Breast MR with special focus on DW-MRI and DCE-MRI.
TLDR
Breast MRI has been shown to have a role in monitoring of neoadjuvant chemotherapy, for the evaluation of therapeutic results during the course of therapy and for improving the early assessment of tumour response to therapy and the assessment of residual tumour after the end of therapy.Abstract:
The use of magnetic resonance imaging (MRI) for the assessment of breast lesions was first described in the 1970s; however, its wide application in clinical routine is relatively recent. The basic principles for diagnosis of a breast lesion rely on the evaluation of signal intensity in T2-weighted sequences, on morphologic assessment and on the evaluation of contrast enhancement behaviour. The quantification of dynamic contrast behaviour by dynamic contrast-enhanced (DCE) MRI and evaluation of the diffusivity of water molecules by means of diffusion-weighted MRI (DW-MRI) have shown promise in the work-up of breast lesions. Therefore, breast MRI has gained a role for all indications that could benefit from its high sensitivity, such as detection of multifocal lesions, detection of contralateral carcinoma and in patients with familial disposition. Breast MRI has been shown to have a role in monitoring of neoadjuvant chemotherapy, for the evaluation of therapeutic results during the course of therapy. Breast MRI can improve the determination of the remaining tumour size at the end of therapy in patients with a minor response. DCE-MRI and DW-MRI have shown potential for improving the early assessment of tumour response to therapy and the assessment of residual tumour after the end of therapy. Breast MRI is important in the postoperative work-up of breast cancers. High sensitivity and specificity have been reported for the diagnosis of recurrence; however, pitfalls such as liponecrosis and changes after radiation therapy have to be carefully considered.read more
Citations
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Perfusion and vascular permeability: basic concepts and measurement in DCE-CT and DCE-MRI.
Charles A. Cuenod,Daniel Balvay +1 more
TL;DR: Among the many imaging techniques developed to study the microcirculation, the analysis of the tissue kinetics of intravenously injected contrast agents is the most widely used, either as positive enhancement for CT, T1-weighted MRI and ultrasound - dynamic contrast-enhanced-imaging (DCE-im imaging) -- or negative enhancement in T2*- weighted brain MRI -–dynamic susceptibility contrast-MRI (DSC-MRI) -.
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Characterization of breast tumors using diffusion kurtosis imaging (DKI).
TL;DR: Kurtosis imaging could provide valuable information on the diffusion properties related to tumor microenvironment and increase diagnostic confidence of breast tumors.
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Diagnostic assessment by dynamic contrast-enhanced and diffusion-weighted magnetic resonance in differentiation of breast lesions under different imaging protocols
TL;DR: The combination of ADC and other multi-sided characteristics can increase the capability of discriminating malignant and benign breast lesions, even under different imaging protocols, and thus are promising in clinical applications for discriminating lesion type and for personalized treatment planning.
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Accuracy of diffusion kurtosis imaging in characterization of breast lesions.
TL;DR: Diffusion kurtosis imaging is an accurate additional tool for the characterization and differentiation of breast lesions with high Kapp and Dapp sensitivity and specificity rates and increases the specificity of breast MRI.
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Quantitative evaluation of breast cancer response to neoadjuvant chemotherapy by diffusion tensor imaging: Initial results
Edna Furman-Haran,Noam Nissan,Verónica Ricart‐Selma,Carmen Martinez‐Rubio,Hadassa Degani,Julia Camps‐Herrero +5 more
TL;DR: Diffusion tensor imaging (DTI) yields several parameters that have not been tested in response evaluation to neoadjuvant chemotherapy (NAC) and need to be tested in further studies.
References
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Separation of diffusion and perfusion in intravoxel incoherent motion MR imaging.
TL;DR: Clinical results showed significant promise of the IVIM method for tissue characterization by perfusion patterns and for functional studies in the evaluation of the microcirculation in physiologic and pathologic conditions, as, for instance, in brain ischemia.
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Diffusion-Weighted Magnetic Resonance Imaging as a Cancer Biomarker: Consensus and Recommendations
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TL;DR: DW-MRI should be tested as an imaging biomarker in the context of well-defined clinical trials, by adding DW-MRI to existing NCI-sponsored trials, particularly those with tissue sampling or survival indicators, and standards for measurement, analysis, and display are needed.
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Dynamic breast MR imaging: are signal intensity time course data useful for differential diagnosis of enhancing lesions?
Christiane K. Kuhl,Peter Mielcareck,Sven Klaschik,Claudia Leutner,Eva Wardelmann,Jürgen Gieseke,Hans H. Schild +6 more
TL;DR: The shape of the time-signal intensity curve is an important criterion in differentiating benign and malignant enhancing lesions in dynamic breast MR imaging and a type III time course is a strong indicator of malignancy and is independent of other criteria.
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Magnetic resonance imaging of the breast: recommendations from the EUSOMA working group.
Francesco Sardanelli,Carla Boetes,Bettina Borisch,Thomas Decker,Massimo Federico,Fiona J. Gilbert,Thomas H. Helbich,S H Heywang-Köbrunner,Werner A. Kaiser,Michael J. Kerin,Robert E. Mansel,Lorenza Marotti,L. Martincich,L. Mauriac,Hanne Meijers-Heijboer,Roberto Orecchia,Pietro Panizza,Antonio Ponti,Arnie Purushotham,Peter Regitnig,Marco Rosselli Del Turco,Fabienne Thibault,Robin Wilson +22 more
TL;DR: The working group strongly suggests that all breast cancer specialists cooperate for an optimal clinical use of this emerging technology and for future research, focusing on patient outcome as primary end-point.
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Clinical Application of Antiangiogenic Therapy: Microvessel Density, What It Does and Doesn't Tell Us
TL;DR: It is contended that, although microvessel density is a useful prognostic marker, it is not, by itself, an indicator of therapeutic efficacy, nor should it be used to guide the stratification of patients for therapeutic trials.