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      Diffusion-weighted imaging of the breast: current status as an imaging biomarker and future role

      review-article
      Author(s): 1 ,
      Publication date (Electronic):
      Journal: BJR Open
      Publisher: The British Institute of Radiology.

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          Abstract

          Diffusion-weighted imaging (DWI) of the breast is a MRI sequence that shows several advantages when compared to the dynamic contrast-enhanced sequence: it does not need intravenous contrast, it is relatively quick and easy to implement (artifacts notwithstanding). In this review, the current applications of DWI for lesion characterization and prognosis as well as for response evaluation are analyzed from the point of view of the necessary steps to become a useful surrogate of underlying biological processes (tissue architecture and cellularity): from the proof of concept, to the proof of mechanism, the proof of principle and finally the proof of effectiveness. Future applications of DWI in screening, DWI modeling and radiomics are also discussed.

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          Most cited references114

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          Imaging biomarker roadmap for cancer studies

          James P B O'Connor, Eric Aboagye, Judith E Adams … (2016)
          Imaging biomarkers (IBs) are integral to the routine management of patients with cancer. IBs used daily in oncology include clinical TNM stage, objective response and left ventricular ejection fraction. Other CT, MRI, PET and ultrasonography biomarkers are used extensively in cancer research and drug development. New IBs need to be established either as useful tools for testing research hypotheses in clinical trials and research studies, or as clinical decision-making tools for use in healthcare, by crossing ‘translational gaps’ through validation and qualification. Important differences exist between IBs and biospecimen-derived biomarkers and, therefore, the development of IBs requires a tailored ‘roadmap’. Recognizing this need, Cancer Research UK (CRUK) and the European Organisation for Research and Treatment of Cancer (EORTC) assembled experts to review, debate and summarize the challenges of IB validation and qualification. This consensus group has produced 14 key recommendations for accelerating the clinical translation of IBs, which highlight the role of parallel (rather than sequential) tracks of technical (assay) validation, biological/clinical validation and assessment of cost-effectiveness; the need for IB standardization and accreditation systems; the need to continually revisit IB precision; an alternative framework for biological/clinical validation of IBs; and the essential requirements for multicentre studies to qualify IBs for clinical use.
          Article 0 comments Cited 274 times – based on 0 reviews     Review now
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            MR imaging of intravoxel incoherent motions: application to diffusion and perfusion in neurologic disorders.

            D Le Bihan, E Breton, D Lallemand … (1986)
            Molecular diffusion and microcirculation in the capillary network result in a distribution of phases in a single voxel in the presence of magnetic field gradients. This distribution produces a spin-echo attenuation. The authors have developed a magnetic resonance (MR) method to image such intravoxel incoherent motions (IVIMs) by using appropriate gradient pulses. Images were generated at 0.5 T in a high-resolution, multisection mode. Diffusion coefficients measured on images of water and acetone phantoms were consistent with published values. Images obtained in the neurologic area from healthy subjects and patients were analyzed in terms of an apparent diffusion coefficient (ADC) incorporating the effect of all IVIMs. Differences were found between various normal and pathologic tissues. The ADC of in vivo water differed from the diffusion coefficient of pure water. Results were assessed in relation to water compartmentation in biologic tissues (restricted diffusion) and tissue perfusion. Nonuniform slow flow of cerebrospinal fluid appeared as a useful feature on IVIM images. Observation of these motions may significantly extend the diagnostic capabilities of MR imaging.
            Article 0 comments Cited 268 times – based on 0 reviews     Review now
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              Preoperative prediction of sentinel lymph node metastasis in breast cancer based on radiomics of T2-weighted fat-suppression and diffusion-weighted MRI

              Yuhao Dong, Qianjin Feng, Wei Yang … (2018)
              To predict sentinel lymph node (SLN) metastasis in breast cancer patients using radiomics based on T2-weighted fat suppression (T2-FS) and diffusion-weighted MRI (DWI).
              Article 0 comments Cited 101 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Julia Camps-Herrero:
                ORCID: http://orcid.org/0000-0002-8061-6272
                Journal
                Journal ID (nlm-ta): BJR Open
                Journal ID (iso-abbrev): BJR Open
                Journal ID (publisher-id): bjro
                Title: BJR Open
                Publisher: The British Institute of Radiology.
                ISSN (Electronic): 2513-9878
                Publication date Collection: 2019
                Publication date (Electronic): 08 March 2019
                Volume: 1
                Issue: 1
                Electronic Location Identifier: 20180049
                Affiliations
                [1 ] org-divisionHead of Radiology Department, Breast Unit. Hospital Universitario de la Ribera , Alzira, Spain
                Author notes
                Address correspondence to: . E-mail: juliacamps@ 123456gmail.com
                Author information
                http://orcid.org/0000-0002-8061-6272
                Article
                Publisher-manuscript ID: BJRO-D-18-00049
                DOI: 10.1259/bjro.20180049
                PMC ID: 7592470
                PubMed ID: 33178933
                SO-VID: c037b1e5-6a57-481f-93a4-aa1352cf422f
                Copyright © © 2019 The Authors. Published by the British Institute of Radiology
                License:

                This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution and repr http://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted non-commercial reuse, provided the original author and source are credited.

                History
                Date received : 13 December 2018
                Date revision received : 07 February 2019
                Date accepted : 12 February 2019
                Page count
                Figures: 6, Tables: 0, Equations: 0, References: 114, Pages: 0, Words: 10042
                Categories
                Subject: Review Article
                Compound subject: bjrcr, BJRCR

                Data availability:

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