Diffusion Breast MRI: Current Standard and Emerging Techniques

Mendez, Ashley M; Fang, Lauren K.; Meriwether, Claire H.; Batasin, Summer; Loubrie, Stephane; Rodríguez‐Soto, Ana E.; Rakow‐Penner, Rebecca

doi:10.3389/fonc.2022.844790

Cited by 13 publications

(11 citation statements)

References 238 publications

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“…Water mobility, quantified via apparent diffusion coefficient (ADC), is being utilized in preclinical and clinical studies as a quantitative MRI biomarker that is sensitive to tissue alteration due to disease evolution and response to treatment [ 1 , 2 , 3 , 4 ]. ADC measurement has desirable features of being largely independent of magnet field strength, being derived by a simple mathematical model of monoexponential MRI signal decay as a function of diffusion weighting ( b -value), and being widely available as a standard technique on preclinical and clinical MRI systems.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Apparent Diffusion Coefficient Repeatability and Reproducibility for Preclinical MRIs Using Standardized Procedures and a Diffusion-Weighted Imaging Phantom

et al. 2023

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Relevant to co-clinical trials, the goal of this work was to assess repeatability, reproducibility, and bias of the apparent diffusion coefficient (ADC) for preclinical MRIs using standardized procedures for comparison to performance of clinical MRIs. A temperature-controlled phantom provided an absolute reference standard to measure spatial uniformity of these performance metrics. Seven institutions participated in the study, wherein diffusion-weighted imaging (DWI) data were acquired over multiple days on 10 preclinical scanners, from 3 vendors, at 6 field strengths. Centralized versus site-based analysis was compared to illustrate incremental variance due to processing workflow. At magnet isocenter, short-term (intra-exam) and long-term (multiday) repeatability were excellent at within-system coefficient of variance, wCV [±CI] = 0.73% [0.54%, 1.12%] and 1.26% [0.94%, 1.89%], respectively. The cross-system reproducibility coefficient, RDC [±CI] = 0.188 [0.129, 0.343] µm2/ms, corresponded to 17% [12%, 31%] relative to the reference standard. Absolute bias at isocenter was low (within 4%) for 8 of 10 systems, whereas two high-bias (>10%) scanners were primary contributors to the relatively high RDC. Significant additional variance (>2%) due to site-specific analysis was observed for 2 of 10 systems. Base-level technical bias, repeatability, reproducibility, and spatial uniformity patterns were consistent with human MRIs (scaled for bore size). Well-calibrated preclinical MRI systems are capable of highly repeatable and reproducible ADC measurements.

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Section: Introductionmentioning

confidence: 99%

Evaluation of Apparent Diffusion Coefficient Repeatability and Reproducibility for Preclinical MRIs Using Standardized Procedures and a Diffusion-Weighted Imaging Phantom

et al. 2023

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“…The role of MRI for the detection and management of breast cancer continues to evolve with a growing number of studies indicating that it could be an impactful method for screening in an expanded population of women 2–4 . Building on the success of msDWI of the breasts in the prone position, a supine DWI exam may have the potential to provide a comfortable, efficient, and noninvasive MRI to screen for breast cancer 6,17,21 . This study established a baseline supine msDWI protocol with 4‐shots and RT, as 4‐shots significantly improved sharpness and distortion over 2‐shots, while RT significantly improved sharpness, aliasing, perceived SNR, and overall image quality over free‐breathing.…”

Section: Discussionmentioning

confidence: 99%

“…[2][3][4] Building on the success of msDWI of the breasts in the prone position, a supine DWI exam may have the potential to provide a comfortable, efficient, and noninvasive MRI to screen for breast cancer. 6,17,21 This study established a baseline supine msDWI protocol with 4-shots and RT, as 4-shots significantly improved sharpness and distortion over 2-shots, while RT significantly improved sharpness, aliasing, perceived SNR, and overall image quality over free-breathing. Further, ADCs in fibroglandular tissues did not significantly vary with the number of shots or RT vs. FB.…”

Section: Discussionmentioning

confidence: 99%

“…Acquisition of DWI of the breasts with supine positioning has been rarely investigated, 16 but DWI of the breasts with prone positioning has been extensively investigated, with several advanced DWI methods providing improvements in image quality 17–24 . In particular, multishot DWI (msDWI) methods, which can reduce distortion and improve resolution, have been assessed in the breasts in previous studies 18,19,23 .…”

mentioning

confidence: 99%

“…11,12,14,15 Acquisition of DWI of the breasts with supine positioning has been rarely investigated, 16 but DWI of the breasts with prone positioning has been extensively investigated, with several advanced DWI methods providing improvements in image quality. [17][18][19][20][21][22][23][24] In particular, multishot DWI (msDWI) methods, which can reduce distortion and improve resolution, have been assessed in the breasts in previous studies. 18,19,23 While these studies can be used as a starting point for supine DWI, a number of factors impacting the performance of DWI will vary between the two positions.…”

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confidence: 99%

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Multishot Diffusion‐Weighted MRI of the Breasts in the Supine vs. Prone Position

Moran

Middione

Mazzoli

et al. 2022

Magnetic Resonance Imaging

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Background Diffusion‐weighted imaging (DWI) may allow for breast cancer screening MRI without a contrast injection. Multishot methods improve prone DWI of the breasts but face different challenges in the supine position. Purpose To establish a multishot DWI (msDWI) protocol for supine breast MRI and to evaluate the performance of supine vs. prone msDWI. Study Type Prospective. Population Protocol optimization: 10 healthy women (ages 22–56), supine vs. prone: 24 healthy women (ages 22–62) and five women (ages 29–61) with breast tumors. Field Strength/Sequence 3‐T, protocol optimization msDWI: free‐breathing (FB) 2‐shots, FB 4‐shots, respiratory‐triggered (RT) 2‐shots, RT 4‐shots, supine vs. prone: RT 4‐shot msDWI, T2‐weighted fast‐spin echo. Assessment Protocol optimization and supine vs. prone: three observers performed an image quality assessment of sharpness, aliasing, distortion (vs. T2), perceived SNR, and overall image quality (scale of 1–5). Apparent diffusion coefficients (ADCs) in fibroglandular tissue (FGT) and breast tumors were measured. Statistical Tests Effect of study variables on dichotomized ratings (4/5 vs. 1/2/3) and FGT ADCs were assessed with mixed‐effects logistic regression. Interobserver agreement utilized Gwet's agreement coefficient (AC). Lesion ADCs were assessed by Bland–Altman analysis and concordance correlation (ρc). P value <0.05 was considered statistically significant. Results Protocol optimization: 4‐shots significantly improved sharpness and distortion; RT significantly improved sharpness, aliasing, perceived SNR, and overall image quality. FGT ADCs were not significantly different between shots (P = 0.812), FB vs. RT (P = 0.591), or side (P = 0.574). Supine vs. prone: supine images were rated significantly higher for sharpness, aliasing, and overall image quality. FGT ADCs were significantly higher supine; lesion ADCs were highly correlated (ρc = 0.92). Data Conclusion Based on image quality, supine msDWI outperformed prone msDWI. Lesion ADCs were highly correlated between the two positions, while FGT ADCs were higher in the supine position. Evidence Level 2. Technical Efficacy Stage 1.

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Probing Renal Microstructure and Function with Advanced Diffusion MRI: Concepts, Applications, Challenges, and Future Directions

Stabinska,

Wittsack,

Lerman

et al. 2023

Magnetic Resonance Imaging

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Diffusion measurements in the kidney are affected not only by renal microstructure but also by physiological processes (i.e., glomerular filtration, water reabsorption, and urine formation). Because of the superposition of passive tissue diffusion, blood perfusion, and tubular pre‐urine flow, the limitations of the monoexponential apparent diffusion coefficient (ADC) model in assessing pathophysiological changes in renal tissue are becoming apparent and motivate the development of more advanced diffusion‐weighted imaging (DWI) variants. These approaches take advantage of the fact that the length scale probed in DWI measurements can be adjusted by experimental parameters, including diffusion‐weighting, diffusion gradient directions and diffusion time. This forms the basis by which advanced DWI models can be used to capture not only passive diffusion effects, but also microcirculation, compartmentalization, tissue anisotropy. In this review, we provide a comprehensive overview of the recent advancements in the field of renal DWI. Following a short introduction on renal structure and physiology, we present the key methodological approaches for the acquisition and analysis of renal DWI data, including intravoxel incoherent motion (IVIM), diffusion tensor imaging (DTI), non‐Gaussian diffusion, and hybrid IVIM‐DTI. We then briefly summarize the applications of these methods in chronic kidney disease and renal allograft dysfunction. Finally, we discuss the challenges and potential avenues for further development of renal DWI.Level of Evidence5Technical EfficacyStage 2

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Diffusion Breast MRI: Current Standard and Emerging Techniques

Cited by 13 publications

References 238 publications

Evaluation of Apparent Diffusion Coefficient Repeatability and Reproducibility for Preclinical MRIs Using Standardized Procedures and a Diffusion-Weighted Imaging Phantom

Evaluation of Apparent Diffusion Coefficient Repeatability and Reproducibility for Preclinical MRIs Using Standardized Procedures and a Diffusion-Weighted Imaging Phantom

Multishot Diffusion‐Weighted MRI of the Breasts in the Supine vs. Prone Position

Probing Renal Microstructure and Function with Advanced Diffusion MRI: Concepts, Applications, Challenges, and Future Directions

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