title: Intravoxel incoherent motion imaging of tumor microenvironment in locally advanced breast cancer.
abstract: Diffusion-weighted imaging plays important roles in cancer diagnosis, monitoring, and treatment. Although most applications measure restricted diffusion by tumor cellularity, diffusion-weighted imaging is also sensitive to vascularity through the intravoxel incoherent motion effect. Hypervascularity can confound apparent diffusion coefficient measurements in breast cancer. We acquired multiple b-value diffusion-weighted imaging at 3 T in a cohort of breast cancer patients and performed biexponential intravoxel incoherent motion analysis to extract tissue diffusivity (D(t)), perfusion fraction (f(p)), and pseudodiffusivity (D(p)). Results indicated significant differences between normal fibroglandular tissue and malignant lesions in apparent diffusion coefficient mean (±standard deviation) values (2.44 ± 0.30 vs. 1.34 ± 0.39 μm(2)/msec, P < 0.01) and D(t) (2.36 ± 0.38 vs. 1.15 ± 0.35 μm(2)/msec, P < 0.01). Lesion diffusion-weighted imaging signals demonstrated biexponential character in comparison to monoexponential normal tissue. There is some differentiation of lesion subtypes (invasive ductal carcinoma vs. other malignant lesions) with f(p) (10.5 ± 5.0% vs. 6.9 ± 2.9%, P = 0.06), but less so with D(t) (1.14 ± 0.32 μm(2)/msec vs. 1.18 ± 0.52 μm(2)/msec, P = 0.88) and D(p) (14.9 ± 11.4 μm(2)/msec vs. 16.1 ± 5.7 μm(2)/msec, P = 0.75). Comparison of intravoxel incoherent motion biomarkers with contrast enhancement suggests moderate correlations. These results suggest the potential of intravoxel incoherent motion vascular and cellular biomarkers for initial grading, progression monitoring, or treatment assessment of breast tumors.
authors.affiliation: Department of Radiology, New York University Langone Medical Center, New York, New York, USA. eric.sigmund@nyumc.org
authors.forename: E E
authors.initials: EE
authors.lastname: Sigmund
authors.forename: G Y
authors.initials: GY
authors.lastname: Cho
authors.forename: S
authors.initials: S
authors.lastname: Kim
authors.forename: M
authors.initials: M
authors.lastname: Finn
authors.forename: M
authors.initials: M
authors.lastname: Moccaldi
authors.forename: J H
authors.initials: JH
authors.lastname: Jensen
authors.forename: D K
authors.initials: DK
authors.lastname: Sodickson
authors.forename: J D
authors.initials: JD
authors.lastname: Goldberg
authors.forename: S
authors.initials: S
authors.lastname: Formenti
authors.forename: L
authors.initials: L
authors.lastname: Moy
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D001943:Breast Neoplasms / Q000473:pathology*; D003287:Contrast Media; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008875:Middle Aged; D009068:Movement; D009389:Neovascularization, Pathologic / Q000473:pathology; D012984:Software
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA