Partridge SC, Murthy RS, Ziadloo A, et al.. Diffusion tensor magnetic resonance imaging of the normal breast
Department of Radiology, University of Washington, Seattle, WA 98195, USA. Magnetic Resonance Imaging
(Impact Factor: 2.09).
04/2010; 28(3):320-8. DOI: 10.1016/j.mri.2009.10.003
The objective of this study was to evaluate diffusion anisotropy of the breast parenchyma and assess the range and repeatability of diffusion tensor imaging (DTI) parameters in normal breast tissue.
The study was approved by our institutional review board and included 12 healthy females (median age, 36 years). Diffusion tensor imaging was performed at 1.5 T using a diffusion-weighted echo planar imaging sequence. Diffusion tensor imaging parameters including tensor eigenvalues (lambda(1), lambda(2), lambda(3)), fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were measured for anterior, central and posterior breast regions.
Mean normal breast DTI measures were lambda(1)=2.51 x 10(-3) mm(2)/s, lambda(2)=1.89 x 10(-3) mm(2)/s, lambda(3)=1.39 x 10(-3) mm(2)/s, ADC=1.95+/-0.24 x 10(-3) mm(2)/s and FA=0.29+/-0.05 for b=600 s/mm(2). Significant regional differences were observed for both FA and ADC (P<.05), with higher ADC in the central breast and higher FA in the posterior breast. Comparison of DTI values calculated using b=0, 600 s/mm(2) vs. b=0, 1000 s/mm(2), showed significant differences in ADC (P<.001), but not FA. Repeatability assessment produced within-subject coefficient of variations of 4.5% for ADC and 11.4% for FA measures.
This study demonstrates anisotropy of water diffusion in normal breast tissue and establishes a normative range of breast FA values. Attention to the influence of breast region and b value on breast DTI measurements may be important for clinical interpretation and standardization of techniques.
Available from: Lori R Arlinghaus
- "Slice-based affine registration of the individual diffusion-weighted images to the nondiffusion-weighted image is typically used in DW-MRI studies of the brain. Until recently, however, these techniques have not been used in DW-MRI studies of the breast . "
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ABSTRACT: The current state-of-the-art assessment of treatment response in breast cancer is based on the response evaluation criteria in solid tumors (RECIST). RECIST reports on changes in gross morphology and divides response into one of four categories. In this paper we highlight how dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion-weighted MRI (DW-MRI) may be able to offer earlier, and more precise, information on treatment response in the neoadjuvant setting than RECIST. We then describe how longitudinal registration of breast images and the incorporation of intelligent bioinformatics approaches with imaging data have the potential to increase the sensitivity of assessing treatment response. We conclude with a discussion of the potential benefits of breast MRI at the higher field strength of 3T. For each of these areas, we provide a review, illustrative examples from clinical trials, and offer insights into future research directions.
Journal of Oncology 09/2010; 2010. DOI:10.1155/2010/919620
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ABSTRACT: Fat suppression is essential for diffusion-weighted imaging (DWI) in the body. However, the chemical shift selective (CHESS) pulse often fails to suppress fat signals in the breast. The purpose of this study was to compare DWI using CHESS and DWI using short inversion time inversion recovery (STIR) in terms of fat suppression and the apparent diffusion coefficient (ADC) value.
DWI using STIR, DWI using CHESS, and contrast-enhanced T1-weighted images were obtained in 32 patients with breast carcinoma. Uniformity of fat suppression, ADC, signal intensity, and visualization of the breast tumors were evaluated.
In 44% (14/32) of patients there was insufficient fat suppression in the breasts on DWI using CHESS, whereas 0% was observed on DWI using STIR (P < 0.0001). The ADCs obtained for DWI using STIR were 4.3% lower than those obtained for DWI using CHESS (P < 0.02); there was a strong correlation of the ADC measurement (r = 0.93, P < 0.001).
DWI using STIR may be excellent for fat suppression; and the ADC obtained in this sequence was well correlated with that obtained with DWI using CHESS. DWI using STIR may be useful when the fat suppression technique in DWI using CHESS does not work well.
Japanese journal of radiology 05/2009; 27(4):163-7. DOI:10.1007/s11604-009-0314-7 · 0.84 Impact Factor
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ABSTRACT: 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.
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.
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.
Microanatomical differences between benign and malignant breast lesions as well as breast parenchyma can be visualized by using DTI.
European Radiology 01/2011; 21(1):1-10. DOI:10.1007/s00330-010-1901-9 · 4.01 Impact Factor
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