title: Diffusion-weighted imaging of the breast: principles and clinical applications.
abstract: Diffusion-weighted imaging provides a novel contrast mechanism in magnetic resonance (MR) imaging and has a high sensitivity in the detection of changes in the local biologic environment. A significant advantage of diffusion-weighted MR imaging over conventional contrast material-enhanced MR imaging is its high sensitivity to change in the microscopic cellular environment without the need for intravenous contrast material injection. Approaches to the assessment of diffusion-weighted breast imaging findings include assessment of these data alone and interpretation of the data in conjunction with T2-weighted imaging findings. In addition, the analysis of apparent diffusion coefficient (ADC) value can be undertaken either in isolation or in combination with diffusion-weighted and T2-weighted imaging. Most previous studies have evaluated ADC value alone; however, overlap in the ADC values of malignant and benign disease has been observed. This overlap may be partly due to selection of b value, which can influence the concomitant effect of perfusion and emphasize the contribution of multicomponent model influences. The simultaneous assessment of diffusion-weighted and T2-weighted imaging data and ADC value has the potential to improve specificity. In addition, the use of diffusion-weighted imaging in a standard breast MR imaging protocol may heighten sensitivity and thereby improve diagnostic accuracy. Standardization of diffusion-weighted imaging parameters is needed to allow comparison of multicenter studies and assessment of the clinical utility of diffusion-weighted imaging and ADC values in breast evaluation.
authors.affiliation: Department of Diagnostic Radiology, Kitasato University School of Medicine, Minamiku, Kanagawa, Japan. reikow@hotmail.co.jp
authors.forename: Reiko
authors.initials: R
authors.lastname: Woodhams
authors.forename: Saadallah
authors.initials: S
authors.lastname: Ramadan
authors.forename: Peter
authors.initials: P
authors.lastname: Stanwell
authors.forename: Satoko
authors.initials: S
authors.lastname: Sakamoto
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Hata
authors.forename: Masanori
authors.initials: M
authors.lastname: Ozaki
authors.forename: Shinichi
authors.initials: S
authors.lastname: Kan
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Inoue
mesh_terms: D001940:Breast / Q000473:pathology*; D001941:Breast Diseases / Q000175:diagnosis*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*