The Role of Parallel Diffusion-Weighted Imaging and Apparent Diffusion Coefficient (ADC) Map Values for Evaluating Breast Lesions

Abstract

OBJECTIVE To evaluate the feasibility of using diffusion-weighted imaging (DWI) with an array spatial sensitivity encoding technique (ASSET) and apparent diffusion coefficient (ADC) map values with different b values to distinguish benign and malignant breast lesions. MATERIALS AND METHODS Fifty-six female patients with 60 histologically proven breast lesions and 20 healthy volunteers underwent MRI. A subset of normal volunteers (n = 7) and patients (n = 16) underwent both conventional DWI and ASSET-DWI, and the image quality between the two methods was compared. Finally, ASSET-DWI with b = 0, 600 s/mm2 and b = 0, 1000 s/mm2 were compared for their ability to distinguish benign and malignant breast lesions. RESULTS The ASSET-DWI method had less distortion, fewer artifacts, and a lower acquisition time than other methods. No significant difference (P > 0.05) was detected in ADC map values between ASSET-DWI and conventional DWI. For ASSET-DWI, the sensitivity of ADC values for malignant lesions with a threshold of less than 1.44 × 10−3 mm2/s (b = 600 s/mm2) and 1.18 × 10−3 mm2/s (b = 1000s/mm2) was 80% and 77.5% respectively. The specificity of both groups was 95%. CONCLUSION ASSET-DWI evaluation of breast tissue offers decreased distortion, susceptibility to artifacts, and acquisition time relative to other methods. The use of ASSET-DWI is feasible with b values ranging from 600 to 1000 s/mm2 and provides increased specificity compared to other techniques. Thus, the ADC value of a breast lesion can be used to further characterize malignant lesions from benign ones.

Diffusion-weighted Imaging of the Breast: Principles and Clinical Applications

“…Microperfusion effect has not been observed at a b value of less than 600 sec/mm 2 in normal fibroglandular breast tissue or in adipose tissue, a finding that is consistent with reports that the mammary gland is not a highly vascular organ (15,16). However, the fact that microperfusion is high in both benign and malignant lesions is common knowledge in the scientific community (17).…”

“…In one study, the sensitivityencoding technique (34) was used, resulting in a reduction in the number of phase-encoding steps and in acquisition time, with an associated reduction in susceptibility and chemical shift artifacts (3). Similarly, in another study, in which diffusionweighted breast imaging with the proprietary array spatial sensitivity encoding technique (ASSET; GE Healthcare, Waukesha, Wis) was used, there was a reduction in image distortion, susceptibility artifacts, and acquisition time relative to other methods (Fig 2) (17).…”

Breast DWI at 3 T: influence of the fat-suppression technique on image quality and diagnostic performance

“…5,9,28,29 Differences in DWI pulse sequence parameters or the use of different fatsuppression methods prevent a direct comparison between studies. Using PI, lower SNR and CNR had been reported by Jin et al 16 To isolate the effect of the fat-suppression technique, all other acquisition parameters were kept as constant as possible.…”

“…16,17 Given that the present DWI sequence includes higher b-values (b ¼ 2000 and 3000 s/mm 2 ) the decision was made to exclude PI to gain SNR. Thus, the purpose of the present study was to compare quantitatively DWI-STIR and -SPAIR when no PI is used regarding SNR and CNR, fat-suppression uniformity, and ADC quantification for lesion differentiation and characterization in the clinical setting.…”

Comparison between diffusion‐weighted imaging, ‐weighted, and postcontrast ‐weighted imaging after MR‐guided, high intensity, focused ultrasound treatment of uterine leiomyomata: Preliminary results

“…The ADC has been related to the state of tissue during the evolution of cerebral ischemia, 45,46,51 fibroid progression, 12,28 and tumor changes. [52][53][54][55][56][57] Since DWI/ADC mapping can detect changes within the water tissue at the earliest time points, this may provide a method of early indication of treated uterine fibroids using MRg-HIFUS.…”