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European Radiology
Published in: European Radiology 10/2022

04-05-2022 | Breast

A survey by the European Society of Breast Imaging on the implementation of breast diffusion-weighted imaging in clinical practice

Authors: Roberto Lo Gullo, Varadan Sevilimedu, Pascal Baltzer, Denis Le Bihan, Julia Camps-Herrero, Paola Clauser, Fiona J. Gilbert, Mami Iima, Ritse M. Mann, Savannah C. Partridge, Andrew Patterson, Eric E. Sigmund, Sunitha Thakur, Fabienne E. Thibault, Laura Martincich, Katja Pinker, on behalf of the EUSOBI International Breast Diffusion-Weighted Imaging working group

Published in: European Radiology | Issue 10/2022

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Abstract

Objectives

To perform a survey among all European Society of Breast Imaging (EUSOBI) radiologist members to gather representative data regarding the clinical use of breast DWI.

Methods

An online questionnaire was developed by two board-certified radiologists, reviewed by the EUSOBI board and committees, and finally distributed among EUSOBI active and associated (not based in Europe) radiologist members. The questionnaire included 20 questions pertaining to technical preferences (acquisition time, magnet strength, breast coils, number of b values), clinical indications, imaging evaluation, and reporting. Data were analyzed using descriptive statistics, the Chi-square test of independence, and Fisher’s exact test.

Results

Of 1411 EUSOBI radiologist members, 275/1411 (19.5%) responded. Most (222/275, 81%) reported using DWI as part of their routine protocol. Common indications for DWI include lesion characterization (using an ADC threshold of 1.2–1.3 × 10−3 mm2/s) and prediction of response to chemotherapy. Members most commonly acquire two separate b values (114/217, 53%), with b value = 800 s/mm2 being the preferred value for appraisal among those acquiring more than two b values (71/171, 42%). Most did not use synthetic b values (169/217, 78%). While most mention hindered diffusion in the MRI report (161/213, 76%), only 142/217 (57%) report ADC values.

Conclusion

The utilization of DWI in clinical practice among EUSOBI radiologists who responded to the survey is generally in line with international recommendations, with the main application being the differentiation of benign and malignant enhancing lesions, treatment response assessment, and prediction of response to chemotherapy. Report integration of qualitative and quantitative DWI data is not uniform.

Key Points

• Clinical performance of breast DWI is in good agreement with the current recommendations of the EUSOBI International Breast DWI working group.
• Breast DWI applications in clinical practice include the differentiation of benign and malignant enhancing, treatment response assessment, and prediction of response to chemotherapy.
• Report integration of DWI results is not uniform.
Appendix
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Metadata
Title
A survey by the European Society of Breast Imaging on the implementation of breast diffusion-weighted imaging in clinical practice
Authors
Roberto Lo Gullo
Varadan Sevilimedu
Pascal Baltzer
Denis Le Bihan
Julia Camps-Herrero
Paola Clauser
Fiona J. Gilbert
Mami Iima
Ritse M. Mann
Savannah C. Partridge
Andrew Patterson
Eric E. Sigmund
Sunitha Thakur
Fabienne E. Thibault
Laura Martincich
Katja Pinker
on behalf of the EUSOBI International Breast Diffusion-Weighted Imaging working group
Publication date
04-05-2022
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 10/2022
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-022-08833-0

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