TSE imaging, ueMRM) for the differentiation of mass lesions. Eur Radiol 20:1101–1110CrossRefPubMed

17.

Baltzer PA, Dietzel M, Vag T et al (2009) Diffusion weighted imaging - useful in all kinds of lesions? A systematic review. Eur Radiol 19:765–769CrossRef

18.

Baltzer PA, Renz DM, Herrmann KH et al (2009) Diffusion-weighted imaging (DWI) in MR mammography (MRM): clinical comparison of echo planar imaging (EPI) and half-Fourier single-shot turbo spin echo (HASTE) diffusion techniques. Eur Radiol 19:1612–1620CrossRefPubMed

19.

Guo Y, Cai YQ, Cai ZL et al (2002) Differentiation of clinically benign and malignant breast lesions using diffusion-weighted imaging. J Magn Reson Imaging 16:172–178CrossRefPubMed

20.

Hatakenaka M, Soeda H, Yabuuchi H et al (2008) Apparent diffusion coefficients of breast tumors: clinical application. Magn Reson Med Sci 7:23–29CrossRefPubMed

21.

Kinoshita T, Yashiro N, Ihara N et al (2002) Diffusion-weighted half-Fourier single-shot turbo spin echo imaging in breast tumors: differentiation of invasive ductal carcinoma from fibroadenoma. J Comput Assist Tomogr 26:1042–1046CrossRefPubMed

22.

Kuroki Y, Nasu K, Kuroki S et al (2004) Diffusion-weighted imaging of breast cancer with the sensitivity encoding technique: analysis of the apparent diffusion coefficient value. Magn Reson Med Sci 3:79–85CrossRefPubMed

23.

Kuroki-Suzuki S, Kuroki Y, Nasu K et al (2007) Detecting breast cancer with non-contrast MR imaging: combining diffusion-weighted and STIR imaging. Magn Reson Med Sci 6:21–27CrossRefPubMed

24.

Marini C, Iacconi C, Giannelli M et al (2007) Quantitative diffusion-weighted MR imaging in the differential diagnosis of breast lesion. Eur Radiol 17:2646–2655CrossRefPubMed

25.

Park MJ, Cha ES, Kang BJ et al (2007) The role of diffusion-weighted imaging and the apparent diffusion coefficient (ADC) values for breast tumors. Korean J Radiol 8:390–396CrossRefPubMed

26.

Rubesova E, Grell AS, De Maertelaer V et al (2006) Quantitative diffusion imaging in breast cancer: a clinical prospective study. J Magn Reson Imaging 24:319–324CrossRefPubMed

27.

Wenkel E, Geppert C, Schulz-Wendtland R et al (2007) Diffusion weighted imaging in breast MRI: comparison of two different pulse sequences. Acad Radiol 14:1077–1083CrossRefPubMed

28.

Woodhams R, Kakita S, Hata H et al (2009) Diffusion-weighted imaging of mucinous carcinoma of the breast: evaluation of apparent diffusion coefficient and signal intensity in correlation with histologic findings. AJR Am J Roentgenol 193:260–266CrossRefPubMed

29.

Woodhams R, Matsunaga K, Iwabuchi K et al (2005) Diffusion-weighted imaging of malignant breast tumors: the usefulness of apparent diffusion coefficient (ADC) value and ADC map for the detection of malignant breast tumors and evaluation of cancer extension. J Comput Assist Tomogr 29:644–649CrossRefPubMed

30.

Woodhams R, Matsunaga K, Kan S et al (2005) ADC mapping of benign and malignant breast tumors. Magn Reson Med Sci 4:35–42CrossRefPubMed

31.

Charles-Edwards EM, deSouza NM (2006) Diffusion-weighted magnetic resonance imaging and its application to cancer. Cancer Imaging 6:135–143CrossRefPubMed

32.

Hagmann P, Jonasson L, Maeder P et al (2006) Understanding diffusion MR imaging techniques: from scalar diffusion-weighted imaging to diffusion tensor imaging and beyond. Radiographics 26(Suppl 1):S205–S223CrossRefPubMed

33.

Partridge SC, Murthy RS, Ziadloo A et al (2010) Diffusion tensor magnetic resonance imaging of the normal breast. Magn Reson Imaging 28:320–328CrossRefPubMed

34.

Partridge SC, Ziadloo A, Murthy R et al (2010) Diffusion tensor MRI: preliminary anisotropy measures and mapping of breast tumors. J Magn Reson Imaging 31:339–347CrossRefPubMed

Title: Diffusion tensor magnetic resonance imaging of the breast: a pilot study
Authors: Pascal A. T. Baltzer
Anja Schäfer
Matthias Dietzel
David Grässel
Mieczyslaw Gajda
Oumar Camara
Werner A. Kaiser
Publication date: 01-01-2011
Publisher: Springer-Verlag
Published in: European Radiology / Issue 1/2011
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-010-1901-9

ACC 2024 Congress

Springer Medicine

Diffusion tensor magnetic resonance imaging of the breast: a pilot study

Abstract

Objectives

Methods

Results

Conclusions

ACC 2024 Congress

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2011

Diffusion-weighted MRI for detecting liver metastases: importance of the b-value

Self-gating MR imaging of the fetal heart: comparison with real cardiac triggering

High-pitch dual-source CT angiography of the aortic valve-aortic root complex without ECG-synchronization

Low-dose computed tomography of the paranasal sinus and facial skull using a high-pitch dual-source system—First clinical results

Detection of non-palpable breast cancer in asymptomatic women by using unenhanced diffusion-weighted and T2-weighted MR imaging: comparison with mammography and dynamic contrast-enhanced MR imaging

Conspicuity of breast cancer according to histopathological type and breast density when imaged by full-field digital mammography compared with screen-film mammography