title: Diffusion tensor magnetic resonance imaging of the breast: a pilot study.
abstract: OBJECTIVE
  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.
authors.affiliation: Institute of Diagnostic and Interventional Radiology, Friedrich Schiller University Jena, Erlanger Allee 101, 07740, Jena, Germany. pascal.baltzer@med.uni-jena.de
authors.forename: Pascal A T
authors.initials: PA
authors.lastname: Baltzer
authors.forename: Anja
authors.initials: A
authors.lastname: Schäfer
authors.forename: Matthias
authors.initials: M
authors.lastname: Dietzel
authors.forename: David
authors.initials: D
authors.lastname: Grässel
authors.forename: Mieczyslaw
authors.initials: M
authors.lastname: Gajda
authors.forename: Oumar
authors.initials: O
authors.lastname: Camara
authors.forename: Werner A
authors.initials: WA
authors.lastname: Kaiser
mesh_terms: D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D010865:Pilot Projects; D011859:Radiography; D012680:Sensitivity and Specificity